238-25 Exhibit B.pdf

CERTIFICATION OF NON-INVOLVEMENT IN PROHIBITED ACTIVITIES IN RUSSIA OR BELARUS Pursuant to N.J,S.A. 52:32-60,1, et seq, (2022, ¢. 3) any person or enllty (hereinafter "Vendor'") that seeks to enter Into or renew a cont‘acl with a State agenoy for the provision of goods or services, or the purohase of bonds or other obligations, must complete the certification below indicating whether or nat the Vendor is Identified on the Office of Forsign Assets Goatrol (QFAC) Specially Designated Nationals and Blocked Persons ist, available —_ here; Allpsiieanolousssareh oftedan oN, If the Department of the Treasury finds that ¢ Vendor has made a gariifloation In violation of the law, It shell take any aation as may be appropriate and provided by law, rule or contract, Including but fot limited to, imposing sanations, séeking compliance, recovering damages, declaring the party IN default and seeking debarment or suspension of the party, |, the undersigned, certify that | have read the definition of *Vendor™ below, and have reviewed the Office of Foreign Assats Gontro] (OFAC) Specially Designated Nationals and Slocked Persons list, and having dona so odrtify; (Gheok the Appropriate Box) a, Thal the Vendor is not Identified on the OFAC Suectally Desianaled Nationals ued Gloaked Parsons list op OR That | am unable to certify as to “A® above, because the Venclor Is {dentified on the OFAC. Specially . -Rgslonatad Nationals and. Blocked Parsons lielon account of activity ralaved.te Russia andlor Belarus. —.— — ft “That--am-unable-to-cartify-as-to-"A-above, because the Vendor Is-Identified-on- the a .) 6. ded Parsoris list, However, the Vendor is engaged In aailvily related lo Russia and/or Belarus consistent with fecisral law, regulatlon, floense or exemption. A detailed description of how the Vendor's activity related to Russia and/or Balarus Is consistent with federal law Is set forth below. (Atfaoh Additional Shoals # Nocassary,) Kotouabe exxrobce 6 Cots TIgpalure of Vendars Authorized Representative Daje AOL. LAB OWLS C4 Ba ~ aS FF Sid. Tlie Name abd Tile of Vanor's Aulhorizad Roprosarfalive Vgndors FEIN CABOWS LA COMSLLCTIOM [Kc DIA BI{- bit; wao) ay D CF! Ao Ad C Or a Number WAT OWES Nf o70&> Construct on Ft O@VErizan, NE} Vendors Address {City/State/Zip Cade) Vendor's Email Address ‘Vendor moans: (1) A natural person, corporation, company, tinited

Ao Ad C Or a Number WAT OWES Nf o70&> Construct on Ft O@VErizan, NE} Vendors Address {City/State/Zip Cade) Vendor's Email Address ‘Vendor moans: (1) A natural person, corporation, company, tinited partnership, limited lablity partnership, Enited Ueblity cormpany, business association, sole proprietorship, Jolnt venti, partnarship, soclety, trust, of any olhor nofigaverwmental entity, organizallon, at group; (2) Any governmental entity of instrutmontality of a government, Including & multatoral development institution, as defined in Sactlon 1701(0)(8) of tie thiemational Financial Institutions Act, 22 U.S.C, 262r(0}'S}, or (3) Any parent, successor, subuni, diract or Indlract subsidiary, of any entity onder common o¥marship or control with, any entity desoribed in paragraph (1) or (2). WaRev. 1.22,2024 34