Attachment 4 - SEI Certification.docx
DOCX document 46 KB Posted
- Attached to
- RFP 2025-19 Microsoft 365 and Related Cloud Services Development, Administration, and Support
- Solicitation number
- 0000039683
- Issued by
- California
About this file
This is a Small Disadvantaged Business (SDB) and Emerging Small Business (ESB) Certification document for Covered California's RFP 2025-19 regarding Microsoft 365 and Related Cloud Services Development, Administration, and Support. The attachment serves as a certification form that proposers must complete to demonstrate their eligibility status as either a state-certified small disadvantaged business or emerging small business. The document requires applicants to provide documentation of their current certification from the California Department of General Services and includes attestations regarding the applicant's ownership structure, control, and operational status in compliance with state certification requirements. This certification is a mandatory submission requirement for proposers seeking consideration under small business set-asides or preferences associated with the solicitation.
The certification document does not contain pricing information, contract terms, or specific project requirements, as it functions solely as a verification mechanism for qualifying proposers. Proposers claiming SDB or ESB status must attach current and valid certification documentation as evidence of their eligible status. Failure to provide complete and accurate certification documentation may result in the proposer being deemed ineligible for any small business preferences or set-asides that may apply to this Microsoft 365 services contract opportunity with Covered California.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment 2 - Payee Data Record (STD. 204).pdf | ||
| Attachment 3 - Contractor Certification Form.docx | DOCX document | |
| Exhibit B - Budget Detail and Payment Provisions.docx | DOCX document | |
| Attachment 2a - Payee Data Record Supplement (STD. 205).pdf | ||
| Attachment 6 - Proposal Checklist.docx | DOCX document | |
| Exhibit B, Attachment 1 - Cost Worksheet.docx | DOCX document | |
| RFP_2025-19.pdf | ||
| Attachment 5 - Bidder Declaration (GSPD-05-105).pdf | ||
| Attachment 1 - Proposal Cover Page.docx | DOCX document | |
| Attachment 7 - HBEX 707 Generative Artificial Intelligence Risk Assessment.pdf | ||
| Attachment 8 - DVBE Declarations (STD. 843).pdf | ||
| Exhibit C - IT General Terms and Conditions.docx | DOCX document | |
| Exhibit A, Attachment 1 - Work Authorization.docx | DOCX document | |
| Exhibit A - Scope of Work.docx | DOCX document | |
| Exhibit D - Privacy Addendum.docx | DOCX document | |
| STD 213.pdf | ||
| Exhibit C, Attachment 1 - Resumes.docx | DOCX document |
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Text version
Covered California RFP 2025-17 Health Program Consulting Pool California Health Benefit Exchange Budget Detail
ATTACHMENT 4 – STATEMENT OF ECONOMIC INTERESTS CERTIFICATION
In order to be deemed responsive, the Proposer must enter its information below where indicated with brackets and provide an authorized signature for certification.
[Month XX, 2026]
[Proposer Organization Name] [Address] [City, State Zip]
Covered California Attention: Miranda Wilson 1601 Exposition Blvd.
Sacramento, CA 95815
Upon award of the contract, [Proposer Organization Name] agrees to provide a completed Title 10, California Code of Regulations, Chapter 12, Article 1, Statement of Economic Interests (Form 700), if required.
[Proposer Representative Name]
File details come from the government source that posted it. Updated .