26CRY001_-_CA_Civil_Rights_Certification.pdf

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Attached to
26CRY0001 - Mobile Radiology and Ultrasound Services
Solicitation number
0000040110
Issued by
California

About this file

This is a California Civil Rights Laws Certification form issued by the Department of General Services Office of Legal Services for state contracts valued at $100,000 or above. The certification applies to the Mobile Radiology and Ultrasound Services contract (26CRY0001) for the Veterans Home of California - Yountville. Contractors submitting bids or proposals for this contract must certify compliance with specified civil rights requirements at the time of bid submission or contract renewal.

The certification requires bidders to attest under penalty of perjury that they comply with the Unruh Civil Rights Act (California Civil Code Section 51) and the Fair Employment and Housing Act (California Government Code Section 12960) for contracts executed or renewed after January 1, 2017. Additionally, if a contractor maintains an internal policy against any sovereign nation or peoples recognized by the United States government, the contractor must certify that such policies are not applied in violation of either the Unruh Civil Rights Act or the Fair Employment and Housing Act. The authorized representative of the proposing firm must execute the certification and provide the firm name, federal identification number, printed name and title, county and state of execution, and execution date.

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DEPARTMENT OF GENERAL SERVICES

OFFICE OF LEGAL SERVICES

STATE OF CALIFORNIA

CALIFORNIA CIVIL RIGHTS LAWS CERTIFICATION

DGS OLS 04 (Rev. 01/17)

Pursuant to Public Contract Code section 2010, a person that submits a bid or proposal to, or otherwise proposes to enter into or renew a contract with, a state agency with respect to any contract in the amount of $100,000 or above shall certify, under penalty of perjury, at the time the bid or proposal is submitted or the contract is renewed, all of the following:

1. CALIFORNIA CIVIL RIGHTS LAWS: For contracts executed or renewed after January 1, 2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of theCivil Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code); and

2. EMPLOYER DISCRIMINATORY POLICIES: For contracts executed or renewed after January 1, 2017, if a Contractor has an internal policy against a sovereign nation or peoples recognized by the United States government, the Contractor certifies that such policies arenot used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing Act (Section 12960 of the Government Code).

CERTIFICATION

I, the official named below, certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

By (Authorized Signature)

Printed Name and Title of Person Signing

Executed in the County of Executed in the State of

Date Executed

Proposer/Bidder Firm Name (Printed) Federal ID Number

ProposerBidder Firm Name Printed:
Federal ID Number:
Printed Name and Title of Person Signing:
Executed in the County of:
Executed in the State of:
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