Att_3_Force_Labor_Form_Solicitation_No._BPM006379_GLA.pdf

Request for Proposal

Solicitation No. BPM006379

Capacity Development/Technical Assistance to Small Public Drinking Water Systems

Arizona Department of Environmental Quality (ADEQ)

1110 W. Washington Street

Phoenix, AZ 85007

Solicitation Attachment – Forced Labor of Ethnic Uyghurs Ban | Revision No. 3 | Revised 12-22

Attachment 3 – Forced Labor of Ethnic Uyghurs Ban

Please note that if any of the following apply to the Contractor, then the Contractor 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 use any contractors, subcontractors or suppliers that use the forced labor or any goods or services produced by 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, all Contractors must select one of the following:

X Company 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 does participate in the use of Forced Uyghurs Labor as described in A.R.S. § 35-394.

☐ Exempt Contractor: Select all statements that apply to the Contractor:

☐ Contractor is a sole proprietorship;

☐ Contractor has fewer than ten (10) employees; and/or

☐ Contractor is a non-profit organization.

Geo-Logic Associates, Inc.

Company name Signature of person authorized to sign

8777 North Gainey Center Drive, Suite 250 R. Douglas Bartlett, RG, Vice President

Address Printed name and Title

Scottsdale, Arizona 85258 dbartlett@geo-logic.com; (480) 659-7131

City, State, ZIP Contact email address Contact phone number