2-InGenesis, Inc. - BPM006391_Attachment_D_Boycott.pdf
PDF 363 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 form required by the Arizona Department of Health Services (ADHS) for solicitation BPM006391, Registry Staffing for the Arizona State Hospital. The disclosure form is a compliance document pursuant to Arizona Revised Statutes (A.R.S.) 35-393.01, which mandates that public entities include written certification in contracts confirming that companies are not engaged in boycotts of Israel and will not engage in such boycotts during contract performance. The form applies to all offerors unless the contract meets specific exemption criteria, including an estimated value under $100,000, sole proprietorship status, fewer than ten employees, or non-profit organization classification. All offerors must select one of three certification options: confirmation of non-participation in Israel boycotts, acknowledgment of current boycott participation, or claim of exemption based on applicable criteria.
InGenesis, Inc., a San Antonio, Texas-based company, submitted this disclosure form with Veronica Edwards, Chief Executive Officer, as the authorized signatory. The company's contact information is listed as 18756 Stone Oak Parkway, Suite 200, San Antonio, TX 78258, with email edwardsv@ingenesis.com and phone (210) 366-0033. The form does not indicate which certification option InGenesis selected, though the company name appears marked on the document. This disclosure form serves as a mandatory compliance requirement for the procurement process and will become part of the public record in accordance with Arizona Administrative Code regulations.
View the file
Other files
Show 40 more
50 files listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 x
InGenesis, Inc.
18756 Stone Oak Parkway, Suite 200
San Antonio TX 78258 edwardsv@ingenesis.com (210) 366-0033
Veronica Edwards, CEO 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
File details come from the government source that posted it. Updated .