6-[On-Call Pipelining and Drainage Repair Services] 2 BPM005628 Boycott of Israel Disclosure.pdf
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- Attached to
- On-Call Pipelining and Drainage Repair Services
- Solicitation number
- BPM005628
- Issued by
- Arizona
About this file
This is a Boycott of Israel Disclosure form for Solicitation No. BPM005628 issued by the State of Arizona Department of Transportation for On-Call Pipelining and Drainage Repair Services. The disclosure form is required by Arizona Revised Statutes (A.R.S.) 35-393.01 and mandates that public entities include written certification in contracts that companies are not currently engaged in and will not engage in boycotts of goods or services from Israel during the contract term.
The form establishes exemptions for solicitations or contracts with estimated values less than $100,000, sole proprietorships, contractors with fewer than ten employees, and non-profit organizations. Offerors must select one of three certification options: confirmation that the company does not participate in a boycott of Israel and agrees not to during contract performance; acknowledgment that the company does participate in a boycott of Israel; or indication of exempt status based on the specified criteria. The submitted response becomes public record in accordance with Arizona Administrative Code Rule 2-7-C317. Southwest Siteworks LLC, located at 6727 N Silverbell Road, Tucson, Arizona 85743, with Jacob Buckley serving as President, submitted the disclosure form indicating the exempt solicitation option.
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Text version
Procurement
ATTACHMENT 2
BOYCOTT OF ISRAEL DISCLOSURE
Solicitation No: BPM005628 Available online at https://app.az.gov
(Rev 09/2022)
Boycott of Israel Disclosure 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; 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.
3. "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 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
City State Zip Title
Southwest Siteworks LLC
6727 N Silverbell RD
Tucson AZ 85743
Jacob Buckley
President x https://app.az.gov/
Boycott of Israel Disclosure
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