EO16_certification.pdf

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Attached to
Region 8 Traffic Signs
Solicitation number
2138969
Issued by
New York

About this file

This is an Executive Order No. 16 Certification form required by the State of New York for vendor compliance with state contracting restrictions. The certification applies to the Region 8 Traffic Signs procurement, which establishes a one-time purchase contract for traffic signs and related materials serving six counties in New York: Columbia, Dutchess, Putnam, Orange East, Orange West, and Ulster. Vendors responding to this solicitation must complete the certification form to attest to their business operations and compliance status regarding activities in Russia.

The certification requires vendors to confirm whether they conduct business operations in Russia as defined by Executive Order No. 16, which prohibits state entities from contracting with companies engaged in commercial activity, transactions, or business partnerships in Russia. Vendors must select one of four responses: no operations in Russia, operations being wound down with detailed schedules, operations limited to vital health and safety services or federal compliance, or ongoing business operations in Russia. The form requires vendor name, signatory information, title, and date, with certification under penalties of perjury. Vendors conducting business in Russia are nonetheless encouraged to respond to preserve future contracting opportunities in the event sanctions are lifted. No specific contract award dates, pricing information, or set-aside goals are detailed in this certification document, though the related solicitation identifies contracting goals of 6.00% for Service-Disabled Veteran-Owned Businesses, 1.00% for Minority Business Enterprises, and 8.00% for Women Business Enterprises.

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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 https://www.governor.ny.gov/executive-order/no-16-prohibiting-state-agencies-and-authorities-contracting-businesses-conducting

Certification: Off
Vendor Name:
Name:
Date:
Title:

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