25520001_-_CALIFORNIA_CIVIL_RIGHTS_LAWS_CERTIFICATION.pdf
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- Attached to
- 25520001 - Third Party Adjusting Services
- Solicitation number
- 0000036506
- Issued by
- California
About this file
This document is a California Department of General Services (DGS) Civil Rights Laws Certification form required for state contracts valued at $100,000 or above. The certification, which applies to contracts executed or renewed after January 1, 2017, mandates that contractors affirm compliance with the Unruh Civil Rights Act and the Fair Employment and Housing Act.
The form requires contractors to certify that they do not have internal policies discriminating against sovereign nations or peoples recognized by the United States government, and that any such policies would not violate civil rights laws. Contractors must sign the document under penalty of perjury, providing their firm name, federal ID number, authorized signature, printed name and title, county and state of execution, and date of execution. This certification is a mandatory requirement for bidding on or renewing state contracts meeting the specified monetary threshold.
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Text version
DEPARTMENT OF GENERAL SERVICES
OFFICE OF LEGAL SERVICES
STATE OF CALIFORNIA
CALIFORNIA CIVIL RIGHTS LAWS CERTIFICATION
DGS OLS 04 (Rev. 01/17)
Pursuant to Public Contract Code section 2010, a person that submits a bid or proposal to, or otherwise proposes to enter into or renew a contract with, a state agency with respect to any contract in the amount of $100,000 or above shall certify, under penalty of perjury, at the time the bid or proposal is submitted or the contract is renewed, all of the following:
1. CALIFORNIA CIVIL RIGHTS LAWS: For contracts executed or renewed after January 1, 2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of theCivil Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code); and
2. EMPLOYER DISCRIMINATORY POLICIES: For contracts executed or renewed after January 1, 2017, if a Contractor has an internal policy against a sovereign nation or peoples recognized by the United States government, the Contractor certifies that such policies arenot used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing Act (Section 12960 of the Government Code).
CERTIFICATION
I, the official named below, certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
By (Authorized Signature)
Printed Name and Title of Person Signing
Executed in the County of Executed in the State of
Date Executed
Proposer/Bidder Firm Name (Printed) Federal ID Number
| ProposerBidder Firm Name Printed: |
| Federal ID Number: |
| Printed Name and Title of Person Signing: |
| Executed in the County of: |
| Executed in the State of: |
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