NEW JERSEY SCHOOLS DEVELOPMENT AUTHORITY
SOURCE DISCLOSURE CERTIFICATION FORM
Bidder: Contract No.: _____________________
I hereby certify and say:
1. I have personal knowledge of the facts set forth herein and am authorized to make
this Certification on behalf of the Bidder.
2. The Bidder submits this Certification as part of a bid proposal in response to the
referenced solicitation issued by the New Jersey Schools Development Authority
(the “Authority”), in accordance with the requirements of N.J.S.A. 52:34-13.2.
3. The following is a list of every location where services will be performed by
Bidder and all subcontractors. If any of the services cannot be performed within
the United States, the Bidder shall state, with specificity, the reasons why the
services cannot be performed in the United States.
Performed in U.S.
4. Any changes to the information set forth in this Certification during the term of
any contract awarded under the referenced solicitation or extension thereof will be
immediately reported by the Bidder to the NJSDA.
5. I understand that, after award of a contract to the Bidder, it is determined that the
Bidder has shifted services declared above to be provided within the United States
to sources outside the United States, prior to a written determination by the
NJSDA that extraordinary circumstances require the shift of services or that the
failure to shift the services would result in economic hardship to the State of New
Jersey, the Bidder shall be deemed in breach of contract, which contract will be
subject to termination for cause.