26FS0002_-_Darfur_Contracting_Act.pdf
PDF 202 KB Posted
- Attached to
- 26FS0002 - Sanitation System Pumping Services
- Solicitation number
- 0000038538
- Issued by
- Fresno County, Inyo County, Kings County, Madera County, Mariposa County, Merced County, Mono County, Monterey County, San Benito County, Tulare County, Fremont City, Fresno City, Kingsburg City, Inyokern CDP, Monterey Park City, Madera City, Madera Acres CDP, Madera Ranchos CDP, Corte Madera Town, Mariposa CDP, Merced City, University of California-Merced CDP, Mono City CDP, Monterey City, Kings Beach CDP, Monterey Park Tract CDP, East Tulare Villa CDP, Tulare City, Mono Vista CDP, California
About this file
This is a Darfur Contracting Act Certification form issued by the State of California for solicitation 26FS0002, which pertains to Sanitation System Pumping Services at the Veterans Home of California at Fresno located at 2811 West Cesar Chavez Blvd., Fresno, CA 93706. The form addresses compliance requirements for companies with international business activities or operations conducted within the previous three years. Bidders must either certify that their company is not a scrutinized company under Public Contract Code Section 10476, or provide written permission from the California Department of General Services (DGS) if they are a scrutinized company. The specific details regarding service scope, quantities, timelines, site visits, and bidder meetings are found in the accompanying Scope of Work (Exhibit A) and Notice to Prospective Bidders. All questions from prospective bidders must be submitted via email as specified in the IFB Letter.
The certification form provides two options for eligible bidders: Option 1 requires completion of a certification statement under penalty of perjury by an authorized company representative stating the company is not scrutinized; Option 2 permits scrutinized companies to submit a bid if they have obtained written permission from the DGS Director on a case-by-case basis, which must be included with the proposal. Companies without international business activities within the previous three years are exempt from completing this certification. The form requires submission of the company name, Federal ID Number, authorized signature, and printed name and title of the signing official. No pricing, set-aside information, incumbent details, or funding sources are addressed in this certification document.
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Text version
Public Contract Code Sections 10475 -10481 applies to any company that currently or within the previous three years has had business activities or other operations outside of the United States. For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company that has been granted permission by the Department of General Services to submit a proposal.
If your company has not, within the previous three years, had any business activities or other operations outside of the United States, you do not need to complete this form.
OPTION #1 - CERTIFICATION
If your company, within the previous three years, has had business activities or other operations outside of the United States, in order to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete the certification below.
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that a) the prospective proposer/bidder named below is not a scrutinized company per Public Contract Code 10476; and b) I am duly authorized to legally bind the prospective proposer/bidder named below. This certification is made under the laws of the State of California.
Company/Vendor Name (Printed) Federal ID Number
By (Authorized Signature)
Printed Name and Title of Person Signing
OPTION #2 – WRITTEN PERMISSION FROM DGS
Pursuant to Public Contract Code Section 10477(b), the Director of the Department of General Services may permit a scrutinized company, on a case-by-case basis, to bid on or submit a proposal for a contract with a state agency for goods or services, if it is in the best interests of the state. If you are a scrutinized company that has obtained written permission from the DGS to submit a bid or proposal, complete the information below.
STATE OF CALIFORNIA
DARFUR CONTRACTING ACT CERTIFICATION
DGS PD 1 (Rev. 12/19)
Date
Solicitation: 26FS0002
We are a scrutinized company as defined in Public Contract Code section 10476, but we have received written permission from the Department of General Services to submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission from DGS is included with our bid or proposal.
Company/Vendor Name (Printed) Federal ID Number
By (Authorized Signature)
Printed Name and Title of Person Signing
Date
| OPTION #1 - CERTIFICATION |
| OPTION #2 – WRITTEN PERMISSION FROM DGS |
| Federal ID Number: |
| Printed Name and Title of Person Signing: |
| CompanyVendor Name Printed_2: |
| Federal ID Number_2: |
| Printed Name and Title of Person Initialing: |
| CompanyVendor Name: |
| ADA Instructions: |
| Date of signature: |
| Date of signature 2: |
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