Attachment_1_Proposal_Checklist.pdf

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Attached to
Request for Proposals, OCPSC25003, California Love, California Strong Project
Solicitation number
0000037365
Issued by
Sacramento County, San Francisco City, California

About this file

This document is a Proposal Requirement Checklist for Request for Proposals #OCPSC25003 issued by the California Governor's Office of Land Use and Climate Innovation (LCI) for the "California Love, California Strong" project. The checklist serves as a mandatory compliance document to ensure proposers adhere to all RFP requirements and submission specifications. Proposers must submit proposals electronically via email by the deadline specified in the Key Dates Table, formatted in 12-point Times New Roman, Arial, or Calibri font with specific header requirements. The proposal package must include a comprehensive set of attachments in prescribed order: title page, table of contents, proof of minimum qualifications, personnel resumes, the completed checklist itself, contractor scope of work response, cost worksheet response, proposal certification sheet, proposer references form, and various statutory compliance certifications including bidder declarations, conflict of interest statements, and artificial intelligence usage disclosures. All proposals must be written in third-person perspective and submitted with supporting documentation including Secretary of State status verification, Franchise Tax Board clearance, and California Department of Tax and Fee verification.

The RFP includes specific participation requirements for Small Businesses (25% if applicable) and Disabled Veteran Business Enterprises (3% if applicable), with DVBE participation incentives ranging from 1 percent to 5 percent depending on confirmed participation levels. Proposers claiming DVBE participation must submit completed DVBE Subcontractor Agreements, Commercially Useful Function certifications, and proof of DGS/OSDS certification for each DVBE identified. Failure to submit required attachments, remain in good standing with state tax agencies, or comply with formatting and certification requirements may result in proposal rejection and deemed non-responsiveness. The checklist includes provisions for TACPA preferences (available for contracts exceeding $100,000), compliance with the Darfur Contracting Act and Iran Contracting Act certifications (for contracts $100,000 or above and $1,000,000 or above respectively), and requires authorized company officials to sign all certification documents. Contractors awarded under this solicitation who commit to DVBE participation must submit a Prime Contractor's Certification-DVBE Subcontracting Report upon contract completion, with LCI authorized to withhold $10,000 (or full payment if less) from final payment pending receipt of accurate DVBE reporting.

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Attachment_2_Notice_to_Bidders_v2.pdf PDF

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ATTACHMENT 1: PROPOSAL REQUIREMENT CHECKLIST

REQUEST FOR PROPOSALS – CALIFORNIA LOVE, CALIFORNIA STRONG

RFP# OCPSC25003

Attachment 1 – Proposal Requirement Checklist The purpose of Attachment 1 – Proposal Requirement Checklist is to ensure that the Proposer has adhered to all requirements of this RFP solicitation. This attachment is to be completed, signed, and included with your proposal submission in order to be eligible for evaluation. Failure to include this attachment or adhere to the requirements set forth may result in disqualification.

Attachments with an asterisk (*) next to it indicates that it is required to be submitted with your proposal. Some attachments can be found online. For those attachments, a hyperlink has been provided. Other attachments have been included in this document for Proposers to review and complete.

TASK CHECKBOX

Letter of Commitment: A Letter of Commitment was submitted by the due date and time identified in the Key Dates Table of this RFP solicitation. The letter included:

• Minimum one (1) page but no more than two (2) pages typed on company letterhead

• Size 12 font for body text. Times New Roman, Arial, or Calibri for typeface.

• The name and address of your organization (NOTE: You may use a Post

Office box, but also provide your company’s physical street address for our records)

• The name, title, email, and signature of a company official who has the authority to sign a legal binding contract

• A brief synopsis of your organization’s interest in doing this project

• Confirmation that your company plans to submit a proposal in response to this solicitation

Deadline: The proposal was submitted to be received by LCI by the due date and time identified in the Key Dates Table of this RFP solicitation. ☐

Delivery Format: Proposal was submitted electronically via e-mail. ☐

Submission Format: Proposal was submitted in the format requirement below:

Size 12 font for body text. Times New Roman, Arial, or Calibri for typeface.

The pages of the proposal shall include a header in the top righthand corner of each page. The name of the proposer on the top line; the solicitation number on the middle line; and the page count on the bottom line. See the following example:

ABC Consulting Company

RFP #SPPD12345

Proposals must be written from a third person point of view. Do not use first person terminology including, but not limited to: my, I, mine, our, we, we’re, we’ve, Clear Form

RFP# OCPSC25003

us. Instead, be more exact and use specific terms such as [the Governor’s Office of Land Use and Climate Innovation] or [LCI], or the [Proposer’s Name] or [Proposer’s Acronym] to clearly distinguish who it is that is being mentioned.

Proposal was submitted with attachments in the following order:

• Title Page*

• Table of Contents*

• Proof of Minimum Qualifications*

• Personnel Resumes/CVs/Biosketches*

• Attachment 1: Proposal Requirement Checklist*

• Attachment 4: Contractor Scope of Work Response*

• Attachment 5: Contractor Cost Worksheet Response*

• Attachment 6: Proposal Certification Sheet*

• Attachment 7: Proposer References Form*

• Attachment 8: Bidder Declaration GSPD 05-105*

• Attachment 9: DVBE Subcontractor Agreement*, (if applicable)

• Attachment 10: Commercially Useful Function Certification* (if applicable)

• Attachment 11: Payee Data Record STD 204*

• Attachment 12: Contractor Certification Clauses CCC 04/2017*

• Attachment 13: CA Civil Rights Law Certification DGS OLS 04* (if applicable)

• Attachment 14: Darfur Contracting Act Certification DGS PD 1*

• Attachment 15: Iran Contracting Act Certification* (if applicable)

• Attachment 17: DVBE Declaration STD 843* (if applicable)

• Attachment 18: TACPA Preferences Request STD 830* (if applicable)

• Attachment 19: TACPA Manufacturer’s Summary DGS PD 525* (if applicable)

• Attachment 20: TACPA Bidder’s Summary DGS PD 526* (if applicable)

• Attachment 21: TACPA Monthly Report Template GSPD 12-002

• Attachment 22: Conflict of Interest and Confidentiality Statement*

• Attachment 23: GenAI Reporting and Factsheet STD 1000*

• Attachment 24: DVBE Subcontracting Report STD 817

• Secretary of State Status Verification Printout*

• Franchise Tax Board Status Verification Printout*

• CA Department of Tax and Fee Status Verification Printout*

• Small Business / Disabled Veterans Business Enterprise Certification

Printouts* Title Page*: The purpose of the title page is to provide in one location, information needed by LCI administrative staff. It must contain the following information:

• Request For Proposal Solicitation Number

• Project Name

• Date of Submission

• Proposer Name

• Subcontractor Names, if applicable

• Proposer Address

• Proposer Email

• Proposer Phone

Table of Contents*: The proposal must have a table of contents at the beginning of the proposal to allow for easy navigation. ☐

Proof of Minimum Qualifications*: A detailed response is present that summarizes how the proposing team meets the minimum qualifications. ☐

Personnel Resumes/CVs/Biosketches*: A resume, CV, or biosketch is required for each member of the proposer’s team, inclusive of subcontractor members. ☐

Attachment 1: Proposal Requirement Checklist* This attachment serves as a checklist for proposers to ensure they have completed all the requirements and attachments that are needed to respond to this solicitation.

Attachment 2: Request For Proposals - Notice to Bidders.

This attachment is provided with the RFP solicitation for information only and is not required to be returned with proposals.

N/A

Attachment 3: Draft Standard Agreement This Draft Standard Agreement includes a STD 213 Standard Agreement Form as well as the Exhibits that will be used in the awarded contract.

• STD 213 Standard Agreement Form

• Exhibit A – Scope of Work o This attachment serves as the scope of work for this solicitation. Its purpose is to identify in detail the services to be provided, tasks, and deliverables that are required of this project.

• Attachment A1 (Awarded Contractor’s Scope of Work Response)

• Exhibit B – Budget Detail and Payment Provisions

• Attachment B1 (Awarded Contractor Cost Worksheet Response)

• Exhibit C – General Terms and Conditions (GTC 04/2017)

• Exhibit D – Special Terms and Conditions

• Exhibit E – Resumes/CVs/Biosketches

This attachment is provided with the RFP solicitation for information only and is not required to be returned with proposals.

N/A

Attachment 4: Contractor Scope of Work Response* Attachment 4 serves as the required template to build your proposal in response to this solicitation. Here is where you will identify how you plan to accomplish the goals, tasks, and deliverables identified in the Exhibit A - Scope of Work.

You may add additional sections in the template if necessary. When an award has been made from this solicitation, the awarded Contractor’s response will be made a part of the contract agreement as Attachment A1.

Format:

• Written in the 3rd person point of view

• Size 12 font for body text. Times New Roman, Arial, or Calibri for typeface.

• Includes a header with company name, solicitation number, and page count

The Proposal Response identifies all 7 components:

1. Summary

2. Project/Team Management Plan

3. Scope of Work

4. Methodology/Approach to Work

5. Tasks

6. Work Plan

7. Work Schedule/Timeline

Attachment 5: Contractor Cost Worksheet Response* Attachment 5 serves as the required template to build your budget in response to this solicitation. Ensure that all budget categories are accounted for. Note that this template has two worksheets.

When an award has been made from this solicitation, the awarded Contractor’s cost sheet will be made a part of the contract agreement as Attachment B1 – Contractor Cost Worksheet.

Attachment 6: Proposal Certification Sheet* This attachment summarizes the proposer’s information and is required to be submitted as a part of your proposal. An unsigned Proposal Certification Sheet may cause the proposal to be deemed nonresponsive.

Attachment 7: Proposer References Form* This attachment serves as a reference form for LCI staff to conduct a reference check after the submission deadline has passed. Failure to fully complete and return this attachment may cause your proposal to be rejected and deemed non-responsive.

Attachment 8: Bidder Declaration GSPD 05-105* This attachment serves as a summary of who is working on this project and identifies any certifications that may be held by either the prime proposer or any of its subcontractors. If subcontractors are being used on this project, they must be listed on this document. The Proposer must complete, sign, and submit this attachment with their proposal.

The form can be obtained via the internet by visiting the following online hyperlink:

https://www.dgs.ca.gov/en/PD/Forms.

Proposal will not be accepted if this required form is not included with the proposal submission.

Failure to fully complete and return this attachment with your proposal will cause your proposal to be rejected and deemed non-responsive.

Attachment 9: DVBE Subcontractor Agreement* (if applicable) This attachment is required to be filled out for each DVBE Subcontractor the proposer will be subcontracting with.

Attachment 10: Commercially Useful Function Certification* (if applicable) This attachment is required to be filled out for each contractor and subcontractor(s) that are a certified Small Business, Micro Business, or Disabled Veteran Business- Owned Enterprise (DVBE) to ensure that they meet the CUF requirements under Government Code (GC) 14837(d) (4)(A) (i-v) (for SB) and Military and Veterans Code section 999(b)(5)(B) (i) (I-V) (for DVBE).

After the proposal receipt deadline has concluded, LCI staff will review proposals and conduct an evaluation to ensure that the certified contractor and subcontractor(s) are performing a commercially useful function.

Proposal will not be accepted if this required form is not included with the proposal submission.

Failure to fully complete and return this attachment with your proposal will cause your proposal to be rejected and deemed non-responsive.

Attachment 11: Payee Data Record STD 204* This attachment serves as the standard form to add vendors to the Financial Information System for the State of California to receive payments.

The form can be obtained via the internet by visiting the following online hyperlink:

https://www.dgs.ca.gov/en/PD/Forms.

Attachment 12: Contractor Certification Clauses CCC 04/2017* This attachment serves as a statement of compliance with the requirements of contractors who are entering into agreements with the State of California.

The form can be obtained via the internet by visiting the following online hyperlink:

Contractor Certification Clauses

Attachment 13: CA Civil Rights Law Certification DGS OLS 04* (if applicable) ☐ https://www.dgs.ca.gov/en/PD/Forms https://www.dgs.ca.gov/en/PD/Forms https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language

This attachment serves as a statement of compliance with the California Civil Rights Laws and Employer Discriminatory Policies pursuant to Public Contract Code section 2010. This attachment is required in response to solicitations valued at $100,000 or above. Required if applicable.

The form can be obtained via the internet by visiting the following online hyperlink:

https://www.dgs.ca.gov/OLS/Forms.

Attachment 14: Darfur Contracting Act Certification DGS PD 1* This attachment serves as a statement of compliance pursuant to Public Contract Code section 10478 when engaging in business activities or other operations outside of the United States.

The form can be obtained via the internet by visiting the following online hyperlink:

https://www.dgs.ca.gov/en/PD/Forms.

Attachment must be filled out completely and signed if applicable for this project.

Attachment 15: Iran Contracting Act Certification* (if applicable) This attachment serves as a statement of compliance pursuant to Public Contract Code section 2202-2208. This attachment is required in response to solicitations valued at $1,000,000 or above. Required if applicable.

The form can be obtained via the internet by visiting the following online hyperlink:

https://www.dgs.ca.gov/en/PD/Forms.

Attachment 16: CA DVBE Bid Incentive Instructions This attachment serves as an introduction to the Disabled Veteran Business-Owned Enterprise (DVBE) program and provides instructions on the requirements for DVBE participation.

This attachment is provided with the RFP solicitation for information only and is not required to be returned with proposals.

N/A

Attachment 17: DVBE Declaration STD 843* (if applicable) This attachment serves as the standard form for DVBE declarations. The owner(s) and manager(s) of the DVBE must complete this declaration when a DVBE contractor or subcontractor will provide materials, supplies, services, or equipment pursuant to Military and Veterans Code Section 999.2. Violations are misdemeanors and punishable by imprisonment or fine and violators are liable for civil penalties.

Required if applicable.

Attachment must be filled out completely and signed if this form is applicable for this project.

The form can be obtained via the internet by visiting the following online hyperlink:

https://www.dgs.ca.gov/OLS/Forms https://www.dgs.ca.gov/en/PD/Forms.

Attachment 18: TACPA Preferences Request STD 830* (if applicable) Target Area Contract Preference Act (TACPA) preferences are available only if the lowest responsible bid and resulting contract exceeds $100,000. The STD 830 form is the request form for worksite or workforce and will be submitted to the Department of General Services’ Procurement Division for review and approval.

Required if applicable.

Attachment must be filled out completely and signed if this form is applicable for this project.

The form can be obtained via the internet by visiting the following online hyperlink:

TACPA Preferences Request

Attachment 19: TACPA Manufacturer’s Summary DGS PD 525* (if applicable) This attachment serves as the Manufacturer’s Summary of Contract Activities and Labor Hours as it relates to the TACPA preference. Proposers claiming the TACPA preference must also fill out and return this DGS PD 525 form. Required if applicable.

Attachment must be filled out completely and signed if this form is applicable for this project.

The form can be obtained via the internet by visiting the following online hyperlink:

MANUFAC Summary Form DGSPD 525 (ca.gov)

Attachment 20: TACPA Bidder’s Summary DGS PD 526* (if applicable) This attachment serves as the Bidder’s Summary of Contract Activities and Labor Hours as it relates to the TACPA preference. Proposers claiming the TACPA preference must also fill out and return this DGS PD 526 form. Required if applicable.

Attachment must be filled out completely and signed if this form is applicable for this project.

The form can be obtained via the internet by visiting the following online hyperlink:

DGS PD 526 (ca.gov)

Attachment 21: TACPA Monthly Report Template GSPD 12-002 This attachment serves as a monthly reporting template when proposers are granted TACPA preferences. Contractor will be required to use this template to report monthly the labor hours, goods, and services in order for the Department of General Services’ Procurement Division to monitor performance and ensure the contractor is in compliance.

https://www.dgs.ca.gov/en/PD/Forms https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std830.pdf https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0525.pdf https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0526.pdf

The form can be obtained via the internet by visiting the following online hyperlink:

DGS PD 12-002 TACPA Monthly Performance Report of Labor Hours (ca.gov)

Attachment 22: Conflict of Interest and Confidentiality Statement* The Proposer must agree to LCI’s conflict of interest clauses and confidentiality requirements by submitting a signed and dated Conflict of Interest and Confidentiality Statement.

This attachment is required to be completed, signed and included with your proposal submission.

Attachment 23: GenAI Reporting and Factsheet STD 1000* The Proposer must indicate whether or not they will be using/offering Generative Artificial Intelligence (GenAI) technology, model, or service for this proposal.

This attachment is required to be completed, signed and included with your proposal submission.

The form can be obtained via the internet by visiting the following online hyperlink:

GenAI Reporting Factsheet

Attachment 24: DVBE Subcontracting Report STD 817 If the winning proposer is confirmed to have one or more DVBE subcontractors, they must complete and submit an accurate Prime Contractor’s Certification – DVBE Subcontracting Report (STD 817) upon contract completion. Military and Veterans Code section 999.7 requires LCI to withhold $10,000, or full payment if less than $10,000, from the prime contractor’s final payment pending receipt of a complete and accurate STD 817.

N/A

Secretary of State Status Verification Printout* The Proposer must be in good standing in order to be qualified to do business in California.

Secretary of State

Franchise Tax Board Status Verification Printout* The Proposer must not be listed as a Top 500 tax delinquency with the Franchise Tax Board.

Franchise Tax Board

CA Department of Tax and Fee Status Verification Printout* The Proposer must not be listed as a top 500 with the CA Department of Tax and Fee. Provide a printout of your company’s status.

https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd12-002.pdf https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std1000.pdf https://bizfileonline.sos.ca.gov/ https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/corporate-income-tax-list.html

CDTFA

SB/DVBE Status Certification Printouts* A printout of the DGS certification for SB or DVBE for the Proposer and each subcontractor.

CaleProcure

Small Business (SB) Participation of 25%* (if applicable) Refer to the Attachment 2 Request For Proposals Notice to Bidders to identify if this RFP solicitation requires a minimum of 25% Small Business Participation.

Disabled Veterans Business Enterprise (DVBE) Participation of 3%* (if applicable) Refer to the Attachment 2 Request For Proposals Notice to Bidders to identify if this RFP solicitation requires a minimum of 3% DVBE Participation.

By signing below, I certify that the above is true and accurate.

RFP Solicitation #:

Organization Name:

Print Name / Title:

Phone:

E-mail:

Signature:

https://www.cdtfa.ca.gov/taxes-and-fees/top500.htm https://caleprocure.ca.gov/pages/PublicSearch/supplier-search.aspx?psNewWin=true

ATTACHMENT 6: PROPOSAL CERTIFICATION SHEET

Only an individual who is authorized to contractually bind the proposing firm shall sign the Proposal Certification Sheet. The signature must indicate the title or position that the individual holds in the firm.

This Proposal Certification Sheet must be signed and returned along with all “required attachments” as an entire package with signatures. The proposal must be submitted in accordance with the instructions for this solicitation.

An Unsigned Proposal Certification Sheet may cause the proposal to be deemed nonresponsive

1. Company Name 2. Telephone Number 3. E-Mail Address

4. Address

Type of organization:

5. ☐ Sole proprietorship

8. ☐ Limited Liability Company

6. ☐ Partnership

9. ☐ Other:

7. ☐ Corporation

10. Federal Employee ID No. (FEIN) 11. California Corporation No.

12. Indicate applicable license and/or certification information:

13. Proposer’s Name (Print) 14. Title

15. Signature 16. Date

17. Are you certified with the Department of General Services, Office of Small Business and Disabled Veteran Business Enterprise Services (OSDS) as:

a. Small Business Enterprise

Yes ☐ No ☐

b. Disabled Veteran Business Enterprise

Yes ☐ No ☐

If yes, enter certification number: If yes, enter certification number:

A copy of your Certification is required to be included if either of the above items is checked “Yes”.

Date application was submitted to OSDS, if an application is pending: __________________

ATTACHMENT 7: PROPOSER REFERENCES FORM

Submission of this form is mandatory. Failure to complete and return this attachment with your proposal may cause your proposal to be rejected and deemed non-responsive. By furnishing the references, the proposer authorizes the State to contact the named company, person or entity to discuss the Contractor’s past performance.

Complete the below table listing information for three references that can speak to how the Proposer could fulfill the goals of the program.

REFERENCE 1

Name of Firm:

Street Address City State Zip Code

Contact Person: Telephone Number:

E-Mail:

Dates of Service: Value or Cost of Service:

Brief Description of Service Provided

REFERENCE 2

REFERENCE 3

RFP# OCPSC25003

ATTACHMENT 9: DVBE SUBCONTRACTOR AGREEMENT

PART A: NAMED PARTIES

This Agreement is entered into between Contractor: ____________________________, hereinafter (Contractor Name) referred to as Proposer, and DVBE subcontractor:

_______________________________________________, (DVBE

Subcontractor Name) hereinafter referred to as Subcontractor, on: ___________________, consisting of the following conditions:

(Date)

1) Proposer has submitted or intends to submit a proposal on a solicitation issued by the State of California, Governor’s Office of Land Use and Climate Innovation, hereinafter referred to as LCI. LCI will enter into a contract (the primary agreement) with the Proposer if the Proposer is awarded the contract.

2) Proposer declares the Subcontractor as a disabled veteran business enterprise subcontractor in the proposal; and Proposer intends to employ the subcontractor to perform certain work or services under the primary agreement if the Proposer is awarded contract agreement from LCI.

3) Subcontractor intends to provide certain work or services or products/goods under the primary agreement if the contract is awarded to the Proposer.

PART B: AGREEMENT

LCI requires the Proposer to provide, prior to the contract award, a written agreement signed by the Proposer and each disabled veteran business enterprise subcontractor proposed by the Proposer in the proposal submitted to LCI, to include certain terms and conditions specified below. These written agreements shall become null and void if the Proposer is not awarded a contract as result of this proposal request.

Proposer and the Subcontractor agree that, in the event LCI awards the primary agreement to the Proposer, the Proposer will employ the Subcontractor to provide goods and/or services in accordance with the following terms and conditions:

1) The term of this Agreement is: _______________________________________.

The parties estimate that the goods and/or services will be provided/performed by the Subcontractor within the contract term.

2) The parties estimate that the goods and/or services will be provided/performed by the Subcontractor commencing on: ____________ and completed by:

3) The rate and conditions of payment by the Bidder to the Subcontractor are:

RFP# OCPSC25003

4) The percentage of the entire primary contract to be awarded to the Subcontractor is:

(Must commit at least 3% of the entire bid amount unless otherwise specified within the solicitation.)

5) Description of services and/or goods to be performed/supplied by the DVBE Subcontractor:

(Attach Additional Sheets If Necessary) This Agreement has been executed by the parties identified below:

Proposer’s Company Name Subcontractor’s Company Name:

By (Authorized Signature):

Date Signed By (Authorized Signature)

Date Signed:

Printed Name and Title of Person Signing Printed Name and Title of Person Signing:

DVBE PROGRAM REQURIEMENTS SUPPLIER CHECKLIST

Please do not submit this checklist with your proposal. It is provided for your use only.

Checking every box of your elected compliance option does not guarantee that your proposal will be evaluated compliant.

☐ Attachment 8 – Bidder Declaration

☐ Attachment 10 – CUF Certification Note: This is applicable if you are a certified DVBE bidder or subcontractor

☐ Attachment 17 – DVBE Declaration (STD 843) Note: This is applicable if you are a certified DVBE bidder or subcontractor

☐ Attached completed DVBE Subcontractor Agreement(s) Note This is only applicable if you intend to utilize a DVBE subcontractor

☐ Provide proof of DVBE certification for each DVBE identified via a printout from the DGS/OSDS Cal eProcure website.

THE REMAINDER OF THIS PAGE WAS INTENTIONALLY LEFT BLANK

RFP# OCPSC25003

ATTACHMENT 10: COMMERCIALLY USEFUL FUNCTION

(CUF) CERTIFICATION

THE BIDDER MUST COMPLETE AND SUBMIT WITH ITS PROPOSAL.

Bidder Name Subcontractor Name (submit one form for each SB/DVBE (prime and/or subcontractor(s))

Mark all that apply:

☐ DVBE

☐ Small Business or Micro Business

☐ N/A

Mark all that apply:

☐ DVBE

☐ Small Business or Micro Business

☐ N/A

All certified small business (SB), micro business (MB), and/or DVBE Contractors, subcontractors or suppliers must meet the commercially useful function requirements under Government Code Section 14837 (for SB), Military and Veterans Code Section 999 (for DVBE), and Title II California Code of Regulations, Section 1896.4 and 1896.62.

Answer questions 1-5 below, as they apply to your company for the goods and/or services being acquired in this solicitation. A California certified SB, MB, or DVBE business must be deemed to perform a Commercially Useful Function (CUF) by meeting ALL of the following CUF requirements for Contract award consideration.

CUF Requirements Yes No

1. Is responsible for the execution of a distinct element of the resulting Contract. ☐ ☐

2. Carries out its obligation by actually performing, managing, or supervising the work involved. ☐ ☐

3. Performs work that is normal for its business services and functions. ☐ ☐

4. Is responsible, with respect to products, inventories, materials, and supplies required for the Contract, for negotiating price, determining quality and quantity, ordering, installing, if applicable, and making payment. If this is a SERVICE with NO goods involved, check N/A and go to #5.

☐ ☐N/A

5. Is not further subcontracting a portion of the work that is greater than that expected to be subcontracted by normal industry practices.

If the answer to any of the five (5) questions is “NO” (except for #4 when marked with “N/ A”), may result in your proposal being deemed non-responsive.

The Bidder must provide a written statement below detailing the role, services, and goods the subcontractor(s) will provide to meet the commercially useful function requirement. If the Bidder is not claiming a SB or DVBE, indicate “Not claiming a preference” in the box below.

Written Statement or Statement of No Claim

At the State’s option prior to award, the Bidder may be required to submit additional written clarifying information. By signing this form, the undersigned Bidder certifies that the Certified Small Business or DVBE satisfies the Commercially Useful Function requirement, and will provide the role, services, and/or goods stated above.

Bidder Signature

Bidder Printed/Typed Name and Title

ATTACHMENT 16: CA DVBE BID INCENTIVE

INSTRUCTIONS

CALIFORNIA DISABLED VETERAN BUSINESS ENTERPRISE PARTICIPATION

REQUIREMENT AND INCENTIVE

1. Authority A. The Disabled Veteran Business Enterprise (DVBE) Participation Goal Program for state contracts is established in Public Contract Code Section 10115 et seq., Military and Veterans Code Section 999 et seq., and California Code of Regulations, Title 2, Division 2, Chapter 3, Subchapter 10.5, Article 1, Section

1896.60 et seq.

B. Only DVBEs certified by the California Department of General Services (DGS), Office of Small Business and DVBE Services (OSDS), who perform a Commercially Useful Function (CUF) relevant to this solicitation, shall be used to satisfy the DVBE goals. As defined in Military and Veterans Code Section 999 and California Code of Regulations, Title 2, Division 2, Chapter 3, Subchapter 10.5, Article 2, Section 1896.71, a person or an entity is deemed to perform a CUF if a person or entity does all of the following:

1) Is responsible for the execution of a distinct element of the work of the contract.

2) Carries out the obligation by actually performing, managing, or supervising the work involved.

3) Performs work that is normal for its business services and functions.

4) Is responsible, with respect to products, inventories, materials, and supplies required for the contract, for negotiating price, determining quality and quantity, ordering, installing, if applicable, and making payment.

5) Is not further subcontracting a portion of the work that is greater than that expected to be subcontracted by normal industry practices.

C. A contractor, subcontractor, or supplier will not be considered to perform a CUF if the contractor’s, subcontractor’s, or supplier’s role is limited to that of an extra participant in a transaction, contract, or project through which funds are passed in order to obtain the appearance of DVBE participation.

D. Bidder must verify each DVBE subcontractor/supplier certification with DGS/OSDS to ensure DVBE participation eligibility prior to submitting a bid.

2. DVBE Participation Requirement Bidder must refer to Attachment 2 for DVBE participation requirement.

3. DVBE Participation Incentive

In accordance with Section 999.5 of the Military and Veterans Code, a bid incentive will be given to bidders who provide DVBE participation.

For evaluation purposes only, LCI shall apply a bid incentive to bids that propose California certified DVBE participation as identified on Attachment 6, Bidder Declaration. The bid incentive amount for awards based on lowest bid will vary in conjunction with the percentage of DVBE participation. The following bid incentive percentages will apply:

If the 3% participation requirement is not waived:

Confirmed DVBE Participation of: DVBE Incentive:

3% to 3.99% inclusive 3%

4% to 4.99% inclusive 4%

5% or higher 5%

If the 3% participation requirement is waived:

Confirmed DVBE Participation of: DVBE Incentive:

1% to 1.99% inclusive 1%

2% to 2.99% inclusive 2%

3% to 3.99% inclusive 3%

4% to 4.99% inclusive 4%

5% or higher 5%

NOTE: The DVBE Participation Incentive cannot displace a direct award to a California certified Small Business or a California certified Micro Business.

4. Resources and Information For assistance regarding the DVBE participation requirement and/or incentive, please contact LCI’s DVBE Advocate at Contracts@lci.ca.gov regarding this solicitation. To locate certified DVBEs and obtain additional information regarding the DVBE program, please refer to the DGS/OSDS website at http://www.dgs.ca.gov or contact the DGS/OSDS by telephone at (916) 375-4940.

5. Required Documents Bidder shall document the DVBE participation commitment by completing and submitting all of the following documents with their bid:

A. Attachment 8 – Bidder Declaration mailto:bso@opr.ca.gov http://www.dgs.ca.gov/

Failure to complete and submit the Bidder Declaration included in this solicitation may render your bid non-responsive.

B. Attachment 10 – CUF Evaluation Worksheet Failure to complete and submit the CUF Evaluation Worksheet for each DVBE(s) including subcontractor(s) included in this solicitation may render your bid non-responsive.

C. Attachment 17 – DVBE Declaration (STD 843) Failure to complete and submit the STD 843 included in this solicitation may render your bid non-responsive.

D. DVBE Subcontractor Agreement included in this Attachment. Bidder shall submit a completed DVBE Subcontractor Agreement for each DVBE subcontractor identified in the bid. Only the bidder shall fill out this Agreement and either mail, fax, or email the Agreement to the selected DVBE(s) for signature. Each DVBE Subcontractor Agreement will include: the term of intended subcontract with the DVBE, anticipated dates the DVBE will perform required work, rate and conditions of payment, the percentage of the entire contract amount that will be committed to the DVBE, and the description of services and/or goods to be performed/supplied by the DVBE subcontractor. If further verification is necessary, LCI will obtain additional information to verify the above requirements.

Failure to submit a DVBE Subcontractor Agreement for each DVBE subcontractor identified may render your bid non-responsive.

E. Proof of DVBE Certification for each DVBE subcontractor identified on the Bidder Declaration (Attachment 6) via a printout from the DGS/OSDS Cal eProcure website.

6. Replacement of DVBE Subcontractor(s) Bidder understands and agrees that should award of the contract be based in part on a commitment to use the DVBE subcontractor(s) identified in their bid, per Military and Veterans Code Section 999.5, a DVBE subcontractor may only be replaced by another DVBE subcontractor and must be approved by the Department of General Services (DGS).

Failure to seek a DVBE substitution when necessary and adhere to the DVBE participation level identified in the bid may be cause for contact termination, recovery of damages under rights and remedies due to LCI, and penalties outlined in Military and Veterans Code Section 999.9, and Public Contract Code Section 10115.10, or Public Contract Code Section 4110 (applies to public works only).

7. DVBE Subcontractor Participation Reporting Requirements A. Contractors that make a commitment to achieve DVBE subcontractor participation for a contract shall download from www.dgs.ca.gov, complete, sign, and submit to LCI with the final invoice for payment, a Prime Contractor’s Certification - DVBE Subcontracting Report (STD 817) certifying all of the https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.dgs.ca.gov%2F&data=04%7C01%7CValerie.Roybal%40dmv.ca.gov%7C0efa0e6db67347ae596508da08829dd2%7C9ea0f73ca0d34b208018f0b0793ee9cd%7C0%7C0%7C637831654356227241%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=XklPdonDGub34iimwQUD0Xz5F9yUZJacG6q5o3TGtEM%3D&reserved=0 following:

1) The total dollar amount the contractor received under the contract.

2) The Agreement number and the name, address, and certification ID number of all DVBE subcontractors that participated in the performance of the contract.

3) The total dollar amount and percentage of the contract’s total dollar amount the contractor committed to each DVBE subcontractor.

4) The total dollar amount the contractor paid each DVBE subcontractor.

5) That all payments under the contract have been made to the DVBE subcontractor(s).

6) The actual percentage of DVBE participation that was achieved. Upon request, the contractor shall provide proof of payment for the work.

B. LCI will withhold $10,000.00 (or the full dollar amount if less than $10,000.00) from the final payment, until the contractor complies with the certification requirements above. A contractor that fails to comply with the certification requirements above shall, after written notice, be allowed to cure the defect.

Notwithstanding any other law, if, after at least 15 calendar days but not more than 30 calendar days from the date of written notice, a contractor refuses to comply with the certification requirements above, LCI shall permanently deduct $10,000.00 (or the full dollar amount if less than $10,000.00) from the final payment (Military and Veterans Code Section 999.7).

C. A person or entity that knowingly provides false information shall be subject to a civil penalty for each violation (Military and Veterans Code Section 999.5;

Government Code Section 14841).

D. A contractor shall comply with the rules, regulations, ordinances, and statutes that apply to the DVBE program as defined in Section 999 of the Military and Veterans Code, including, but not limited to, the requirements of Section 999.5(d).

8. DVBE Subcontractor Invoices To ensure that DVBE participation is applied correctly, all DVBE subcontractor invoices submitted to the contractor shall include the contract number.

ATTACHMENT 22: CONFLICT OF INTEREST AND

CONFIDENTIALITY STATEMENT

As an authorized representative or corporate officer of the company named below, I have the authority to bind the company contractually, and I agree that all persons employed by this company will adhere to the following policy:

All information belonging to the Governor’s Office of Land Use and Climate Innovation (LCI) or its affiliated agencies is considered sensitive and confidential and cannot be disclosed to any person or entity that is not directly approved to participate in the work required to execute this Agreement.

I certify that I have no personal or financial interest and no present or past employment or activity which would be incompatible with my participation in any activity related to the planning or procurement processes for the project or procurement. I agree that no gift, benefit, gratuity or consideration will be accepted and there is no personal or financial interest, or association initiated on a project or procurement.

I certify that I will keep all project information, including but not limited to, information concerning the planning, processes, development or procedures of the project, and all communication with LCI or its affiliates related to any procurement process, confidential and secure. I will not copy, give or otherwise disclose such information to any other person unless LCI has on file a Conflict of Interest and Confidentiality Statement signed by the other person(s), and the disclosure is authorized and necessary for the project. I understand that the information to be kept confidential includes, but is not limited to, specifications, administrative requirements, terms and conditions, concepts and discussions, as well as written and electronic materials. I further understand that if I leave this project before it ends, I must still keep all project information confidential. I agree to follow any instructions provided by the project relating to the confidentiality of project information.

I fully understand that any unauthorized disclosure I make may be basis for civil and/or criminal penalties. I agree to advise the Contract Manager immediately in the event of an unauthorized disclosure, inappropriate access, misuse, theft or loss of data.

I warrant that if my company is awarded the Contract, it will not enter into any agreements or discussions with a third party concerning such materials prior to receiving written confirmation from LCI that such third party has an agreement with the State similar in nature to this one. All materials provided for this project, except where explicitly stated will be promptly returned or destroyed, as instructed by an authorized LCI representative. If the materials are destroyed and not returned, a letter attesting to their complete destruction, which documents the destruction procedures, must be sent to the Contract Manager before payment can be made for services rendered. In addition, all copies or derivations, including any working or archival backups of the information, will be physically and/or electronically destroyed within five (5) calendar days immediately following either the end of the Contract period or the final payment, as determined by the Contract Manager.

All personnel assigned to this project shall be provided with a Conflict of Interest and Confidentiality Statement and will be expected to sign and return it to the Contract Manager before beginning work on this project.

Representative Name / Title:

Company Name:

Address:

Telephone / Fax Number:

Email Address:

Signature/Date:

ATTACHMENT 6: PROPOSAL CERTIFICATION SHEET
ATTACHMENT 7: PROPOSER REFERENCES FORM
ATTACHMENT 9: DVBE SUBCONTRACTOR AGREEMENT
ATTACHMENT 10: COMMERCIALLY USEFUL FUNCTION (CUF) CERTIFICATION
ATTACHMENT 16: CA DVBE BID INCENTIVE INSTRUCTIONS
ATTACHMENT 22: CONFLICT OF INTEREST AND CONFIDENTIALITY STATEMENT
RFP Solicitation:
Organization Name:
Print Name Title:
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1 Company Name:
2 Telephone Number:
3 EMail Address:
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Limited Liability: Off
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10 Federal Employee ID No FEIN:
11 California Corporation No:
12 Indicate applicable license andor certification information:
13 Proposers Name Print:
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a Small Business Enterprise: Off
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undefined:
referred to as Proposer and DVBE subcontractor:
consisting of the:
goods andor services in accordance with the following terms and conditions:
2 The parties estimate that the goods andor services will be providedperformed by:
the Subcontractor commencing on:
3 The rate and conditions of payment by the Bidder to the Subcontractor are:
Must commit at least 3 of the entire bid amount unless otherwise specified within:
Subcontractor:
Proposers Company Name:
Subcontractors Company Name:
Date Signed:
Date Signed_2:
Printed Name and Title of Person Signing:
Printed Name and Title of Person Signing_2:
Bidder Name:
Subcontractor Name submit one form for each SBDVBE prime andor subcontractors:
DVBE: Off
Small Business or Micro Business: Off
NA: Off
DVBE_2: Off
Small Business or Micro Business_2: Off
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Written Statement or Statement of No ClaimRow1:
Bidder PrintedTyped Name and Title:
Representative Name Title:
Company Name:
Address:
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Date58_af_date:
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File details come from the government source that posted it. Updated .