26-76002-001_SFQ_SB_ONLY_Addendum__1.pdf

Department of State Hospitals RFQ Number: 26-76002-001, Addendum #1 Contractor: TBD

REQUEST FOR QUOTE (RFQ)

Notice to Prospective Proposers

RFQ Number: 26-76002-001 “Translation and Interpretation Services”

**Limited to DGS-certified Small Business**

April 1, 2026

You are invited to review and respond to this Department of State Hospitals (DSH) solicitation. In accordance with Government Code section 14838, the DSH is seeking quotes only from DGS-certified Small Business Enterprises to perform translation and interpretation services.

In submitting a quote, proposer agrees that they have read, understood, and will comply with the instructions found herein. Failure to comply with any of the requirements may result in rejection of a quote. By submitting a response, proposer agrees to the terms and conditions stated in this solicitation and any resulting agreement.

All agreements entered into with the State of California will include by reference the state’s General Terms and Conditions and Contractor Certification Clauses that may be view and downloaded at:

https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List- Folder/Standard-Contract-Language.

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia and Russian entities and individuals. “Economic Sanctions” refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine, as well as any sanctions imposed under state law. By submitting a bid or proposal, Contractor represents that it is not a target of Economic Sanctions. Should the State determine Contractor is a target of Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or entities, that shall be grounds for rejection of the Contractor’s bid any time prior to contract execution, or, if determined after contract execution, shall be grounds for termination by the State.

Revision 6-1-2021

TABLE OF CONTENTS

RFQ NUMBER: 26-76002-001

I. DESCRIPTION OF SERVICES

A. Description of Services/Background:

B. Agreement Term and Security Provisions:

II. MINIMUM QUALIFICATIONS (MQ)

A. Proof of Legal Right To Do Business:

B. References:

C. Agreement to Sign:

III. QUOTE REQUIREMENTS AND INFORMATION

A. Key Action Dates:

B. Proposer’s Questions:

C. Submission of Quotes:

IV. QUOTE EVALUATION AND AWARD

A. Responsiveness and Responsibility Determination:

B. False Statements Disclaimer:

C. Intention to Award:

D. Tie Breaker:

E. Letter of Award:

F. Disposition of Quotes:

G. Tax Delinquency Disclaimer:

V. REQUIRED ATTACHMENTS

A. Listing of Attachments:

ATTACHMENT 1 – QUOTE SUBMISSION CHECKLIST

ATTACHMENT 2 – PROPOSERS CERTIFICATION

ATTACHMENT 3 – MINIMUM QUALIFICATION RESPONSE

ATTACHMENT 4 – PROPOSERS REFERENCES

ATTACHMENT 5 – PROPOSERS RATE SHEET

ATTACHMENT 6 – INSURANCE CERTIFICATION

ATTACHMENT 7 – DARFUR CONTRACTING ACT CERTIFICATION

ATTACHMENT 8 – PROPOSER DECLARATION FORM (GSPD-05-105)

ATTACHMENT 9 – GENERATIVE ARTIFICIAL INTELLIGENCE (GENAI)

REPORTING & FACTSHEET (STD 1000)

ATTACHMENT 10 – CONTRACTOR CERTIFICATION CLAUSES (ccc 04/2017)

ATTACHMENT 11 – PAYEE DATA RECORD (STD. 204)

ATTACHMENT 12 – DVBE DECLARATION FORM (STD. 843)

ATTACHMENT 13 – CALIFORNIA CIVIL RIGHTS LAW CERTIFICATION

ATTACHMENT 14 – SAMPLE AGREEMENT

I. DESCRIPTION OF SERVICES

A. Description of Services/Background:

1. The Department of State Hospitals (DSH) manages the nation’s largest inpatient forensic mental health hospital system. Its mission is to provide evaluation and treatment in a safe and responsible manner, seeking innovation and excellence in state hospital operations, across a continuum of care and settings. DSH is responsible for the daily care and provision of mental health treatment of its patients. DSH oversees five state hospitals located at Atascadero, Coalinga, Metropolitan – Los Angeles, Napa and Patton. In Fiscal Year (FY) 2016-17, DSH served 13,403 patients with an average daily census of 7,087.

The DSH is required to maintain legally prescribed staffing ratios to meet licensing and certification requirements for the healthcare services and treatment of forensic patients throughout the State. In the provision of these healthcare services, the DSH employs nearly 11,000 personnel including clinical staff. Medical treatment is provided by both on-site hospital staff and when necessary by outside medical providers under various health care contracts. An average of 55,000 invoices for these contracts are processed annually by the DSH which result in approximately $30 million spent on outside medical claims annually.

2. The Service is needed to provide translation services/interpreter for our DSH forensic evaluators conducting sexually violent predator (SVP), Offender with Mental Disorders (OMD), and Incompetent to Stand Trial (IST) interviews with clients with limited English Proficiency (LEP). Also, services need to be available 365 days per year, 7 days per week, 24 hours pr day on an “as-needed basis.”

3. Please carefully review and consider the minimum qualifications, and the detailed

Scope of Work located in Attachment 13, Sample Agreement, Exhibit A, Scope of Work, in order to complete your bid.

B. Agreement Term and Security Provisions:

1. The term of any agreement resulting from this RFQ is anticipated to be July 1, 2026, through June 30, 2028. Any agreement resulting from this RFQ shall have no force or effect until it is signed by both parties and approved by the Department of General Services (DGS), if such approval is required. Performance shall start no later than on the expressed date set by the awarding agency and after all approvals have been obtained and the agreement is fully executed.

2. Should the Contractor fail to commence work at the agreed upon time, the DSH reserves the right to terminate the agreement upon five (5) days written notice to the Contractor.

3. Generative Artificial Intelligence (GenAI):

i. The State of California seeks to realize the potential benefits of GenAI, through the development and deployment of GenAI tools, while balancing the risks of these new technologies.

ii. Proposer/Offeror/Contractor must notify the State in writing if their solution or service includes, or makes available, any GenAI including, GenAI from third parties or subcontractors.

iii. The State has developed a GenAI Reporting and Factsheet (STD 1000) to be completed by the Proposer/Offeror/Contractor.

iv. Failure to submit the GenAI Reporting and Factsheet (STD 1000) will result in disqualification of the Proposer/Offeror/Contractor.

v. Failure to report GenAI to the State may void any resulting contract. The State reserves its right to seek any and all relief to which it may be entitled to as a result of such non-disclosure.

vi. Upon receipt of a Proposer/Offeror/Contractor GenAI Reporting and Factsheet (STD 1000), the state reserves the right to incorporate GenAI Special Provisions into the final contract or reject bids/offers that present an unacceptable level of risk to the State.

II. MINIMUM QUALIFICATIONS (MQ)

A. Proof of Legal Right To Do Business:

Proposers must submit proof of their legal right to do business in the State of California:

1. Proposers must submit a copy of their license to do business in the State of California, where applicable.

2. Proposers must certify that they are and will continue to meet all terms and conditions for operating a business in the city/county in which the business is headquartered.

3. Proposers which are corporations, regardless of where they are incorporated, shall submit a print-out from the California Secretary of State website (http://businesssearch.sos.ca.gov) which shows that their corporation is registered and is currently in good standing.

B. References:

Proposer must submit applicable references:

1. Proposer must provide a list of three (3) references/ three (3) letters of reference from customers for whom the proposer has provided services of the same nature and type as those outlined in this solicitation. References submitted must be for services provided in the past two (2) years (from the date of this solicitation). At least one reference must be from a governmental entity, and if the proposer has provided services to the DSH during this timeframe, one of the references must be from a DSH contract manager. Each reference must be able to address each of the following:

i. The proposer’s responsiveness to requests for service

ii. The proposer’s ability to provide services as compared to his or her agreed upon contract

iii. The customer’s overall assessment of the proposer’s performance

The list of references shall include the following:

i. Company

ii. Name and title

iii. Address

iv. Phone number

The DSH reserves the right to utilize these references in determining whether a proposer is responsible.

C. Agreement to Sign:

1. The proposer shall certify that, if awarded an agreement, they shall sign and return two (2) originals of the Standard Agreement signature pages (Std. 213), to be received by the DSH no later than seven (7) calendar days from the date that DSH e-mails the agreement to the email address provided by proposer on the Minimum Qualifications Response Form (Attachment 3). This requirement shall be ten (10) calendar days if the DSH elects to mail the agreement. The DSH reserves the right, at its sole discretion, to require documentation to be submitted in addition to the Std.

213. If the DSH exercises that right, the contractor must submit all required documentation within the timeframes noted here.

2. The DSH reserves the right, at its sole discretion, to cancel a proposed award to a proposer who does not submit the required documentation described herein. Should the DSH cancel a proposed award for this reason, the DSH reserves the right, at its sole discretion, to award the contract to the next lowest, responsive and responsible proposer.

III. QUOTE REQUIREMENTS AND INFORMATION

A. Key Action Dates:

Event Date Time RFQ available to prospective proposers March 27, 2026 1:30 p.m.

Deadline for Submission of Questions April 2, 2026 5:00 p.m.

Deadline for Response to Questions April 9, 2026 4:00 p.m.

Final Date for Quote Submission April 13, 2026 5:00 p.m.

Opening Quote April 14, 2026 10:00 a.m.

Anticipated Start Date July 1, 2026 8:00 a.m.

B. Proposer’s Questions:

1. Proposers should notify DSH immediately through the departmental contact person listed below if they need clarification about the services being sought or have questions about the RFQ instructions or requirements. The level of detail that shall be provided, in response, is subject to the availability of the DSH resources. A copy of all questions asked and the DSH responses, if any, shall be provided to all Proposers at the close of the Question and Answer period.

Departmental Contact:

Renetta Buckner

Department of State Hospitals 1215 O Street, MS-1

Sacramento, CA 95814 Email: Renettabuckner@dsh.ca.gov renetta.buckner@dsh.ca.gov

Phone: (916) 909-1482

2. Verbal comments regarding this RFQ are unofficial and are not binding on the DSH unless later confirmed in writing as an official addendum.

3. Proposers that fail to report a known or suspected problem with the RFQ or fail to seek clarification and/or correction of the RFQ, submit a quote at their own risk.

C. Submission of Quotes:

1. Quotes may be received by any of the methods checked below:

E-Mail: Fax: Delivered (Mail, Hand, or Overnight):

2. All submissions must be sent to the contact person listed above.

3. Signature Requirements:

i. All documents requiring a signature must be signed by a person authorized to bind the proposer contractually. Unsigned forms may be cause for rejection.

ii. When signing the Proposer Certification Sheet, the signatory must indicate the title or position that they hold in the firm.

4. General Contents:

i. All quotes shall include all of the documents identified in Section VI, Required Attachments, Attachment 1, Quote Submission Checklist.

ii. Quotes should provide straightforward and concise descriptions of the proposer's ability to satisfy the requirements of this RFQ. The quote must be complete and accurate. Omissions, inaccuracies or misstatements will be sufficient cause for rejection of a quote.

iii. Quotes must be submitted for the performance of all the services described herein. Any deviation from the work specifications will not be considered and shall cause a quote to be rejected.

iv. A quote shall be rejected if it is conditional or incomplete, or if it contains any alterations of form or other irregularities of any kind. The state may reject any or all quotes and may waive an immaterial deviation in a quote. The state’s waiver of an immaterial defect shall in no way modify the RFQ document or excuse the proposer from full compliance with all requirements if awarded the agreement.

v. Before submitting a response to this solicitation, proposers should review, correct all errors, and confirm compliance with the RFQ requirements.

vi. Where applicable, proposers must carefully examine work sites and specifications. Proposers shall investigate conditions, character, and quality of surface or subsurface materials or obstacles that might be encountered. No additions or increases to the agreement amount will be made due to a lack of careful examination of work sites and specifications.

5. General Considerations:

i. No oral understanding or agreement shall be binding on either party.

ii. Costs for developing quotes and anticipation of award of the agreement are entirely the responsibilities of the proposer and shall not be charged to the State of California.

6. Withdrawing and Resubmitting:

i. A proposer may modify a quote, after its submission, by withdrawing their original quote package and resubmitting a new quote package prior to the quote submission deadline. Proposer’s modifications offered in any other manner, oral or written, will not be considered.

ii. A proposer may withdraw their quote by submitting a written withdrawal request to the DSH – Contracts Office, signed by the proposer or an authorized agent. A proposer may thereafter submit a new quote package prior to the quote submission deadline. Quotes may not be withdrawn without cause, subsequent to the quote submission deadline. The DSH Contracts Office is located at:

Department of State Hospitals – Sacramento Contracts Office

1215 O Street, MS-1 Sacramento, CA 95814

7. Modification and Rejections:

i. The DSH may modify the RFQ, prior to the solicitation due date and time, by the issuance of an addendum to all parties who received a solicitation package.

ii. The DSH reserves the right to reject all quotes. The DSH is not required to award an agreement.

iii. The DSH does not accept alternate contract language from a prospective contractor, unless offered through the Question and Answer period. A quote with alternate contract language will be considered a counter proposal and will be rejected. The State’s General Terms and Conditions (GTC) are not negotiable. Proposers are hereby advised that proposals of alternate contract language or attempts to negotiate the state’s Terms and Conditions after the selection of a proposed awardee shall be considered a counter proposal for the purposes of this solicitation. In such a situation, the DSH shall notify the proposed awardee that they must accept the state’s language and terms as offered or be disqualified from being awarded a contract. Should a contractor fail to accept the language and terms offered, the DSH shall disqualify that vendor and award the contract to the next lowest proposer and issue a revised Letter of Intent if applicable.

IV. QUOTE EVALUATION AND AWARD

A. Responsiveness and Responsibility Determination:

1. After the due date and time, each quote will be opened and the DSH will evaluate each quote to determine its responsiveness and each proposer’s responsibility to the published requirements of this RFQ.

2. A responsive proposer is one who submits a quote that meets all of the submission requirements and minimum qualification requirements stated in the RFQ. A responsible proposer is one that is trustworthy and possesses the necessary quality, fitness and capacity to satisfactorily perform the proposed work. Proposers who are determined to not be responsible or who submit non-responsive quotes shall have their quotes rejected.

3. Responsive quotes shall be considered evidence of the proposer’s responsibility.

The DSH reserves the right to reevaluate a proposer’s responsibility prior to award and is in no way limited to submitted quote packages in making a determination as to a proposer’s responsibility. In determining whether a proposer is responsible, the DSH may require proposers to submit evidence of their qualifications at such times, and under such conditions, as it may require.

B. False Statements Disclaimer:

4. Quotes that contain false or misleading statements, or which provide references which do not support an attribute or condition claimed by the proposer, may be rejected.

C. Intention to Award:

The DSH intends, if an award is made, to award to the lowest responsive responsible.

D. Tie Breaker:

1. Should two or more proposers submit quotes resulting in a tie, DSH shall determine the proposed awardee via a coin toss witnessed by two DSH admin staff.

i. In accordance with Government Code section 14838, subdivision (f), in the event of a precise tie between a small business or microbusiness, and a disabled veteran-owned small business or microbusiness, the agreement shall be awarded to the disabled veteran-owned small business or microbusiness.

ii. In all other circumstances, a coin toss witnessed by two DSH admin staff shall determine the proposed awardee.

E. Letter of Award:

5. Whenever an agreement is awarded under a procedure which provides for competitive bidding, but the agreement is not to be awarded to the low proposer, the low proposer shall be notified by telegram, electronic facsimile transmission, overnight courier, electronic mail, or personal delivery five (5) working days prior to the award of the agreement.

6. Upon written request by any proposer, notice of the proposed award shall be posted in a public place in the office of the awarding agency at least five (5) working days prior to awarding the agreement.

F. Disposition of Quotes:

7. Upon quote opening, all documents submitted in response to this RFQ will become the property of the State of California, and will be regarded as public records under the California Public Records Act (Government Code section 6250, et seq.) and subject to review by the public. Should a proposer desire to keep any or all components of their response to this RFQ confidential, the proposer would need to obtain a protective order from a court of competent jurisdiction.

G. Tax Delinquency Disclaimer:

8. Pursuant to the Public Contract Code section 10295.4, persons or companies identified as the largest tax delinquents by the Franchise Tax Board (FTB) or the California Department of Tax and Fee Administration (CDTFA) are ineligible to enter into any agreement with the state for non-IT goods or services. Any agreement entered into in violation of section 10295.4 is void and unenforceable.

Prior to executing any state agreement or renewal for non-IT goods or services, the DSH shall verify that the proposed awardee(s) is not on a prohibited list by checking both the FTB and CDTFA websites. The established lists can be found at:

i. FTB: https://www.ftb.ca.gov/aboutFTB/Delinquent_Taxpayers.shtml

ii. CDTFA: https://www.cdtfa.ca.gov/taxes-and-fees/top500.htm

V. REQUIRED ATTACHMENTS

A. Listing of Attachments:

Refer to the following list for additional attachments that are a required part of this solicitation.

Attachment 1 Bid Submission Checklist Attachment 2 Proposer’s Certification Attachment 3 Minimum Qualifications Response Attachment 4 Proposer’s References Attachment 5 Proposer’s Rate Sheet(s) Attachment 6 Insurance Certifications Attachment 7 Darfur Contracting Act Certification (Only if applicable) Attachment 8 Proposer Declaration Form (GSPD-05-105)

Attachment 9 Generative Artificial Intelligence (GenAI) (STD 1000) Attachment 10 Contractor Certification Clauses (CCC 04/2017) Attachment 11 Payee Data Record (Std. 204) Attachment 12 DVBE Declarations Form (Std. 843) Attachment 13 California Civil Rights Law Certification Attachment 14 Sample Standard Agreement (Std. 213 and Exhibits)

Note: Attachment 14 is included for reference only. Only the successful proposer will submit these documents, when requested by DSH.

ATTACHMENT 1 – QUOTE SUBMISSION CHECKLIST

Complete this checklist to confirm the items in your quote. For your quote to be considered responsive, Attachments 1 through 13 in this checklist must be submitted by the Quote Submittal Deadline indicated in this RFQ. Include this checklist with your quote package.

Contractor Name:

Attachment Name of Attachment

______ Attachment 1 Quote Submission Checklist

______ Attachment 2 Proposer’s Certification

______ Attachment 3 Minimum Qualifications Response

______ Attachment 4 Proposer’s References

______ Attachment 5 Proposer’s Rate Sheet(s)

______ Attachment 6 Insurance Certifications

______ Attachment 7 Darfur Contracting Act Certification https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/PD_1.pdf

______ Attachment 8 Proposer Declaration Form (GSPD 05-105) https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf

Attachment 9

Attachment 10

Generative Artificial Intelligence (GenAI) (STD 1000) STD 1000 Generative Artificial Intelligence (GenAI) Reporting & Factsheet (ca.gov)

Contractor Certification Clauses (CCC-4/2017) https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of- Legal-Services-Resources-List-Folder/Standard-Contract-Language

______ Attachment 11 Payee Data Record (Std. 204) https://www.documents.dgs.ca.gov/dgs/FMC/PDF/Std204.pdf

______ Attachment 12 DVBE Declarations Form (Std. 843) https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/pd_843.pdf

______ Attachment 13 California Civil Right Certification OLS004.pdf (ca.gov)

ATTACHMENT 2 – PROPOSERS CERTIFICATION

The signature affixed hereon and dated certifies compliance with all the requirements of this quote document. The signature below authorizes the verification of this certification.

By signing below, the proposer represents and warrants that statements and representations contained in the documents and data submitted in connection with this quote are true and correct and that they meet the Minimum Qualifications as stated above. In the event the proposer’s submittal in connection with this quote contains false statements or misrepresentations of fact, the quote may be rejected or any succeeding contract terminated for cause and the proposer deemed to be a non-responsible proposer which may adversely affect future quotes submitted by the proposer. In addition, any misrepresentation of fact or fraud in connection with an attempt to secure a state contract, could result in legal action being taken against the proposer.

An Unsigned Proposer’s Certification May Be Cause for Rejection

Company Name Telephone Number Fax Number

Address Email

Name Title

Original Signature Date

California Certified Small Business or Disabled Veteran Business Enterprise Number

California Certified Disabled Veteran Business Enterprise Number:

California Certified Small Business Number:

ATTACHMENT 3 – MINIMUM QUALIFICATION RESPONSE

Proposer’s Name: _______________________________________________________________

Minimum Qualification Proposer's Response

Proposer must submit a copy of their license to do business in the State of California including any proof of “Doing Business As (DBA)” documentation, as applicable.

Business License(s) Included?

Yes No N/A

Proposers must certify that they are and will continue to meet all terms and conditions for operating a business in the city/county in which the business is headquartered.

Do you so certify?

Yes No

Proposers which are corporations shall submit a printout from the California Secretary of State website which shows that their corporation is currently in good standing.

Printout included?

Yes No

If a proposer is using any name other than his or her own, a Fictitious Name Permit (FNP) must be on file with the California Department of Consumer Affairs.

Fictitious Name Permit included?

Yes No

The proposer certifies that they understand the insurance requirements and, if awarded an agreement, shall sign and return the originals of the Standard Agreement signature pages (Std. 213) and any required insurance documents as directed.

Email: _____________________________________________________________

Do you so certify?

Yes No

I, the undersigned, declare that the certifications required above are true and that I am authorized to make such certifications and bind the proposer contractually

Signature of Declarer Print First and Last Name Date Signed

ATTACHMENT 4 – PROPOSERS REFERENCES

References Name of Company

Address

Contact Name Telephone Email Address

Name of Company

Address

Contact Name Telephone Email Address

Name of Company

Address

Contact Name Telephone Email Address

ATTACHMENT 5 – PROPOSERS RATE SHEET

Important Considerations:

1. The proposer shall set forth the bid rates in clear, legible figures in the space provided.

2. By submitting a bid, the proposer agrees that his or her final bid constitutes an irrevocable offer which shall be valid for 180 calendar days from the bid submission date.

3. DSH does not expressly or by implication agree that the actual amount of work will correspond therewith and reserves the right to omit portions of the work as may be deemed necessary or advisable by DSH. The estimates listed below are a good faith estimate and are not a guarantee of business and is subject to change depending on fluctuation in patient population. The amounts indicated below will be used solely for comparison of quotes. DSH makes no guarantee, expressed or implied for actual number of hours to be used. However, the actual rates quoted by the proposer shall be binding for the term of the agreement.

4. Proposer’s Rate Structure:

Proposer shall place their quote amount for language(s) listed below.

Language Rate Per Minute

Spanish to English

All other languages

ATTACHMENT 6 – INSURANCE CERTIFICATION

This form reminds Proposers of the insurance requirements that may be imposed by this solicitation and provides samples of some of the forms that they may be required to produce prior to being awarded an agreement.

Initial Certification

Proposer acknowledges that they have reviewed and understand the insurance requirements for this solicitation as described in Attachment 13, Sample Agreement, Exhibit G, Insurance Requirements.

Proposer acknowledges that they have reviewed and understand the sample insurance forms provided with this attachment.

Proposer certifies that, if awarded an agreement, the Proposer shall provide the DSH with all required insurance documents as may be applicable, in a timely manner. This includes, but may not be limited to:

Certificates of insurance showing the Proposer’s insurance coverage types and limitations, Proof that the Proposer has insured the State of California, its officers, employees, and agents. Proposer further understands that this proof shall come in the form of either:

An endorsement to the Proposer’s insurance policy (Form CG 20 10 11 85 or as broad as), A copy of the Proposer’s current insurance policy that shows that the policy already insures all parties required to be insured by this Agreement.

Proposer certifies that, should Commercial General Liability insurance be required, and should the Proposer use a subcontractor to complete a portion of this Agreement, the Proposer shall either:

Include the subcontractor as an additional named insured under the Proposer’s policy, Ensure that each subcontractor is insured under their own Commercial General Liability policy.

Proposer acknowledges that they understand that the DSH reserves the right, at its sole discretion, to cancel a proposed award to a Proposer who does not submit the required documentation described herein.

This form must be submitted with your quote.

Proposers are reminded that there is no requirement to submit proof of insurance with their proposal. Proof of insurance shall only be required of those firms awarded an agreement.

ATTACHMENT 7 – DARFUR CONTRACTING ACT CERTIFICATION

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 proposal 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 or 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 proposal 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/proposer named below is not a scrutinized company per Public Contract Code section 10476;

and b) I am duly authorized to legally bind the prospective proposer/proposer 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

Date Executed Executed in the County and State of

OPTION #2 – WRITTEN PERMISSION FROM DGS

Pursuant to Public Contract Code section 10477, subsection (b), the Director of the Department of General Services may permit a scrutinized company, on a case-by-case basis, to proposal 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 proposal or proposal, complete the information below.

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 proposal or proposal pursuant to Public Contract Code section 10477, subsection (b). A copy of the written permission from DGS is included with our proposal or proposal.

Company/Vendor Name (Printed) Federal ID Number

Initials of Submitter

Printed Name and Title of Person Initialing

ATTACHMENT 8 – PROPOSER DECLARATION FORM (GSPD-05-105)

Form is located at the following web address:

https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf

ATTACHMENT 9 – GENERATIVE ARTIFICIAL INTELLIGENCE (GENAI) REPORTING &

FACTSHEET (STD 1000)

Form is located at the following web address:

STD 1000 Generative Artificial Intelligence (GenAI) Reporting & Factsheet (ca.gov)

ATTACHMENT 10 – CONTRACTOR CERTIFICATION CLAUSES (CCC 04/2017)

Form is located at the following web address:

https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-

List-Folder/Standard-Contract-Language.

ATTACHMENT 11 – PAYEE DATA RECORD (STD. 204)

Form is located at the following web address:

http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf

ATTACHMENT 12 – DVBE DECLARATION FORM (STD. 843)

Note: This only applies if a proposer or a subcontractor is a DVBE Form is located at the following web address:

https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/pd_843.pdf

ATTACHMENT 13 – CALIFORNIA CIVIL RIGHTS LAW CERTIFICATION

Note: This only applies for contracts $100,000.00 and above.

Form is located at the following web address:

https://www.documents.dgs.ca.gov/dgs/FMC/DGS/OLS004.pdf

ATTACHMENT 14 – SAMPLE AGREEMENT (STD 213 AND EXHIBITS)

Department of State Hospitals RFQ Number: 26-76002-001

Exhibit A

SCOPE OF WORK

1. CONTRACTED PARTIES:

Contractor shall provide professional language Interpreter services via telephone and/or videoconference, or in person for the Department of State Hospitals (DSH) Forensic Evaluators conducting interviews with limited English proficiency (LEP) clients.

2. AGREEMENT TERM:

The term of the Agreement shall be July 01, 2026, through June 30, 2029, at the amount listed in the Budget Detail of this Exhibit.

Contract Manager:

Department of State Hospitals

Contractor Name: TBD

Section/Unit: Forensic Services Division Section/Unit:

Attention: Attention:

Address: 1215 O Street, MS-9

Address:

Phone: Fax: 916-651-1168 Phone: Fax:

Email: Email:

Project Representatives:

Contractor Name: TBD Section/Unit: Forensic Services Division Section/Unit:

Attention: Attention:

Address: 1215 O Street, MS-9

Address:

Phone: Fax: 916-651-1168 Phone: Fax:

Email: Email:

3. CONTRACTOR RESPONSIBILITIES:

Contractor shall provide professional interpretation services to assist DSH Evaluators in communicating with LEP clients while conducting interviews with Sexually Violent Predators (SVP), Offenders with a Mental Disorder (OMD) Incompetent to Stand Trial (IST)

A. Contractor shall provide DSH with toll-free telephone access to interpreter services 365 days a year, 7 days a week, 24 hours a day that connects only to those interpreters assigned, certified, and credentialed as medical or healthcare interpreters as defined in the Interpreter Operational Requirements below. Services are performed via Zoom and Webex.

B. Interpreter Operational Requirements:

A. The interpreter must be knowledgeable in medical and healthcare terminology and be able to translate medical information and terminology to the DSH Evaluator and/or LEP client.

i. The interpreter must be comfortable and transparent in translating sexually explicit information, including questions regarding sexual history and sexual symptoms.

ii. The interpreter must remain neutral in the conversation unless prompted by the DSH Evaluator with additional instructions.

iii. The interpreter must use the utmost courtesy when conversing with the DSH Evaluator and/or the LEP client and shall refrain from entering a disagreement with the DSH Evaluator and/or LEP client.

iv. The interpreter shall accurately interpret the LEP relay the message in its entirety with meaning preserved throughout the conversation. Information will not be edited or deleted which may erroneously change the meaning of the DSH Evaluator and/or statements.

All conversations or interpretation between the interpreter, the DSH Evaluator, and the LEP client shall remain confidential and will not be shared with individuals unrelated to the call.

4. DSH RESPONSIBILITIES:

A. DSH will provide Contractor with a list of names and identifying information for the DSH Evaluators who will be using translation services under the agreement.

B. The DSH will provide the Contractor with correctional facility codes to list on the invoices.

C. The DSH Evaluator will provide Contractor with the name and a preferred language

D. The DSH may routinely evaluate the work performance of the Contractor, personnel, subcontractors, or other parties associated with the Contractor to determine if the DSH standards and departmental policies and procedures are being maintained. If it is found that any party fails to perform or is physically or mentally incapable of providing services as required by the Agreement, then that party shall not perform services for the DSH.

5. AMENDMENTS:

A. The parties reserve the right to amend this Agreement by extending its term for two (2) additional terms of up to one (1) year each, and to add funding sufficient for these periods at the same rates. This right to amend is in addition to the right to amend for other reasons contained in this Agreement or noted in the solicitation that resulted in this agreement, if applicable. Any amendment shall be in writing and signed by both parties, and be approved by the Department of General Services if such approval is required.

INTERPRETER

Summary:

To provide interpreting services via telephone, in person and/or via video conferencing to our customers and their clients by performing the following duties:

Essential Duties and Responsibilities:

Facilitate understanding in communication by faithfully interpreting, into the target language, everything being said without adding, omitting or changing anything. Consecutive interpretation occurs at intervals, with the speaker pausing at intervals to allow the interpreter to speak.

Maintain impartiality and show no bias or preference toward either party while interpreting.

Interpret in the first form at all times; clarify when necessary (informing both parties) and maintain the highest level of confidentiality as well as abide by Code of Ethics for Interpreters.

Be aware of his/her own culture and other cultures encountered in his/her duties and be able to explain any cultural differences when appropriate.

Preserve the highest level of proficiency by continuing to improve his/her interpreting skills.

Demonstrate the highest level of customer service toward our clients at all times.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

Education and/or Experience:

Minimum one year certificate from college or technical school; At least two years (300 hours) interpreting experience; Certification by a recognized/approved public and/or private credentialing body is desired.

Language Skills:

Interpreter must be fluent at a native or near-native level in both the source and target language.

He/she must demonstrate mastery of a broad spectrum of general vocabulary in both English and the target language and must have an active knowledge of technical and non-technical medical and social services-related terminology in both languages. He/she must be able to read and comprehend simple instructions, short correspondence, and memos and must be able to write simple correspondence. Interpreter must be able to effectively present information in one-on-one and small group situations.

Akan Dutch Inupiaq Mongolian Spanish Albanian Ewe Amharic Estonian Italian Nepali Swahili Apache Farsi Japanese Norwegian Swedish Arabic Finnish Karen Nuer Tagalog Armenian Flemish Kashmiri Oromo Taiwanese Assyrian French Khmer Pashto Tamil Bambara Kirundi Patois Tewa Behdini Fukienese Korean Persian Thai Bengali Fulani Krio Polish Tiwa Bosnian Fuzhou Kunama Portuguese Tibetan Bulgarian Georgian Kurdish Tigrinya Burmese German Laotian Punjabi Taishanese Cambodian Greek Latvian Romanian Tongan Cantonese Gujarati Lithuanian Russian Towa Catalan Maay Samoan Turkish Chinese Haua Macedonian Serbian Ukrainian Chuukese Hebrew Malay Urdu Chiu-Chow Hindi Malayalam Sicilian Uzbek Croatian Hmong Mandarin Sinhalese Vietnamese Czech Hungerian Marshallese Slovak Wolof Danish Ibo Mien Somali Yoruba Dari Ilocano Mixteco Sorani Yupik Dinka Indonesian

Exhibit B

BUDGET DETAIL AND PAYMENT PROVISIONS

1. INVOICING AND PAYMENT:

A.

B.

C.

D.

2.

Attention: Accounts Payable

1215 O Street, MS-2 Sacramento, CA 95814

OR

DSHSac.AccountsPayable@dsh.ca.gov

B. Contractor shall submit one original of each invoice, unless emailed.

D.

The maximum amount of this agreement shall not exceed (amount).

Language Rate per minute Spanish to English TBD

All other languages TBD

E. Contractor must only invoice for the time that interpreter service is provided. Time required to establish the language services needed and/or connection time to the appropriate interpreter will not be chargeable. Billing of the interpretation period starts when the interpreter answers and begins interpreting. The interpretation period is ended when the interpreter has been disconnected from both the DSH Evaluator and the LEP client.

F. Invoices will be prepared at the end of every calendar month and delivered to DSH no later than the 15th day of the calendar month immediately following the month under the invoice.

G. Invoices will reflect billing increments of one-tenth of one minute. For any period of time which falls between tenths of a minute, Contractor will round up to the next tenth of a minute. One-tenth of one minute is defined as six seconds.

H. The minimum billable charge shall be equal to a one-minute charge at the rate of the language for which interpreter service is provided.

I. Invoices must contain the following information, at a minimum:

a) Master contract number (4-20-03-0825A)

b) Date of invoice.

c) Contractor name and address.

d) DSH account number and DSH/Forensics Division.

e) Billing period.

f) Interpreter Connection Time.

g) Total number of calls interpreted.

h) Total number of billable interpretation minutes.

i) Total number of interpreter calls.

j) Percentage of calls connected in 30 seconds or less.

k) Total number of calls resulting in interpreter connection times of greater than 60 seconds.

l) Total number of dropped calls between the time the call is answered by an automated attendant or live operator and the time an interpreter is online.

m) Total dollar amount of credits and /or penalties for qualifying calls that do not meet the criteria established.

n) Total dollar amount due.

o) Any applicable prompt payment discount(s) available.

p) Date and time of each interpreter service occurrence provided.

q) Interpreter language associated with the call.

r) Duration of the interpreted service provided, measured in tenth of a minute increments.

s) Contract rate per minute.

t) Billable amount associated with each call.

u) Interpreter identification number or code as assigned by the Contractor.

Agreement Number: 26-76002-001

Exhibit D, Special Terms and Conditions

EXHIBIT D

SPECIAL TERMS AND CONDITIONS

1.

A. The Contractor shall procure and maintain all license(s), permits, registrations and

Contractor shall provide proof of any such documentation upon request by DSH. In the event any license(s), permit(s), registration(s), and certification(s) expire at any time during the term of this agreement, Contractor agrees to provide to the State a copy of the

In the event the Contractor fails to keep in effect at all times all required documentation, the State may, in addition to any other remedies it may have, terminate this agreement upon occurrence of

B. The Contractor shall provide services as outlined in this Agreement. Contractor shall be responsible to fulfill the requirements of the Agreement and shall incur expenses at its own risk and invest sufficient amount of time and capital to fulfill the obligations as contained

C. The Contractor and its agents, employees, and subcontractors shall keep informed of, observe, and comply with, all prevailing Federal, State, and local laws, and rules and regulations made pursuant to said Federal, State, and local laws, which in any way affect the conduct of the work of this Agreement. If any conflict arises between provisions of the plans and specifications and any such law above referred to, then Contractor shall immediately notify the state in writing.

D. The Contractor certifies that it has appropriate systems and controls in place to ensure that State funds will not be used in the performance of this Contract for the acquisition, operation, or maintenance of computer software in violation of copyright law

E. If signing this agreement as a sole proprietor, The Contractor certifies that it is not an alien that is ineligible for state and local benefits, as defined in Subtitle B of the Personal

F. Pursuant to Public Contract Code section 10295.4, persons or companies identified as the largest tax delinquents by the Franchise Tax Board (FTB) or the California Department of Tax and Fee Administration (CDTFA) are ineligible to enter into any contract with the state for non-void and unenforceable.

G. If contract activities include collection of organic waste, the Contractor must be aware and adhere to Public Resources Code § 42649.1 et. seq. concerning organic waste recycling requirements. Organic waste includes: food waste, green waste, landscape and pruning waste, nonhazardous wood waste, and food-soiled paper waste that is mixed in with food

H. The Contractor's, and any subcontractor's, own data center or cloud computing, where data may be stored, must be physically located in the continental United States. Remote

2.

A. Contractor, including its officers and members, shall not use funds received from DSH pursuant to this Agreement to support or pay for costs or expenses related to the

i. Campaigning or other partisan activities to advocate for either the election or defeat of any candidate for elective office, or for or against the passage of any ii.

B. This provision is not intended and shall not be construed to limit any expression of a view, opinion, or position of any member of Contractor as an individual or private citizens, as long as state funds are not used; nor does this provision limit Contractor from merely

3.

A. DSH reserves the right to use and reproduce all publications, reports, and data produced or delivered pursuant to this Agreement. DSH further reserves the right to authorize others to use or reproduce such materials, provided the author of the report is acknowledged in

B. If the publication and/or report are prepared by non-employees of DSH, and the total cost for such preparation exceeds $5,000, the publication and/or report shall contain the numbers and dollar amounts of all agreements and subcontracts relating to the preparation of the publication and report in a separate section of the report (Government Code §

4.

A. -by-shall be given access to all data, working papers, etc., which Contractor se defined as "The practice of an employee using their influence or power to aid or hinder another in the employment setting because of a personal relationship." Accordingly, Contractor shall not use their influence or power to aid or hinder another in DSH's or Contractor's employment setting because of a personal relationship. The Contractor shall disclose any personal relationship with any current DSH workforce member by completing DSH 3215 Verification of Personal Relationships and Hiring of Relatives. Contractor shall also disclose any personal relationships with any current subcontractor(s)' workforce member.

5.

A. Contractor shall not disclose data or documents or disseminate the contents of the final or any preliminary report without written permission of DSH Contract Manager. Contractor shall consult with DSH regarding any Public Records Request Act that involves DSH as a

B. Permission to disclose information or documents on one occasion shall not authorize Contractor to further disclose such information or documents on any other occasion except

C. Contractor shall not comment publicly to the press, or any other media, regarding the data or documents generated, collected, or produced in connection with this Agreement, or olved in the performance of this Agreement, or as required by law. Contractor shall consult with DSH regarding any request from the media that involves DSH data, information or

D. If requested by DSH, Contractor shall require each of its employees or officers who will be involved in the performance of this Agreement to agree to the Contract terms in a form to

E. Each subcontract shall contain the foregoing provisions related to the confidentiality of

F. After any data or documents submitted has become a part of the public records of DSH, Contractor may at its own expense and upon written approval by DSH or designee publish

LEGAL NOTICE

This report was prepared as an account of work sponsored by the Department of State Hospitals (Department) but does not necessarily represent the views of the Department or any of its employees except to the extent, if any, that it has formally been approved by the Department. For information regarding any such action, communicate directly with the Department at P.O. Box 952050, Sacramento, California, 94252-2050. Neither said Department nor the State of California, nor any officer or employee thereof, or any of its contractors or subcontractors makes any warranty, express or implied, or assumes any legal liability whatsoever for the contents of this document. Nor does any party represent that use of the data contained herein, would not infringe upon privately owned rights without obtaining permission or authorization from any party who has any rights in connection with the data.

6.

A.

characteristics, of a scientific or technical nature. It may, for example, document research, experimental, developmental, or engineering work; or be usable or be used to define a design or process; or support a premise or conclusion asserted in any deliverable document called for by this Agreement. The data may be graphic or pictorial delineations in media, such as drawings or photographs, charts, tables, mathematical models, collections or extrapolations of data or information, etc. It may be in machine form, as punched cards, magnetic tape, computer printouts, or may be retained in computer deduced, read out or postulated for utilization in the performance of this Agreement. Any electronic data processing program, model or software system developed or substantially modified by Contractor in the performance of this Agreement at the expense of DSH, together with complete documentation thereof, shall be treated in the same manner as

D. Prior to the expiration of any legally required retention period and before destroying any data, Contractor shall notify DSH of any such contemplated action; and DSH may within 30 days of said notification determine whether or not this data shall be further preserved.

DSH shall pay the expense of further preserving this data. DSH shall have unrestricted

E. Contractor shall use best efforts to furnish competent witnesses to testify in any court of

F. All financial, statistical, personal, technical, and other data and information relating to available to carry out the Agreement, or which become available to Contractor in order to carry out this Agreement, shall be protected by Contractor from unauthorized use and

G. If…