Attachment_5_-_Darfur_Contracting_Act_Certification.pdf
PDF 437 KB Posted
- Attached to
- RFQ IDR6 S2660011 Pest Control Services (SJWA)
- Solicitation number
- 0000039857
- Issued by
- Riverside County, Lake Riverside CDP, Riverside City, California
About this file
This is a Darfur Contracting Act Certification form required by the California Department of Fish and Wildlife (CDFW) for the RFQ IDR6 S2660011 Pest Control Services solicitation at San Jacinto Wildlife Area. The certification requirement is mandated under California Public Contract Code Section 10478 and applies to all bidders submitting proposals for this pest control services contract. Bidders must complete the form by selecting one of three certification options and providing their company name, Federal Employer Identification Number (FEIN), and the printed name and title of the authorized representative initialing or signing the document.
Bidders have three certification options: (1) certify that they do not currently have and have not had business activities or operations outside the United States within the previous three years; (2) certify that they are a scrutinized company as defined under PCC 10476 but have received written permission from the Department of General Services to submit a bid; or (3) certify that they currently have or have had business activities outside the United States within the previous three years but are not a scrutinized company, which requires an authorized signature under penalty of perjury. All State Price Schedule applications will be disqualified if this form is not completed with either paragraph one or two initialed, or paragraph three both initialed and certified. Electronic signatures are accepted as legally binding equivalents to handwritten signatures under California Civil Code 1633.5(b).
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Text version
IDR6, San Jacinto Wildlife Area S2660011, Pest Control Services at SJWA
CDFW SFC RFQ (06/2026)
Attachment 5 – Darfur Contracting Act Certification
A completed DARFUR Contracting Act Certification is required with your bid. Please use this link to go directly to the form:
https://www.dgs.ca.gov//-/media/Divisions/PD/Acquisitions/Solicitation-Document- Attachments/Darfur-Contracting-Act.pdf
State of California - Department of Fish and Wildlife
DARFUR CONTRACTING ACT CERTIFICATION
DFW 1080 (REV. 05/15/23)
Pursuant to California Code, Public Contract Code (PCC) – PCC § 10478, if a bidder or proposer currently or within the previous three years has had business activities or other operations outside of the United States, it must certify that it is not a “scrutinized” company as defined in PCC § 10476.
Therefore, to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number (FEIN) and complete only one of the following three paragraphs (via initials for paragraph 1 or paragraph 2, or via initials and certification for paragraph 3)
Company/Vendor Name (Printed) FEIN
Printed Name and Title of Person Initialing (option 1 or 2) Date
1. ________ Initials
2. ________ Initials
3. ________ Initials
We do not currently have, or we have not had within the previous three years, business activities or other operations outside of the United States.
OR
We are a scrutinized company as defined in PCC § 10476, but we have received written permission from the Department of General Services (DGS) to submit a bid or proposal pursuant to PCC § 10477(B). A copy of the written permission from DGS is included with our bid or proposal.
OR
We currently have, or we have had within the previous three years, business activities or other operations outside of the United States, but we certify below that we are not a scrutinized company as defined in PCC § 10476.
CERTIFICATION For Number 3
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective proposer/bidder to the clause listed above in paragraph 3. This certification is made under the laws of the State of California.
With accordance to California Civil Code §1633.5(b), I acknowledge that by providing my electronic signature for this form, I agree that my electronic signature is legal binding equivalent to a handwriting signature. I hereby confirm that my electronic signature represents my execution or authentication of this form, and my intent to be bound by it.
By (Authorized Signature)
Printed Name and Title of Person Signing
Executed in the County and State of Date Executed
NOTE: State Price Schedule (SPS) Applications will be disqualified unless your application includes this form with either paragraph 1 or paragraph 2 initialed or paragraph 3 initialed and certified.
https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10478.
https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10476.
https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10476.
http://www.dgs.ca.gov/dgs/Home.aspx https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10477.
https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10476.
https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fleginfo.legislature.ca.gov%2Ffaces%2Fcodes_displaySection.xhtml%3FsectionNum%3D1633.5%26lawCode%3DCIV&data=05%7C01%7CLucia.Rodriguez%40wildlife.ca.gov%7Cf7d61fe8902f4fc2ddc908db44de0a8a%7C4b633c25efbf40069f1507442ba7aa0b%7C0%7C0%7C638179492686187568%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=SgmSIctaufa78R%2BCFlJqmUDsiiE%2FYw%2FCR%2BZhi4%2BcxQ0%3D&reserved=0
| DFW 1080 (DARFUR) - rev.05-15-23.pdf |
| OR |
| OR |
| CompanyVendor Name Printed: |
| FEIN: |
| Printed Name and Title of Person Initialing option 1 or 2: |
| Date: |
| Initials: |
| Initials_2: |
| Initials_3: |
| Printed Name and Title of Person Signing: |
| Executed in the County and State of: |
| Date Executed: |
| SAVE: |
| PRINT: |
| CLEAR: |
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