DisclosureofProhibitedActivitesinRussiaBelarus_(2)_(4).pdf

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Attached to
Maintenance and Repair Light Duty Vehicles
Solicitation number
2026-16
Issued by
Essex County, New Jersey

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This is a Certification of Noninvolvement in Prohibited Activities in Russia or Belarus form required by the State of New Jersey for vendors seeking to enter into or renew contracts with state agencies. The certification, established pursuant to N.J.S.A. 52:32-60.1 (L. 2022, c. 3), applies to the City of Newark's bid solicitation 2026-16 for Maintenance and Repair Light Duty Vehicles, with bids due by 2:00 pm on Wednesday, July 22, 2026. All bids must be submitted electronically through the City's e-Procurement Portal (ProcureNow system), with public opening and reading of bids occurring immediately after the deadline. Bidders are instructed to complete the submission process well in advance of the deadline, as the system will not accept submissions once the countdown timer expires.

Vendors must certify their status regarding the Office of Foreign Assets Control (OFAC) Specially Designated Nationals and Blocked Persons list, selecting one of three options: confirming they are not identified on the list for Russia and Belarus-related activity, indicating inability to make such certification, or certifying their presence on the list while demonstrating compliance with federal law and applicable licenses or exemptions. The form requires vendors to provide their legal name, Federal Employer Identification Number (FEIN), complete address, contact information, and authorization signature. New Jersey's Department of the Treasury is authorized to impose sanctions, seek compliance, recover damages, declare vendors in default, and pursue debarment or suspension for any false certifications made in violation of the law.

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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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