ATTACHMENT_A.pdf

Attachment A – Bid Forms and Bidder’s Checklist

• Bidder’s Checklist (1 page)

• Exhibit B, Attachment I, Service Contracts Bid Form (DPR 940B – 4 Pages)

• Payee Data Record (STD 204 – 2 Pages)

• Payee Data Record Supplement (STD 205)

• Bidder’s Declaration (GSPD 05-105 – 2 Pages)

• Disabled Veteran Business Enterprise Declarations (DGS PD 843 – 1 Page)

• Commercially Useful Function – Bidder Certification (DPR 87 – 1 page)

• Darfur Contracting Act (DPR 74 – 1 Page)

• California Civil Rights Laws Attachment (DGS OLS 04 – 1 Page)

• Generative Artificial Intelligence (GenAI) Disclosure (STD1000 - 1 page)

C24067004 Modular Building Rental Training Section

DPR 940B (Rev. 5/2011)(Excel 5/5/2011)

Training Section

1/16/2025

C24067004

Modular Building Rental

State of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

SERVICE CONTRACTS BID FORM Page 1 of 4

DATE

UNIT

PROJECT

BID OPENING

FIRM NAME FAX NO.

ADDRESS CITY/STATE/ZIP CODE

STATUS OF BUSINESS (check appropriate box.)

Individual.

Corporation. State in which incorporated:

Partnership. Full names of partners:

DEPARTMENT OF PARKS AND RECREATION

TITLE

DATE

BIDDER'S PRINTED NAME

LICENSE CLASSIFICATION ARE YOU CLAIMING PREFERENCE AS A SMALL BUSINESS?

NoYes. Small Business Certification No.

THE STATE RESERVES THE RIGHT TO WAIVE ANY IRREGULARITY IN ANY BID OR TO REJECT ANY OR ALL BIDS.

The undersigned hereby proposes to furnish services, materials, or equipment, or to perform all work required in accordance with the bid documents for the foregoing titled project, and such addenda thereto as may be issued prior to bid opening date.

Nondiscrimination Compliance Statement The prospective contractor's signature affixed hereon and dated shall constitute a certification under penalty of perjury under the laws of the State of California that the bidder has, unless exempted, complied with the nondiscrimination program requirements of Government Code Section 12990 and Title 2, California Code of Regulations Section 8103.

Disabled Veteran Business Enterprise Participation In accordance with Public Contract Code Section 10115, the Department of Parks and Recreation has established criteria to implement the disabled veteran business enterprise (DVBE) program goal which bidder must meet; provided, however, the DVBE participation requirement is included herein and made part of the bid documents. (See DVBE Notice included in solicitation for details.)

Small Business Preference A five percent preference will be granted to any bidder currently certified by the Department of General Services as a California Small Business. (See Small Business Notice included in solicitation for details.)

Exhibit B, Attachment 1

PHONE NO.

BIDDER'S SIGNATURE (Signature)

FEDERAL EMPLOYER ID NO.

CONTRACT NUMBER

The undersigned is duly authorized to submit this bid on behalf of the company.

STATE OF CALIFORNIA · DEPARTMENT OF PARKS AND RECREATION

Modular Building Rentals Cost Breakdown

Exhibit B, Attachment I

The bidder hereby proposes to furnish all labor, materials, transportation, and equipment necessary to perform all work required to temporarily rent modular unit(s) 3-months out of the year beginning in the Spring, to use during the state mandated Lifeguard training at Huntington State Beach OR Silver Strand State beach if Huntington location is unavailable.

C24067004

Option #1 –MOTs-44’X12’ & 44’X24’ (see Exhibit A, Attachment I) Monthly Rate

Personal Property

Expense

Taxes Total Monthly Rate

Number of Occurrences

Total Cost

(44’x12’) $ $ $ $ X 6 (months)

(44’ X 24’) $ $ $ $ X 6 (months

Option #2 – MOTs-36’X60’ (see Exhibit A, Attachment I) Monthly Rate

Personal Property Expense

Taxes Total Monthly Rate

Number of Occurrences Total Cost

$ $ $ $ X 6 (months) $

Additive Alternate Option #3 – cost of connecting the modular buildings from the breaker panels to a power pedestal and shall provide for the 44’X12’ modular (only) an AMP Multi-Panel 1200 AMP (see Exhibit A, Attachment I) Monthly Rate

Personal Property Expense

Taxes Total Monthly Rate

Number of Occurrences Total Cost

$ $ $ $ X 6 (months) $

CONTRACTOR’S NAME (Please Print): CONTRACT NO.

Option #1 Services Amount Taxes Total Cost/ per Service

Number of Occurrences

Total Cost

Huntington Beach- Delivery and Installation Charges

X 2*

Huntington Beach- Removal and Return Charges X 2*

Secondary Location-Silver Strand Beach- Delivery and Installation Charges

X 2* $

Secondary Location - Silver Strand Beach- Removal and Return Charges

X 2* $

Option #2 Services Amount Taxes Total Cost/ per Service

Number of Occurrences

Total Cost

Huntington Beach- Delivery and Installation Charges

X 2*

Huntington Beach- Removal and Return Charges X 2*

Secondary Location - Silver Strand Beach- Delivery and Installation Charges

X 2* $

Secondary Location - Silver Strand Beach- Removal and Return Charges

X 2* $

Additive Alternate Option #3 Services Amount Taxes Total Cost/ per Service

Number of Occurrences

Total Cost

Huntington Beach- Delivery and Installation Charges

X 2*

Huntington Beach- Removal and Return Charges X 2*

Secondary Location - Silver Strand Beach- Delivery and Installation Charges

X 2* $

Secondary Location - Silver Strand Beach- Removal and Return Charges

X 2* $

Exhibit B, Attachment I - C24067004 page 3 of 4Cost Breakdown

Total of Option #1 Huntington State Beach $________________________

Total of Option #1 Huntington State Beach written out: ______________________________________________________________________________________________

ALTERNATE LOCATION

Total of Option #1 Silver Strand State Beach $________________________

Total of Option #1 Silver Strand State Beach written out: _____________________________________________________________________________________________

Total of Option #2 Huntington State Beach: $______________________

Total of Option #2 Huntington State Beach written out: ______________________________________________________________________________________________

ALTERNATE LOCATION

Total of Option #2 Silver Strand State Beach: $______________________

Total of Option #2 Silver Strand State Beach written out: ___________________________________________________________________________________________

Total of Additive Alternate Option #3 Huntington State Beach: $__________________

Total of Additive Alternate Option #3 Huntington State Beach written: _______________________________________________________________________________

ALTERNATE LOCATION

Total of Additive Alternate Option #3 Silver Strand State Beach: $__________________

Total of Additive Alternate Option #3 Silver Strand State Beach written: _____________________________________________________________________________

1) The above quantities are estimates only and are given as a basis for comparison of bids, no guarantee is made or implied as the to the exact quantity that will be needed.

2) In case of discrepancy between the unit price and the total set forth for a unit basis item, the unit price shall prevail.

3) Please do not alter, modify, or change the bid proposal sheet. Any alterations, modifications, or changes to this bid proposal sheet will be grounds to reject bid.

4) Each line item must be bid. Pease do not leave any unit price column blank, or this bid proposal sheet will be deemed non-responsive.

5) Two (2), One (1) year extension at the same rates identified in the service contracts Bid Form, marked Exhibit B, Attachment I, are available to be added to this agreement via amendment upon mutual consent from DPR and the contractor.

X 2* - Drop off and pick up Annually April through June for the term of this contract.

Exhibit B, Attachment I - C24067004 page 4 of 4Cost Breakdown

C24067004

DPR 74 (Rev. 5/2013)(Excel 5/16/2013)

DO NOT COMPLETE THIS FORM UNLESS YOUR COMPANY MEETS THE CRITERIA OF OPTION #1 OR OPTION #2.

FOR DEPARTMENT USE ONLYState of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

DARFUR CONTRACTING ACT CERTIFICATION

Public Contract Code Sections 10475 -10481 applies to any company that currently or within the previous three years has had business activities or other operations outside of the United States.

For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company that has been granted permission by the Department of General Services to submit a proposal.

DO NOT COMPLETE OR RETURN THIS FORM IF: Within the previous three years, your company HAS NOT had any business activities or other operations outside of the United States.

AGREEMENT/PAPO NO.

OPTION #1 - CERTIFICATION

If your company, within the previous three years, has had business activities or other operations outside of the United States, in order to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete the certification below.

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that a) the prospective proposer/bidder named below is not a scrutinized company per Public Contract Code 10476; and b) I am duly authorized to legally bind the prospective proposer/bidder named below. This certification is made under the laws of the State of California.

COMPANY/VENDOR NAME (Printed)

BY (Authorized Signature)

PRINTED NAME AND TITLE OF PERSON SIGNING

DATE EXECUTED EXECUTED IN THE COUNTY AND STATE OF

FEDERAL ID NUMBER

OPTION #2 - WRITTEN PERMISSION FROM DGS

Pursuant to Public Contract Code section 10477(b), the Director of the Department of General Services may permit a scrutinized company, on a case-by-case basis, to bid on or submit a proposal for a contract with a state agency for goods or services, if it is in the best interests of the state. If you are a scrutinized company that has obtained written permission from the DGS to submit a bid or proposal, complete the information below.

We are a scrutinized company as defined in Public Contract Code section 10476, but we have received written permission from the Department of General Services to submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission from DGS is included with our bid or proposal.

COMPANY/VENDOR NAME (Printed)

INITIALS OF SUBMITTER

PRINTED NAME AND TITLE OF PERSON INITIALING

FEDERAL ID NUMBER

All other companies, complete Option #1 or Option #2 and return:

STATE OF CALIFORNIA DEPARTMENT OF GENERAL SERVICES

CALIFORNIA CIVIL RIGHTS LAWS ATTACHMENT OFFICE OF LEGAL SERVICES

DGS OLS 04 (Rev. 01/17)

Pursuant to Public Contract Code section 2010, a person that submits a bid or proposal to, or otherwise proposes to enter into or renew a contract with, a state agency with respect to any contract in the amount of $100,000 or above shall certify, under penalty of perjury, at the time the bid or proposal is submitted or the contract is renewed, all of the following:

1. For contracts executed or renewed after January 1, 2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of the Civil Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code); and

2. For contracts executed or renewed after January 1, 2017, if a Contractor has an internal policy against a sovereign nation or people recognized by the United States government, the Contractor certifies that such policies are not used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing Act (Section 12960 of the Government Code).

I, the official named below, certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Proposer/Bidder Firm Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Executed in the County of Executed in the State of

Date Executed

CERTIFICATION

CALIFORNIA CIVIL RIGHTS LAWS:

EMPLOYMENT DISCRIMINATORY POLICIES:

STATE OF CALIFORNIA DEPARTMENT OF GENERAL SERVICES

CALIFORNIA CIVIL RIGHTS LAWS ATTACHMENT OFFICE OF LEGAL SERVICES

DGS OLS 04 (Rev. 01/17)

Pursuant to Public Contract Code section 2010, a person that submits a bid or proposal to, or otherwise proposes to enter into or renew a contract with, a state agency with respect to any contract in the amount of $100,000 or above shall certify, under penalty of perjury, at the time the bid or proposal is submitted or the contract is renewed, all of the following:

1. For contracts executed or renewed after January 1, 2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of the Civil Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code); and

2. For contracts executed or renewed after January 1, 2017, if a Contractor has an internal policy against a sovereign nation or people recognized by the United States government, the Contractor certifies that such policies are not used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing Act (Section 12960 of the Government Code).

I, the official named below, certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Proposer/Bidder Firm Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Executed in the County of Executed in the State of

Date Executed

CERTIFICATION

CALIFORNIA CIVIL RIGHTS LAWS:

EMPLOYMENT DISCRIMINATORY POLICIES:

std1000