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This document is a California Department of General Services (DGS) Civil Rights Laws Certification form for state contracts. The form is required for any bid or proposal involving a state agency contract valued at $100,000 or above, and is specifically applicable to contracts executed or renewed after January 1, 2017. The certification mandates that contractors affirm compliance with two key civil rights laws: the Unruh Civil Rights Act and the Fair Employment and Housing Act.

The certification requires bidders to declare 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 statutes. The form is part of a standard procurement process, identified by solicitation number 25BS0010, and must be signed under penalty of perjury by an authorized representative of the bidding firm, who must provide their firm name, federal ID number, signature, printed name and title, and execution details including county and state.

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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

Solicitation: 25BS0010

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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