Iran Economic Sanctions Act Certification.pdf
PDF 36 KB Posted
- Attached to
- 2025 GISD Surveillance Camera RFP
- Solicitation number
- RFP-GIS-250000002674-2
- Issued by
- Genesee County, Michigan
About this file
This document is an Iran Economic Sanctions Act Certification form for the Genesee Intermediate School District (GISD), located at 2413 West Maple Avenue in Flint, Michigan. The form is a mandatory certification under Public Act 517 of 2012, which requires bidders to certify that they are not an "Iran-linked business" as a prerequisite for submitting a binding bid for services to the school district. The certification is a critical component of the bidding process, with potential bidders required to complete and submit this form to be considered for contract award.
The certification carries significant legal and financial consequences for false statements, including potential contract termination, three-year bidding ineligibility, and substantial financial penalties of $250,000 or twice the bid amount, whichever is greater. By signing the document, the bidder affirms personal knowledge of the Iran Economic Sanctions Act and attests that they are not conducting business activities that would violate the act's provisions. The form must be fully completed with the bidder's name, address, contact information, and an authorized representative's signature to be considered valid for the procurement process.
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Text version
Attachment D
GENESEE INTERMEDIATE SCHOOL DISTRICT
ERWIN L. DAVIS EDUCATION CENTER
2413 WEST MAPLE AVENUE
FLINT, MI 48507-3493
PUBLIC ACT 517 OF 2012
IRAN ECONOMIC SANCTIONS ACT CERTIFICATION
I am the __________________of __________________, or I am bidding in my individual capacity ("Bidder"), with authority to submit a binding bid for the provision of __________________services to Genesee Intermediate School District. I have personal knowledge of the matters described in this Certification, and I am familiar with the Iran Economic Sanctions Act, MCL 129.311, et seq. ("Act"). I am fully aware that the school district will rely on my representations in evaluating bids.
I certify that Bidder is not an Iran-linked business, as that term is defined in the Act. I understand that submission of a false certification may result in contract termination, ineligibility to bid for three (3) years, and a civil penalty of $250,000 or twice the bid amount, whichever is greater, plus related investigation and legal costs.
Any bids that do not include this Certification shall not be accepted.
Owner Name & Address:
Genesee Intermediate School District 2413 West Maple Avenue
Flint, MI 48507-3493
Contractor/Vendor/Respondent Information:
Name: ______________________________________________________________________
Address: ____________________________________________________________________
( )Contact Number: ______________________________________________________________
Person Authorized to Bind the Contractor/Vendor/Respondent:
Print Name Title
Signature Date
Accessibility Report
Filename:
Attachment D Vendor Certification_.pdf
Report created by:
Organization:
[Enter personal and organization information through the Preferences > Identity dialog.]
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