Attachment D 12L Compliance_1.pdf

PDF 103 KB Posted

Attached to
DPH | HIV Prevention CBA Program Admin Services
Solicitation number
SFGOV-0000011811
Issued by
San Francisco County, San Francisco City, California

About this file

Attachment D is a Chapter 12L Compliance Request for Proposals form required by the City and County of San Francisco, Department of Public Health (DPH) for the HIV Prevention Capacity Building Assistance Program Administration Services solicitation (SFGOV-0000011811). The City seeks qualified proposers to provide program administration and staffing services for the getSFcba program, which is funded by the Centers for Disease Control and Prevention under Funding Opportunity Announcement PS 24-0020, component D. The procurement schedule includes a pre-proposal conference on July 23, 2026, a deadline for questions on July 30, 2026, an estimated Q&A addendum posting on August 6, 2026, and a proposal submission deadline of 2:00 PM PT on August 13, 2026. The estimated award announcement is scheduled for September 2026, with a Health Commission presentation anticipated in March 2027 and an estimated contract start date of April 1, 2027.

Non-profit entities that receive a cumulative total of at least $1,000,000 per year in City funds or City-administered funds must complete and submit this Chapter 12L Compliance form with their technical and work proposals. Proposers meeting this threshold must describe their compliance efforts with Chapter 12L provisions regarding public access to meetings and records, and provide a summary and disposition of all substantiated complaints concerning Chapter 12L compliance filed with the City within the previous two years. Failure to comply with Chapter 12L reporting requirements or material misrepresentation in submissions constitutes grounds for proposal rejection and/or subsequent agreement termination. Organizations that do not meet the funding threshold or are not non-profit entities may indicate that the form is not applicable to their organization.

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Other files

File Type Posted
Attachment J - Citys Office of the Controller Accounting Policies & Procedures_1.pdf PDF
Attachment C Reference Form_1.pdf PDF
Attachment I Cost Proposal_Program Administration.xlsx XLSX spreadsheet
Attachment A Contact Information Cover Sheet.pdf PDF
Attachment M City's Contract Terms_1.pdf PDF
Attachment I Cost Proposal_Program Administration_1.xlsx XLSX spreadsheet
Attachment G HCAO Declaration Form_1.pdf PDF
Attachment F MCO Declaration Form.pdf PDF
Attachment D 12L Compliance.pdf PDF
Attachment H First Source Workforce Projection Form and Fact Sheet.pdf PDF
Attachment J - Citys Office of the Controller Accounting Policies & Procedures.pdf PDF
DPH___HIV_Prevention_CBA_Program_Admin_Services.xml XML file
Attachment G HCAO Declaration Form.pdf PDF
Attachment M City's Contract Terms.pdf PDF
RFP_11811_HIV_Prevention_CBA_Program_Admin_Services.pdf PDF
Attachment B Non-Collusion Affidavit Form.pdf PDF
Attachment F MCO Declaration Form_1.pdf PDF
Attachment A Contact Information Cover Sheet_1.pdf PDF
Attachment E CMD LBE Form 2A_Professional Services.pdf PDF
Attachment H First Source Workforce Projection Form and Fact Sheet_1.pdf PDF
Attachment N CDC-RFA-PS-24-0020 Grant.pdf PDF
Attachment E CMD LBE Form 2A_Professional Services_1.pdf PDF
Attachment C Reference Form.pdf PDF
Attachment B Non-Collusion Affidavit Form_1.pdf PDF
Attachment N CDC-RFA-PS-24-0020 Grant_1.pdf PDF
DPH___HIV_Prevention_CBA_Program_Admin_Services.pdf PDF
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Text version

ATTACHMENT “D”

12L COMPLIANCE

REQUEST FOR PROPOSALS SFGOV-0000011811

HUMAN IMMUNODEFICIENCY VIRUS (HIV) PREVENTION CAPACITY BUILDING

ASSISTANCE PROGRAM ADMINISTRATION SERVICES

*THIS FORM MUST BE COMPLETED AND SUBMITTED WITH YOUR TECHNICAL/WORK

PROPOSAL*

Non-Profit Entities: If a Proposer is a non-profit entity that receives a cumulative total per year of at least $1,000,000 in City funds or City-administered funds and is a non-profit organization as defined in Chapter 12L of the S.F. Administrative Code, the Proposer must describe how Proposer will comply with Chapter 12L.

Failure to comply with the reporting requirements of Chapter 12L or material misrepresentation in Proposer’s Chapter 12L submissions shall be grounds for rejection of the Proposal and/or termination of any subsequent Agreement reached on the basis of the Proposal.

☐ This form is not applicable to my organization. My organization is a non-profit that does not receive a cumulative total per year of at least $1,000,000 in City funds or City-administered funds.

☐ This form is not applicable to my organization. My organization is not a non-profit.

Item #1: A statement describing its efforts to comply with the Chapter 12L provisions regarding public access to Proposer’s meetings and records.

Item #2: A summary and disposition of all complaints concerning the Proposer’s compliance with Chapter 12L that were filed with the City in the last two years and deemed by the City to be substantiated. If no such complaints were filed, the Proposer shall include a statement to that effect.

If you need more space for your explanation, please attach a separate document.

Item 2:
If you need more space for your explanation please attach a separate document:
Check Box1: Off
Check Box2: Off

File details come from the government source that posted it. Updated .