Disclosure_of_Prohibited_Activitesin_Russia_Belarus.pdf
PDF 189 KB Posted
- Attached to
- Third Party Elevator Inspections
- Solicitation number
- 2026-14
- Issued by
- Essex County, New Jersey
About this file
This is a certification document for compliance with New Jersey state law regarding prohibited activities in Russia and Belarus, applicable to vendors seeking contracts with the City of Newark, New Jersey, in connection with the Third Party Elevator Inspections RFP (2026-14). The certification requires vendors to verify their status against the Office of Foreign Assets Control (OFAC) Specially Designated Nationals and Blocked Persons list prior to contract award. Vendors must complete the certification by confirming either that they are not identified on the OFAC list for Russia and Belarus-related activities, that they cannot make such certification because they are identified on the list, or that while identified on the list, their activities comply with applicable federal law, regulation, licenses, or exemptions. The RFP response deadline is 2:00 pm on Tuesday, July 7, 2026, with responses submitted exclusively through the City's e-Procurement Portal (OpenGov system), and late submissions will not be accepted.
The certification applies to all entities defined as vendors under New Jersey law, including natural persons, corporations, partnerships, governmental entities, and any parent or subsidiary organizations. Vendors must provide their Federal Employer Identification Number (FEIN), business address, contact information, and the authorized representative's signature and title. Failure to provide an accurate certification may result in sanctions, contract default declarations, suspension, or debarment by the New Jersey Department of the Treasury.
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Text version
CERTIFICATION OF NON‐INVOLVEMENT IN
PROHIBITED ACTIVITIES IN RUSSIA OR BELARUS
NJ Rev. 1.22.2024
Pursuant to N.J.S.A. 52:32-60.1, et seq. (L. 2022, c. 3) any person or entity (hereinafter “Vendori”) that seeks to enter into or renew a contract with a State agency for the provision of goods or services, or the purchase of bonds or other obligations, must complete the certification below indicating whether or not the Vendor is identified on the Office of Foreign Assets Control (OFAC) Specially Designated Nationals and Blocked Persons list, available here:
https://sanctionssearch.ofac.treas.gov/. If the Department of the Treasury finds that a Vendor has made a certification in violation of the law, it shall take any action as may be appropriate and 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, the undersigned, certify that I have read the definition of “Vendor” below, and have reviewed the Office of Foreign Assets Control (OFAC) Specially Designated Nationals and Blocked Persons list, and having done so certify:
(Check the Appropriate Box)
A. That the Vendor is not identified on the OFAC Specially Designated Nationals and Blocked Persons list on account of activity related to Russia and/or Belarus.
OR
B. That I am unable to certify as to “A” above, because the Vendor is identified on the OFAC Specially Designated Nationals and Blocked Persons list on account of activity related to Russia and/or Belarus.
OR
C.
That I am unable to certify as to “A” above, because the Vendor is identified on the OFAC Specially Designated Nationals and Blocked Persons list. However, the Vendor is engaged in activity related to Russia and/or Belarus consistent with federal law, regulation, license or exemption. A detailed description of how the Vendor’s activity related to Russia and/or Belarus is consistent with federal law is set forth below.
(Attach Additional Sheets If Necessary.)
Signature of Vendor’s Authorized Representative Date
Print Name and Title of Vendor’s Authorized Representative Vendor’s FEIN
Vendor’s Name Vendor’s Phone Number
Vendor’s Address (Street Address) Vendor’s Fax Number
Vendor’s Address (City/State/Zip Code) Vendor’s Email Address i Vendor means: (1) A natural person, corporation, company, limited partnership, limited liability partnership, limited liability company, business association, sole proprietorship, joint venture, partnership, society, trust, or any other nongovernmental entity, organization, or group; (2) Any governmental entity or instrumentality of a government, including a multilateral development institution, as defined in Section 1701(c)(3) of the International Financial Institutions Act, 22 U.S.C. 262r(c)(3); or (3) Any parent, successor, subunit, direct or indirect subsidiary, or any entity under common ownership or control with, any entity described in paragraph (1) or (2).
https://pub.njleg.state.nj.us/Bills/2022/PL22/3_.PDF https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/ https://sanctionssearch.ofac.treas.gov/
| Vendors Phone Number: |
| Vendors Fax Number: |
| Vendors Email Address: |
| Group1: Off |
| the Vendors activity related to Russia andor Belarus is consistent with federal law is set forth below 1: |
| the Vendors activity related to Russia andor Belarus is consistent with federal law is set forth below 2: |
| the Vendors activity related to Russia andor Belarus is consistent with federal law is set forth below 3: |
| the Vendors activity related to Russia andor Belarus is consistent with federal law is set forth below 4: |
| the Vendor’s activity related to Russia and/or Belarus is consistent with federal law is set forth below 5: |
| the Vendor’s activity related to Russia and/or Belarus is consistent with federal law is set forth below 6: |
| Signature of Vendor's Authorized Representative: |
| Print Name and Title of Vendors Authorized Representative: |
| Vendors Name: |
| Vendors Address Street Address: |
| Vendors Address CityStateZip Code: |
| Date: |
| Vendors FEIN: |
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