24BS0032_-_STD_1000_GENAI_Reporting_and_Factsheet.pdf
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- Solicitation number
- 0000033726
About this file
This is a Generative Artificial Intelligence (GenAI) Reporting and Factsheet form (STD 1000) from the California Department of General Services Procurement Division, associated with solicitation/contract number 24BS0032. The form requires bidders, offerors, and contractors to disclose whether they will use or offer GenAI technology, models, services, or systems in the performance of state contracts. The form consists of two main sections: bidder/contractor information and a detailed disclosure section requiring information about the GenAI system including model names, versions, parameters, product descriptions, use cases, and intended information domains.
The form requires contractors to explain how their GenAI system avoids adverse impacts on decisions affecting housing, education, employment, credit, healthcare, and criminal justice. Contractors must sign the form certifying their disclosure and agree to submit updated forms if new GenAI use is identified during contract performance. The document includes detailed instructions for completing each section of the form, with clear definitions and purposes for each required element.
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STATE OF CALIFORNIA DEPARTMENT OF GENERAL SERVICES
GENAI REPORTING AND FACTSHEET PROCUREMENT DIVISION
STD 1000 (REV. 07/2024)
Generative Artificial Intelligence (GenAI) Reporting and Factsheet
Section 1: Bidder / Offeror / Contractor Information
Solicitation / Contract Number Bidder ID / Vendor ID (optional)
Business Name Business Telephone Number
Business Address City State Zip Code
Contract / Description of Purchase
Section 2: Disclosure and Factsheet
Will you and/or your subcontractor(s) be using or offering GenAI technology, model, service, or system (collectively, “product”)? Yes No (If no, skip to Signature section of this form.)
If yes, provide details regarding the GenAI system. See GenAI Reporting and Factsheet Instructions at the end of this form for more information.
Failure to provide information requested on this form may result in disqualification or may void any resulting contract.
1. GenAI Model Name, LLM Version (including number of parameters) & list ALL model names/owners for the solution or offering
STD 1000 (REV. 07/2024)
2. (GenAI powered, or driven), applications / product owner
3. Product Description
4. Use Case(s)
5. Intended Information Domain
6. Explain how the GenAI system is not adversely affecting decisions that materially impact access to, or approval for, housing or accommodations, education, employment, credit, health care, and criminal justice.
Signature
By signing this document, I have identified and reported any GenAI use in the performance of this contract. If any new or previously unreported GenAI use is identified in the future in the performance of this contract, we will complete and submit to the State an updated STD 1000.
Signature Date
Submit completed form to the awarding department
STD 1000 (REV. 07/2024)
GenAI Reporting and Factsheet Instructions
Please use the following definitions and instructions to complete the GenAI Reporting and Factsheet:
1. GenAI Model Name, LLM Version (including number of parameters) & list ALL model names/owners for the solution or offering
a. Definition: The unique identifier or name assigned to the specific GenAI model or service.
b. Purpose: Allows users to refer to and distinguish between different GenAI models.
2. (GenAI powered, or driven), applications/product owner:
a. Definition: The name of the organization or entity responsible for creating or deploying the GenAI model or service.
b. Purpose: Helps identify the source and accountability for the GenAI system.
3. Product Description:
a. Definition: A concise summary of the GenAI model’s purpose, functionality, and key characteristics.
b. Purpose: Provides a high-level understanding for users and stakeholders.
4. Use Case(s):
a. Definition: The intended use or goal of the GenAI model (e.g., image recognition, natural language processing, text summarization).
b. Purpose: Helps users assess whether the GenAI model aligns with their needs.
5. Intended Information Domain:
a. Definition: The context, subject matter, or domain for which the GenAI model is designed to operate effectively.
b. Purpose: Helps users determine if the GenAI model is suitable for their specific use case.
6. Adverse Impact:
a. Explain below how you are ensuring the GenAI system is not adversely affecting decisions that materially impact access to, or approval for, housing or accommodations, education, employment, credit, health care, and criminal justice.
7. Signature:
a. The signatory for the Contract shall also sign the STD 1000
| Solicitation Contract: 24BS0032 |
| Number Bidder ID Vendor ID optional: |
| Business Name: |
| Business Telephone Number: |
| Business Address: |
| City: |
| State: |
| Zip Code: |
| Yes: Off |
| No If no skip to Signature section of this form: Off |
| 1 GenAI Model Name LLM Version including number of parameters list ALL model namesowners for the solution or offering: |
| 2 GenAI powered or driven applications product owner: |
| 3 Product Description: |
| 4 Use Cases: |
| 5 Intended Information Domain: |
| 6 Explain how the GenAI system is not adversely affecting decisions that materially impact access to or approval for housing or accommodations education employment credit health care and criminal justice: |
| Date: |
| Contract / Description of Purchase: |
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