Office of General Services

New York State Advisory Council On Procurement Lobbying
State Finance Law §§139-j and 139-k
Model Language and Forms
The following model language and forms have been prepared for use by a Governmental Entity to satisfy the statutory requirements set forth in State Finance Law §§139-j and 139-k. Instructions and background information has been provided for each document. The documents should be modified as necessary to meet the needs of your organization, with examples of acceptable modifications cited.
Form 1 Model Form for Governmental Entity Report of Contact under State Finance Law §139-k(4)
Form 2 Model Summary Policy Language for Inclusion in Solicitation (Last updated 12/14/2006)
Form 3 Model Language to Obtain Offerer's Affirmation of Understanding of and Agreement pursuant to State Finance Law §139-j(6)(b) (Last updated 12/14/2006)
Form 4 Model Language to Obtain an Offerer's Certification of Compliance with State Finance Law §139-k(5)
Form 5 Model Language to Obtain the Offerer's Disclosure of Prior Non-Responsibility Determinations
Form 6 Model Contract Termination Provisions in accordance with State Finance Law §139-k(5)
Form 7 Model Process for the Review and Investigation in accordance with State Finance Law §139-j(8), (9) and (10)
Form 8 Model Form to Refer a Contact for Review and Investigation Under State Finance Law §139-j(9)
Form 9 Model Form for Use by a Non-procuring Governmental Entity to Refer a Contact for Review and Investigation by the Procuring Governmental Entity under State Finance Law §139-j(9)
Form 10 Notification Form for Offerers Determined to be Non-Responsible Bidders
Form 11 Notification Form for Offerers to be Added to the List of Debarred Offerers