26WS0010_-_Bidders_Checklist.pdf
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- Solicitation number
- 0000039350
About this file
This is a Bidder's Checklist document issued by the State of California Department of Veterans Affairs for Solicitation Number 26WS0010, which seeks Temporary/Relief Physician/Surgeon and Chief Medical Officer Services for the Veterans Home of California at West Los Angeles. The checklist outlines the required documentation that bidders must submit with their proposals, including bid rate sheets, payee data records, certifications related to disabled veteran business enterprises and commercially useful functions, proof of business licensure or good standing, contractor certification clauses, and sample invoices. All inquiries regarding the solicitation must be submitted via email, and specific timeline requirements are detailed in the Notice to Prospective Bidders and Invitation for Bid documents. The scope of work and detailed service specifications are provided in Exhibits A and A-1.
Bidders must ensure that the company name appearing on all submitted documents—including licenses, permits, certifications, and insurance—matches exactly with the company name listed on the Payee Data Record (STD 204) to avoid delays in contract award. The checklist requires submission of numerous compliance documents, including bidder certifications, declarations regarding civil rights compliance and the Darfur Contracting Act, and verification of the contractor's current legal status. Failure to submit required documents in the prescribed manner may result in delays to the agreement award process. The document references standard contract language and resources available through the California Department of General Services Office of Legal Services website.
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State of California Solicitation Number: 26WS0010 Department of Veterans Affairs
BIDDER’S CHECKLIST
Temporary/Relief Physician/Surgeon or Chief Medical Office Services
The checklist below is a summary of documents to be submitted based on the 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 the 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
Darfur Contracting Act
California Civil Rights Laws
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 the 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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