26YS0027_-_Darfur_Contracting_Act.pdf
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- Solicitation number
- 0000038973
- 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 Darfur Contracting Act Certification form required by the State of California for a Kitchen Hood Fire Suppression Services contract (Solicitation 26YS0027) at the Veterans Home of California at Yountville. The form applies to any company with business activities or operations outside the United States within the previous three years. Bidders must certify their eligibility to submit proposals by selecting one of two options: either certifying that the company is not a scrutinized company as defined under Public Contract Code Section 10476, or providing written permission from the Department of General Services if the company is a scrutinized company. Companies without international business activities in the previous three years are exempt from completing this certification. All questions regarding the solicitation must be submitted via email, and prospective bidders should review the Notice to Prospective Bidders (IFB Letter) for the project timeline and the Scope of Work (Exhibit A) for detailed service requirements.
The certification form requires authorized company representatives to sign under penalty of perjury and include the company name, Federal ID Number, printed name, and title. For scrutinized companies, a copy of written permission from the Department of General Services must be included with the bid or proposal submission. This certification is made under the laws of the State of California and is a mandatory compliance requirement for bid eligibility. The form does not address pricing terms, contract duration, funding amounts, or award dates, as these details are contained in separate solicitation documents referenced in the Notice to Prospective Bidders.
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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: 26YS0027
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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