Disclosure and Certification with respect to State Finance Law 139-j and 139-k-2.pdf
PDF 105 KB Posted
- Attached to
- King Shaw Kitchen Equipment
- Solicitation number
- 2138476
- Issued by
- Tioga County, New York
About this file
This is a Disclosure and Certification Form C required under New York State Finance Law 139-j and 139-k for the King Shaw Kitchen Equipment procurement at Cornell University in Ithaca, New York. The form requires offerers to disclose any prior determinations of non-responsibility by governmental entities within the past four years based on violations of State Finance Law 139-j or intentional provision of false or incomplete information. Offerers must also disclose any terminations or withholding of procurement contracts by governmental entities for similar violations. The certification requires offerers to attest that all information provided regarding compliance with State Finance Law 139-j and 139-k is complete, true, and accurate. All responses must be submitted with the offerer's name, address, signature of authorized representative, and submission date.
The form serves as a mandatory compliance document for all bidders responding to the King Shaw Hall kitchen equipment invitation for bid, with proposals due September 17, 2026 at 2:00 p.m. EST. Bidders must complete and sign the form as part of their proposal submission, certifying their responsibility status and compliance history. The form does not contain pricing information, but rather functions as a qualification and integrity verification document to ensure that only vendors meeting New York State responsibility standards are considered for award of this kitchen equipment contract.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit A 2023.doc | DOC document | |
| IFB 9.14.26.docx | DOCX document | |
| IFB 8.25.26.docx | DOCX document | |
| Exhibit_A-1_3_31_2020.docx | DOCX document | |
| King Shaw - Final Kitchen Order (002).pdf | ||
| ESCALATION_CLAUSE_Doc1 3.21.25(1).docx | DOCX document |
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FORM C
Disclosure and Certification with respect to State Finance Law §§139-j and 139-k
Procurement Description/ID No._______________________
1. Has a Governmental Entity, as defined in State Finance Law §139-j(1)(a), made a determination of non-responsibility with respect to the Offerer within the previous four years where such finding was due to a violation of State Finance Law §139-j or the intentional provision of false or incomplete information with respect to previous determinations of non-responsibility?
No ___ Yes ___
If yes, provide the following details:
Governmental Entity which made the finding:
Date of finding:
Basis of finding:
2. Has a Governmental Entity terminated or withheld a procurement contract with the Offer because of violations of State Finance Law §139-j or the intentional provision of false or incomplete information with respect to previous determinations of non-responsibility?
No ___ Yes ___
If yes, identify the following:
Governmental Entity which terminated the contract:
Date of contract termination or withholding:
Identify the related procurement contract:
Offerer CERTIFIES that all information provided by Offerer with respect to its compliance with State Finance Law §§139-j and 139-k is complete, true and accurate.
Name of Offerer:
Address:
Signature of Person Submitting Form: _________________________________ Name:
Title:
Date:
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