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Iran FormIRAN CONTRACTING ACT CERTIFICATION (Public Contract Code section 2200 et seq.) As required by California Public Contract Code Section 2204, the Contractor certifies subject to penalty for perjury that the option checked below relating to the Contractor's status in regard to the Iran Contracting Act of 2010 (Public Contract Code Section 2200 et seq.) is true and correct: ® The Contractor is not: (1) identified on the current list of person and entities engaged in investment activities in Iran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code Section 2203; or (2) a financial instruction that extends, for 45 days or more, credit in the amount of $20,000,000 or more to any other person or entity identified on the current list of persons and entities engaging in investment activities in Iran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code Section 2203, if that person or entity uses or will use the credit to provide goods or services in the energy sector in Iran. ❑ The City has exempted the Contractor from the requirements of the Iran Contracting Act of 2010 after making a public finding that, absent the exemption, the City will be unable to obtain the goods and/or services to be provided pursuant to the Contract. ❑ The amount of the Contract payable to the Contractor for the Project does not exceed $1,000,000. Signature: Printed Name: Nikolas Radonich Title: Secretary / Treasurer Firm Name: ERS Industrial Services, Inc. Date: 3/6/2024 Note: In accordance with Public Contract Code Section 2205, false certification of this form shall be reported to the California Attorney General and may result in civil penalties equal to the greater of $250,000 or twice the Contract amount, termination of the Contract and/or ineligibility to bid on contracts for three years. FEBRUARY 2024 SECTION 00 41 00 2024 FILTER REHABILITATION PROJECT BID FORMS 13