Certificate_of_Non-Involvement_in_Prohibited_Activities_In_Russia_or_Belarus.pdf

This document is a Certification of Non-Involvement in Prohibited Activities in Russia or Belarus form issued by the State of New Jersey, specifically for Contract #07-WS2025 related to a Maintenance and Repair: Cranes project for the City of Newark. The form requires vendors seeking to enter into a contract with a state agency to certify their status regarding involvement with entities or activities in Russia and Belarus, as tracked by the Office of Foreign Assets Control (OFAC).

The certification requires vendors to indicate whether they are identified on the OFAC Specially Designated Nationals and Blocked Persons list, with three possible response options: (A) not being identified on the list, (B) being identified but unable to certify, or (C) being identified but engaged in activities consistent with federal law, regulations, licenses, or exemptions. The form includes spaces for vendor contact information, signature, and a detailed definition of "vendor" that encompasses various business entity types, including corporations, partnerships, and governmental entities.