Bidder_Declaration_Form_DFW1082.pdf
PDF 908 KB Posted
- Attached to
- RFQ-LED-0627-01, Forklift
- Solicitation number
- 0000040241
- Issued by
- California
About this file
This is a Bidder Declaration Form (DFW 1082) issued by the State of California Department of Fish and Wildlife for use in responding to RFQ-LED-0627-01, a solicitation for a forklift and accessories to support a new law enforcement warehouse facility in Southern California. The form requires prime bidders to provide their California vendor name and identify any current minority business (MB), small business (SB), or disadvantaged veteran business enterprise (DVBE) certifications. Quotes for the forklift are due September 16, 2026. The equipment will be utilized by various enforcement districts and programs for safe movement of equipment and deliveries at the warehouse facility, with operation restricted to certified personnel.
The Bidder Declaration Form requires disclosure of all subcontractors to be used on the contract, including their contact information, complete business addresses, California certification status, specific work to be performed, and corresponding percentage of bid price. Bidders must certify under penalty of perjury that all information provided is accurate and complete. The form accommodates up to four subcontractors with space for detailed documentation of each subcontractor's role and contribution to the contract. No contract value, term length, incumbent vendor information, or detailed evaluation criteria are specified in the available documentation.
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Other files
| File | Type | Posted |
|---|---|---|
| Payee_Data_Form_std204.pdf | ||
| 06_RFQ-LED-0627-01__Forklift.docx | DOCX document | |
| PostConsumer-Content_Certification_Form__CIWMB074.pdf | ||
| DARFUR_DFW1080ext.pdf |
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Text version
State of California – Department of Fish and Wildlife
BIDDER DECLARATION
DFW 1082 (REV. 09/30/21)
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: ____________________________________________
| Subcontractor Name, Contact Person, Phone Number & Email |
| Fix it Now |
| Authorizers Printed Name: |
| Date: |
| SAVE: |
| PRINT: |
| CLEAR: |
| What is your California vendor name: |
| MB SB DVBE: |
| None: Off |
| Will subcontractors be used for this contract Yes: Off |
| Will subcontractors be used for this contract No: Off |
| 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: |
| Subcontractor Name Contact Person Phone Number and Email: |
| 0: |
| Subcontractor Name Contact Person Phone Number and Email 1: |
| Subcontractor Name Contact Person Phone Number and Email 2: |
| Subcontractor Name, Contact Person, Phone Number and Email: |
| 3: |
| Subcontractor complete address: |
| 0: |
| 1: |
| 2: |
| 3: |
| CA Certification Number MB SB DVBE or None 0: |
| CA Certification Number MB SB DVBE or None 1: |
| CA Certification Number (MB, SB, DVBE, or None) 2: |
| CA Certification Number MB SB DVBE or None 3: |
| Work performed or good provided for this contract 0: |
| Work performed or good provided for this contract: |
| 1: |
| Work performed or good provided for this contract 2: |
| Work performed or good provided for this contract 3: |
| Corresponding percentage of bid price 0: |
| Corresponding percentage of bid price 2: |
| Corresponding percentage of bid price 1: |
| Corresponding percentage of bid price 3: |
File details come from the government source that posted it. Updated .