Iran Free Procurement Certification Form (BOP 1701).pdf
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- Attached to
- Construction Equipment - PA-DOT State and local contract opportunity
- Solicitation number
- 6100063609
- Issued by
- Pennsylvania
About this file
The Iran Free Procurement Certification Form (BOP-1701) is a document issued by the Pennsylvania Department of General Services (DGS) Bureau of Procurement, dated January 26, 2017. The form is designed for vendors seeking to contract with Commonwealth entities for goods or services valued at $1,000,000 or more, requiring certification that the vendor is not engaged in investment activities in Iran.
The document provides two compliance options: Option #1 allows vendors to certify they are not on the current list of persons engaged in investment activities in Iran, while Option #2 provides a potential exemption process for vendors seeking a case-by-case approval from DGS. The form includes significant legal consequences for false certifications, including potential civil penalties up to $250,000 or twice the contract amount, contract termination, and a three-year prohibition on bidding for Commonwealth contracts. Vendors must complete either Option #1 or Option #2, providing their company name, an authorized signature, and the printed name and title of the person signing the certification.
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Text version
BOP-1701
Published: 1/26/2017
IRAN FREE PROCUREMENT CERTIFICATION FORM
(Pennsylvania’s Procurement Code Sections 3501-3506, 62 Pa.C.S. §§ 3501-3506)
To be eligible for an award of a contract with a Commonwealth entity for goods or services worth at least $1,000,000 or more, a vendor must either: a) certify it is not on the current list of persons engaged in investment activities in Iran created by the Pennsylvania Department of General Services (“DGS”) pursuant to Section 3503 of the Procurement Code and is eligible to contract with the Commonwealth under Sections 3501-3506 of the Procurement Code; or b) demonstrate it has received an exception from the certification requirement for that solicitation or contract pursuant to Section 3503(e).
To comply with this requirement, please insert your vendor or financial institution name and complete one of the options below. Please note: Pennsylvania 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 bid on contracts. (Section 3503 of the Procurement Code.)
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 eligible to contract with the Commonwealth of Pennsylvania Sections 3501-3506 of the Procurement Code.
Vendor Name/Financial Institution (Printed)
By (Authorized Signature)
Printed Name and Title of Person Signing Date Executed
OPTION #2 – EXEMPTION
Pursuant to Procurement Code Section 3503(e), DGS may permit a vendor/financial institution engaged in investment activities in Iran, on a case-by-case basis, to enter into a contract for goods and services.
If you have obtained a written exemption from the certification requirement, please fill out the information below, and attach the written documentation demonstrating the exemption approval.
Vendor Name/Financial Institution (Printed)
By (Authorized Signature)
Printed Name and Title of Person Signing Date Executed
| IRAN FREE PROCUREMENT CERTIFICATION FORM |
| (Pennsylvania’s Procurement Code Sections 3501-3506, 62 Pa.C.S. §§ 3501-3506) |
| OPTION #1 - CERTIFICATION |
| OPTION #2 – EXEMPTION |
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