Attachment_10_-_Iran_Contracting_Act_Certification.docx
DOCX document 21 KB Posted
- Attached to
- RFP 23-21 On-site Scanning and Imaging Services
- Solicitation number
- 0000031328
- Issued by
- California
About this file
This document is an Iran Contracting Act Certification required for RFP 23-21 On-site Scanning and Imaging Services issued by the Court. The certification requires bidders to either declare that they are not on the list of persons engaged in investment activities in Iran, or that they have received written permission from the Court to submit a bid. Bidders must complete and sign the certification as part of their bid submission. The RFP is for on-site scanning and imaging services, with a contract term that may include renewal options.
The certification outlines the pricing terms, which require bidders to complete either paragraph 1 or 2 of the certification. Paragraph 1 involves declaring that the bidder is not on the list of persons engaged in investment activities in Iran, while paragraph 2 requires the bidder to have received written permission from the Court to submit a bid. The certification must be executed under penalty of perjury by an authorized representative of the bidding company.
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Text version
RFP 23-21 On-site Scanning and Imaging Services ATTACHMENT 10IRAN contracting act certification
Pursuant to Public Contract Code (PCC) section 2204, an Iran Contracting Act certification is required for solicitations of goods or services of $1,000,000 or more.
To submit a bid to the Court, you must complete ONLY ONE of the following two paragraphs. To complete paragraph 1, check the corresponding box and complete the certification for paragraph 1. To complete paragraph 2, simply check the corresponding box.
1. We are not on the current list of persons engaged in investment activities in Iran created by the California Department of General Services (“DGS”) pursuant to PCC 2203(b), and we are not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another person, for 45 days or more, if that other person will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS.
OR
2. We have received written permission from the Court to submit a bid pursuant to PCC 2203(c) or (d). A copy of the written permission from the Court is included with our bid.
CERTIFICATION FOR PARAGRAPH 1:
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that the information provided in this form is true and correct and that I am duly authorized to legally bind the Bidder to this certification. This certification is made under the laws of the State of California.
| Legal Name of Company (Printed): |
| Federal ID Number: |
| Signature: |
| Date Executed: |
Printed Name and Title of Person Signing:
| Executed in the County of: |
| In the State of: |
Rev. 2020-07 Page 1 of 1
File details come from the government source that posted it. Updated .