08._Darfur_v_12_2019.pdf

PDF 245 KB Posted

Attached to
25WS0024 - *SB ONLY* - Water Softener Services
Solicitation number
0000035941
Issued by
Los Angeles County, East Los Angeles CDP, Lake Los Angeles CDP, Los Angeles City, California

About this file

This document is a Darfur Contracting Act Certification form issued by the State of California's Department of General Services (DGS) for Agreement Number 25WS0024. The form is designed to ensure compliance with Public Contract Code Sections 10475-10481, which applies to companies that have conducted business activities outside the United States within the previous three years. The certification requires companies to either declare they are not a "scrutinized company" or obtain written permission from the DGS to submit a bid or proposal if they are considered a scrutinized company.

The form provides two options for companies: Option #1 allows companies to certify under penalty of perjury that they are not a scrutinized company, while Option #2 is for scrutinized companies that have received written permission from the DGS to submit a bid or proposal. Companies must provide their company/vendor name, Federal ID Number, an authorized signature, and the printed name and title of the person signing. The document emphasizes that companies with no business activities outside the United States in the past three years do not need to complete the form.

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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

Agreement Number: 25WS0024

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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