RFP 11022_Attachment L.pdf
PDF 107 KB Posted
- Attached to
- RES-50-Beds-Moderate-Males-JSO-Central-C13
- Solicitation number
- RFP-14916
- Issued by
- Leon County, Florida
About this file
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 governmental entities that would grant access to Personal Identifying Information. The attestation form must be completed and signed by an officer or representative of the bidding entity. The form requires the signatory to declare under penalties of perjury that the entity is not owned by the government of 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 the government of a Foreign Country of Concern does not have a Controlling Interest in the entity.
The attestation is associated with a Florida Department of Juvenile Justice contract opportunity seeking a fifty-bed moderate-risk residential program for males ages ten to nineteen requiring Juvenile Sexual Offender Treatment Services in Circuit 13 of DJJ's Central Region in Tampa, Florida. Interested respondents must complete and submit this attestation as part of their bid or proposal package to demonstrate compliance with Florida's foreign ownership restrictions for contracts involving access to personal identifying information.
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Text version
PUR 1355 (10/23) Page 1 of 1 Rule 60A-1.020, F.A.C.
FOREIGN COUNTRY OF CONCERN ATTESTATION
(PUR 1355)
This form must be completed by an officer or representative of an entity submitting a bid, proposal, or reply to, or entering into, renewing, or extending, a contract with a Governmental Entity which would grant the entity access to an individual’s Personal Identifying Information.
Capitalized terms used herein have the definitions ascribed in Rule 60A-1.020, F.A.C.
Name of entity is not owned by the government of a Foreign Country of Concern, is not organized under the laws of nor has its Principal Place of Business in a Foreign Country of Concern, and the government of a Foreign Country of Concern does not have a Controlling Interest in the entity.
Under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated in it are true.
Printed Name:
Title:
Signature: Date:
https://www.flrules.org/gateway/RuleNo.asp?title=GENERAL%20REGULATIONS&ID=60A-1.020
File details come from the government source that posted it. Updated .