eo-16 certification.pdf

PDF 49 KB Posted

Attached to
Managed Service Provider (MSP) for Temporary Staffing Services
Solicitation number
2139499
Issued by
New York

About this file

This is an Executive Order No. 16 Certification document issued by New York State for use in the Roswell Park Comprehensive Cancer Center's Managed Service Provider (MSP) for Temporary Staffing Services solicitation. The certification requires vendors to attest to their compliance with Executive Order No. 16, which prohibits state entities from contracting with businesses conducting operations in Russia. Vendors must declare their status regarding Russian business operations by selecting one of three options: confirmation of no Russian business operations, disclosure of wind-down activities if currently operating in Russia, or explanation of vital health and safety services or federal compliance requirements that necessitate continued Russian operations. The certification must be signed by an authorized representative with knowledge of the vendor's business operations and submitted under penalties of perjury.

The document serves as a mandatory compliance requirement for all vendors responding to the Roswell Park staffing services RFP, which seeks MSP proposals to support approximately 6 full-time equivalents in locum tenens and allied health staffing, 40 FTEs in non-clinical and professional staffing, and 3 FTEs in executive and faculty interim placement and search services. The certification applies to this New York State contract opportunity and remains in effect while federal sanctions against Russia are active. Vendors are encouraged to respond to solicitations regardless of their current Russian business status, as sanctions may be lifted during the procurement process or after award, preserving potential contracting opportunities.

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Other files

File Type Posted
EEO Policy Statement.docx DOCX document
Attachment B FINAL.xlsx XLSX spreadsheet
EEO Staffing Plan.docx DOCX document
Appendix A-1 EEO Requirements (v.12.2025-1)-FINAL Clean.docx DOCX document
Attachment A FINAL.xlsx XLSX spreadsheet
Non-Collusion Affidavit.docx DOCX document
RFP 27-07 Scope of Work FINAL.docx DOCX document
Disclosure Form.docx DOCX document
Appendix A Roswell Park Required Clauses (v.12.2025-1)-FINAL Clean.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

Certification: Off
Vendor Name:
Name:
Date:
Title:
Provider Number:
Text1:

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