19-Commercially_Useful_Function-Bidder_Cert(DPR-87).pdf
PDF 714 KB Posted
- Attached to
- S25650009
- Solicitation number
- 0000038825
- Issued by
- Shasta County, Shasta CDP, Shasta Lake City, Mount Shasta City, California
About this file
This is a Commercially Useful Function Bidder Certification form issued by the California Department of Parks and Recreation for contract opportunity S25650009, a Boat Boarding Float Replacement project at McArthur-Burney Falls Memorial State Park. The form must be completed by all California Certified Small Business (SB), Micro Business (MB), and Disabled Veteran Business Enterprise (DVBE) suppliers serving as prime contractors, subcontractors, or suppliers. Bidders are required to certify their eligibility status, provide their DGS certification number and expiration date, and indicate whether they are functioning as a prime contractor or subcontractor. The certification process requires submission of supporting documentation, including the GSPD-05-105 Bidder Declaration and, if applicable, the DGS PD 843 Disabled Veteran Business Enterprise Declarations form.
Bidders must answer five questions affirming that they meet commercially useful function requirements under Government Code Section 14837(d)(4)(A) for Small and Micro Businesses and Military and Veterans Code Section 999(b)(5)(B)(i) for DVBEs. These questions confirm that the business will execute a distinct element of work, carry out contract obligations through actual performance or management, perform work normal to its business operations, maintain responsibility for products and materials (for goods contracts), and subcontract only normal portions of work consistent with industry practices. All responses must be certified under penalty of perjury by the certified business owner or authorized corporate representative, with the form subject to approval or denial by the DPR buyer or evaluator.
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Text version
State of California – Natural Resources Agency
DEPARTMENT OF PARKS AND RECREATION
COMMERCIALLY USEFUL FUNCTION – BIDDER CERTIFICATION
All California Certified Small Business (SB), Micro Business (MB), and Disabled Veteran Business Enterprise (DVBE) suppliers contracting and subcontracting must complete this certification form.
LEGAL BUSINESS NAME (including “Doing Business As” DBA name) DPR REFERENCE/AGREEMENT NUMBER
CERTIFICATIONS (mark all that apply)
Small Business Micro Business DVBE
DGS CERTIFICATION NUMBER
(OSDS)
EXPIRATION DATE
For this agreement, this business is the: Prime Contractor Subcontractor
All Certified Small Business, Micro Business, and/or DVBE prime contractors, subcontractors or suppliers must meet the commercially useful function requirements under Government Code Section 14837(d)(4)(A) for Small and Micro Businesses, and Military and Veterans Code Section 999(b)(5)(B)(i) for DVBEs.
A. Is the GSPD-05-105, Bidder Declaration attached? Yes No
B. Is the DGS PD 843, Disabled Veteran Business Enterprise Declarations form attached if applicable?
Yes No N/A
Please answer the following 5 questions as they apply to your company for the goods and/or services being acquired in this solicitation:
Will your business be responsible for the execution of a distinct element of the resulting work?
Yes No
Will your business carry out the obligation of the contract by actually performing, managing or supervising the work involved?
Yes No
3 Will you perform work that is normal for your business, service and functions? Yes No
Will your business be responsible for products, inventories, materials, suppliers required for the contract, negotiating price, determining quality and quantity, ordering, installing (if applicable) and making payment?
(Note: This only applies to GOODS. If this is a service, mark N/A and skip to #5.)
Goods Services
Yes No N/A
If subcontracting a portion of the work, is it a normal portion as expected by current industry practices? (Also answer Yes if not subcontracting any portion.)
Yes No
A response of “No” may result in your quote being deemed non-responsive and disqualified.
BIDDER’S CERTIFICATION
The signatory of this document must be the certified business owner (or authorized representative in the case of a corporation) and as such, hereby certifies under penalty of perjury under the laws of the State of California that all information provided herein is truthful and accurate.
PRINTED NAME AND TITLE OF AUTHORIZED SIGNER SIGNATURE DATE
DEPARTMENT OF PARKS AND RECREATION USE
APPROVED DENIED
DPR BUYER/EVALUATOR PRINTED NAME SIGNATURE DATE
DPR 87 (Rev. 5/2025)(Word to PDF 5/28/2025)
| COMMERCIALLY USEFUL FUNCTION – BIDDER CERTIFICATION |
| BIDDER’S CERTIFICATION |
| DEPARTMENT OF PARKS AND RECREATION USE |
| LEGAL BUSINESS NAME including Doing Business As DBA name: |
| DPR REFERENCEAGREEMENT NUMBER: |
| DVBE: Off |
| DGS CERTIFICATION NUMBER OSDS: |
| EXPIRATION DATE: |
| PRINTED NAME AND TITLE OF AUTHORIZED SIGNER: |
| DATE: |
| DPR BUYEREVALUATOR PRINTED NAME: |
| DATE_2: |
| 4: Off |
| Small Business: Off |
| Micro Business: Off |
| 1: Off |
| 2: Off |
| 3: Off |
| 5: Off |
| DPRApp: Off |
| A: Off |
| B: Off |
| Contractor: Off |
File details come from the government source that posted it. Updated .