1-Appendix B Terms and Conditions Acceptance Form.docx

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Attached to
ADA Digital Accessibility – WCAG 2. 1 AA / 2. 2 AA Compliance Services
Solicitation number
AFI-2025-117
Issued by
Indiana

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Terms and Conditions Acceptance Form Summary

This is a Terms and Conditions Acceptance Form for a state and local contract opportunity in Indiana administered by AFI (serving as the Lead Contracting Agency) for ADA Digital Accessibility – WCAG 2.1 AA/2.2 AA Compliance Services. The form serves as a vendor certification document requiring authorized representatives to acknowledge agreement with a comprehensive set of federal and state regulatory requirements before contract award.

The form requires vendors to initial their agreement with ten federal compliance standards, including Debarment and Suspension, Equal Employment Opportunity, Davis Bacon Act, Copeland Anti-Kickback Act, Contract Work Hours and Safety Standards Act, Right to Inventions Made Under a Contract or Agreement, Clean Air and Water Act, Byrd Anti-Lobbying Amendment, Solid Waste Disposal Act, Energy Policy and Conservation Act, and Record Retention. Additionally, vendors must submit nine supporting New Jersey-specific documentation requirements, including an Ownership Disclosure Form, Non-Collusion Affidavit, Affirmative Action Affidavit, Political Contribution Disclosure Form, Stockholder Disclosure Form, Certification of Non-Involvement in Prohibited Activities in Iran, New Jersey Business Registration Certificate, EEO/AA Evidence, and McBride-Principals Form. The form must be signed and dated by an authorized company representative.

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Terms and Conditions Acceptance Form

Vendor Certification
Vendor Initial if AGREE to terms

1. Debarment and Suspension

2. Equal Employment Opportunity

3. Davis Bacon Act

4. Copeland “Anti-Kickback” Act

5. Contract Work Hours and Safety Standards Act

6. Right to Inventions Made Under a Contract or Agreement

7. Clean Air and Water Act

8. Byrd Anti-Lobbying Amendment

9. Solid Waste Disposal Act

10. Energy Policy & Conservation Act

11. Record Retention

New Jersey Requirements:

Doc #1 Ownership Disclosure Form

Doc # 2 Non-Collusion Affidavit DOC

Doc # 3 Affirmative Action Affidavit

Doc# 4 Political Contribution Disclosure Form

Doc # 5 Stockholder Disclosure Form

Doc # 6 Certification of Non-Involvement in Prohibited Activities in Iran

Doc #7 New Jersey Business Registration Certificate

Doc #8 EEO/AA Evidence

Doc #9 McBride-Principals Form

Name of Company Printed Name of Authorized Representative

Date Signature of Authorized Representative 2 | Page Term and Conditions Acceptance Form

File details come from the government source that posted it. Updated .