Attachment_6_-_Darfur_Contracting_Act_Certification.docx
DOCX document 26 KB Posted
- Solicitation number
- 0000036101
- Issued by
- San Bernardino County, San Bernardino City, California
About this file
This document is a Darfur Contracting Act Certification form for RFP 25-04, which pertains to Flexible Spending Accounts, COBRA, and Retiree Billing services. The certification is required under Public Contract Code (PCC) section 10478 for bidders who have conducted business activities outside of the United States within the previous three years. The form requires bidders to either certify they are not a "scrutinized company" as defined in PCC 10476 or obtain written permission from the Court to submit a proposal.
The certification form mandates that bidders complete one of three possible declarations: affirming no business activities outside the United States in the past three years, providing written permission from the Court to submit a proposal, or certifying they are not a scrutinized company despite having international business activities. The document requires the bidder to provide company name, federal ID number, and a signed certification under penalty of perjury, with the certification executed in a specific county and state. This form appears to be part of a broader effort to ensure ethical contracting practices and compliance with state regulations regarding international business operations.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit_C1_-_P_A_FSA_Brochure.pdf | ||
| Attachment_5_-_Good_Standing_Form.docx | DOCX document | |
| Attachment_7B_-_DVBE_Declaration.docx | DOCX document | |
| Attachment_1_-_Administrative_Rules.docx | DOCX document | |
| Exhibit_E_-_2025_Benefit_Fair_Locations.xlsx | XLSX spreadsheet | |
| Exhibit_C2_-_P_A_Agreement.pdf | ||
| Exhibit_A_-USIMarketingLetterRFP25-04FSACOBRARetireeBill.pdf | ||
| Attachment_2_-_Services_-_Short_Form_Agreement_Terms.docx | DOCX document | |
| Attachment_4_-_General_Certifications_Form.docx | DOCX document | |
| Exhibit_B_-_Payment_Provisions.docx | DOCX document | |
| RFP_25-04_Flexible_Spending_Accounts_COBRA_Retiree_Billing.docx | DOCX document | |
| Exhibit_C3_-_P_A_Flexible_Benefits_Plan_Summary.pdf | ||
| Attachment_3_-_Acceptance_of_Short_Form_Agreement_Terms.docx | DOCX document | |
| Attachment_7A_-_Bidder_Declaration.docx | DOCX document | |
| Exhibit_D_-_FSA_RFP_25-04_Matrix_-_MUST_COMPLETE.xls | XLS spreadsheet |
Show all 15
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
RFP 25-04 Flexible Spending Accounts COBRA Retiree BillingATTACHMENT 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 .