25BS0010_-_Bidders_Checklist.pdf
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- Solicitation number
- 0000037000
- Issued by
- Inyo County, Kern County, Los Angeles County, Orange County, Riverside County, San Bernardino County, Orange Cove City, Inyokern CDP, Kernville CDP, East Los Angeles CDP, Lake Los Angeles CDP, Los Angeles City, Orange City, Lake Riverside CDP, Riverside City, Orangevale CDP, San Bernardino City, Orange Blossom CDP, California
About this file
This document is a Bidder's Checklist from the California Department of Veterans Affairs for Solicitation Number 25BS0010, seeking Temporary/Relief Skilled Nursing Facility (SNF) Administrator Services. The checklist outlines the comprehensive documentation required from potential bidders, including various certifications, declarations, and supporting materials such as a bid rate sheet, payee data record, business licenses, and proof of required training and certifications.
The checklist emphasizes strict compliance with submission requirements, noting that all documents must have a consistent company name matching the Payee Data Record (STD 204). Bidders must complete and submit multiple forms including Bidder Certification, Disabled Veteran Business Enterprise (DVBE) Declarations, Darfur Contracting Act compliance, and California Civil Rights Laws documentation. Additional requirements include a valid California business license or equivalent documentation proving good standing, a sample invoice, and verification of all necessary professional credentials.
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State of California Solicitation Number: 25BS0010 Department of Veterans Affairs
BIDDER’S CHECKLIST
Temporary/Relief Skilled Nursing Facility (SNF) Administrator Services
The checklist below is a summary of documents to be submitted based on the requirements in the Invitation for Bid.
This checklist should be returned with your bid. Place a check mark or “X” next to each document being submitted.
Signatures are required on the documents where specified.
The company name listed on all documents submitted (ex., licenses, permits, certifications, and insurance) must be identical to the company name on the Payee Data Record (STD 204). Failure to submit these documents in the manner prescribed may delay the award of Agreements.
Bidder’s Checklist
Bidder Certification
Bid Rate Sheet
Signed Payee Data Record - STD 204 (and STD 205, if applicable)
Bidder Declaration - GSPD-05-105
Commercially Useful Function (CUF) Certification, if applicable
Disabled Veteran Business Enterprise (DVBE) Declarations – DGS PD 843, if applicable
Darfur Contracting Act
California Civil Rights Laws
Contractor Certification Clauses (CCC-4/2017) - The CCC-4/2017 can be found on the Internet at https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List- Folder/Standard-Contract-Language
Valid California city or county business license; or, if a corporation located within the State of California, incorporation documents or letter from the Secretary of State; or, if not a California business, an affidavit that business is in good standing with the State, Province, or Country in which business is headquartered.
Sample Invoice
Proof of required training, licenses, permits, and certifications https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language
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