2-BPM006391 Attac D Boycott Dup Kupplin.pdf
PDF 274 KB Posted
- 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 Boycott of Israel Disclosure attachment for Request for Proposal No. BPM006391, Registry Staffing for the Arizona State Hospital, issued by the Arizona Department of Health Services. The procurement seeks contract(s) for registry staffing services, primarily targeting Behavioral Health Technicians (BHTs) and Registered Nurses (RNs) to supplement the hospital's existing staffing resources. The hospital anticipates a need for approximately twenty (20) Registry BHTs per shift on an as-needed, if-needed basis across all shifts. The proposal responses were due by March 10, 2025, with the solicitation covering Maricopa County and Phoenix City jurisdiction. The Arizona Department of Health Services does not guarantee a specific volume of service utilization; however, multiple contractors are anticipated to be engaged to ensure an adequate candidate pool. No specific contract term, renewal options, or award dates are detailed in this attachment.
Pursuant to A.R.S. 35-393.01, all offerors must provide written certification regarding their participation in boycotts of Israel. Offerors must select one of three compliance options: certification that the company does not participate in and agrees not to participate in a boycott of Israel; acknowledgment that the company does participate in a boycott of Israel; or identification as an exempt solicitation, contract, or contractor if the estimated contract value is less than $100,000, the contractor is a sole proprietorship, the contractor has fewer than ten employees, or the contractor is a non-profit organization. The disclosed offeror, Kupplin Worldwide, LLC (Austin, Texas), selected the non-boycott certification option. No pricing information, set-asides, incumbents, or funding amounts are specified in this disclosure document.
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Text version
ATTACHMENT D
Boycott of Israel Disclosure
REQUEST FOR PROPOSAL
No.: BPM006391
REGISTRY STAFFING FOR THE ARIZONA
STATE HOSPITAL
ARIZONA DEPARTMENT OF
HEALTH SERVICES
150 North 18th Avenue, Suite 530 Phoenix, AZ 85007
Solicitation Attachment – Boycott of Israel Disclosure | Revision No. 1 | Revised 09-22
Please note that if any of the following apply to this Solicitation, Contract, or Contractor, then the Offeror shall select the “Exempt Solicitation, Contract, or Contractor” option below:
● The Solicitation or Contract has an estimated value of less than $100,000;
● Contractor is a sole proprietorship;
● Contractor has fewer than ten (10) employees; and/or
● Contractor is a non-profit organization.
Pursuant to A.R.S. § 35-393.01, public entities are prohibited from entering into contracts “unless the contract includes a written certification that the company is not currently engaged in, and agrees for the duration of the contract to not engage in, a boycott of goods or services from Israel.”
Under A.R.S. § 35-393:
1. "Boycott" means engaging in a refusal to deal, terminating business activities or performing other actions that are intended to limit commercial relations with entities doing business in Israel or in territories controlled by Israel, if those actions are taken either:
(a) Based in part on the fact that the entity does business in Israel or in territories controlled by Israel.
(b) In a manner that discriminates on the basis of nationality, national origin or religion and that is not based on a valid business reason.
2. "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.
5. "Public entity": (a) 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. (b) Includes the universities under the jurisdiction of the Arizona board of regents and community college districts as defined in section 15-1401.
The certification below does not include boycotts prohibited by 50 United States Code Section 4842 or a regulation issued pursuant to that section. See A.R.S. § 35-393.03.
In compliance with A.R.S. § 35-393 et seq., all offerors must select one of the following:
☐ The Company submitting this Offer does not participate in, and agrees not to participate in during the term of the contract, a boycott of Israel in accordance with A.R.S. § 35-393 et seq. I understand that my entire response will become a public record in accordance with A.A.C. R2-7-C317.
☐ The Company submitting this Offer does participate in a boycott of Israel as described in A.R.S. § 35-393 et seq.
☐ Exempt Solicitation, Contract, or Contractor.
Indicate which of the following statements applies to this Contract:
● Solicitation or Contract has an estimated value of less than $100,000;
● 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 Email address Phone number https://advance.lexis.com/document/?pdmfid=1000516&crid=1d22ae96-91e7-4fa9-b751-02b4d725faa3&pddocfullpath=%2Fshared%2Fdocument%2Ffe%2Furn%3AcontentItem%3A654C-M4F3-GXF6-84SC-00000-00&pdcontentcomponentid=4313&pdteaserkey=sr0&pditab=allpods&ecomp=rd-zk&earg=sr0&prid=a8f940d3-c58d-4e64-9124-f2bfdcdb31d8 Dell Typewritten text Kupplin Worldwide, LLC
Dell Typewritten text 8870 Business Park Dr. Ste. 200
Dell Typewritten text Austin, Texas 78759
Dell Typewritten text Anila Moledina, CEO
Dell Typewritten text anilamoledina@kupplin.com, 512-300-1478
Dell Typewritten text X
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