07 Iran Free Procurement Certification.pdf

PDF 29 KB Posted

Attached to
Presort Mail Processing Services
Solicitation number
6100066317
Issued by
Pennsylvania

About this file

This is an Iran Free Procurement Certification Form issued by the Commonwealth of Pennsylvania pursuant to Pennsylvania's Procurement Code Sections 3501-3506. The certification applies to vendors and financial institutions seeking to contract with Commonwealth entities for goods or services valued at $1,000,000 or more. Vendors must either certify that they are not on the current list of persons engaged in investment activities in Iran maintained by the Pennsylvania Department of General Services, or demonstrate that they have received a written exemption from the certification requirement on a case-by-case basis. The form provides two options for compliance: Option #1 allows vendors to certify their eligibility to contract with the Commonwealth, while Option #2 permits vendors to submit documentation of an approved exemption from DGS.

Pennsylvania law establishes significant penalties for submitting false certifications under this requirement, including civil penalties equal to the greater of $250,000 or twice the contract amount, contract termination, and a three-year period of ineligibility to bid on future Commonwealth contracts. The certification must be executed by an authorized official of the vendor or financial institution and includes the vendor's name, the authorized signature, the printed name and title of the signatory, and the date of execution. This certification requirement applies to the Presort Mail Processing Services contract, which involves the processing of Commonwealth agencies' First-Class Letter, First-Class Post Card, First-Class Flat, and Standard Presort Mail Services for delivery to the United States Postal Service.

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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

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