EO16_certification24.pdf
PDF 29 KB Posted
- Attached to
- RQ24-008 Bridge Maintenance Material Region 9
- Solicitation number
- 2119139
- Issued by
- Broome County, New York
About this file
This is a Certification Form under Executive Order No. 16 that prohibits State Agencies and Authorities from contracting with businesses conducting business operations in Russia. The form requires vendors to certify their business relationship status with Russia as part of the contracting process with state entities. The Executive Order directs all Affected State Entities to refrain from entering into new contracts or renewing existing contracts with entities conducting business in Russia while federal sanctions remain in effect.
The certification form provides four response options for vendors: 1) No business operations in Russia, 2a) Business operations in Russia but winding down operations, 2b) Limited business operations in Russia only for vital health and safety services or federal compliance, and 3) Active business operations in Russia. Vendors must provide detailed descriptions for options 2a and 2b if selected. The form requires the vendor's legal entity name, authorized signature, name, title, and date, with certification under penalties of perjury that the information provided is true and accurate.
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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 https://www.governor.ny.gov/executive-order/no-16-prohibiting-state-agencies-and-authorities-contracting-businesses-conducting
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