Staten Island Family Courthouse Consolidation - Design Build Services - RFQ

DORMITORY AUTHORITY OF THE STATE OF NEW YORK
OMNIBUS PROCUREMENT
CERTIFICATION
I, the undersigned, an authorized signatory of ,
(the "Firm") hereby represent that they are knowledgeable about the Firm's business and operations
and certify to the Dormitory Authority of the State of New York ("DASNY") under penalty of perjury
that the answers provided herein are true to the best of their knowledge and belief as follows with
respect to certain actions taken and to be taken in connection with the Firm's submission of a
[bid/proposal] and the execution of any resulting contract (the "Contract") in response to DASNY's
[notice to bidders/request for proposal] for Project # [ ] as follows:
A. Non-Collusive Bidding Certification
1. The prices in the [bid/proposal], have been arrived at independently without collusion,
consultation, communication or agreement, for the purpose of restricting competition, as to any matter
relating to such prices with any other [bidder/proposer] or with any competitor;
2. Unless otherwise required by law, the prices which have been quoted in the [bid/proposal] have
not been knowingly disclosed by the [bidder/proposer] and will not knowingly be disclosed by the
[bidder/proposer] prior to opening, directly or indirectly, to any other [bidder/proposer] or to any
competitor; and
3. No attempt has been made or will be made by the [bidder/proposer] to induce any other person,
partnership, or corporation to submit or not to submit a [bid/proposal] for the purpose of restricting
competition.
B. Non-Segregated Facilities
The Firm does not, nor shall not, maintain or provide for the employees of such Firm any segregated
facilities at any establishments, and that the Firm does not, nor shall not, permit the employees of such
Firm to perform the services of such employees at any location under the control of such Firm where
segregated facilities are maintained. The Firm agrees that a breach of this certification is a violation
of the nondiscrimination clauses of the Contract.
C. Non-discrimination in Employment in Northern Ireland
The Firm stipulates that it, and any individual or legal entity in which the Firm holds a ten percent
(10%) or greater ownership interest, and any such entity that holds such an interest in the Firm, either:
1. Has no business operations in Northern Ireland; or
2. Shall take all lawful steps in good faith to conduct any business operations it has or in which
it has such an interest in Northern Ireland in accordance with the MacBride Fair Employment
Principles as set forth in Chapter 807 of the Laws of 1992 and shall permit any independent
monitoring of its compliance with said Principles.
D. Federal Equal Employment Opportunity Act
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DORMITORY AUTHORITY OF THE STATE OF NEW YORK
OMNIBUS PROCUREMENT
CERTIFICATION
The Firm is compliant with the Federal Equal Employment Opportunity Act of 1972 (P.L. 92-261), as
amended.
E. Commitment to Opportunity Programs
The Firm acknowledges and agrees to be bound in accordance with NYS Executive Law Article 15-
A, and in conformance with regulations promulgated by the Division of Minority and Women's
Business Development of the NYS Department of Economic Development. A list of NYS certified
M/WBEs may be obtained from the ESDC directory of certified businesses located at
www.nylovesmwbe.ny.gov.
F. Commitment to Service-Disabled Veteran-Owned Business
The Firm acknowledges and agrees to be bound in accordance with NYS Executive Law Article 17-
B, and in conformance with applicable regulations. A list of NYS certified SDVOB may be obtained
from the NYS Office of General Services Division of Services-Disabled Veterans' Business
Development located at https://ogs.ny.gov/veterans.
G. Transfer of Offset Credits
The Firm acknowledges notice that DASNY may assign or otherwise transfer offset credits created by
the Contract to third parties located in New York State.
H. 2005 Procurement Lobbying Law
1. The Firm understands and has to date and agrees hereinafter to comply with DASNY's
procedures relative to permissible contacts for this procurement as required by State Finance Law
139-j (3) and 139-k (6) (b);
2. No "governmental entity," as defined in State Finance Law 139-j and 139-k has made a
finding in the last four years that the Firm was not responsible;
a. If yes, please note the governmental entity, the date of the finding and the basis of the
finding regarding each finding of non-responsibility. Attach additional pages, if
necessary.
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DORMITORY AUTHORITY OF THE STATE OF NEW YORK
OMNIBUS PROCUREMENT
CERTIFICATION
3. No "governmental entity" as defined in State Finance Law 139-j and 139-k has terminated
or withheld a procurement contract with the Firm due to the intentional provision of false or incomplete
information required by such laws and/or the failure to comply with the requirements of State Finance
Law 139-k(3) relating to permissible contacts.
a. If yes, please note the governmental entity, the date of the termination or withholding
of contract and the basis of termination or withholding of contract. Attach additional
pages, if necessary.
I. Code of Business Ethics
The Firm acknowledges notice of and has read DASNY's Code of Business Ethics attached as Exhibit
A hereto and acknowledges that the Firm's failure to comply shall justify termination of the Contract
by DASNY and may result in the rejection of the Firm's [bid/proposal] for future work with DASNY.
J. Iran Divestment
That to the best of its knowledge and belief, the Firm and each person and each person signing on
behalf of any other party, that each person is not on the list created pursuant to paragraph (b) of
subdivision 3 of section 165-a of the State Finance Law.
K. Russia Divestment - EO 16
Executive Order No. 16 provides that "all Affected State Entities are directed to refrain from entering
into any new contract or renewing any existing contract with an entity conducting business operations
in Russia." The Executive Order remains in effect while sanctions imposed by the federal government
are in effect. As defined in Executive Order No. 16, an "entity conducting business operations in
Russia" means an institution or company, wherever located, conducting any commercial activity in
Russia or transacting business with the Russian Government or with commercial entities
headquartered in Russia or with their principal place of business in Russia in the form of contracting,
sales, purchasing, investment, or any business partnership.
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DORMITORY AUTHORITY OF THE STATE OF NEW YORK
OMNIBUS PROCUREMENT
CERTIFICATION
That to the best of its knowledge and belief, the Firm and each person and each person signing on
behalf of any other party, represents as follows:
____ 1. No, Vendor does not conduct business operations in Russia within the
meaning of Executive Order No. 16.
_______ 2.a. Yes, Vendor conducts business operations in Russia within the meaning of
Executive Order No. 16 but has taken steps to wind down business operations in Russia or is in
the process of winding down business operations in Russia. (Please provide a detailed description
of the wind down process and a schedule for completion.)
_______ 2.b. Yes, Vendor conducts business operations in Russia within the meaning of
Executive Order No. 16 but only to the extent necessary to provide vital health and safety services
within Russia or to comply with federal law, regulations, executive orders, or directives. (Please
provide a detailed description of the services being provided or the relevant laws, regulations, etc.)
________ 3. Yes, Vendor conducts business operations in Russia within the meaning of
Executive
L. Certification
The Firm acknowledges that intentional submission of false or misleading information may constitute
a felony under Penal Law Section 210.40 or a misdemeanor under Penal Law Section 210.35 or
Section 210.45, and may also be punishable by a fine of up to $10,000 or imprisonment of up to five
years under 18 U.S.C. Section 1001 and hereby represents that all information contained here provided
to DASNY is complete, true and accurate.
By: ________________________________
Name: ______________________________
Title: _______________________________
Date: _______________________________
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DORMITORY AUTHORITY OF THE STATE OF NEW YORK
OMNIBUS PROCUREMENT
CERTIFICATION
Exhibit A: Dormitory Authority of the State of New York - Code of Business Ethics
A. Ethics Programs
1. DASNY is a public-benefit corporation of the State of New York and expects the highest degree
of ethical business conduct by its employees and the many contractors, consultants and vendors
with whom it interacts on behalf of its clients, bondholders and the people of the State of New
York. DASNY, by mandate of its Board of Directors, administers a comprehensive corporate
integrity program to ensure that, as public officers, DASNY employees at all levels perform their
official duties consistent with the requirements of the New York State Public Officers Law; other
applicable laws, rules, and regulations; and policies of DASNY.
2. DASNY encourages and supports a fair, open and honest business relationship with its contractors,
consultants and vendors based on quality, service and cost. Moreover, DASNY believes that a
"level playing field" in the marketplace can only be achieved through adherence to ethical business
practices by all participants involved in the process.
3. To promote a working relationship with DASNY based on ethical business practices, contractors,
consultants and vendors are expected to:
a. furnish all goods, materials and services to DASNY as contractually required and specified;
b. submit complete and accurate reports to DASNY and its representatives as required;
c. not seek, solicit, demand or accept any information, verbal or written, from DASNY or its
representatives that provides an unfair advantage over a competitor;
d. not engage in any activity or course of conduct that restricts open and fair competition on
Authority-related projects and transactions;
e. not engage in any course of conduct with DASNY employees or representatives that constitutes
a conflict of interest or creates the appearance of a conflict of interest;
f. not offer any unlawful gifts or gratuities to DASNY employees or representatives, or engage
in bribery or other criminal activity; and
g. report to DASNY any activity by an DASNY employee or contractor, consultant or vendor of
DASNY that is inconsistent with DASNY's Code of Business Ethics.
4. DASNY encourages its contractors, consultants and vendors to advance and support ethical
business conduct and practices among their respective directors, officers and employees,
preferably through the adoption of corporate ethics awareness training programs and written codes
of conduct. In addition to considering technical competence and financial stability, DASNY will
consider the corporate integrity of all contractors, consultants and vendors prior to the awarding
of contracts or issuing of purchase orders.
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DORMITORY AUTHORITY OF THE STATE OF NEW YORK
OMNIBUS PROCUREMENT
CERTIFICATION
B. Conduct of DASNY Employees
DASNY employees are expected to conduct business with contractors, consultants and vendors in a
fair, consistent and professional manner. DASNY's Code of Business Ethics and Employee Conduct
entitled Serving Responsibly, and other DASNY policies and procedures, guide the manner in which
DASNY employees are required to interact with contractors, consultants and vendors. Additionally,
the New York State Public Officers Law sets forth legal parameters within which DASNY employees
must perform their official duties with respect to, among other things, conflicts of interest and the
acceptance of gifts.
Limits on Gifts to DASNY Employees
1. Pursuant to Section 73(5) of the Public Officers Law, no person shall offer any gift having more
than a nominal value to an DASNY employee under circumstances in which it:
a. could be reasonably inferred the gift was intended to influence the employee in the
performance of his or her official duties;, or
b. could reasonably be expected to influence the employee in the performance of his or her
official duties;, or
c. was intended as a reward for any official action on the part of the employee.
2. A gift is anything more than nominal in value, in any form, given to an DASNY employee. Gifts
include, but are not limited to, money, service, loan, travel, lodging, meals, refreshments,
entertainment, discount, forbearance or promise. Any firm or its agents, either doing business or
seeking to do business with DASNY (contractors, consultants, vendors, etc.), is prohibited from
directly or indirectly offering or giving any gifts, even gifts of nominal value, to DASNY
employees as such gifts are deemed to be per se improper.
3. As is stated in the Prohibited Interests section of the Construction and Consultant Contract
documents, violations of these gift provisions may be grounds for immediate contract termination
and/or referral for civil action or criminal prosecution.
C. Employing Relatives of DASNY Employees
Although contractors, consultants and vendors may employ relatives of DASNY employees, DASNY
must be made aware of such circumstances as soon as possible, preferably in writing, to ensure a
conflict of interest situation does not arise. DASNY reserves the right to request that contractors,
consultants and vendors modify the work assignment of an DASNY employee's relative where a
conflict of interest, or the appearance thereof, is deemed to exist. Please be advised that DASNY
employees are required to disclose information regarding the hiring of relatives by contractors,
consultants and vendors and recuse themselves from matters that may present a conflict of interest.
For purposes of this document, the term "relatives" refers to spouses, domestic partners, parents,
children, sisters, brothers, sisters-in-law, brothers-in-law, parents-in-law, sons/daughters-in-law,
stepparents, stepchildren, aunts, uncles, nieces, nephews, first cousins, grandparents by blood
relationship or by marriage, or persons residing in the same household.
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DORMITORY AUTHORITY OF THE STATE OF NEW YORK
OMNIBUS PROCUREMENT
CERTIFICATION
Hiring Former DASNY Employees
Contractors, consultants and vendors may hire former DASNY employees. However, as a general
rule, former employees of DASNY may neither appear nor practice before DASNY, nor receive
compensation for services rendered on a matter before DASNY, for a period of two years following
their separation from DASNY service. In addition, former DASNY employees are subject to a
"lifetime bar" from appearing before DASNY or receiving compensation for services regarding any
transaction in which they personally participated or which was under their active consideration during
their tenure with DASNY. Violations will be referred to the New York State Commission on Public
Integrity for appropriate action.
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