ICM_BPM004656_-_Uyghurs_Forced_Labor_Attestation-signed-ICM-12-11-22.pdf
PDF 341 KB Posted
- Attached to
- Master Agreement AZ|CTR063768
- Contract number
- CTR063768
- Issued by
- Arizona
About this file
This document is a Forced Labor of Ethnic Uyghurs Ban form from the State of Arizona State Procurement Office, specifically for Solicitation No. BPM004656 related to Document Management Services. The form is completed by ICM Conversions Inc. dba ICM Document Solutions, a Phoenix-based company, and pertains to compliance with Arizona Revised Statutes (A.R.S.) § 35-394, which requires contractors to certify they do not use forced labor of ethnic Uyghurs in the People's Republic of China.
The document requires the contractor to affirm that they do not use, and agree not to use during the contract term, any forced labor of ethnic Uyghurs, any goods or services produced by such labor, or any contractors, subcontractors, or suppliers engaging in such practices. ICM Conversions Inc. has checked the box indicating compliance with this requirement. The form applies to companies with ten or more full-time employees and provides an exemption for sole proprietorships, companies with fewer than ten employees, and non-profit organizations. The document was signed by Ryan Wells, Chief Revenue Officer, with contact information provided for the company's Phoenix, Arizona location.
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Forced Labor of Ethnic Uyghurs Ban State of Arizona
State Procurement Office 100 N 15th Avenue, Ste 350
Phoenix, AZ 85007 Solicitation No.: BPM004656
PAGE
Description: Document Management Services
OF
SPO Form 205 – Forced Labor of Ethnic Uyghurs Ban | Revision No. 2 | Revised 11-22
Forced Labor of Ethnic Uyghurs Ban Please note that if any of the following apply to the Contractor, then the Contractor shall select the “Exempt Contractor” option below:
● Contractor is a sole proprietorship;
● Contractor has fewer than ten (10) employees; OR
● Contractor is a non-profit organization.
Pursuant to A.R.S. § 35-394, written certification is required to show that the company entering into a contract with a public entity does not use the forced labor, or use any contractors, subcontractors or suppliers that use the forced labor or any goods or services produced by the forced labor or any goods or services produced by the forced labor, of ethnic Uyghurs in the People's Republic of China.
Under A.R.S. § 35-394:
1. "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, limited liability company or other entity or business association, including a wholly owned subsidiary, majority-owned subsidiary, parent company or affiliate, that engages in for-profit activity and that has ten or more full-time employees.
2. "Public entity" means this State, a political subdivision of this State or an agency, board, commission or department of this State or a political subdivision of this State.
In compliance with A.R.S. § 35-394, all Contractors must select one of the following:
☐ The Company does not use, and agrees not to use during the term of the contract, any of the following:
● Forced labor of ethnic Uyghurs in the People’s Republic of China;
● Any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of
China; or
● Any Contractors, Subcontractors, or suppliers that use the forced labor or any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of China.
☐ The Company does participate in the use of Forced Uyghurs Labor as described in A.R.S. § 35-394.
☐ Exempt Contractor: Select all statements that apply to the Contractor:
☐ Contractor is a sole proprietorship;
☐ Contractor has fewer than ten (10) employees; and/or ☐ Contractor is a non-profit organization.
Company name Signature of person authorized to sign
Address Printed name and Title
City, State, ZIP Contact email address Contact phone number
ICM Conversions Inc. dba ICM Document Solutions
4100 E. Broadway Road Suite 180
Phoenix, AZ 85040
Ryan Wells - Chief Revenue Officer ryanw@icmdocs.com --- 480-269-9299
File details come from the government source that posted it. Updated .