eo-16 certification.pdf
PDF 49 KB Posted
- Solicitation number
- 2136958
- Issued by
- Erie County, New York
About this file
This is an Executive Order No. 16 Certification document required by the State of New York for all state entities and authorities in connection with the Roswell Park Comprehensive Cancer Center's Request for Proposals for a Revenue Integrity, Managed Care Contract Performance & Patient Financial Platform. The certification addresses vendor compliance with New York's prohibition on contracting with entities conducting business operations in Russia. Vendors must certify their status regarding Russian business operations by selecting one of three options: confirming they do not conduct business in Russia, confirming they are winding down operations in Russia with a detailed timeline, or confirming they only maintain operations in Russia to provide vital health and safety services or comply with federal law. The certification requires the vendor's legal entity name, authorized signatory information, provider number, and initiative name, executed under penalties of perjury by someone knowledgeable about the vendor's business operations.
The Executive Order remains in effect while federal sanctions against Russia remain in place. Vendors are encouraged to submit responses and certifications regardless of their current Russian business operations status, as sanctions may be lifted during the solicitation or award process, potentially preserving contracting opportunities. The certification form provides space for detailed explanations for vendors selecting options 2.a or 2.b, ensuring transparency regarding the nature and timeline of any business wind-down activities or the specific vital services or legal compliance requirements justifying continued operations in Russia.
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Other files
| File | Type | Posted |
|---|---|---|
| Disclosure Form.docx | DOCX document | |
| EEO Policy Statement.docx | DOCX document | |
| RFP 27-03 Extension Addendum 1 FINAL.docx | DOCX document | |
| Roswell Park_Business Asscociate Agreement (v. 09.2025).docx | DOCX document | |
| Non-Collusion Affidavit.docx | DOCX document | |
| RFP 27-03 QA Addendum 3 FINAL.docx | DOCX document | |
| Template_Appendix C (Information & System Security Reqs)_10.2025.docx | DOCX document | |
| Appendix A Roswell Park Required Clauses (v.12.2025-1).docx | DOCX document | |
| Appendix B - Roswell Park Terms and Conditions (v 02.2025).docx | DOCX document | |
| EEO Staffing Plan.docx | DOCX document | |
| RFP 27-03 Extension Addendum 2 FINAL.docx | DOCX document | |
| RFP 27-03 Scope of Work FINAL.docx | DOCX document | |
| RFP 27-03 Clarification Addendum 4 FINAL.docx | DOCX document | |
| Appendix A-1 EEO Requirements (v.12.2025-1).docx | DOCX document |
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Text version
Executive Order No. 16 provides that “all Affected State Entities are directed to refrain from entering into any new contract or renewing any existing contract with an entity conducting business operations in Russia.” The complete text of Executive Order No. 16 can be found here.
The Executive Order remains in effect while sanctions imposed by the federal government are in effect.
Accordingly, vendors who may be excluded from award because of current business operations in Russia are nevertheless encouraged to respond to solicitations to preserve their contracting opportunities in case the sanctions are lifted during a solicitation or even after award in the case of some solicitations.
As defined in Executive Order No. 16, an “entity conducting business operations in Russia” means an institution or company, wherever located, conducting any commercial activity in Russia or transacting business with the Russian Government or with commercial entities headquartered in Russia or with their principal place of business in Russia in the form of contracting, sales, purchasing, investment, or any business partnership.
Is Vendor an entity conducting business operations in Russia, as defined above? Please answer by checking one of the following boxes:
1. No, Vendor does not conduct business operations in Russia within the meaning of Executive Order No. 16.
2.a. Yes, Vendor conducts business operations in Russia within the meaning of Executive Order No. 16 but has taken steps to wind down business operations in Russia or is in the process of winding down business operations in Russia. (Please provide a detailed description of the wind down process and a schedule for completion.)
2.b. Yes, Vendor conducts business operations in Russia within the meaning of Executive Order No. 16 but only to the extent necessary to provide vital health and safety services within Russia or to comply with federal law, regulations, executive orders, or directives. (Please provide a detailed description of the services being provided or the relevant laws, regulations, etc.)
3. Yes, Vendor conducts business operations in Russia within the meaning of Executive Order No. 16.
The undersigned certifies under penalties of perjury that they are knowledgeable about the Vendor’s business and operations and that the answer provided herein is true to the best of their knowledge and belief.
Vendor Name:
(legal entity)
By:
(signature)
Name:
Title:
Date:
Certification Under Executive Order No. 16 Prohibiting State Agencies and Authorities from Contracting with
Businesses Conducting Business in Russia
Provider Number: ______________________________
Initiative Name: _______________________________ https://www.governor.ny.gov/executive-order/no-16-prohibiting-state-agencies-and-authorities-contracting-businesses-conducting
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