ATTACHMENT_DARFUR_FORM_(NEW).pdf

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Attached to
IFB C25-33029 Moving Services (NSD, GEB, OCB)
Solicitation number
C25-33029
Issued by
California

About this file

This document is a Darfur Contracting Act Certification form issued by the California Department of General Services Procurement Division for state contract bidding. The form applies to companies that have conducted business activities outside the United States within the previous three years, requiring them to certify their status as either a non-scrutinized company or a scrutinized company that has obtained permission from the Department of General Services to submit a proposal. The document provides two certification options: Option #1 allows companies to certify they are not a scrutinized company under penalty of perjury, while Option #2 is for scrutinized companies that have received written permission from DGS to bid on state contracts.

The certification is specifically related to Public Contract Code Sections 10475-10481, which governs the eligibility of companies with international business activities to bid on California state contracts. Companies must disclose and certify their status, with the understanding that the Department of General Services may grant permission to bid on a case-by-case basis if it is in the best interests of the state. Companies without international business activities in the previous three years are not required to complete the form. The document serves as a mechanism to ensure transparency and compliance with state regulations regarding contracting with companies that have operations in regions of concern.

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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.

If your company has not, within the previous three years, had any business activities or other operations outside of the United States, you do not need to complete this form.

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) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

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.

DEPARTMENT OF GENERAL SERVICES

PROCUREMENT DIVISION

STATE OF CALIFORNIA

DARFUR CONTRACTING ACT CERTIFICATION

DGS PD 1 (Rev. 12/19)

Date

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) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date

OPTION #1 - CERTIFICATION
OPTION #2 – WRITTEN PERMISSION FROM DGS
Federal ID Number:
Printed Name and Title of Person Signing:
CompanyVendor Name Printed_2:
Federal ID Number_2:
Printed Name and Title of Person Initialing:
CompanyVendor Name:
ADA Instructions:
Date of signature:
Date of signature 2:

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