Bidder_Dec-DFW1082.pdf
PDF 462 KB Posted
- Attached to
- RFQ-R2-0626-01, Utility Vehicle
- Solicitation number
- 0000036661
- Issued by
- Sacramento County, California
About this file
This document is a Bidder Declaration form from the State of California's Department of Fish and Wildlife (DFW), identified as form DFW 1082 and revised on 05/15/23. The form is designed to collect information about prime bidders and potential subcontractors for a state contract. The document requires bidders to provide details about their California vendor name, current state certifications (Minority Business/Small Business/Disabled Veteran Business Enterprise), and disclose whether subcontractors will be used in the contract.
The form includes a detailed table for listing subcontractors, which requires information such as the subcontractor's name, contact details, complete address, California certification number, specific work to be performed, and the corresponding percentage of the bid price. The document also includes a certification section where the authorizer must confirm under penalty of perjury that the provided information is true and correct, and acknowledges the legal binding nature of an electronic signature in accordance with California Civil Code §1633.5(b). The form is designed to ensure transparency and accountability in the state's contracting process, particularly regarding business diversity and subcontractor involvement.
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| Darfur-DFW1080.pdf |
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Text version
State of California – Department of Fish and Wildlife
BIDDER DECLARATION
DFW 1082 (REV. 05/15/23)
1. Primebidder information:
a. What is your California vendor’s name?
b. Identify your current California Certification(s) number(s):
(MB/SB/DVBE): _____________ or None (If “None”, proceed to number 2)
c. Will subcontractors be used for this contract? YES NO (If yes, indicate in the space below the distinct element of work your business will perform in this contract. If no, skip to the certification at the bottom of this page.)
2. If subcontractors will be used, list all subcontractors for this contract in the table below. (Attach additional pages if necessary):
EXAMPLE
Subcontractor Name, Contact Person, Phone Number & Email
Fix it Now John Smith Jr.
(916) 445-1234
JSmithJr@fixitnow.com
Subcontractor complete address
1234 Fix It Pl.
Sacramento, CA
95821
CA Certification Number (MB, SB, DVBE, or None)
SB # 15245
Work performed or good provided for this contract
Office repairs
Corresponding % of bid price 25%
CERTIFICATION: By signing this form (Bidder Declaration), I certify under penalty of perjury that the information provided is true and correct.
With accordance to California Civil Code §1633.5(b), I acknowledge that by providing my electronic signature for this form, I agree that my electronic signature is legal binding equivalent to a handwriting signature. I hereby confirm that my electronic signature represents my execution or authentication of this form, and my intent to be bound by it.
Authorizer’s printed name: _______________________________________ Date: ______________
Authorizer’s signature: ____________________________________________
File details come from the government source that posted it. Updated .