5. CMD Form 3 Compliance Affidavit - SFGOV-0000011976.pdf
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- Solicitation number
- SFGOV-0000011976
- Issued by
- San Francisco County, San Francisco City, California
About this file
This is a CMD Compliance Affidavit form issued by the City and County of San Francisco's Contract Monitoring Division for Architecture, Engineering, and Professional Services contracts under Chapter 14B of the San Francisco Administrative Code. The form serves as an attestation document that requires the firm owner or authorized representative to certify compliance with all applicable provisions of Chapter 14B and related Rules and Regulations. The affidavit obligates the contractor to provide copies of contracts, subcontract agreements, certified payroll records, and other documents upon request to enable the Human Rights Commission and CMD to investigate potential claims of discrimination or non-compliance with San Francisco Labor and Employment Code Article 131 or Chapter 14B. The document requires the authorized representative to sign and declare under penalty of perjury that all statements are true and accurate.
The affidavit establishes financial accountability provisions whereby any monetary penalties assessed by the Director of the Contract Monitoring Division become immediately payable to the City and County of San Francisco upon demand, with authority for the city to withhold penalties from monies otherwise due to the firm on any city contract. This compliance certification is a mandatory prerequisite for firms seeking to enter into architecture, engineering, and professional services contracts with the City and County of San Francisco and demonstrates the firm's commitment to adherence with local labor and employment regulations as well as contract monitoring requirements.
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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:
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