Discloures__of__Investment__Activities__in__Iran.pdf

This document is a Property Disclosure of Investment Activities in Iran form from the State of New Jersey's Division of Purchase and Property. The form is designed for bidders or offerors to certify their compliance with Public Law 2012, c. 25, which prohibits state contracts with entities engaged in investment activities in Iran. Bidders are required to complete Part 1 by checking one of two boxes: either certifying that they are not listed on the Department of Treasury's Chapter 25 list of entities engaged in prohibited Iranian investment activities, or indicating an inability to certify such compliance.

The form mandates detailed reporting of any investment activities in Iran, including specifics about the bidding entity, its parents, subsidiaries, or affiliates. Failure to complete the certification accurately can result in the proposal being rendered non-responsive. The document includes a sworn certification section where the bidder acknowledges the potential for criminal prosecution for false statements and understands that the State of New Jersey will rely on the provided information. The form provides space for additional details about Iranian investment activities if applicable, with prompts for name, relationship, description of activities, duration of engagement, and contact information.