Bidder_Declaration_blank_.pdf
PDF 102 KB Posted
- Attached to
- RFQ-FISH-0627-01, Boat Trailer
- Solicitation number
- 0000040044
- Issued by
- California
About this file
This is a Bidder Declaration form required by the California Department of Fish and Wildlife for the RFQ-FISH-0627-01 boat trailer procurement. The form serves as a certification document for prime bidders and subcontractors participating in this state contract opportunity. Bidders must provide their California vendor name, current certifications (if applicable, including Minority Business, Small Business, or Disadvantaged Veteran Business Enterprise designations), and disclose whether subcontractors will be used. The form requires detailed information about each subcontractor, including their complete address, certification status, specific work to be performed, and the corresponding percentage of the total bid price allocated to their work.
The declaration functions as a sworn statement under penalty of perjury, requiring the authorizer's signature and date to certify that all provided information is accurate and truthful. Bidders with no certifications may proceed by indicating "None" and proceeding directly to the certification section. The form accommodates up to four subcontractors with dedicated sections for contact information, work descriptions, and bid allocations. This standard form (DFW 1082, updated October 2019) ensures transparency in the bidding process and allows the California Department of Fish and Wildlife to verify contractor qualifications and track subcontractor participation in the boat trailer procurement.
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Other files
| File | Type | Posted |
|---|---|---|
| DARFUR__blank_.pdf | ||
| Payee_Data_Record_STD_204_blank_.pdf | ||
| RFQ-FISH-0627-01.pdf | ||
| Postconsumer-Content_Certification_blank_.pdf |
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Text version
BIDDER DECLARATION
1. Prime bidder information:
a. What is your California vendor 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.
Authorizers printed name: _______________________________________ Date: _______________
Authorizers signature: ____________________________________________
(New 10/2019)
DFW 1082
| CA Vendor name: |
| MB/SB/DVBE Certification Number: |
| None chek box: Off |
| Check box yes: Off |
| Check Box No: Off |
| Distinct element of work: |
| Subcontractor information 1: |
| Subcontractor information 2: |
| Subcontractor information 3: |
| Subcontractor information 4: |
| Subcontractor address 1: |
| Subcontractor address 2: |
| Subcontractor address 3: |
| Subcontractor address 4: |
| Subcontractor CA Cert number 1: |
| Subcontractor CA Cert number 2: |
| Subcontractor CA Cert number 3: |
| Subcontractor CA Cert number 4: |
| Work performed 1: |
| Work performed 2: |
| Work performed 3: |
| Work performed 4: |
| percent 1: |
| percent 2: |
| percent 3: |
| percent 4: |
| Authorizers printed name: |
| Date: |
File details come from the government source that posted it. Updated .