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 – Consulting and Design
Solicitation number
AFI-2025-118
Issued by
Indiana

About this file

This Terms and Conditions Acceptance Form is a vendor certification document for a New Jersey-based state and local contract opportunity related to ADA Digital Accessibility and WCAG 2.1 AA/2.2 AA Compliance Services offered through AFI as the lead contracting agency. The form requires vendors to certify their agreement to ten federal compliance requirements, including Debarment and Suspension, Equal Employment Opportunity, Davis Bacon Act, Copeland Anti-Kickback Act, Contract Work Hours and Safety Standards Act, Right to Inventions, Clean Air and Water Act, Byrd Anti-Lobbying Amendment, Solid Waste Disposal Act, and Energy Policy & Conservation Act, as well as Record Retention obligations.

Vendors must also complete nine New Jersey-specific documentation requirements prior to contract award, 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 documentation, and a McBride-Principals Form. An authorized representative of the vendor must sign and date the form to certify compliance with all listed terms and conditions before the company can be considered for contract award.

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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 .