139-m Certification Attachment.docx
DOCX document 14 KB Posted
- Attached to
- Tele-Mental Health Services
- Solicitation number
- 2135577
- Issued by
- Allegany County, New York
About this file
This is a certification attachment form for a State University of New York (SUNY) procurement issued by SUNY College of Technology at Alfred. The solicitation requires vendors to provide Telemental Health Program Services for Academic Year 2026-27, specifically 100 tele-psychiatric clinical sessions for a minimum of 3,200 students. The contract period runs from July 1, 2026 through June 30, 2027. Questions regarding the procurement must be submitted to crissk@alfredstate.edu no later than June 12, 2026 at 12:00 p.m., with responses provided by Thursday, June 18, 2026. The solicitation will not be held as a sealed bid process; instead, proposals must be submitted electronically via email to the designated campus contact. This procurement is subject to New York State Finance Law Sections 139-j and 139-k (Lobbying Law), and vendors are restricted to contacting only the specified individual listed in the advertisement.
The contract award ceiling is $125,000, and the procurement is being made under SUNY's discretionary authority pursuant to New York State Education Law Section 355(5)(a). The successful contractor must submit vendor responsibility documentation, comply with NYS Finance Law 139-j and -k requirements, and provide documentation related to NYS Tax Law Section 5-a. Additionally, the successful contractor is required to submit valid and current New York State Workers' Compensation and Disability forms. All bidders must certify under penalty of perjury that they have implemented a written policy addressing gender-based violence in the workplace that meets the requirements of New York Executive Law Section 575, subdivision 11. Bidders unable to make this certification must submit a signed statement detailing their reasons for non-compliance; failure to provide either the certification or explanatory statement will result in bid rejection. For joint bids, each party must complete and sign a separate certification attachment.
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This Attachment must be completed and submitted with your proposal
Solicitation No.:__________Title:_________________________Campus:________________
By submission of this bed, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that the bidder has and has implemented a written policy addressing gender-based violence and the workplace and has provided such policy to all of its employees, directors and board members. Such policy shall, at a minimum, meet the requirements of subdivision 11 of section five hundred seventy-five of the executive law.
□ Cannot Certify. If the bidder cannot make the foregoing certification, the bidder shall so indicate by checking this box and shall furnish with the bid a signed statement that sets forth in detail the reasons that the bidder cannot make the certification.
Note: Your bid will not be considered for award if it lacks (i) this certification or (ii) a signed statement explaining why you cannot certify, furnished with the bid. If you submit a statement instead of the certification, SUNY will review it and reserves the right to reject the bed.
Bidder (legal name):__________________________________________________________________ Authorized Signatory (print name):____________________________________________________ Title:________________________________________________________________________________ Email/Phone:________________________________________________________________________
I am authorized to sign this certification on behalf of the Bidder and affirm it is true under the penalties of perjury under the laws of the State of New York.
Signature:________________________________________Date:_________/______20_____
Joint Bids: Each party to a joint bid must complete and sign a separate Attachment XX.
File details come from the government source that posted it. Updated .