5. CMD Form 3 CMD Compliance Affidavit.pdf
PDF 162 KB Posted
- Solicitation number
- SFGOV-0000011970
- Issued by
- San Francisco County, California
About this file
This is a CMD Compliance Affidavit form for the City and County of San Francisco's Contract Monitoring Division, applicable to Architecture, Engineering, and Professional Services contracts. The form is designed for vendors responding to the Department of Public Health's Request for Qualifications for As-Needed Community Outreach and Media Services for the San Francisco Health Network, Behavioral Health Services, and Population Health Division. The RFQ was published on August 10, 2026, with a deadline for questions on August 27, 2026, an estimated Q&A addendum posting on September 4, 2026, and a response submission deadline of 2:00 PM PT on September 16, 2026. The estimated announcement of prequalified lists is October 2, 2026. This RFQ represents a reissue of a previous solicitation to re-open unranked prequalified lists with an expiration date of March 11, 2029. Vendors previously qualified under the prior RFQ remain qualified and are not required to resubmit, though they may choose to do so.
The affidavit requires that the signatory firm comply fully with Chapter 14B of the San Francisco Administrative Code and its implementing Rules and Regulations, as well as Article 131 of the San Francisco Labor and Employment Code. Vendors must agree to provide copies of contracts, subcontract agreements, certified payroll records, and other requested documentation to the Contract Monitoring Division and Human Rights Commission for investigation of discrimination claims or non-compliance. Any monetary penalties assessed by the Director of the Contract Monitoring Division shall be payable to the City and County of San Francisco and may be withheld from monies due to the firm on any City contract. The signatory declares under penalty of perjury that all statements are true and accurate.
View the file
Other files
Show all 23
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
- 19 -
07/01/2024
CITY AND COUNTY OF SAN FRANCISCO
CONTRACT MONITORING DIVISION
CHAPTER 14B
CMD ATTACHMENT 2
Architecture, Engineering, and Professional Services
FORM 3: CMD COMPLIANCE AFFIDAVIT
1. I will ensure that my firm complies fully with the provisions of Chapter 14B of the San Francisco Administrative Code and its implementing Rules and Regulations and attest to the truth and accuracy of all information provided regarding such compliance.
2. Upon request, I will provide the CMD with copies of Contracts, subcontract agreements, certified payroll records and other documents requested so the HRC and CMD (as applicable) may investigate claims of discrimination or non-compliance with either San Francisco Labor and Employment Code Article 131 (formerly known as Administrative Code Chapter 12B) or Chapter 14B.
3. I acknowledge and agree that any monetary penalty assessed against my firm by the Director of the Contract Monitoring Division shall be payable to the City and County of San Francisco upon demand. I further acknowledge and agree that any monetary penalty assessed may be withheld from any monies due to my firm on any Contract with the City and County of San Francisco.
4. I declare and swear under penalty of perjury under the laws of the State of California that the foregoing statements are true and correct and accurately reflect my intentions.
Signature of Owner/Authorized Representative:
Owner/Authorized Representative (Print)
Name of Firm (Print)
Title and Position
Address, City, ZIP
Federal Employer Identification Number (FEIN):
Date:
| Text5: |
| Text6: |
| Text7: |
| Text8: |
| Text9: |
| Text119: |
| Text129: |
| Text213: |
File details come from the government source that posted it. Updated .