26-76002-001_SFQ_SB_ONLY_Addendum_No_2.pdf

Department of State Hospitals RFQ Number: 26-76002-001, Addendum #2 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 2, 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

Department of State Hospitals Contractor Name: TBD Agreement No.: 26-76002-001

Exhibit A, Scope of Work

Exhibit A

SCOPE OF WORK

1. CONTRACTED PARTIES:

Contractor shall provide professional language Interpreter services via telephone and/or videoconference 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) California Forensic (CFAP).

Exhibit A, Scope of Work

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 client’s statement and 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 LEP client’s 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 inmate’s name and a preferred language for inclusion on Contractor’s invoices for each telephone call.

D. The DSH may routinely evaluate the work performance of the Contractor, Contractor’s 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

Exhibit A, Scope of Work 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.

Languages for Telephone Based Interpreter Services

Akan Dutch Inupiaq Mongolian Spanish Albanian Ewe Iraqi Arabic Moroccan Arabic Sudanese Arabic 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 French Canadian Kirundi Patois Tewa Behdini Fukienese Korean Persian Thai Bengali Fulani Krio Polish Tiwa Bosnian Fuzhou Kunama Portuguese Tibetan Bulgarian Georgian Kurdish Portuguese Creole Tigrinya Burmese German Laotian Punjabi Taishanese Cambodian Greek Latvian Romanian Tongan Cantonese Gujarati Lithuanian Russian Towa Catalan Haitian Creole Maay Samoan Turkish Chinese Haua Macedonian Serbian Ukrainian Chuukese Hebrew Malay Serbo Croatian 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

Exhibit B

BUDGET DETAIL AND PAYMENT PROVISIONS

1. INVOICING AND PAYMENT:

A. For services satisfactorily rendered, and upon receipt and approval of invoices submitted as described herein, DSH agrees to compensate Contractor in accordance with the rates specified in Section 5, Budget Detail.

B. DSH is not responsible for services performed by Contractor outside of this agreement, nor for services performed other than as outlined in Exhibit A, Scope of Work.

C. DSH makes no guarantee, either written or implied, as to the actual amount of funds that will be expended under this Agreement.

D. Contractor shall not bill or seek reimbursement from DSH for any goods or services if Contractor received or will receive reimbursement or funding for such goods or services under any federal program, such as the Coronavirus Aid, Relief, and Economic Security (CAREs) Act or Federal Emergency Management Agency (FEMA) disaster relief, except when Contractor has billed Medicare and seeks the difference between the Medicare payment and the DSH contract price.

2. INSTRUCTIONS TO CONTRACTOR:

A. To expedite the processing of invoices submitted to DSH for payment, all invoice(s) shall be submitted to DSH for review and approval at either:

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.

C. Contractor shall type, not handwrite, each invoice on company letterhead. DSH may provide a sample invoice template, if requested, which may be used in lieu of company letterhead.

D. Contractor shall clearly note Contractor’s name and address on each invoice. The name on the invoice must match the Payee Data Record (Std. 204) and the name listed on this Agreement.

B. Contractor shall type, not handwrite, each invoice on company letterhead. DSH may provide a sample invoice template, if requested, which may be used in lieu of company letterhead.

C. Contractor shall clearly note Contractor’s name and address on each invoice. The name on the invoice must match the Payee Data Record (Std. 204) and the name listed on this Agreement.

D. Contractor shall list and itemize in accordance with Section 5, Budget Detail, all services or deliverables provided on each invoice.

E. Contractor shall include the following on each submitted invoice:

i. Date(s) during which the services or deliverables were provided and the date in which the invoice was generated.

ii. Agreement number, which can be found on the Standard Agreement Form (Std.

213).

iii. Small Business certification number, if applicable

iv. Professional license number, if applicable

v. Invoice total

vi. Contractor’s name as it appears on the Std. 213. If Contractor has both a legal and a fictitious name listed on the Std. 213, Contractor may, at its discretion, invoice using the full name as indicated on the Std. 213, or either of the two names listed.

2. BUDGET CONTINGENCY CLAUSE:

A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall no longer be in full force and effect. In this event, the State shall have no liability to pay any funds whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be obligated to perform any provisions of this Agreement.

B. If funding for any Fiscal Year (FY) is reduced or deleted by the Budget Act for purposes of this program, the State shall have the option to either cancel this Agreement with no liability occurring to the State, or offer an Agreement amendment to Contractor to reflect the reduced amount.

C. If this Agreement overlaps Federal and State FY’s, should funds not be appropriated by Congress or approved by the Legislature for the FY in which the Agreement was entered into, and/or any subsequent years covered under this Agreement, the State may exercise its option to cancel this Agreement.

D. In addition, this Agreement is subject to any additional restrictions, limitations, or conditions enacted by Congress or the Legislature which may affect the provisions or terms of funding of this Agreement in any manner.

4. PROMPT PAYMENT CLAUSE:

A. Payment will be made in accordance with, and within the time specified in, Government

Code section 927, et seq.

5. BUDGET DETAIL:

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

Language Rate per minute Spanish to English TBD

All other languages TBD

B. DSH does not expressly or by implication agree that the actual amount of work will correspond with any estimation provided in this Agreement, and reserves the right to omit portions of the estimated amount of work as may be deemed necessary or advisable by DSH. The estimates listed above are a good faith estimate and are not a guarantee of business and is subject to change. The amounts indicated above will be used solely for the purposes of encumbering funds. DSH makes no guarantee, expressed or implied for actual amount of work to be performed. However, the rates contained in Exhibit B shall be binding for the term of this Agreement.

C. At the sole discretion of DSH and for the purposes of accounting, DSH may adjust the total proposed expenditure for each fiscal year as needed. In no event will this change the contract price for the services actually rendered.

D. Contractor must submit all invoices within a reasonable time but, no later than twelve (12) months from the date that services were provided. If Contractor fails to provide invoices within twelve (12) months of the date services are rendered, DSH may elect to reject the invoices for payment as untimely and Contractor will be deemed to have waived any right to payment of the late invoices.

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 “no interpreter available” 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,…