08._Darfur.pdf

PDF 303 KB Posted

Attached to
23VS0018 - Medical Transportation Services
Solicitation number
0000030523
Issued by
Ventura County, California

About this file

The document provided is a Darfur Contracting Act Certification form related to a state contract opportunity for Medical Transportation Services in Ventura County, California. The contract is solicitation number 23VS0018, and it is for the provision of medical transportation services at the Veterans Home of California - Ventura, as detailed in exhibits A-E. The form requires bidders to certify whether they are a scrutinized company with business activities outside of the United States, and if so, to either certify that they are not a scrutinized company or obtain written permission from the Department of General Services to submit a bid.

The contract opportunity is open to all qualified vendors, with no specific set-asides or incumbent information provided. Pricing terms, funding requirements, and other salient details are not included in the provided documentation.

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Text version

Public Contract Code Sections 10475 -10481 applies to any company that currently or within the previous three years has had business activities or other operations outside of the United States. For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company that has been granted permission by the Department of General Services to submit a proposal.

If your company has not, within the previous three years, had any business activities or other operations outside of the United States, you do not need to complete this form.

OPTION #1 - CERTIFICATION

If your company, within the previous three years, has had business activities or other operations outside of the United States, in order to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete the certification below.

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that a) the prospective proposer/bidder named below is not a scrutinized company per Public Contract Code 10476; and b) I am duly authorized to legally bind the prospective proposer/bidder named below. This certification is made under the laws of the State of California.

Company/Vendor Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

OPTION #2 – WRITTEN PERMISSION FROM DGS

Pursuant to Public Contract Code Section 10477(b), the Director of the Department of General Services may permit a scrutinized company, on a case-by-case basis, to bid on or submit a proposal for a contract with a state agency for goods or services, if it is in the best interests of the state. If you are a scrutinized company that has obtained written permission from the DGS to submit a bid or proposal, complete the information below.

STATE OF CALIFORNIA

DARFUR CONTRACTING ACT CERTIFICATION

DGS PD 1 (Rev. 12/19)

Date

Solicitation Number: 23VS0018

We are a scrutinized company as defined in Public Contract Code section 10476, but we have received written permission from the Department of General Services to submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission from DGS is included with our bid or proposal.

Company/Vendor Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date

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