2.IFB_STPD_15-001-C_Exhibits_010816.docx

INVITATION FOR BID

IFB STPD 15-001-C

BIDDER EXHIBITS

FOR

CALNET 3

SUBCATEGORIES 10.1 and 10.2

SATELLITE SERVICES

01/08/2016

Issued by:

STATE OF CALIFORNIA

California Department of Technology Statewide Technology Procurement Division PO Box 1810 Rancho Cordova, CA 95741

Disclaimer: The original PDF version and any subsequent addendums of the IFB released by the Procurement Official of this bid remain the official version. In the event of any inconsistency between the Bidder’s versions, articles, attachments, specifications or provisions which constitute the Contract, the official State version of the IFB in its entirety shall take precedence.

01/08/2016 Page 22

TABLE OF CONTENTS

INTENT TO BID

(Page 1 of 2) Mr. Ricardo Jarquin, Procurement Official California Department of Technology Statewide Technology Procurement Division

P. O. BOX 1810, MS Y12

Rancho Cordova, CA 95741 Phone: (916) 431-4109 Fax: (916) 431-5529 E-mail address: ricardo.jarquin@state.ca.gov

This is to notify you that it is our present intent to respond to the following checked IFB STPD 15-001-C Subcategories:

The individual to whom all information regarding this IFB shall be transmitted is:

(If different individuals are the contacts for different Subcategories, please indicate.)

Name:

Address:

City, State, and ZIP Code:

Telephone:

FAX:

E-Mail:

EXHIBIT 1: INTENT TO BID

(Page 2 of 2) We: (select one)

Comment(s)/Explanation(s)

Sincerely, Name (Signature)

Name and Title

Email

Company

Telephone

FAX

CONFIDENTIALITY STATEMENT

As an authorized representative and / or corporate officer of the company named below, I agree that all persons employed by this company will adhere to the following policy:

All information belonging to the California Department of Technology or its affiliated agencies is considered sensitive and/or confidential and cannot be disclosed to any person or entity that is not directly approved to participate in the work required to execute this Agreement.

I certify that I will keep all project information, including, but not limited to information concerning the planning, processes, development or procedures of the Project, and all communication with California Department of Technology or its affiliates derivate of any procurement process, confidential and secure. I will not copy, give or otherwise disclose such information to any other person unless the California Department of Technology has on file a Confidentiality Statement signed by the other persons, and the disclosure is authorized and necessary for the Project. I understand that the information to be kept confidential includes, but is not limited to, specifications, administrative requirements, terms and conditions, concepts and discussions, as well as written and electronic materials. I further understand that if I leave this project before it ends, I must still keep all project information confidential. I agree to follow any instructions provided by the Project relating to the confidentiality of project information.

I fully understand that any unauthorized disclosure I make may be basis for civil or criminal penalties and / or disciplinary action (for state employees). I agree to advise the contract manager immediately in the event of an unauthorized disclosure, inappropriate access, misuse, theft or loss of data.

All materials provided for this Project, except where explicitly stated will be promptly returned or destroyed, as instructed by an authorized California Department of Technology representative. If the materials are destroyed and not returned, a letter attesting to their complete destruction which documents the destruction procedures must be sent to the contract manager at the California Department of Technology before payment can be made for services rendered. In addition, all copies or derivations, including any working or archival backups of the information, will be physically and / or electronically destroyed within five (5) calendar days immediately following either the end of the contract period or the final payment, as determined by the California Department of Technology.

All personnel assigned to this project shall be provided a Confidentiality Statement and will be expected to sign and return it to the representative listed below before beginning work on this project.

Representative Name

Title

Phone Number

Company Name

Street Address

City/State/Zip Code

Signature

Date

RESPONSE TO ADMINISTRATIVE REQUIREMENTS

Bidder shall indicate agreement to each of the Administrative Requirements as presented in IFB STPD 15-001-C, Section 2.3 in the Table below. By indicating “Yes” the Bidder affirms that it understands the requirement and agrees to comply with it.

For Subcategory:

Name of Bidder (Firm Name):

Signature of Representative: Date:

Typed Name and Title:

WORKERS’ COMPENSATION CERTIFICATION

The undersigned in submitting this document hereby certifies the following:

I am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with such provisions before commencing the performance of the work of this contract.

Signature Date

Name and Title (Print or Type) Street Address

Firm Name City, State, ZIP

DARFUR CONTRACTING ACT OF 2008

Pursuant to Public Contract Code section 10478, if a bidder or proposer currently or within the previous three years has had business activities or other operations outside of the United States, it must certify that it is not a “scrutinized” company as defined in Public Contract Code section 10476.

Therefore, to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete only one of the following three paragraphs (via initials for Paragraph # 1 or Paragraph # 2, or via initials and certification for Paragraph # 3):

Company/Vendor Name (Printed)

Federal ID Number

Printed Name and Title of Person Initialing (for Options 1 or 2)

OR

OR

CERTIFICATION – ONLY FOR # 3, ABOVE

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective proposer/bidder to the clause listed above in # 3. This certification is made under the laws of the State of California.

By (Authorized Signature)

Printed Name and Title of Person Signing

IRAN CONTRACTING ACT OF 2010

IRAN CONTRACTING ACT

(Public Contract Code sections 2202-2208)

Prior to bidding on, submitting a proposal or executing a contract or renewal for a State of California contract for goods or services of $1,000,000 or more, a vendor must either: a) certify it is not on the current list of persons engaged in investment activities in Iran created by the California Department of General Services (“DGS”) pursuant to Public Contract Code section 2203(b) and is not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another person, for 45 days or more, if that other person will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS; or b) demonstrate it has been exempted from the certification requirement for that solicitation or contract pursuant to Public Contract Code section 2203(c) or (d).

To comply with this requirement, please insert your vendor or financial institution name and Federal ID Number (if available) and complete one of the options below. Please note: California law establishes penalties for providing false certifications, including civil penalties equal to the greater of $250,000 or twice the amount of the contract for which the false certification was made; contract termination; and three-year ineligibility to bid on contracts. (Public Contract Code section 2205.)

OPTION #1 - CERTIFICATION

I, the official named below, certify I am duly authorized to execute this certification on behalf of the vendor/financial institution identified below, and the vendor/financial institution identified below is not on the current list of persons engaged in investment activities in Iran created by DGS and is not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another person/vendor, for 45 days or more, if that other person/vendor will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS.

By (Authorized Signature)

Printed Name and Title of Person Signing

OPTION #2 – EXEMPTION

Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a vendor/financial institution engaged in investment activities in Iran, on a case-by-case basis, to be eligible for, or to bid on, submit a proposal for, or enters into or renews, a contract for goods and services.

If you have obtained an exemption from the certification requirement under the Iran Contracting Act, please fill out the information below, and attach documentation demonstrating the exemption approval.

By (Authorized Signature)

STD 213 STANDARD AGREEMENT FOR TELECOMMUNICATIONS

STATE OF CALIFORNIA

STANDARD AGREEMENT

STD. 213 (REVISED 07/12)

REGISTRATION NUMBER

STATE AGENCY’S NAME

California Department of Technology

CONTRACTOR’S NAME

Upon STPD Approval through June 30, 2018

(*) Statement of Work, Appendix C - Special Terms and Conditions – Telecommunications (*) Contractors PMAC in its entirety (*) IFB STPD 15-001-C in its entirety Attachment 1 - Awarded Subcategories Contractor’s Final Bid Response, in its entirety for all Awarded Subcategories, including but not limited to:

i. IFB STPD 15-001-C Business Requirements, for all Awarded Subcategories

ii. IFB STPD 15-001-C SOW Technical Requirements, for all Awarded Subcategories

iii. IFB STPD 15-001-C Catalog A with Costs, for all Awarded Subcategories

iv. IFB STPD 15-001-C Cost Worksheets, for all Awarded Subcategories This agreement is effective upon the start date, or upon STPD approval, whichever is later.

Items shown with an Asterisk (*), are hereby incorporated by reference and made part of this agreement as if attached hereto.

IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.

Statewide Technology Procurement Division (STPD) Use Only

CONTRACTOR

PRINTED NAME AND TITLE OF PERSON SIGNING

ADDRESS

STATE OF CALIFORNIA

AGENCY NAME

California Department of Technology

PRINTED NAME AND TITLE OF PERSON SIGNING

Barbara Garrett, Deputy Director, Office of Technology Services - STND

ADDRESS

P.O. Box 1810, MS Y-13, Rancho Cordova, CA 95741-1810

CONTRACTOR’S LICENSE INFORMATION

(Installation Services Only) For Subcategory:

Name of Bidder:

Bidder shall complete the applicable Contractor’s license information below in accordance with the Contractor’s State License Board, Department of Consumer Affairs. A Contractor’s license of appropriate Class C-7, Low Voltage Systems Contractor, is required before any Bidder can contract business (e.g. submit a bid) which includes the installation of cable and wiring, and minor electrical modification. In addition, if structural modifications are required, a Class B, General Building Contractor, license is required. Licensee must be in the name of the firm or a Responsible Managing Employee. See IFB Part 1, Section 2.3.6, Contractor’s License.

CONTRACTOR

SUBCONTRACTOR 1

SUBCONTRACTOR 2

(Use additional sheets if necessary.)

SERVICE TAXES, FEES, SURCHARGES AND SURCREDITS

THIS EXHIBIT SHALL BE SUBMITTED NO MORE THAN 30 CALENDAR DAYS FOLLOWING CONTRACT AWARD Bidders shall identify all service taxes, fees, surcharges and surcredits that they plan to include on their invoices. Bidders shall submit a copy of this form for each service that a tax, fee, surcharge and/or surcredit applies. Attach additional pages as necessary.

Bidder/Contractor name:

a) The Contractor’s identification number for the service tax, fee, surcharge or surcredit:

b) The regulatory or jurisdictional entity that issued the law, resolution or order that authorizes the imposition the service, tax, fee, surcharge or surcredit identified in “a” above (e.g., FCC, CPUC, BOE, IRS, etc.):

c) The name of the service tax, fee, surcharge or surcredit (the name must match the name or abbreviation used by the issuing authority):

d) The citations in law, regulation or order:

e) The URL identifying and providing citations in law or regulation:

f) The date the law, resolution or order was released:

g) The date the law, resolution or order becomes effective:

h) Purpose of the service tax, fee, surcharge or surcredit:

i) Identify the CALNET 3 Category/Subcategory that is affected:

j) Identify the CALNET 3 Service that is affected:

k) The amount or percentage of the service tax, fee, surcharge or surcredit:

l) Is the State exempt? (yes/no):

m) Additional comments as warranted:

Name of Bidder/Contractor contact person for follow up:

Phone number: Email address:

BIDDING PREFERENCES AND INCENTIVES

For Category/Subcategory:

ALL BIDDERS: COMPLETE ALL SECTIONS BELOW AND SUBMIT WITH YOUR PROPOSAL.

1. SMALL BUSINESS PREFERENCE

Bidder must check the appropriate box from the choices below.

My DGS Small Business certification number is:

Bidder must complete and submit Exhibit 12, GSPD-05-105 Bidder Declaration, indicating the percentage of the revenue that will be received by each DGS certified Small Business Subcontractor.

Bidder must complete and submit an Exhibit 14, Commercially Useful Function Statement, for each Small Business subcontractor.

2. DVBE INCENTIVE

Bidder must check the appropriate box from the choices below.

Bidder must submit a complete Exhibit 12, GSPD-05-105, Bidder Declaration, indicating the percentage of the revenue that will be received by each DGS certified DVBE Subcontractor. Bidder must also submit an Exhibit 11, STD 843 DVBE Declarations, for each DVBE Subcontractor, signed by the DVBE owner/manager. Bidder must complete and submit an Exhibit 14, Commercially Useful Function Statement, for each DVBE subcontractor or supplier.

EXHIBIT 10, CONTINUED

3. ADDITIONAL BIDDING PREFERENCES

The Bidder shall check the appropriate box or boxes from the choices below.

Bidder must submit Exhibit 13, STD 830.

Name of Bidder:

Signature and Date:

STD 843 DVBE DECLARATIONS

A copy of the DVBE Declarations, Form STD 843 is provided on the next page.

The form is also available as a fill and print PDF at:

http://www.documents.dgs.ca.gov/pd/poliproc/STD-843FillPrintFields.pdf When completing this form, beneath the “Solicitation/Contract Number”, write in the Subcategory that the form pertains to.

GSPD 05-105 BIDDER DECLARATION

A copy of the GSPD-05-105 Bidder Declaration and its instructions, are provided on the next two pages. The form with its instructions is also available as a fill and print PDF at:

http://www.documents.dgs.ca.gov/pd/poliproc/Master-Biddeclar08-09.pdf When completing this form, Bidders must write in the Subcategory beneath the “Solicitation Number”.

STD 830 TACPA PREFERENCE REQUEST

A copy of the STD 830 TACPA Preference Request and its instructions, are provided on the next two pages. The form with its instructions is also available as a fill and print PDF at:

http://www.documents.dgs.ca.gov/osp/pdf/std830.pdf When completing this form, Bidders must write in the Subcategory above the “Solicitation Number”.

COMMERCIALLY USEFUL FUNCTION STATEMENT

All certified small business, micro business, and/or DVBE Contractors, subcontractors or suppliers must meet the commercially useful function requirements under Government Code (GC) Section 14837(d)(4)(A) (for SB) and Military and Veterans Code (MVC) Section 999(b)(5)(B) (for DVBE).

Please answer the following questions, as they apply to your company for the goods and services being acquired in this solicitation.

CALNET 3 Category or Subcategory being bid:

Subcontractor Name:

A response of “No” in questions 1 - 3 or a response of ”Yes” in question 4, may result in your claim for Small Business Preference or DVBE Incentive being deemed non-responsive and disqualified.

The bidder must provide a written statement below detailing the role, services and goods the subcontractor(s) will provide to meet the commercially useful function requirement.

At the State’s option prior to award, bidders may be required to submit additional written clarifying information.

Per MVC Section 999.9(a)(6) and GC 14842.5 (a)(6) it is unlawful for a person to knowingly and with intent to defraud, fraudulently represent that a commercially useful function is being performed by a disabled veteran business enterprise in order to obtain or retain a bid preference or a state contract, and that doing so shall subject the person to the penalties stated in MVC Section 999.9 and GC 14842.5.

By signing this form, the undersigned bidder certifies that the Certified Small Business or DVBE satisfies the Commercially Useful Function requirement, and will provide the role, services, and/or goods stated above.

Signature of Company Representative:

Printed/Typed Name and Title of Company Representative:

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