180-26 - Exhibit B. AJ Contractors_compressed.pdf

DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN STANDARD BID DOCUMENT REFERENCE NameofForm | DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN N.J.S.A. 52:32-55 et seq. Statutory | NJS.A. 40A:11-2.1 Reference N.J.S.A. 18A:18A-49.4 Y/N Mandatory Optional N/A Goods and x Applicability | TPCE ¥ | services EEGI: > Construction x Instructions Reference Description P.L. 2012, c.25 prohibits the awarding of State and local public contracts for goods and services with persons or entities engaging in certain investment activities in energy or finance sectors of Iran. Prior to contract award, vendors and contractors must certify that neither they nor any parent entity, subsidiary, or affiliate is listed on the New Jersey Department of the Treasury’s list of entities determined to be engaged in prohibited activities in Iran pursuant to P.L. 2012, c. 25 ("Chapter 25 List"). The Certification form requires the insertion of contracting unit identification information which should be filled in (in italics on the form) prior to its use. P-44