Vendor Certification.docx
DOCX document 23 KB Posted
- Solicitation number
- ITB-17225
- Issued by
- Hillsborough County, Florida
About this file
This is a Vendor Certification form issued by the Florida Department of Transportation pursuant to Florida Statutes Section 287.135, applicable to the District-Wide Mowing, Landscape Maintenance, and Debris Removal Services solicitation in Florida. The certification form requires vendors to provide their business information, including vendor name, FEIN, authorized representative details, and contact information. The form applies to contracts valued at $100,000 or more for boycott-related restrictions and $1,000,000 or more for restrictions related to Sudan, Iran terrorism sectors, Cuba, and Syria activities.
As an authorized representative, the vendor must certify that the company is not listed on the Scrutinized Companies with Activities in Sudan List, the Scrutinized Companies with Activities in the Iran Terrorism Sectors List, or the Scrutinized Companies or Other Entities that Boycott Israel List. The vendor must further certify non-engagement in boycotts of Israel and business operations in Cuba or Syria. The form warns that submission of false certification may result in civil penalties, attorney's fees, costs, and ineligibility for future contract bids. Vendors must sign and date the certification, with the authorized signatory required to print their name and title.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| ITB Package.pdf | ||
| Exhibit C Bid Sheet - Corrected.pdf | ||
| PUR 1355 Foreign Country of Concern.docx | DOCX document | |
| E-Verify.docx | DOCX document | |
| ADDENDUM #1.pdf | ||
| ADDENDUM #2 - TECHNICAL QUESTIONS AND ANSWERS.pdf | ||
| Exhibit A Scope of Services Corrected.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Florida Statutes:
287.135
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
VENDOR CERTIFICATION REGARDING
SCRUTINIZED COMPANIES LISTS
375-030-60
PROCUREMENT
OGC – 08/25
525-010-03
POLICY PLANNING
06/09
Respondent Vendor Name:
Vendor FEIN:
Vendor’s Authorized Representative Name and Title:
Address:
City: State: Zip:
Phone Number:
Email Address:
Section 287.135, Florida Statutes, prohibits a company or other entity from bidding on, submitting a proposal for, or entering into or renewing a contract for goods or services of: i) $100,000 or more if, at the time of bidding on, submitting a proposal for, or entering into or renewing such contract, the company or other entity is on the Scrutinized Companies or Other Entities that Boycott Israel List, created pursuant to Section 215.4725, Florida Statutes, or is engaged in a boycott of Israel; and, ii) $1,000,000 or more if, at the time of bidding on, submitting a proposal for, or entering into or renewing such contract, the company or other entity is on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Terrorism Sectors List, created pursuant to Section 215.473, Florida Statutes, or is engaged in business operations in Cuba or Syria.
As the authorized representative of the company or other entity identified above in the section entitled “Respondent Vendor Name”, I hereby certify that the company or other entity is not listed on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Terrorism Sectors List, or the Scrutinized Companies or Other Entities that Boycott Israel List. I further certify that the company or other entity is not engaged in a boycott of Israel and is not engaged in business operations in Cuba or Syria. I understand that pursuant to Section 287.135, Florida Statutes, the submission of a false certification may subject the company to civil penalties, attorney’s fees, costs, and/or ineligibility to bid on future contracts.
Certified By:
who is authorized to sign on behalf of the above referenced company.
Authorized Signature Print Name and Title:
Date:
File details come from the government source that posted it. Updated .