Attachment_6_-_Darfur_Contracting_Act_Certification.docx
DOCX document 26 KB Posted
- Attached to
- RFP 25-02 Life Insurance Benefit Plans
- Solicitation number
- 0000036099
- Issued by
- San Bernardino County, California
About this file
This document is an Attachment 6 Darfur Contracting Act Certification form for RFP 25-02 Life Insurance, issued by a state or local court system under California Public Contract Code (PCC) section 10478. The certification requires bidders with current or previous three-year business activities outside the United States to either certify they are not a "scrutinized company" or obtain written permission from the Court to submit a proposal.
The certification form provides three compliance options for bidders: (1) declaring no business activities outside the United States in the past three years, (2) obtaining written permission from the Court despite being a "scrutinized company", or (3) certifying they are not a "scrutinized company" while having international business activities. The document requires bidders to provide company name, federal ID number, and an authorized signature, with the certification made under penalty of perjury and subject to California state laws. The form appears to be part of a due diligence process to ensure ethical contracting practices, specifically related to potential business engagements in regions like Darfur.
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RFP 25-02 Life InsuranceATTACHMENT 6 darfur contracting act certification Pursuant to Public Contract Code (PCC) section 10478, if a Bidder currently or within the previous three years has had business activities or other operations outside of the United States, it must either (i) certify that it is not a “scrutinized company” as defined in PCC 10476, or (ii) receive written permission from the Court to submit a proposal.
To submit a proposal to the Court, the Bidder must insert its company name and Federal ID Number below and complete ONLY ONE of the following three paragraphs. To complete paragraph 1 or 2, simply check the corresponding box. To complete paragraph 3, check the corresponding box and complete the certification for paragraph 3.
| Company Name (Printed) |
| Federal ID Number |
Printed Name and Title of Person Checking Box (for paragraph 1 or 2 below)
1. We do not currently have, and we have not had within the previous three years, business activities or other operations outside of the United States.
OR
2. We are a “scrutinized company” as defined in PCC 10476, but we have received written permission from the Court to submit a proposal pursuant to PCC 10477(b). A copy of the written permission from the Court is included with our proposal.
OR
3. 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 PARAGRAPH 3:
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY, that I am duly authorized to legally bind the Bidder to the clause in paragraph 3. This certification is made under the laws of the State of California.
| Legal Name of Company (Printed): |
| Federal ID Number: |
| Signature: |
| Date Executed: |
Printed Name and Title of Person Signing:
| Executed in the County of: |
| In the State of: |
Rev. 2020-07 Page 1 of 1
File details come from the government source that posted it. Updated .