24520004_-_STD_19_State_of_Compliance.pdf
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- Attached to
- 24520004 - HVAC Repair Services
- Solicitation number
- 0000034715
- Issued by
- Amador County, Contra Costa County, El Dorado County, Placer County, Sacramento County, San Joaquin County, Solano County, Sutter County, Yolo County, Amador City, Amador Pines CDP, Sutter Creek City, Contra Costa Centre CDP, El Dorado Hills CDP, Placerville City, San Joaquin City, Sacramento City, San Francisco City, Sutter CDP, West Sacramento City, Yolo CDP, California
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STATE OF CALIFORNIA
NONDISCRIMINATION COMPLIANCE STATEMENT
STD. 19 (Rev. 10/2019)
COMPANY NAME
The company named above (herinafter referred to as "prospective contractor") hereby certifies, unless specifically exempted, compliance with Government Code Section 12990 (a-f) and California Code of
Regulations, Title 2, Division 4, Chapter 5 in matters relating to reporting requirements and the development, implementation and maintenance of a Nondiscrimination Program. Prospective contractor agrees not to unlawfully discriminate, harass or allow harassment against any employee or applicant for employment because of sex, race, color, ancestry, religious creed, national origin, physical disability
(including HIV and AIDS), medical condition (cancer), age (over 40), marital status, denial of family care leave and denial of pregnancy disability leave.
CERTIFICATION
I, the official named below, hereby swear that I am duly authorized to legally bind the prospective contractor to the above described certification. I am fully aware that this certification, executed on the date and in the county below, is made under penalty of perjury under the laws of the State of California.
OFFICIAL'S NAME
DATE EXECUTED EXECUTED IN THE COUNTY OF
PROSPECTIVE CONTRACTOR'S SIGNATURE
PROSPECTIVE CONTRACTOR'S TITLE
PROSPECTIVE CONTRACTOR'S LEGAL BUSINESS NAME
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