5._Darfur_Contracting_Act.pdf
PDF 78 KB Posted
- Attached to
- (1) Wheelchair Lift Van Conversion
- Solicitation number
- 0000031796
- Issued by
- Solano County, California
About this file
This document is a Darfur Contracting Act certification form for a state of California contract opportunity. The contract is for the retrofitting of a wheelchair lift onto a Ford XL 15 Passenger Transit Van, with the van to be delivered to the vendor's facility within 100 miles of Vacaville, CA. The certification form requires vendors to indicate whether they have had business activities or operations outside of the United States within the previous three years. Vendors must either certify that they are not a scrutinized company, obtain written permission from the Department of General Services to submit a proposal, or be ineligible to bid. The contract opportunity is managed by the state of California and Solano County.
The pricing terms, set asides, incumbents, and funding details are not provided in the given document. However, the document does indicate that this is a state and local contract opportunity, suggesting the potential for competitive bidding requirements and procurement processes specific to California and Solano County.
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DEPARTMENT OF CORRECTIONS AND REHABILITATION (CDCR) STATE OF CALIFORNIA
OBS 1500 Darfur Contracting Act (06/11)
DARFUR CONTRACTING ACT
Bid/Agreement Number OR Request for Quote Number: ____________
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.
Select only one of the following options:
OPTION #1 – NO ACTIVITIES OUTSIDE THE US
If your company has not, within the previous three years, had any business activities or other operations outside of the United States, print your company name, date and signature below:
Company/Vendor Name (Printed) Date
By (Authorized Signature)
OPTION #2 - 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
Date Executed Executed in the County and State Of:
OPTION #3 – 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.
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
| BidAgreement Number OR Request for Quote Number: |
| CompanyVendor Name Printed: |
| Date: |
| By Authorized Signature: |
| CompanyVendor Name Printed_2: |
| Federal ID Number: |
| By Authorized Signature_2: |
| Printed Name and Title of Person Signing: |
| Date Executed: |
| Executed in the County and State Of: |
| CompanyVendor Name Printed_3: |
| Federal ID Number_2: |
| By Authorized Signature_3: |
| Printed Name and Title of Person Signing_2: |
File details come from the government source that posted it. Updated .