ATTACHMENT 3- FOLLOW-ON CONTRACT DISCLOSURE FORM.pdf
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- Solicitation number
- 0000040415
- Issued by
- California
About this file
This is a Follow-On Contract Disclosure Form required by the State of California under Public Contract Code Section 10365.5. The form is designed to prevent conflicts of interest and ensure fair competition by prohibiting firms that have provided consulting services to the state from subsequently bidding on related follow-on contracts. Bidders must certify whether their firm or any proposed subcontractors have provided consulting services to the state within five years prior to the solicitation release date. The disclosure requirement applies to consulting contracts and related services, goods, or supplies that may result from the original consulting engagement. Subcontractors providing no more than 10 percent of a consulting services contract's total monetary value are exempt from the prohibition. Employees of consulting firms may work on follow-on contracts under different firms unless they are named contracting parties or subcontract parties in the original agreement.
Bidders must select one of two disclosure options: either certify that neither the firm nor any subcontractor has provided related consulting services within the five-year lookback period, or provide a detailed disclosure of any prior or current consulting services and explain why the firm is not prohibited from bidding under the statute. Violations of PCC Section 10365.5 can result in disqualification from bidding, contract voidance, and potential criminal penalties, regardless of whether violations are intentional, negligent, or inadvertent. The form requires signature and authorization from the bidder's authorized representative or corporate officer, with attestation of the firm name, representative's printed name, title, and date.
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ATTACHMENT 3: FOLLOW-ON CONTRACT DISCLOSURE FORM
PCC Section 10365.5 generally prohibits a person, firm, or subsidiary thereof that has been awarded a consulting services contract from submitting a bid for and/or being awarded an agreement for, the provision of services, procurement of goods or supplies, or any other related action that is required, suggested, or otherwise deemed appropriate in the end product of a consulting services contract.
PCC Section 10365.5 does not apply to any person, firm, or subsidiary thereof that is awarded a subcontract of a consulting services agreement that totals no more than 10 percent of the total monetary value of the consulting services agreement.
Consultants/employees of a firm that provides consulting advice under an original consulting contract are not prohibited from providing services as employees of another firm on a follow-on contract, unless the persons are named contracting parties or named parties in a subcontract of the original contract.
PCC Section 10365.5 does not distinguish between intentional, negligent, and/or inadvertent violations. A violation could result in disqualification from bidding, a void contract, and/or imposition of criminal penalties.
1. CONTRACT DISCLOSURE
Bidder to select the appropriate box below.
☐ I hereby certify that neither my firm nor any subcontractor that my firm intends to use under the contract resulting from this procurement, is currently providing consulting services to the state under a state contract (or as a subcontractor providing more than 10 percent of dollar value of a consulting service contract with the state) or has provided such services within five
(5) years prior to the release of this solicitation that are related in any manner to the services, goods, or supplies being acquired pursuant to this solicitation.
Bidder must sign below. This option is likely to apply to bidding firms that do not currently and/or never have provided consultant services to the state.
☐ Attached is a disclosure of current and/or prior consulting services provided by my firm or a proposed subcontractor to the state under a state contract within five (5) years prior to the release of this solicitation that may be related in some manner to the services, goods, or supplies being acquired pursuant to this solicitation. In addition, provide a detailed explanation why your firm is not prohibited from bidding under PCC Section 10365.5. Please also refer to the Department of General Services’ Management Memo 07-04 for additional information regarding the follow-on contracting prohibition, which is located at https://www.dgs.ca.gov/Resources/ManagementMemos
Bidder must sign below and attach a detailed disclosure.
The Bidder's Authorized Representative or Corporate Officer:
Bidder/Firm Name:
Printed Name of Authorized Representative:
Title/Role:
Signature:
Date:
https://www.dgs.ca.gov/Resources/ManagementMemos
ATTACHMENT 3: FOLLOW-ON CONTRACT DISCLOSURE FORM
1. CONTRACT DISCLOSURE
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