ESBD_399645_1740777119672_Iran Contracting Act.pdf
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- Attached to
- FANS Full Line Grocery
- Solicitation number
- 2025-05-27-009
- Issued by
- Texas
About this file
This document is the Iran Contracting Act Certification form required by California Public Contract Code sections 2202-2208 for contracts of $1 million or more with public entities. The form requires vendors or financial institutions to certify that they are not on the Department of General Services' list of persons engaged in investment activities in Iran and are not extending $20 million or more in credit to entities involved in Iran's energy sector.
The certification provides two options: Option #1 allows vendors to certify they are not on the restricted list, while Option #2 provides an exemption process for vendors who may be engaged in investment activities in Iran but have obtained specific approval to contract with public entities. Penalties for false certification include civil penalties of $250,000 or twice the contract amount, contract termination, and three-year debarment from public contracts. The form requires the vendor's name, Federal ID number, authorized signature, title, date, and location of execution.
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| Federal Regulations Certifications & Affidavits
IRAN CONTRACTING ACT
CERTIFICATION OF ELIGILITY TO PROPOSAL FOR CONTRACTS OF $ 1 MILLION OR MORE
(Public Contract Code sections 2202-2208)22
Pursuant to Public Contract Code 2204. (a) A public entity shall require a person that submits a proposal or proposal to, or otherwise proposes to enter into or renew a contract with, a public entity with respect to a contract for goods or services of one million dollars ($1,000,000) or more to certify, at the time the proposal is submitted or the contract is renewed, that the person is not identified on a list created pursuant to subdivision (b) of Section 2203 as a person engaging in investment activities in Iran described in subdivision (a) of Section 2202.5, or as a person described in subdivision (b) of Section 2202.5, as applicable. A state agency shall submit the certification information to the Department of General Services.
To comply with this requirement, please insert your vendor or financial institution name and Federal ID Number (if available) and complete one of the options below. Please note: California law establishes penalties for providing false certifications, including civil penalties equal to the greater of $250,000 or twice the amount of the contract for which the false certification was made; contract termination; and three-year ineligibility to proposal on contracts. (Public Contract Code section 2205.)
OPTION #1 - CERTIFICATION
I, the official named below, certify I am duly authorized to execute this certification on behalf of the vendor/financial institution identified below, and the vendor/financial institution identified below is not on the current list of persons engaged in investment activities in Iran created by DGS and is not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another person/vendor, for 45 days or more, if that other person/vendor will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS.
Vendor Name/Financial Institution (Printed) Federal ID Number (or n/a)
By (Authorized Signature)
Printed Name and Title of Person Signing
Date Executed Executed in (city, state)
OPTION #2 – EXEMPTION
Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a vendor/financial institution engaged in investment activities in Iran, on a case-by-case basis, to be eligible for, or to proposal on, submit a proposal for, or enters into or renews, a contract for goods and services.
If you have obtained an exemption from the certification requirement under the Iran Contracting Act, please fill out the information below, and attach documentation demonstrating the exemption approval.
Vendor Name/Financial Institution (Printed) Federal ID Number (or n/a)
By (Authorized Signature)
Printed Name and Title of Person Signing Date Executed
22 Iran Contracting: 48 CFR 25.703-3
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