BPM004541_-_Forced_Labor_of_Ethnic_Uyghurs_Ban_r1_09-22_-_Black_Box_Signed.pdf
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- Attached to
- Master Agreement AZ|CTR062445
- Contract number
- CTR062445
- Issued by
- Arizona
About this file
This document is a State of Arizona State Procurement Office form titled "Forced Labor of Ethnic Uyghurs Ban" for Solicitation No. BPM004541, specifically related to Communications Cabling Systems. The form is completed by Norstan Communications Inc. doing business as Black Box Network Services, located in Maple Grove, Minnesota. The document is designed to ensure compliance with Arizona Revised Statutes (A.R.S.) § 35-394, which requires companies contracting with public entities to certify they do not use forced labor of ethnic Uyghurs in the People's Republic of China.
The solicitation pertains to Communications Cabling Systems, with the contractor (Black Box Network Services) affirming that they do not use forced labor of ethnic Uyghurs, goods or services produced by such labor, or subcontractors/suppliers engaged in such practices. The document provides options for contractors to declare their status, including an "Exempt Contractor" designation for sole proprietorships, companies with fewer than ten employees, or non-profit organizations. The form was signed by Jim Cassibo, VP of Finance, with contact information provided for Kristin Zacher, and is part of the State of Arizona's procurement process to ensure ethical sourcing and labor practices.
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Text version
Forced Labor of Ethnic Uyghurs Ban
State of Arizona
State Procurement Office 100 N 15th Avenue, Ste 350
Phoenix, AZ 85007
Solicitation No.: BPM004541
PAGE
OF
Description: Communications Cabling Systems
Forced Labor of Ethnic Uyghurs Ban
Please note that if any of the following apply to the Contractor, then the Offeror 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 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 et seq., all offerors must select one of the following:
□ The Company submitting this Offer 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 submitting this Offer does participate in use of Forced Uyghurs Labor as described in A.R.S. §
35-394.
□ Exempt Contractor
Indicate which of the following statements applies to the Contractor (may be more than one):
□ Contractor is a sole proprietorship;
□ Contractor has fewer than ten (10) employees; and/or
□ Contractor is a non-profit organization.
Norstan Communications Inc. d/b/a Black Box Netw ork Services
Company Name Signature of person authorized to sign
9155 Cottonw ood Lane N
Jim Cassibo, VP Finance
Address Printed name and title
Maple Grove, MN 55369
Kristin.zacher@blackbox.com (480) 253-2671
City, State, ZIP Contact email address Contact phone number
SPO Form 205 – Forced Labor of Ethnic Uyghurs Ban | Revision No. 1 | Revised 09-22
DocuSign Envelope ID: 81CCAAA5-4C61-4E93-9D0E-85257C7E0B74 mailto:Kristin.zacher@blackbox.com
| 2022-09-30T10:03:20-0700 | |
| Digitally verifiable PDF exported from www.docusign.com |
File details come from the government source that posted it. Updated .