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This file is a Darfur Contracting Act Certification form required by the State of California for vendors bidding on state contracts. The form applies to companies that have conducted business activities or operations outside the United States within the previous three years and wish to submit proposals for California state contracts, specifically for solicitation 25FS0030 regarding Commercial Laundry Equipment Maintenance and Repair Services at the Veterans Home of California at Fresno. The certification requires eligible vendors to either declare they are not a scrutinized company under Public Contract Code Section 10476, or to provide written permission from the Department of General Services if they are classified as a scrutinized company.

The form presents two compliance pathways for prospective bidders. Option 1 requires authorized company officials to certify under penalty of perjury that the prospective proposer is not a scrutinized company and that the signatory is duly authorized to bind the company. Option 2 permits scrutinized companies that have obtained written permission from the Department of General Services on a case-by-case basis to submit bids or proposals if such action is determined to be in the best interests of the state. Both options require the vendor to provide company name, Federal ID Number, authorized signature, and the name and title of the signing official. Vendors must complete and submit the appropriate certification with their bid or proposal to be considered eligible.

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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

Solicitation: 25FS0030

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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