20260402121002372 Exhibit E - RFP 2513 Small Business Cert.pdf
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- Attached to
- Global HIS Equity Innovation Hub
- Solicitation number
- 140471
- Issued by
- Los Angeles County, Oakland City, California
About this file
This is an Exhibit E Small Business Preference and Certification Request form for RFP 2513, issued by the State of California's Department of General Services through the Procurement Division. The form allows bidders to request a five percent small business preference on qualifying bids, with the preference amount not to exceed $50,000 per bid. Bidders must certify under penalty of perjury that they meet the requirements of the California Code of Regulations, Title 2, Section 1896 et seq. Small businesses must have their principal place of business located in California and maintain a complete application with proof of annual receipts on file with the Small Business & DVBE Services Branch by 5:00 p.m. on the bid opening date. Alternatively, non-small businesses may claim the preference by committing to subcontract at least 25 percent of the net bid price with one or more certified small businesses and providing detailed information about each subcontractor, including name, address, phone number, scope of work, dollar amount, and percentage of contract.
The certification must be signed in the same legal name style in which the bidder is licensed by the Contractors State License Board, and joint bidders must be jointly licensed and approved in the same form and style as the bid execution. Bidders receiving bonding assistance must identify the firm providing such assistance and note any listed subcontractors with their contract performance percentages. The form directs inquiries to the Small Business & DVBE Services Branch at (800) 559-5529 or (916) 375-4940, with office location at 707 Third Street, West Sacramento, California, or by mail to P.O. Box 989052, West Sacramento, CA 95798-9052. Contact is also available via email at osdchelp@dgs.ca.gov or through the internet at www.pd.dgs.ca.gov/smbus. Penalties for furnishing incorrect supporting information are outlined in Section 1896.16 of the regulations.
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EXHIBIT E
SMALL BUSINESS PREFERENCE AND CERTIFICATION REQUEST
(Bidders requesting a 5% Small Business Preference must sign below and enclose this form in the Bid Package)
Project No. Project Name
The undersigned hereby requests preference as a “Small Business” and further certifies under penalty of perjury, that the firm still meets the requirements of the California Code of Regulations, Title 2, Section 1896 et seq.
NOTICE TO ALL BIDDERS: Section 14835 et seq. of the California Government Code, requires that a five percent preference be given to bidders who qualify as a small business. The rules and regulations of this law, including the definition of a small business for the delivery of service, are contained in Title 2, California Code of Regulations, Section 1896, et seq. A copy of the regulations is available upon request.
If your firm is a Small Business and wishes to claim the small business preference, which may not exceed $50,000 for any bid, your firm must have its principal place of business located in California, have a complete application (including proof of annual receipts) on file with the Small Business & DVBE Services Branch, in the Procurement Division of the State of California Department of General Services, by 5:00 p.m. on the date bids are opened, and be verified by such office.
Or, if your firm is a Non-Small Business and wishes to claim the small business preference, your firm must notify the Trustees by signing below, that your firm commits to subcontract at least 25% of its net bid price with one or more small businesses, submit a timely responsive bid, list the small business subcontractors and include name, address, phone number, portion of the work to be performed, and the dollar amount and percentage per subcontractor, and be determined a responsible bidder.
Questions regarding the preference approval process should be directed to Small Business & DVBE Services, telephone (800) 559-5529 or (916) 375-4940, address: 707 Third Street, First Floor-Room 400, West Sacramento, CA 95605, or if by mail: P.O. Box 989052, West Sacramento, CA 95798-9052. You can also reach them via email (osdchelp@dgs.ca.gov) or on the Internet: www.pd.dgs.ca.gov/smbus.
IMPORTANT NOTICE (Read before signing) The “Small Business Preference and Certification Request” must be signed in the same name style in which the bidder is licensed by the Contractors State License Board. Bidders bidding jointly or as a combination of several business organizations are specially cautioned that such bidders must be jointly licensed and approved in the same form and style in which the bid is executed.
Legal Name Style of Bidder(s):
Signature of Bidder: Date
In the event the bidder has received assistance in obtaining bonding for this project, it shall set forth the name and nature of the firm providing such assistance. Should the firm be listed as a subcontractor, bidder shall set forth the percentage of the contract to be performed by the subcontractor.
Name of Firm: Is Firm a Listed Subcontractor? o YES-Percentage o NO
Special attention is directed to section 1896.16 for penalties for furnishing incorrect supporting information in obtaining preference.
Construction Mgmt.
701.09 • 10/06
Exhibit E RFP 2513 mailto:osdchelp@dgs.ca.gov
| EXHIBIT C |
| SMALL BUSINESS PREFERENCE AND CERTIFICATION REQUEST |
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