Attachment_6-_Proposer_Declaration-_Bidder_Dec.pdf

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Attached to
RFP - 25SS0022 - Financial Governance
Solicitation number
0000039397
Issued by
California

About this file

This is a Bidder Declaration form issued by the State of California Department of General Services, Procurement Division for Solicitation Number 25SS0022. The form requires prime bidders to declare their current California certifications, including Minority Business (MB), Small Business (SB), Nonprofit Veterans Service and Disabled Veteran Business Enterprise (NVBE/DVBE) status. Bidders must indicate whether subcontractors will be used for the contract and, if so, describe the distinct elements of work their firm will perform. For California-certified DVBE bidders, additional disclosures are required regarding broker or agent status and equipment ownership percentages if equipment rental is included in the contract scope.

The form mandates that all subcontractors be listed with complete contact information, California certification status, work descriptions, percentage of bid price allocation, and confirmation of good standing. Bidders must certify under penalty of perjury that all provided information is accurate and truthful. This declaration serves as a compliance mechanism to ensure transparency regarding business certifications and subcontracting arrangements, enabling the state to verify eligibility for various small business and disadvantaged vendor set-asides.

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State of California-Department of General Services, Procurement Division

GSPD-05-105 (REV 08/09)

BIDDER DECLARATION

1. Prime bidder information (Review attached Bidder Declaration Instructions prior to completion of this form}:

Solicitation Number 25SS0022

a. Identify current California certification(s) (MB, SB, NVSA, DVBE}: _____ or None 0_ (If "None'; go to Item #2)

b. Will subcontractors be used for this contract? Yes D No D (If yes, indicate the distinct element of work your firm will perform in this contract e.g., list the proposed products produced by your firm, state if your firm owns the transportation vehicles that will deliver the products to the State, identify which solicited services your firm will perform, etc.). Use additional sheets, as necessary.

c. If you are a California certified DVBE: (1) Are you a broker or agent? Yes D No D

(2) If the contract includes equipment rental,does[f co any own at least 51% of the equipment provided in this contract (quantity and value)? Yes No N/AO

2. If no subcontractors will be used, skip to certification below. Otherwise, list all subcontractors for this contract. (Attach additional pages if necessary):

Subcontractor Name, Contact Person, Subcontractor Address CA Certification (MB, SB, Work performed or goods provided Corresponding Good 51% Phone Number & Fax Number & Email Address NVSA, DVBE or None) for this contract % of bid price Standing? Rental?

CER TIFICATION: By signing the bid response, I certify under penalty of perjury that the information provided is true and correct.

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