09._Darfur_v_12_2019.pdf
PDF 245 KB Posted
- Attached to
- 25WS0024 - Water Softener Services
- Solicitation number
- 0000036224
About this file
This document is a Darfur Contracting Act Certification form from the State of California's Department of General Services (DGS), associated with Agreement Number 25WS0024. The form is designed to certify that companies bidding on California state contracts have not engaged in business activities in scrutinized areas, specifically related to Darfur, within the previous three years. Companies must complete either Option #1 (Certification) or Option #2 (Written Permission from DGS) to be eligible to submit a bid or proposal, depending on their business activities outside the United States.
The certification requires companies to declare under penalty of perjury whether they are a "scrutinized company" as defined by Public Contract Code Sections 10475-10481. If a company has had business activities outside the United States in the past three years, they must either certify they are not a scrutinized company or obtain written permission from the Department of General Services to submit a proposal. Companies with no international business activities in the previous three years are not required to complete the form. The document provides specific instructions and space for companies to provide their company name, Federal ID Number, authorized signature, and other relevant details to comply with the state's contracting requirements.
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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
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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