Attachment_8_-_Iran_Contracting_Act_Certification.docx
DOCX document 22 KB Posted
- Attached to
- RFP 24-01 Voluntary Benefit Plans
- Solicitation number
- 0000032247
- Issued by
- California
About this file
This document is an Iran Contracting Act Certification required as part of a Request for Proposals (RFP) for Voluntary Benefit Plans, RFP #24-01, issued by the California Court. The RFP seeks providers of voluntary benefit plans. Bidders must complete one of two paragraphs in the certification, indicating either that they are not on the list of entities engaged in investment activities in Iran or that they have received written permission from the Court to submit a bid. The certification must be signed under penalty of perjury by an authorized representative of the bidding entity.
The RFP is for the State of California. No additional details are provided regarding the specific products or services requested, quantities, response due dates, award information, or contract term and renewal options.
View the file
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Text version
RFP Title: Voluntary Benefits RFP Number: 24-01
ATTACHMENT 8IRAN 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 .