Iran Free Procurement Certification Form.pdf
PDF 26 KB Posted
- Attached to
- District 3 Herbicide Spraying Service
- Solicitation number
- 6100065252
- Issued by
- Lycoming County, Pennsylvania
About this file
This is an Iran Free Procurement Certification Form issued by the Commonwealth of Pennsylvania under the state's Procurement Code Sections 3501-3506, applicable to the District 3 Herbicide Spraying Service contract opportunity. The certification requirement applies to all vendors seeking contract awards valued at $1,000,000 or more with Commonwealth entities. Vendors must submit bids electronically through the PA Supplier Portal at www.pasupplierportal.state.pa.us, with questions directed to Sandra Duke at sanduke@pa.gov prior to Friday, March 6, 2026, at 10:00 a.m. EST. The herbicide spraying service will be performed within Bradford, Columbia, Lycoming, Montour, Northumberland, Snyder, Sullivan, Tioga, and Union Counties for PennDOT District 3. Bids will be publicly opened and read virtually via Microsoft Teams. The initial contract term is one year, with the option for mutual renewal for a maximum of four additional one-year terms. All line items must be bid, or the bid will be considered void.
Vendors must certify either that they are not engaged in investment activities in Iran and are eligible to contract with the Commonwealth, or demonstrate receipt of a written exemption from the certification requirement on a case-by-case basis per Procurement Code Section 3503(e). Pennsylvania law establishes significant penalties for false certifications, including civil penalties equal to the greater of $250,000 or twice the contract amount, contract termination, and three-year ineligibility to bid on future Commonwealth contracts. Interested bidders experiencing technical difficulties may contact the Supplier Service Center at (877) 435-7363, option #1. Mailed bids will not be accepted.
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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
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