26FS0005_-_Darfur.pdf
PDF 202 KB Posted
- Solicitation number
- 0000038758
- Issued by
- Fresno County, Inyo County, Kings County, Madera County, Mariposa County, Merced County, Mono County, Monterey County, San Benito County, Tulare County, 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 for the State of California, specifically related to Solicitation 26FS0005 for Grease Trap Cleaning and Disposal Services at the Veterans Home of California at Fresno. The form addresses compliance requirements under Public Contract Code Sections 10475-10481, which apply to companies with business activities or operations outside the United States within the previous three years. Bidders must complete this certification form to establish eligibility to submit a proposal, with specific timelines and submission requirements detailed in the Notice to Prospective Bidders and related scope of work documentation. All questions regarding the solicitation must be submitted via email, and additional details concerning the grease trap cleaning and disposal services are outlined in Exhibit A of the associated scope of work.
The certification form provides two options for eligible bidders: Option 1 requires companies without foreign operations in the previous three years to certify they are not scrutinized companies per Public Contract Code 10476, while Option 2 accommodates scrutinized companies that have obtained written permission from the Department of General Services to submit bids on a case-by-case basis. Both options require authorized company representatives to provide the company name, Federal ID Number, and signature. Bidders selecting Option 2 must include a copy of the written DGS permission with their proposal submission.
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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: 26FS0005
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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