BMB-008.pdf
PDF 233 KB Posted
- Solicitation number
- 0000039005
About this file
This is a Commercially Useful Function (CUF) Certification form issued by the California Department of Insurance for certified Disabled Veteran Business Enterprises (DVBEs), Small Businesses (SBs), and Micro Businesses (MBs) participating in state and local contracting opportunities. The form applies to the California Department of Fish and Wildlife's Invitation for Bids (IFB P2580035) for hazardous waste collection, testing, and disposal services to support the Wildlife Health Laboratory (WHL). Any certified SB, MB, or DVBE serving as a prime contractor, subcontractor, or supplier must complete this certification to demonstrate compliance with state requirements.
The CUF Certification requires respondents to affirm that their business will execute a distinct element of the work, perform or manage the obligations through actual work execution, provide services normal to their business functions, and avoid excessive subcontracting beyond standard industry practices. Contractors must also confirm they will not serve merely as pass-through entities to create the appearance of small business or DVBE participation. Failure to respond affirmatively to questions one through three, or responding affirmatively to question four regarding excessive subcontracting, will result in disqualification. Respondents must provide a detailed written statement explaining their role, services, and goods, and submit the form with an authorized signature under penalty of perjury. The form requires currently certified firms to include their OSDS reference number and certification expiration date.
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| File | Type | Posted |
|---|---|---|
| IFB_P2580035_Hazardous_Waste_Testing_and_Disposal_v2.pdf |
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STATE OF CALIFORNIA - DEPARTMENT OF INSURANCE
COMMERCIALLY USEFUL FUNCTION CERTIFICATION
CDI-FBMD-BMB 008 (New 05/2025)
Every certified Disabled Veteran Business Enterprise (DVBE), Small Business (SB) and Micro Business (MB) must complete this form if they will perform an element of the work.
1 CONTRACTOR NAME (Completing Form) BUSINESS NAME “or” DOING BUSINESS AS (DBA) NAME: OSDS REF # (Currently certified firms only): Expiration Date
2 COMMERCIALLY USEFUL FUNCTION (CUF)
All certified SB, MB, and/or DVBE prime contractors, subcontractors or suppliers must meet the CUF requirements under Government Code, section 14837 (d)(4) (for SB) and Military and Veterans Code, section 999(b)(5)(B) (for DVBE).
Please answer the following questions, as they apply to your company for the goods and services being acquired in this solicitation:
Mark All That Apply: DVBE SB MB 1 If awarded a contract, will your business be responsible for the execution of a distinct element of the resulting work?
Yes No
2 If awarded a contract, will your business carry out the obligation of the contract by actually performing, managing, or supervising the work involved?
Yes No
3 If awarded a contract, will you perform work that is normal for your business, service and functions? Yes No
4 If awarded a contract, will your business subcontract a portion of the work greater than would be expected by normal industry practices?
Yes No
5 If awarded a contract, will your business role be 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 SB and/or DVBE participation?
Yes No
A response of "No" in questions 1-3 or a response of "Yes" in question 4 may result in your quote being deemed non-responsive and disqualified.
3 WRITTEN STATEMENT
Provide a written statement below detailing the role, services and goods your company will provide to meet the commercially useful function requirement. At the State's option prior to award, you may be required to submit additional clarifying information.
4 AUTHORIZING SIGNATURE (REQUIRED)
The signatory of this document must be the certified business owner (or authorized representative in the case of a corporation) and as such, herby certifies under penalty of perjury under the laws of the State of California that all information provided herein is truthful and accurate.
AUTHORIZED REPRESENTATIVE SIGNATURE: TITLE:
PRINTED NAME: DATE:
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