23._DVBE_Participation_(CCHCS-MC-1786).pdf

PDF 115 KB Posted

Attached to
SD23-00080 Portable Diagnostic Sleep Testing Services
Solicitation number
0000031431
Issued by
California

About this file

This document is a Disabled Veteran Business Enterprise (DVBE) Participation form for a California Department of Corrections and Rehabilitation (CDCR) and California Correctional Health Care Services (CCHCS) contract opportunity, Bid Number SD23-00080 for Portable Diagnostic Sleep Testing Services. The contract is exempt from DVBE participation requirements; however, bidders are encouraged to report if they or any of their subcontractors are DVBE-certified by the Department of General Services, Office of Small Business and DVBE Services (DGS/OSDS). The form requests information on DVBE prime and subcontractor names, addresses, phone numbers, type of work, contract/subcontract dollar amounts, DGS/OSDS certification numbers, and certification expiration dates.

The contract opportunity is for portable diagnostic sleep testing services for the State of California. While DVBE participation is not required, the state is committed to achieving the legislatively established DVBE participation goal to the maximum extent feasible in professional services, commodities, and construction contracts.

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Text version

Bid Number: SD23-00080

CCHCS-MC-1786 – Disabled Veteran Business Enterprise (DVBE) Participation in Exempt Contracts Rev. 11/06/2018

DISABLED VETERAN BUSINESS ENTERPRISE (DVBE)

PARTICIPATION IN EXEMPT CONTRACTS

In accordance with Public Contract Code Section 10115 et seq., it is the policy of the California Department of Corrections and Rehabilitation to achieve the legislatively established goal to the maximum extent feasible in the procurement of professional services, commodities, and construction contracts with DVBEs.

This contract is exempt from DVBE participation requirements; however, if you or any of your subcontractors are a DVBE, please complete this form and return it with your bid proposal or proposed contract. Provide the DVBE prime and subcontractor information as requested below. Include only DVBEs that are currently certified by the Department of General Services, Office of Small Business and DVBE Services (DGS/OSDS).

DVBE NAME

ADDRESS

TELEPHONE NUMBER

P rim e

S u b

TYPE OF

CONTRACTABLE/

SUBCONTRACTABLE

WORK

CONTRACT/

SUBCONTRACT

DOLLAR

AMOUNT

DGS/OSDS

CERTIFICATION

NUMBER EXPIRES

DVBE NAME ADDRESS TELEPHONE NUMBERRow1:
DVBE NAME ADDRESS TELEPHONE NUMBERRow2:
TYPE OF CONTRACTABLE SUBCONTRACTABLE WORK:
CONTRACT SUBCONTRACT DOLLAR AMOUNT:
NUMBER:
EXPIRES:
TYPE OF CONTRACTABLE SUBCONTRACTABLE WORK_2:
CONTRACT SUBCONTRACT DOLLAR AMOUNT_2:
NUMBER_2:
EXPIRES_2:
DVBE NAME ADDRESS TELEPHONE NUMBERRow3:
TYPE OF CONTRACTABLE SUBCONTRACTABLE WORK_3:
CONTRACT SUBCONTRACT DOLLAR AMOUNT_3:
NUMBER_3:
EXPIRES_3:
DVBE NAME ADDRESS TELEPHONE NUMBERRow4:
Row1_2:
TYPE OF CONTRACTABLE SUBCONTRACTABLE WORKRow4:
CONTRACT SUBCONTRACT DOLLAR AMOUNTRow4:
NUMBERRow4:
EXPIRESRow4:
DVBE NAME ADDRESS TELEPHONE NUMBERRow5:
Row2:
Row2_2:
TYPE OF CONTRACTABLE SUBCONTRACTABLE WORKRow5:
CONTRACT SUBCONTRACT DOLLAR AMOUNTRow5:
NUMBERRow5:
EXPIRESRow5:
DVBE NAME ADDRESS TELEPHONE NUMBERRow6:
Row3:
Row3_2:
TYPE OF CONTRACTABLE SUBCONTRACTABLE WORKRow6:
CONTRACT SUBCONTRACT DOLLAR AMOUNTRow6:
NUMBERRow6:
EXPIRESRow6:
DVBE NAME ADDRESS TELEPHONE NUMBERRow7:
Row4:
Row4_2:
TYPE OF CONTRACTABLE SUBCONTRACTABLE WORKRow7:
CONTRACT SUBCONTRACT DOLLAR AMOUNTRow7:
NUMBERRow7:
EXPIRESRow7:
DVBE NAME ADDRESS TELEPHONE NUMBERRow8:
Row5:
Row5_2:
TYPE OF CONTRACTABLE SUBCONTRACTABLE WORKRow8:
CONTRACT SUBCONTRACT DOLLAR AMOUNTRow8:
NUMBERRow8:
EXPIRESRow8:
DVBE NAME ADDRESS TELEPHONE NUMBERRow9:
Row6:
Row6_2:
TYPE OF CONTRACTABLE SUBCONTRACTABLE WORKRow9:
CONTRACT SUBCONTRACT DOLLAR AMOUNTRow9:
NUMBERRow9:
EXPIRESRow9:
Row1:

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