Disclosure_of_Iran_Investments.docx
DOCX document 25 KB Posted
- Attached to
- Family Fun Day 2026
- Solicitation number
- 2026-008
- Issued by
- Essex County, New Jersey
About this file
This is a Standard Bid Document form issued by the State of New Jersey regarding disclosure of investment activities in Iran, applicable to state and local public contracts for goods, services, and construction awarded by New Jersey entities, including the City of Newark. The form requires all vendors and contractors to certify, under penalty of perjury, that neither they nor any parent entity, subsidiary, or affiliate is listed on the New Jersey Department of the Treasury's Chapter 25 List of entities engaged in prohibited investment activities in the energy or finance sectors of Iran pursuant to Public Law 2012, c. 25. Vendors must complete the certification prior to contract award and review the Chapter 25 List, available on the Treasury's website, before submitting their certification. The form provides three options: certification that the vendor meets the requirements, disclosure of activities if the vendor or its affiliates are listed on the Chapter 25 List, or provision of additional information in Part 2. Vendors maintain a continuing obligation to notify the contracting unit in writing of any changes to the certification information from the date of certification through contract completion.
Vendors who fail to comply with the Iran investment disclosure requirements face significant penalties, including sanctions, compliance actions, recovery of damages, contract default declarations, and potential debarment or suspension from future state and local contracting opportunities. The certification must be executed by an authorized officer or representative of the entity and constitutes a material part of any resulting contract. False statements or misrepresentations in the certification constitute criminal offenses under New Jersey law and render any resulting contract voidable and unenforceable at the contracting unit's discretion. This disclosure requirement applies to all vendors and contractors bidding on the City of Newark's Family Fun Day 2026 procurement and other state and local contracts in New Jersey.
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Other files
| File | Type | Posted |
|---|---|---|
| Family_Fun_Day_2026.pdf | ||
| Federal_Debarment_Form.pdf | ||
| DisclosureofProhibitedActivitesinRussiaBelarus_(2).pdf | ||
| Disclosure_of_Iran_Investments.docx | DOCX document | |
| Vendor_Submission_Forms_(2025).pdf | ||
| W-9_(March2024)_(5).pdf |
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Text version
STANDARD BID DOCUMENT REFERENCE
| Name of Form |
| DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN |
| Statutory Reference |
| N.J.S.A. 52:32-55 et seq. |
N.J.S.A. 40A:11-2.1 N.J.S.A. 18A:18A-49.4
Applicability
Y/N
| Mandatory |
| Optional |
| N/A |
| LPCL |
| Y |
| Goods and Services |
| X |
| PSCL |
| Y |
| Construction |
X
Instructions Reference
| Description |
| P.L. 2012, c.25 prohibits the awarding of State and local public contracts for goods and services with persons or entities engaging in certain investment activities in energy or finance sectors of Iran. Prior to contract award, vendors and contractors must certify that neither they nor any parent entity, subsidiary, or affiliate is listed on the New Jersey Department of the Treasury’s list of entities determined to be engaged in prohibited activities in Iran pursuant to P.L. 2012, c. 25 ("Chapter 25 List"). |
The Certification form requires the insertion of contracting unit identification information which should be filled in (in italics on the form) prior to its use.
Disclosure of Investment Activities in Iran
Person or Entity
Part 1: Certification
COMPLETE PART 1 BY CHECKING EITHER BOX.
Pursuant to Public Law 2012, c. 25, any person or entity that is a successful bidder or proposer, or otherwise proposes to enter into or renew a contract, must complete the certification below to attest, under penalty of perjury, that neither the person or entity, nor any parent entity, subsidiary, or affiliate is identified on the State Department of Treasury's Chapter 25 list as a person or entity engaging in investment activities in Iran. The list is found on Treasury’s website at www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf.
The Chapter 25 list must be reviewed prior to completing the below certification. If a vendor or contractor is found to be in violation of law, action may be taken as appropriate and as may provided by law, rule or contract, including but not limited to imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party.
I certify, pursuant to Public Law 2012, c. 25, that neither the person or entity listed above, nor any parent entity, subsidiary, or affiliate thereof is listed on the N.J. Department of the Treasury’s list of entities determined to be engaged in prohibited activities in Iran pursuant to P.L. 2012, c. 25 ("Chapter 25 List"). I further certify that I am the person listed above, or I am an officer or representative of the entity listed above and am authorized to make this certification on its behalf. I will skip Part 2 and sign and complete the Certification below.
OR
I am unable to certify as above because the person or entity and/or a parent entity, subsidiary, or affiliate thereof is listed on the N.J. Department of the Treasury’s Chapter 25 list. I will provide a detailed, accurate and precise description of the activities in Part 2 below sign and complete the Certification below.
Part 2: Additional Information
PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN IRAN.
You must provide a detailed, accurate and precise description of the activities of the person or entity, or a parent entity, subsidiary, or affiliate thereof engaging in investment activates in Iran below and, if more space is needed, on additional sheets provided by you.
Part 3: Certification of True and Complete Information
I, being duly sworn upon my oath, hereby represent and state that the foregoing information and any attachments there to the best of my knowledge are true and complete. I attest that I am authorized to execute this certification on behalf of the above-referenced person or entity.
I acknowledge that the Name of Contracting Unit is relying on the information contained herein and thereby acknowledge that I am under a continuing obligation from the date of this certification through the completion of any contracts with the Reference to Contracting Unit to notify the Reference to Contracting Unit in writing of any changes to the answers of information contained herein.
I acknowledge that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if I do so, I recognize that I am subject to criminal prosecution under the law and that it will also constitute a material breach of my agreement(s) with the Name of Contracting Unit and that the Reference to Contracting Unit at its option may declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print)
Title
Signature
Date
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