Certification of Non-Involvement in Prohibited Activities in Russia or Belarus

BID #: LOTTERY RFP 2023

DUE: TBD

VALUE: TBD

100

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Executive Summary

This document is a mandatory certification form, designated as Exhibit G, for vendors participating in the Lottery RFP 2023. It requires bidders to certify their non-involvement in prohibited activities in Russia or Belarus, as defined by P.L.2022, c.3. Vendors must either attest that they are not engaged in such activities or provide a detailed description of any involvement. Failure to provide this certification or submitting a willfully false statement can lead to severe consequences, including the bid being rendered non-responsive, contract termination, and the assessment of appropriate penalties, fines, and sanctions. If a bidder is found to be engaged in prohibited activities, they are granted 90 days to cease these activities and provide an updated certification; otherwise, the State will not award contracts, renew existing ones, or will terminate any contracts issued after the effective date of P.L.2022, c.3.

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Document Text

--- Document: Certification of Non-Involvement in Prohibited Activities in Russia or Belarus Document ---
CERTIFICATION OF NON‐INVOLVEMENT IN PROHIBITED ACTIVITIES 
IN RUSSIA OR BELARUS PURSUANT TO P.L.2022, c.3 
NJ Rev. 3.29.2022 
CONTRACT / BID SOLICITATION TITLE 
CONTRACT / BID SOLICITATION No. 
CHECK THE APPROPRIATE BOX 
I, the undersigned , am authorized by the person or entity  seeking to enter into or renew the contract identified 
above, to certify that the Vendor/Bidder is not engaged in prohibited activities in Russia or Belarus as such 
term is defined in P.L.2022, c.3,1 section 1.e, except as permitted by federal law.   
I understand that if this statement is willfully false, I may be subject to penalty, as set forth in P.L.2022, c.3, 
section 1.d. 
OR 
I, the undersigned am   unable to certify above because the person or entity seeking to enter into or renew the 
contract identified above, or one of its parents, subsidiaries, or affiliates may have engaged in prohibited 
activities in Russia or Belarus.  A detailed, accurate and precise description of the activities is provided below. 
Failure to provide such description will result in the Quote being rendered as non-responsive, and the 
Department/Division will not be permitted to contract with such person or entity, and if a Quote is accepted or 
contract is entered into without delivery of the certification, appropriate penalties, fines and/or sanctions will be 
assessed as provided by law.    
Description of Prohibited Activity 
Attach Additional Sheets If Necessary. 
If you certify that the bidder is engaged in activities prohibited by P.L. 2022, c. 3, the bidder shall have 90 days to cease 
engaging in any prohibited activities and on or before the 90th day after this certification, shall provide an updated 
certification. If the bidder does not provide the updated certification or at that time cannot certify on behalf of the entity that 
it is not engaged in prohibited activities, the State shall not award the business entity any contracts, renew any contracts, 
and shall be required to terminate any contract(s) the business entity holds with the State that were issued on or after the 
effective date of P.L. 2022, c. 3. 
Signature of Authorized Representative 
Date 
Print Name and Title of Authorized Representative 
Vendor Name 
1 Engaged in prohibited activities in Russia or Belarus” means (1) companies in which the Government of Russia or Belarus has any direct equity share; 
(2) having any business operations commencing after the effective date of this act that involve contracts with or the provision of goods or services to the
Government of Russia or Belarus; (3) being headquartered in Russia or having its principal place of business in Russia or Belarus, or (4) supporting,
assisting or facilitating the Government of Russia or Belarus in their campaigns to invade the sovereign country of Ukraine, either through in-kind support
or for profit.
EXHIBIT G
LOTTERY RFP 2023