SPO_Form_205_Forced_Labor_of_Ethnic_Uyghurs_Ban.pdf
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- Attached to
- Master Agreement AZ|CTR057889
- Contract number
- CTR057889
- Issued by
- Arizona
About this file
This document is a Forced Labor of Ethnic Uyghurs Ban Certification Form issued by the Arizona Department of Transportation (ADOT) for the Infrastructure Delivery and Operations division. The form is specifically for ADOT ECS Contract Nos. CTR045714 and CTR045751, completed by WSP USA Inc., located in Tempe, Arizona. The certification is pursuant to Arizona Revised Statutes (A.R.S.) § 35-394, which prohibits public entities from entering into contracts with companies that use forced labor of ethnic Uyghurs in the People's Republic of China.
The document requires the company (in this case, WSP USA Inc.) to certify that it does not and will not use forced labor of ethnic Uyghurs, goods or services produced by such labor, or engage with consultants, subconsultants, or suppliers that utilize such labor during the contract term. WSP USA Inc. has selected the certification option confirming they do not use such labor, with the document signed by Joy Melita, Sr Vice President of Transportation Business Leader, validating the company's compliance with the state's requirements for contract eligibility.
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Text version
Infrastructure Delivery and Operations
FORCED LABOR OF ETHNIC UYGHURS BAN
Certification Form
ADOT ECS Contract No: CTR045714 / CTR045751 Forced Labor of Ethnic Uyghurs Ban Certification Form (rev 10-2022)
Forced Labor of Ethnic Uyghurs Ban Please note that if any of the following apply to the Consultant, then the Offeror shall select the “Exempt Consultant” option below:
• Consultant is a sole proprietorship;
• Consultant has fewer than ten (10) employees; OR
• Consultant is a non-profit organization.
Pursuant to A.R.S. § 35-394, the State of Arizona prohibits a public entity from entering into or renewing a contract with a company unless the contract includes written certification that the company does not use the forced labor, or any goods or services produced by the forced labor, or use any consultants, subconsultants, 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.
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.
(a) Based in part on the fact that the entity does business in Israel or in territories controlled by Israel.
(b) In a manner that discriminates on the basis of nationality, national origin or religion and that is not based on a valid business reason.
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 et seq., all offerors must select one of the following:
The Company submitting this Offer 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 Consultants, Subconsultants, 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 submitting this Offer does participate in use of Forced Uyghurs Labor as described in A.R.S. § 35-394.
Exempt Consultant.
Indicate which of the following statements applies to this Consultant (may be more than one):
☐ Consultant is a sole proprietorship;
☐ Consultant has fewer than ten (10) employees; and/or ☐ Consultant is a non-profit organization.
Company Name Signature of Person Authorized to Sign
Address Printed Name
City State Zip Title x
WSP USA Inc.
1230 W Washington Street, Suite 405
Tempe, AZ 85288
Joy Melita
Sr Vice President, Transportation Business Leader
For
Bailey, Corinne (USCB721882) G. Fly
Forced Labor of Ethnic Uyghurs Ban
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