2-Attachment E Forced Labor of Ethnic Uyghurs Ban.pdf
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- Attached to
- Registry Staffing for the Arizona State Hospital
- Solicitation number
- BPM006391
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Forced Labor of Ethnic Uyghurs Ban certification form required by the Arizona Department of Health Services in connection with the Registry Staffing for the Arizona State Hospital solicitation (BPM006391). The certification requires all offerors to attest compliance with Arizona Revised Statutes 35-394, which prohibits contractors from using forced labor of ethnic Uyghurs in the People's Republic of China, or any goods or services produced by such forced labor, during the contract term. Offerors must select one of two compliance statements: either confirming non-participation in forced Uyghur labor practices, or disclosing participation in such practices. The form applies to companies with ten or more full-time employees; sole proprietorships, organizations with fewer than ten employees, and non-profit organizations are exempt from this requirement.
The submitted certification form indicates that Cirrus Concept Consulting, LLC dba Alto Healthcare Staffing, located at One Elizabeth Place #110 in Dayton, Ohio, with authorized signatory Doug Schroeder (dschroeder@altostaffing.com, 513-476-4115), has executed this document. The form does not specify which compliance option was selected by the contractor, nor does it reference pricing, contract term, renewal provisions, or other substantive contract terms. This certification serves as a mandatory compliance requirement for participation in the Arizona Department of Health Services' registry staffing procurement.
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Text version
Attachment E
Forced Labor of Ethnic Uyghurs Ban
ARIZONA DEPARTMENT OF
HEALTH SERVICES
150 North 18th Avenue, Suite 530
Phoenix, AZ 85007 Solicitation No.: BPM006391
PAGE
Description: REGISTRY STAFFING FOR THE
ARIZONA STATE HOSPITAL
OF
SPO Form 205 – Forced Labor of Ethnic Uyghurs Ban | Revision No. 1 | Revised 09-22
Forced Labor of Ethnic Uyghurs Ban
Please note that if any of the following apply to the Contractor, then the Offeror shall select the “Exempt
Contractor” option below:
● Contractor is a sole proprietorship;
● Contractor has fewer than ten (10) employees; OR
● Contractor is a non-profit organization.
Pursuant to A.R.S. § 35-394, written certification is required to show that the company entering into a contract with a public entity does not use the forced labor, or any goods or services produced by the forced labor, of ethnic Uyghurs in the People's Republic of China.
Under A.R.S. § 35-394:
1. "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, limited liability company or other entity or business association, including a wholly owned subsidiary, majority-owned subsidiary, parent company or affiliate, that engages in for-profit activity and that has ten or more full-time employees.
2. "Public entity" means this State, a political subdivision of this State or an agency, board, commission or department of this State or a political subdivision of this State.
In compliance with A.R.S. §§ 35-394 et seq., all offerors must select one of the following:
☐ The Company submitting this Offer does not use, and agrees not to use during the term of the contract, any of the following:
● Forced labor of ethnic Uyghurs in the People’s Republic of China;
● Any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of
China; or
● Any Contractors, Subcontractors, or suppliers that use the forced labor or any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of China.
☐ The Company submitting this Offer does participate in use of Forced Uyghurs Labor as described in A.R.S. §
35-394.
☐ Exempt Contractor
Indicate which of the following statements applies to the Contractor (may be more than one):
☐ Contractor is a sole proprietorship;
☐ Contractor has fewer than ten (10) employees; and/or
☐ Contractor is a non-profit organization.
Company Name Signature of person authorized to sign
Address Printed name and title
City, State, ZIP Contact email address Contact phone number
Cirrus Concept Consulting, LLC dba Alto Healthcare Staffing
One Elizabeth Place #110
Dayton, Ohio 45417
Doug Schroeder dschroeder@altostaffing.com 513-476-4115
File details come from the government source that posted it. Updated .