25CRY017_-_CA_Civil_Rights_Declaration.pdf

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Attached to
25CRY017 - Non-Emergency Medical Transportation Services
Solicitation number
0000037187
Issued by
Colusa County, Contra Costa County, Lake County, Marin County, Napa County, Solano County, Sonoma County, Yolo County, Colusa City, Contra Costa Centre CDP, Auburn Lake Trails CDP, South Lake Tahoe City, Shaver Lake CDP, Blue Lake City, China Lake Acres CDP, Lake Isabella CDP, Lake of the Woods CDP, Lakeside CDP, Hidden Valley Lake CDP, Lakeport City, Lower Lake CDP, North Lakeport CDP, Upper Lake CDP, Elizabeth Lake CDP, Lake Hughes CDP, Lake Los Angeles CDP, Lakewood City, Marina Del Rey CDP, San Marino City, Bass Lake CDP, Yosemite Lakes CDP, Lucas Valley-Marinwood CDP, Marin City CDP, Lake Don Pedro CDP, Lake City CDP, Crowley Lake CDP, June Lake CDP, Mammoth Lakes Town, Twin Lakes CDP, Virginia Lakes CDP, Marina City, Napa City, Lake of the Pines CDP, Lake Wildwood CDP, Lake Forest City, Bucks Lake CDP, Lake Almanor Country Club CDP, Lake Almanor Peninsula CDP, Lake Almanor West CDP, Lake Davis CDP, Canyon Lake City, Lake Elsinore City, Lakeland Village CDP, Lake Mathews CDP, Lake Riverside CDP, Lakeview CDP, Big Bear Lake City, Lake Arrowhead CDP, Silver Lakes CDP, Spring Valley Lake CDP, Lake San Marcos CDP, Lake Nacimiento CDP, Emerald Lake Hills CDP, Lakehead CDP, Shasta Lake City, Lake Shastina CDP, Sonoma City, Sonoma State University CDP, Lake California CDP, Phoenix Lake CDP, Pine Mountain Lake CDP, Lake Sherwood CDP, Yolo CDP, Plumas Lake CDP, California

About this file

This document is a California Civil Rights Laws Certification form issued by the State of California Department of General Services, Office of Legal Services for solicitation 25CRY017. The certification applies to any person or entity submitting a bid or proposal to enter into or renew a state contract valued at $100,000 or above. Bidders and proposers are required to certify compliance with two key civil rights statutes: the Unruh Civil Rights Act (Section 51 of the Civil Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code). For contracts executed or renewed after January 1, 2017, contractors must also certify that any internal policies against sovereign nations or peoples recognized by the United States government are not applied in violation of these civil rights laws. The certification must be executed under penalty of perjury by an authorized representative of the proposing firm.

The document requires completion of specific fields including the proposer/bidder firm name, Federal ID Number, authorized signature, printed name and title of the signing official, county and state of execution, and date executed. This certification form serves as a mandatory compliance requirement for state contract participation and must accompany bid and proposal submissions for qualifying contract opportunities. No specific pricing, funding amounts, or contract performance terms are addressed in this certification document, as it functions solely as a legal compliance attestation form.

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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: 25CRY017

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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