24HS0010_-_Darfur.pdf
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- Solicitation number
- 0000034476
- Issued by
- Shasta County, California
About this file
This is a Darfur Contracting Act Certification form (DGS PD 1) from the State of California Department of General Services. The form implements Public Contract Code Sections 10475-10481, which requires companies that have had business activities or operations outside the United States within the previous three years to certify their status when bidding on or submitting proposals for State of California contracts.
The form provides two certification options: Option #1 allows companies to certify under penalty of perjury that they are not a scrutinized company as defined in Public Contract Code 10476, while Option #2 is for scrutinized companies that have obtained special written permission from the Department of General Services (DGS) to bid or submit proposals pursuant to Public Contract Code section 10477(b). Companies that have not conducted business outside the US in the previous three years are exempt from completing the form. Both options require the company's name, Federal ID Number, authorized signature, printed name and title of signer, and date.
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Text version
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.
If your company has not, within the previous three years, had any business activities or other operations outside of the United States, you do not need to complete this form.
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) Federal ID Number
By (Authorized Signature)
Printed Name and Title of Person Signing
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.
STATE OF CALIFORNIA
DARFUR CONTRACTING ACT CERTIFICATION
DGS PD 1 (Rev. 12/19)
Date
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) Federal ID Number
By (Authorized Signature)
Printed Name and Title of Person Signing
Date
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