20-DARFUR__DPR-074_.xlsx
XLSX spreadsheet 24 KB Posted
- Attached to
- S25650009
- Solicitation number
- 0000039040
- Issued by
- Shasta County, Shasta CDP, Shasta Lake City, Mount Shasta City, California
About this file
This is a DARFUR Contracting Act Certification form (DPR 74, Revised May 2013) issued by the State of California Department of Parks and Recreation for the Boat Boarding Float Replacement project at McArthur-Burney Falls Memorial State Park. The form applies to any company with business activities or operations outside the United States within the previous three years. Companies meeting this criterion must complete and submit the certification form to be eligible to bid on or submit proposals for this State of California contract. The form requires authorized company officials to certify their eligibility status and provide corporate identification information.
The certification form provides two options for eligible companies: Option #1 requires companies to certify under penalty of perjury that they are not a scrutinized company as defined in Public Contract Code Section 10476, with the authorized signatory providing company name, Federal ID Number, signature, printed name and title, and execution location and date. Option #2 is available for scrutinized companies that have received written permission from the California Department of General Services to submit bids or proposals on a case-by-case basis when determined to be in the state's best interest, requiring submission of documentation of such permission along with company identification information. Companies that have not conducted business activities or operations outside the United States within the previous three years are not required to complete or return this form.
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Text version
DPR 74
FOR DEPARTMENT USE ONLY
DO NOT COMPLETE THIS FORM UNLESS YOUR COMPANY MEETS THE CRITERIA OF OPTION #1 OR OPTION #2.
DPR 74 (Rev. 5/2013)(Excel 5/16/2013)
State of California - Natural Resources Agency
DEPARTMENT OF PARKS AND RECREATION
DARFUR CONTRACTING ACT CERTIFICATION
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.
DO NOT COMPLETE OR RETURN THIS FORM IF: Within the previous three years, your company HAS NOT had any business activities or other operations outside of the United States.
AGREEMENT/PAPO NO.
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) BY (Authorized Signature)
PRINTED NAME AND TITLE OF PERSON SIGNING
DATE EXECUTED
EXECUTED IN THE COUNTY AND STATE OF
FEDERAL ID NUMBER
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.
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)
INITIALS OF SUBMITTER
PRINTED NAME AND TITLE OF PERSON INITIALING
FEDERAL ID NUMBER
All other companies, complete Option #1 or Option #2 and return:
File details come from the government source that posted it. Updated .