26HS0006_-_Darfur.pdf
PDF 202 KB Posted
- Solicitation number
- 0000037829
- Issued by
- Fresno County, Kings County, Madera County, Merced County, Monterey County, San Benito County, Santa Clara County, Santa Cruz County, Fresno City, Kingsburg City, Monterey Park City, Madera City, Madera Acres CDP, Madera Ranchos CDP, Corte Madera Town, Merced City, University of California-Merced CDP, Monterey City, Kings Beach CDP, Santa Clara City, Santa Cruz City, Monterey Park Tract CDP, California
About this file
This is a Darfur Contracting Act Certification form issued by the State of California for solicitation 26HS0006, which concerns Fire Protection System Services (Sprinklers & Hydrants) at the California Central Coast Veterans Cemetery. The solicitation is restricted to certified Small Business and Micro Business firms only. A mandatory walkthrough is required for all bidders, and the specific scope of work, project details, and timeline of events are contained in the accompanying Scope of Work (Exhibit A) and supplementary exhibits A-D documents. All questions must be submitted via email in accordance with the solicitation timeline.
The certification form addresses compliance with Public Contract Code Sections 10475-10481, which requires companies with business activities or operations outside the United States within the previous three years to certify their status. Bidders must select either Option #1, certifying under penalty of perjury that the company is not a scrutinized company, or Option #2, providing written permission from the Department of General Services if the company is classified as scrutinized. The form requires completion with company name, Federal ID Number, authorized signature, and printed name and title of the signatory. Companies with no international business activities within the previous three years are exempt from completing this certification requirement.
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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: 26HS0006
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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