Crystal Image Technologies KVM-16H Especificaciones Pagina 18

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Iran Economic Sanctions Act Certification
I am the (title)_______________ of _(bidder Company_________________, or I am
bidding in my individual capacity ("Bidder"), with authority to submit a binding bid for the
Carson City-Crystal Area School Cabling and Network Upgrade. I have personal knowledge of
the matters described in this Certification, and I am familiar with the Iran Economic Sanctions
Act, MCL 129.311, et seq. ("Act"). I am fully aware that the school district will rely on my
representations in evaluating bids.
I certify that Bidder is not an Iran-linked business, as that term is defined in the Act. I
understand that submission of a false certification may result in contract termination, ineligibility
to bid for three (3) years, and a civil penalty of $250,000 or twice the bid amount, whichever is
greater, plus related investigation and legal costs.
_________________________________________
(signature)
_________________________________________
(printed)
_________________________________________
(date)
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