Attachment_22_-_DGS-PD_525_Manufacturers_Summary.pdf

Section II

Manufacturing Packaging Handling Warehousing Shipping 1.

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7.

BIDDER'S SIGNATUREBIDDER'S NAME AND TITLE

I hereby certify under penalty of perjury that manufacturer provided the above information to me. The proposed employee labor hours indicated above correlate with the hours reported on the preference request form STD 830 that accompany this bid.

Bidder's Certification: Must be completed and signed by the Bidder to be eligible for bidding preferencesSection IV

DATE

Separate "Manufacturer's Summaries " are required for each site that is identified as a manufacturer of the contract goods.

(Employee Labor Hours)

STATE OF CALIFORNIA

Manufacturer's Information: Must be completed by Manufacturer

NAME & TITLE OF PERSON SIGNING AS MANUFACTURER

MANUFACTURER'S SIGNATURE

Manufacturer's Information and certification: must be completed and signed by the Manufacturer

AGENCY/DEPT

To be eligible for the bidding preferences, the following data/information must be provided AND signed, as indicated, by both the Manufacturer and the Bidder.

Any person furnishing false certifications, willfully providing false information, omitting information, or failing to comply with the preference requirements is subject to sanctions as set forth in statutes

Report the projected production capacity of your facility for each product type/solicitation line item. This form must accompany STD 830 bid preference request form submittal to the designated contracting official at the awarding department. Enter the number of all employee labor hours in an 8-hour shift at this site required and necessary to perform the contract. Employee labor hours may cover such activities as manufacturing, packaging, handling, warehousing and/or shipping the product (see reverse for additional information). Do not include labor-free time (automation or machine hours /storage/etc.). Should additional lines be needed, copies of this form can be used.

Production Capacity (Units Per 8-Hr Shift)

Number Of employees Used in 8-Hr Shift (of the product Production Cycle)

Other*

Total Number Of Contract Labor Hours Per PS Type Or Line

Item

Product Type Or Line Item (Manufactured At This Site)

DGS/PD 525 (Rev. 01/05) MANUFACTURER'S SUMMARY Of Contract Activities and Labor Hours

Section I

SOLICITATION NUMBER

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Section III

* EXPLAIN "OTHER" ACTIVITIES OF THE MANUFACTURINGCYCLE MUST BEDEFIND HERE, IF USED (Use additional sheets, if necessary)

MANUFACTURER'S NAME AND ADDRESS

Grand Total

Contract Quantity (include Product

Units)

PHONE NUMBER DATE

EmptyFAX NUMBER

FAX NUMBER

PHONE NUMBER

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Production Capacity: Indicate the manufacturing capacity for each product type/line item in an 8-hour period.

Total Hours: For each product type/line Item, identify the total number of employee contract labor hours projected to be used for the entire contract period.

Section I To be completed by the Bidder Section III To be completed by the Manufacturer

Solicitation Number: Enter the solicitation number identified on the front page of the Invitation For Bid for which this form is being submitted.

Firm & Address: Enter the manufacturer’s name & address.

Agency/Department: Enter the name of the buying Agency and/or Department (e.g., State and Consumer Services Agency, Department of General Services)

Authorized Representative: Type or print the name and title of the person signing the form.

Section II To be completed by the Manufacturer Contract Phone Number: Enter the telephone number and fax number for the manufacturer.

Date: Enter the date the form is completed and signed by the manufacturer

Signature: Signed by the manufacturer

Section IV To be completed by the Bidder

References and Instruction

The California Legislature has declared that it serves a public purpose and is a benefit to the State to encourage business investment, promote job development, and to facilitate job maintenance in economically distressed areas of the state. It is the intent of the Legislature to further these goals by providing appropriate preferences to California based companies submitting bids or proposals for state contracts to be performed at worksites in economically distressed areas when the contract is for goods or services in excess of $100,000. To obtain preferences, the bidder must demonstrate that a minimum 50% (for goods contracts) or 90% (for services contracts) of the projected employee labor hours necessary for the contract will be performed within the economically distressed area. This includes manufacturer’s employee labor hours.

Product Type or Line Item: List the product type or line item as specified on the solicitation. Identify each product type or match the line items on the solicitation.

the solicitation. Identify each product type or match the line items on the solicitation.

Employees used in 8-Hr Period: Indicate the number of employees used for the various production segments during an 8-hour period (example: .5, 1.5, 2). List only the production processes pertaining to the production of the bid product/line item.

Production tasks may include: manufacturing, packaging, handling, shipping, and/or other.

Production hours listed under “other” must be defined.

If the bidder requests TACPA contract preferences1, the completed Manufacturer’s Summary must be signed by both the manufacturer2 and the bidder for each requested preference. The information provided on this form will be used to evaluate the total manufacturing employee labor hours required to complete this contract.

MANUFACTURER'S SUMMARY Empty

This section identifies the projected production capacity of the manufacturer’s facility; number of employees used for each type of the bid product and total of the projected employee contract labor hours used to manufacturer the bid product for the entire contract period.

1Target Area Contract Preferences Act, GC § 4530 et seq.

Contract Quantity: List the number of product unit(s) (i.e. # cases, pounds, etc.). Use the same quantity and unit of measure used in the state’s solicitation.

Section IV must be completed and signed by the bidder to be eligible for the bidding preference.

2 The State considers the manufacturer to be the company or companies that add value to the product by converting or transforming it from the raw or bulk product into the final bid product.