26CRY008_-_Bidders_Checklist.pdf
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- Solicitation number
- 0000039790
- Issued by
- Colusa County, Contra Costa County, Lake County, Marin County, Napa County, Solano County, Sonoma County, Yolo County, Colusa City, Contra Costa Centre CDP, Auburn Lake Trails CDP, South Lake Tahoe City, Shaver Lake CDP, Blue Lake City, China Lake Acres CDP, Lake Isabella CDP, Lake of the Woods CDP, Lakeside CDP, Hidden Valley Lake CDP, Lakeport City, Lower Lake CDP, North Lakeport CDP, Upper Lake CDP, Elizabeth Lake CDP, Lake Hughes CDP, Lake Los Angeles CDP, Lakewood City, Marina Del Rey CDP, San Marino City, Bass Lake CDP, Yosemite Lakes CDP, Lucas Valley-Marinwood CDP, Marin City CDP, Lake Don Pedro CDP, Lake City CDP, Crowley Lake CDP, June Lake CDP, Mammoth Lakes Town, Twin Lakes CDP, Virginia Lakes CDP, Marina City, Napa City, Lake of the Pines CDP, Lake Wildwood CDP, Lake Forest City, Bucks Lake CDP, Lake Almanor Country Club CDP, Lake Almanor Peninsula CDP, Lake Almanor West CDP, Lake Davis CDP, Canyon Lake City, Lake Elsinore City, Lakeland Village CDP, Lake Mathews CDP, Lake Riverside CDP, Lakeview CDP, Big Bear Lake City, Lake Arrowhead CDP, Silver Lakes CDP, Spring Valley Lake CDP, Lake San Marcos CDP, Lake Nacimiento CDP, Emerald Lake Hills CDP, Lakehead CDP, Shasta Lake City, Lake Shastina CDP, Sonoma City, Sonoma State University CDP, Lake California CDP, Phoenix Lake CDP, Pine Mountain Lake CDP, Lake Sherwood CDP, Yolo CDP, Plumas Lake CDP, California
About this file
This is a Bidder's Checklist document issued by the State of California Department of Veterans Affairs for solicitation number 26CRY008, concerning Temporary Relief Speech Pathology Services at the Veterans Home of California at Yountville. The checklist outlines the required documentation and certifications that bidders must submit with their proposals, including a bid rate sheet, signed Payee Data Record (STD 204), bidder declarations, and proof of valid business licensure or incorporation status. Bidders are instructed to return the completed checklist with their bid submissions, and all company names must be identical across all submitted documents to prevent delays in contract award.
The checklist specifies mandatory certifications and compliance documents including the Bidder Certification, Bidder Declaration (GSPD-05-105), Contractor Certification Clauses (CCC-4/2017), and declarations regarding non-collusion, civil rights compliance, and various statutory requirements such as the Darfur Contracting Act and Iran sanctions compliance. Bidders must also provide applicable certifications for Commercially Useful Function (CUF) and Disabled Veteran Business Enterprise (DVBE) status if applicable. A sample invoice template is referenced for bidder guidance. All questions regarding the solicitation must be submitted via email, and additional details regarding the scope of work and timeline can be found in the Notice to Prospective Bidders and Exhibit A.
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State of California Solicitation Number: 26CRY008 Department of Veterans Affairs
BIDDER’S CHECKLIST
Speech Pathology Services
The checklist below is a summary of documents to be submitted based on requirements in the Invitation for Bid. This checklist should be returned with your bid. Place a check-mark or “X” next to each document being submitted.
Signatures are required on the documents where specified.
The company name listed on all documents submitted (ex., licenses, permits, certifications, and insurance) must be identical to the company name on the Payee Data Record (STD 204). Failure to submit these documents in the manner prescribed may delay award of Agreements.
Bidder’s Checklist
Bidder Certification
Bid Rate Sheet
Signed Payee Data Record - STD 204
Bidder Declaration - GSPD-05-105
Commercially Useful Function (CUF) Certification, if applicable
Disabled Veteran Business Enterprise (DVBE) Declarations – DGS PD 843, if applicable
Iran, if applicable
Darfur Contracting Act
California Civil Rights Laws
Non-Collusion Declaration
Contractor Certification Clauses (CCC-4/2017) - The CCC-4/2017 can be found on the Internet at https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List- Folder/Standard-Contract-Language
Valid California city or county business license; or, if a corporation located within the State of California, incorporation documents or letter from the Secretary of State; or, if not a California business, an affidavit that business is in good standing with the State, Province, or Country in which business is headquartered.
Sample Invoice https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language
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