RFP 11022_Attachment L.pdf

This is a Foreign Country of Concern Attestation form (PUR 1355) required by the State of Florida under Rule 60A-1.020, F.A.C., for entities bidding on or entering into contracts with a governmental entity that would provide access to personal identifying information. The attestation must be completed and signed by an officer or representative of the bidding entity and pertains to the Department of Juvenile Justice's request for a fifty-bed moderate-risk residential program for males ages ten to nineteen requiring Juvenile Sexual Offender Treatment Services. The program will be located at a Department-owned facility at 9502 Columbus Drive, Tampa, Florida 33619, in Circuit 13 of the Central Region, or at a respondent-owned or leased building within Florida.

Under penalties of perjury, the signatory must attest that the entity is not owned by a Foreign Country of Concern, is not organized under the laws of a Foreign Country of Concern, does not have its Principal Place of Business in a Foreign Country of Concern, and that no Foreign Country of Concern has a Controlling Interest in the entity. The form requires the printed name, title, signature, and date of the authorized representative. This attestation is a prerequisite for contract eligibility and compliance with Florida's foreign ownership restrictions for entities handling sensitive personal information.