Bid_Forms_C26715006.pdf

Project No. 1 Contractor Qualifications Questionnaire

Project No. 2 Contractor Qualifications Questionnaire

Bid Due Date: Friday, October 2, 2026 at 2:00 PM

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.

Verification: By signing this Bid Form, the bidder assures the state that it has not been convicted of violating a state or federal law regarding the employment of undocumented aliens, in the preceding five years.

The prospective contractor's signature affixed hereon and dated shall constitute a certification that the representations made by the prospective contract in the bid are made under penalty of perjury under the laws of the State of California.

Important: Pursuant to Title 2, California Code of Regulations, Section 8103 and Business and Professions Code Section 7028.15, no bid will be considered unless it contains the certifications and license information requested on this form. The State reserves the right to waive any irregularity in any bid or to reject any or all bids.

LICENSE NO. & DIR NO.

DPR 482B (Rev. 7/2026)(Excel 7/29/2026)

KIND OF WORK NAME AND ADDRESS

PROJECT LOCATION

PROJECT NAME

STATUS OF BUSINESS (Check appropriate box.)

Individual.

Corporation. State in which incorporated:

Partnership. Full names of partners:

Listed hereinafter are the names, addresses and contractor's license numbers of all subcontractors who will perform work or labor or render services in an amount in excess of one-half of one percent of the general contractor's total bid if this bid is accepted and the portion of the work that each will perform. Material vendors are not included.

BY (Authorized Signature)

PRINTED NAME AND TITLE OF PERSON SIGNING

CONTRACTOR/BIDDER FIRM NAME (Printed)

MAILING ADDRESS

LICENSE CLASSIFICATION

DATE

BID DATEBID TIME

CERTIFICATION

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to the clause(s) listed above. This certification is made under the laws of the State of California. I understand that failure to submit the Public Works Bid Form without the appropriate bidder signature will result in rejection of the bid.

Exhibit B, Attachment 1 Page 1 of 2

PUBLIC WORKS BID FORM

State of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

E-MAIL ADDRESS

LICENSE NO. LICENSE EXPIRATION DATE DIR REGISTRATION NO.

PHONE NO.

Wilder Ranch State Park

Bunkhouse Reroofing

02:00 PM October 2, 2026

Contractor's Name:

Agreement Number: C26715006

Exhibit B, Attachment 1

The bidder hereby declares to have carefully examined the location of the proposed work, Scope of Work, and Specifications as set forth herein, and hereby proposes to furnish all labor and equipment necessary to perform all the work required to provide roof replacement and haul away for the Bunkhouse Reroof at WILDER RANCH STATE PARK, Santa Cruz County, California, it being understood that the main roofing materials for the project (shingles, cedar breather, cap sheet, and ¾" sheathing) shall be furnished by District and are excluded from the project bid, and that project scheduling shall be subject to material availability and weather conditions, complete and ready for use in accordance with the contract d0ell!ments therefore, for the following stipulated sums which shall include all applicable taxes and other expenses:

Item Description Item Total

1. Removal of old roof, haul away of old roof, repair to soffits and gutter seams, and install treated wood shingles. $__________

Base Quote Lump Sum Total (Item 1):

Base Quote Lump Sum Total Written (Item 1):

Note: In case of discrepancy between the stipulated totals and the actual sum of the totals, the actual sum of all item totals shall prevail.

ADDENDUM ACKNOWLEDGEMENT (Please initial for Addenda received)

Addendum #1 -----

Addendum #2 -----

Addendum #3 -----

Addendum #4 -----

Addendum #5 -----

Addendum #6 -----

The bidder agrees to complete all work within NINETY (90) calendar days from the date of written notice to commence work. This time includes ten (10) calendar days allowed for the contractor to begin work.

Section 000806 – Page 1 of 2 Contractor Qualifications

CONTRACTOR QUALIFICATIONS QUESTIONNAIRE

DEPARTMENT OF PARKS AND RECREATION

Wilder Ranch State Park Bunkhouse Reroofing

PROJECT NO. 1

Project Name/Location:

Project Scope:

Contract Amount:

Completion Date:

Contracting Agency/Owner:

Name:

Telephone/email:

Name of Prime Contractor:

Name of Sub-Contractor:

Section 000806 – Page 2 of 2 Contractor Qualifications

PROJECT NO. 2

Project Name/Location:

Project Scope:

Contract Amount:

Completion Date:

Contracting Agency/Owner:

Name:

Telephone/email:

Name of Prime Contractor:

Name of Sub-Contractor:

DPR 479IW (Rev. 7/2026)(Excel 7/17/2026)(Page 1 of 5)

1. Bidder's attention is directed to the Disabled Veteran Business Enterprise (DVBE) Participation Requirement for bidders, as outlined in the accompanying bid package.

Disabled Veteran Business Enterprise (DVBE) Notice

2. What is a Disabled Veteran Business Enterprise (DVBE)?

a. For a business to be considered a Disabled Veteran Business Enterprise (DVBE), they must be certified with the State of California - Department of General Services in accordance with California Code of Regulations, Title 2, Section 1896.94. Please see the following website for more information about DVBE certification benefits and eligibility requirements:

www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Apply-for-or- Re-apply-as-Small-Business-Disabled-Veteran-Business-Enterprise

b. Only DVBEs who perform a commercially useful function relevant to this solicitation, may be used to satisfy the DVBE incentive program requirements.

3. Commercially Useful Function Definition

a. California Code of Regulations, Title 2, § 1896.61(l): The term "DVBE contractor, subcontractor or supplier" means any person or entity that satisfies the ownership (or management) and control requirements of §1896.61(f); is certified in accordance with §1896.70;

and provides services or goods that contribute to the fulfillment of the contract requirements by performing a commercially useful function.

b. A person or entity must perform a commercially useful function (CUF) as defined under Military and Veterans Code (MVC) §999.

c. A contractor, subcontractor, or supplier will not be considered to perform a commercially useful function if the contractor's, subcontractor's, or supplier's role is limited to that of an extra participant in a transaction, contract, or project through which funds are passed in order to obtain the appearance of disabled veteran business enterprise participation.

4. What is the DVBE Incentive Program?

a. The DVBE Incentive Program was established by statute and applies to contracts solely financed by State funds. This program is separate from the DVBE Participation Program. The incentive is designed to encourage bidders to partner with DVBE subcontractors.

The DVBE Participation Requirement for this solicitation has been waived – however the DVBE Incentive still applies.

There is no minimum DVBE participation requirement for this solicitation.

DVBE Incentive for Invitation For Bid (IFB) (Participation Requirement Waived)

State of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Apply-for-or-Re-apply-as-Small-Business-Disabled-Veteran-Business-Enterprise

DPR 479IW (Rev. 7/2026)(Page 2 of 5)

b. The incentive may be combined with other incentives and preferences up to an established cap of $100,000.00. The incentive is used only for evaluation purposes and does not alter the amounts of the actual bids.

5. Reporting Requirement

a. If, for this agreement, a contractor made a commitment to achieve disabled veteran business enterprise (DVBE) participation, within 60 days of receiving final payment under this agreement (or within such other time period as may be specified elsewhere in this agreement) the contractor must certify in a report to the awarding department:

i) the total amount the prime contractor received under the contract

ii) the name and address of the DVBE(s) that participated in the performance of the contract

iii) the amount each DVBE received from the prime contractor

iv) that all payments under the contract have been made to the DVBE(s)

v) the actual percentage of DVBE participation that was achieved

b. You will be required to report to DPR the actual dollars spent with each DVBE subcontractor on form STD. 817. If awarded the contract you will receive this form at the completion of the contract. A person or entity that knowingly provides false information shall be subject to a civil penalty for each violation. (Military & Veterans Code (M&VC) § 999.5(d)).

6. Who is eligible to receive the incentive?

a. Any responsive and responsible bidder who has attained .01% DVBE participation or higher with a registered and certified DVBE.

7. Documentation

a. Bidders must document DVBE participation commitment by completing and submitting the following forms:

1) GSPD 05-105, Bidder Declaration: The GSPD 05-105 is used to document the proposed prime contractor and subcontractors, including their roles and responsibilities. The form must be submitted with the bid package. If there is a discrepancy between the dollar amount and percentage of bid for DVBE participation then the percentage shall prevail.

2) DGS PD 843, DVBE Declaration: All disabled veteran owners and disabled veteran managers of the DVBE must complete the form and submit it with the bid package. A DGS A DGS PD 843 needs to be submitted by every DVBE supplier who is part of a bid whether they are the prime contractor or subcontractor.

b. Bids that fail to submit the completed required forms to confirm the level of DVBE participation will not be eligible to receive the DVBE incentive. Clerical and typographical errors on these forms may be corrected at the State’s sole discretion.

c. Information submitted by the bidders to claim the DVBE incentive(s) will be verified by the State. If evidence of an alleged violation is found during the verification process, the State shall initiate an investigation, in accordance with the requirements of the PCC §10115, et seq., and MVC §999 et seq., and follow the investigatory procedures required by the 2 CCR §1896.80.

Contractors found to be in violation of certain provisions may be subject to loss of certification, penalties and/or contract termination.

c. Table A – Invitation For Bid (IFB) (aka Low Price Method)

a. Low Price Method

A B C

$98,000.00 $102,100.00 $100,000.00

0% 8% 4.5%

1 3 2 n/a 5% 4% n/a

$4,900.00

(5% x $98,000)

$3,920.00

(4% x $98,000) n/a

97,100.00

($102,100 - $4,900)

96,080.00

($100,000 - $3,920)

3 2 1

DPR 479IW (Rev. 7/2026)(Page 3 of 5)

Confirmed DVBE

Participation of DVBE Incentive Amount for IFB

5% or more

4% - 4.99%

3% - 3.99%

2% - 2.99%

.01% - 1.99%

5% of lowest responsive and responsible bid

4% of lowest responsive and responsible bid

3% of lowest responsive and responsible bid

2% of lowest responsive and responsible bid

1% of lowest responsive and responsible bid

Final Rank:

DVBE Incentive (from Table A)

Incentive Amount

(% x Lowest Responsive and

Responsible Bid Price)

Adjusted Bid Price

(Bidder's Price - Bidder's Incentive

Amount)

Bidder Name

Original Bid Price

DVBE Participation for certified

DVBE Prime or Subcontractors

Initial Ranking

8. How does the DVBE Incentive Program Work?

a. The DVBE incentive is used only for evaluation purposes to determine the successful bidder and does not alter the amounts of the actual bids. A dollar cap of $100,000.00 is set for all combined incentives and preferences.

b. For contracts to be awarded based on the Low Price Method, the incentive amount is equal to a percentage of the lowest responsive and responsible bid based on the amount of DVBE participation in the bid being evaluated per Table A below. The Computation Method does not include the small business preference; however, the small business preference may be applied and may affect the application of the incentive and the outcome of the ranking.

9. Computation Method

The State of California www.dgs.ca.gov/PD

Department of General Services 24-hour recording: (916) 322-5060

Office of Small Business and DVBE Services FAX: (916) 375-4950

707 Third Street, First Floor – Room 400 Certification@dgs.ca.gov West Sacramento, CA 95605

DPR 479IW (Rev. 7/2026)(Page 4 of 5)

10. Substitution of Proposed DVBE

a. If awarded the contract, the DVBE subcontractors and/or contractors proposed by bidder must be used unless prior written notice of substitution is provided to the state and the state approves such substitution.

b. The notice must include a minimum of: (1) a written explanation of the reason for the substitution; and (2) an updated GSPD 05-105 must be submitted to the award office of Department of Parks and Recreation. The substitution request must before approved before the substitution can take place.

c. Failure to adhere to at least the DVBE participation proposed by the successful bidder may be cause for contract termination and recovery of damages under the rights and remedies due the state under the default section of the contract.

d. Contractor understands and agrees that should award of this contract be based in part on their commitment to use the Disabled Veteran Business Enterprise (DVBE) subcontractor(s) identified in their bid or offer, per Military and Veterans Code 999.5 (e), a DVBE subcontractor may only be replaced by another DVBE subcontractor and must be approved by the State. Changes to the scope of work that impact the DVBE subcontractor(s) identified in the bid or offer and approved DVBE substitutions will be documented by contract amendment.

e. Failure of Contractor to seek substitution and adhere to the DVBE participation level identified in the bid or offer may be cause for contract termination, recovery of damages under rights and remedies due to the State, and penalties as outlined in M&VC § 999.9; Public Contract Code (PCC) § 10115.10, or PCC § 4110 (applies to public works only).

11. To locate DVBE contractors:

a. Contact the department’s contracting official named in this solicitation for any DVBE contractors who may have identified themselves as potential subcontractors, and to obtain suggestions for search criteria to possibly identify DVBE contractors for the solicitation. You may also contact the department’s SB/DVBE Advocate for assistance – www.parks.ca.gov/advocate.

b. Access the list of all certified DVBEs by using the Department of General Services, Procurement Division (DGS-PD) online certified firm database at:

https://caleprocure.ca.gov/pages/PublicSearch/supplier-search.aspx?psNewWin=true

Search by “Keywords” or United Nations Standard Products and Services Codes (UNSPSC), that apply to the elements of work you want to subcontract to a DVBE.

c. Check for subcontractor ads that may be placed on the California State Contracts Register (CSCR) for this solicitation prior to the closing date. You may access the CSCR at:

www.Caleprocure.ca.gov

d. The State of California, Department of General Services, Procurement Division, Office of Small Business and DVBE Services (OSDS) offers many services that assist contractor/business owners with a variety of information designed to streamline the State contracting process. OSDS also certifies http://www.dgs.ca.gov/PD mailto:Certification@dgs.ca.gov http://www.parks.ca.gov/advocate https://caleprocure.ca.gov/pages/PublicSearch/supplier-search.aspx?psNewWin=true http://www.caleprocure.ca.gov/

b. DGS PD 843, DVBE Declaration

DPR 479IW (Rev. 7/2026)(Page 5 of 5)

a. GSPD 05-105, Bidder Declaration

DISABLED VETERAN BUSINESS ENTERPRISE (DVBE)

DVBE Documentation Checklist

1. The State of California acknowledges the service and sacrifice of its disabled veterans, in part, through the “Disabled Veteran Business Enterprise (DVBE) Participation Program.” As mandated bylaw, state agencies have a goal to award at least 3% of their annual contract dollars to certifiedDVBE’s.

2. When a firm bids on a state DPR contract that contains DVBE participation, the firm may benefit from the DVBE Incentive program. We encourage all suppliers to obtain as much DVBE participation as possible.

3. INCOMPLETE DOCUMENTATION (GSPD 05-105 AND DGS PD 843) WILL RESULT IN

DISQUALIFICATION FROM FURTHER PARTICIPATION IN THE SELECTION PROCESS FOR THE

CONTRACT.

4. The following checklist is provided to assist bidders with their DVBE participation documentation:

All DVBE participation is indicated.

The names of each participating DVBE company is listed with the corresponding percentage of the total bid price for the services/goods to be provided by each subcontractor.

A copy of the printout from eProcurement system showing the company’s DVBE certification status.

The DVBE participation percentage listed agrees with the dollar value claimed.

A completed and signed DGS PD 843 is included with the bid for every DVBE (whether prime contractor or subcontractor) included.

State of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

The undersigned declares:

I am the of , the party (Position Title) (Company Name) making the foregoing bid.

The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The bid is genuine andnot collusive or sham. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding. The bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost elementof the bid price, or of that of any other bidder. All statements contained in the bid are true. The bidder has not, directly, or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.

Any person executing this declaration on behalf of a bidder that is a corporation,partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder

I declare under penalty of perjury under the laws of the State of California thatthe foregoing is true and correct, and that this declaration is executed on

, at , (Date) (City) (State/Zip Code)

(Print or Type Name)

(Signature)

Bidders are cautioned that making false certification may subject the certifier to criminal prosecution.

The Department of Parks and Recreation (DPR) reserves the right under California Public Contract Code Section 10162 to reject any bidder, any officer of such bidder, or any employee of such bidder who has a proprietary interest in such bidder who has been disqualified, removed or otherwise prevented from bidding on, or completing a federal, state or local govern-ment project because of a violation of law or violation of safety regulations.

Failure to return this form with the bid shall not be cause for rejection; however, bidders must furnish the completed form within the time frame prescribed by the DPR. Failure to submit this form within the time frame prescribed by the DPR may be deemed refusal of an award which shall be cause for forfeiture of bidder's security.

By my signature, I certify under penalty of perjury under the laws of the State of California that the foregoing questionnaire and statements pursuant to California Public Contract Code Section 10162 are true and correct.

DPR 20 (New 10/2003)(Excel 10/24/2008)

NOTICE TO BIDDERS

CERTIFICATION

State of California - The Resources Agency

DEPARTMENT OF PARKS AND RECREATION

CALIFORNIA PUBLIC CONTRACT CODE SECTION 10162

PARK UNIT NAME

In accordance with Section 10162 of the California Public Contract Code, bidders shall complete, HAVE YOU, ANY OFFICER OF YOUR BUSINESS, OR ANY EMPLOYEE OF YOUR BUSINESS WHO HAS PROPRIETARY INTEREST IN YOUR BUSINESS EVER BEEN DISQUALIFIED, REMOVED, OR OTHERWISE PREVENTED FROM BIDDING ON, OR COMPLETING A FEDERAL, STATE, OR LOCAL GOVERNMENT PROJECT BECAUSE OF A VIOLATION OF LAW OR VIOLATION OF SAFETY REGULATIONS? Yes (Explain circumstances below. Attach additional pages if needed.) No

BIDDER SIGNATURE PRINTED NAME DATE

under penalty of perjury, the question below. Please answer the following:

Questionnaire

PROJECT NAME

NAME OF BUSINESS

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 - Natural Resources Agency

CALIFORNIA DEPARTMENT OF PARKS AND RECREATION

FAIR CHANCE EMPLOYMENT ACT

Public Contract Code 10186:

(a) This section shall be known, and may be cited, as the "Fair Chance Employment Act."

(b) Any person submitting a bid to the state on a contract involving onsite construction-related services shall certify that the person will not ask an applicant for onsite construction-related employment to disclose orally or in writing information concerning the conviction history of the applicant on or at the time of an initial employment application.

(c) This section shall not apply to a position for which the person or the state is otherwise required by state or federal law to conduct a conviction history background check or to any contract position with a criminal justice agency, as that term is defined in Section 13101 of the Penal Code.

(d) This section shall not apply to a person to the extent that he or she obtains workers from a hiring hall pursuant to a bona fide collective bargaining agreement.

CERTIFICATION

By my signature, I certify under penalty of perjury under the laws of the State of California that I have read, understand and will abide by California Public Contract Code Section 10186.

DPR 282PW (New 8/2016)(Word8/11/2016)

Contractor/Bidder Firm Name (Printed)

Federal ID Number

By (Authorized Bidders Signature)

Printed Name and Title of Person Signing

Date Executed

Executed in the County of

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: