06. IranFreeProcurementCertificationForm.pdf
PDF 30 KB Posted
- Attached to
- Passenger Vehicles Supplement State and local contract opportunity
- Solicitation number
- 6100064373
- Issued by
- Dauphin County, Harveys Lake Borough, Pennsylvania
About this file
This document is an Iran Free Procurement Certification Form issued by the Pennsylvania Department of General Services (DGS), specifically the Bureau of Procurement, published on January 26, 2017. The form is designed for vendors seeking to contract with Commonwealth entities for goods or services valued at $1,000,000 or more, requiring vendors to certify they are not engaged in investment activities in Iran.
The form provides two certification options: Option #1 allows vendors to certify they are not on the current list of persons engaged in investment activities in Iran and are eligible to contract with the Commonwealth, while Option #2 provides a potential exemption process for vendors engaged in such activities. The document outlines significant penalties for false certifications, including civil penalties up to $250,000 or twice the contract amount, contract termination, and a three-year prohibition from bidding on contracts. Vendors must complete either Option #1 or Option #2, providing their vendor/financial institution name and an authorized signature to demonstrate compliance with Pennsylvania's Procurement Code Sections 3501-3506.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 04. BOP-2201 EO 2021-06 Worker Protection Form BOP FINAL.pdf | ||
| Procurement Vendor Registration Guide.pdf | ||
| 02b PCID 1067 - Delivery of Vehicles.pdf | ||
| 02c. PCID 1075 - Genl Reg's for Delivery DOT.pdf | ||
| COSTARS Program Election to Participate Form.pdf | ||
| 02b. PCID 1067 Eff 070524.pdf | ||
| 02. Passenger Vehicles Contract Supp 4 Specs Pt 1 08.07.25.pdf | ||
| 02a. Passenger Vehicles Minimum Specifications.xls | XLS spreadsheet | |
| 03. BOP-1307 LOBBYING CERTIFICATION FORM.pdf | ||
| 05. GSPUR-89 Reciprocal_Limitations_Act_Reqirements.pdf | ||
| Attaching Bid Documents.pdf | ||
| Supplier Bidding Guide.pdf | ||
| 01.Terms and Conditions 8.07.25 v1.pdf | ||
| Cost Submittal Sheet -Passenger Vehicles Supplement #48.18.25.xlsx | XLSX spreadsheet |
Show all 14
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
BOP-1701
Published: 1/26/2017
IRAN FREE PROCUREMENT CERTIFICATION FORM
(Pennsylvania’s Procurement Code Sections 3501-3506, 62 Pa.C.S. §§ 3501-3506)
To be eligible for an award of a contract with a Commonwealth entity for goods or services worth at least $1,000,000 or more, a vendor must either: a) certify it is not on the current list of persons engaged in investment activities in Iran created by the Pennsylvania Department of General Services (“DGS”) pursuant to Section 3503 of the Procurement Code and is eligible to contract with the Commonwealth under Sections 3501-3506 of the Procurement Code; or b) demonstrate it has received an exception from the certification requirement for that solicitation or contract pursuant to Section 3503(e).
To comply with this requirement, please insert your vendor or financial institution name and complete one of the options below. Please note: Pennsylvania law establishes penalties for providing false certifications, including civil penalties equal to the greater of $250,000 or twice the amount of the contract for which the false certification was made; contract termination; and three-year ineligibility to bid on contracts. (Section 3503 of the Procurement Code.)
OPTION #1 - CERTIFICATION
I, the official named below, certify I am duly authorized to execute this certification on behalf of the vendor/financial institution identified below, and the vendor/financial institution identified below is not on the current list of persons engaged in investment activities in Iran created by DGS and is eligible to contract with the Commonwealth of Pennsylvania Sections 3501-3506 of the Procurement Code.
Vendor Name/Financial Institution (Printed)
By (Authorized Signature)
Printed Name and Title of Person Signing Date Executed
OPTION #2 – EXEMPTION
Pursuant to Procurement Code Section 3503(e), DGS may permit a vendor/financial institution engaged in investment activities in Iran, on a case-by-case basis, to enter into a contract for goods and services.
If you have obtained a written exemption from the certification requirement, please fill out the information below, and attach the written documentation demonstrating the exemption approval.
Vendor Name/Financial Institution (Printed)
By (Authorized Signature)
Printed Name and Title of Person Signing Date Executed
| IRAN FREE PROCUREMENT CERTIFICATION FORM |
| (Pennsylvania’s Procurement Code Sections 3501-3506, 62 Pa.C.S. §§ 3501-3506) |
| OPTION #1 - CERTIFICATION |
| OPTION #2 – EXEMPTION |
File details come from the government source that posted it. Updated .