BMB-009.pdf
PDF 139 KB Posted
- Solicitation number
- 0000037885
- Issued by
- California
About this file
This is a Darfur Contracting Act Certification form issued by the California Department of Insurance (CDI) for companies bidding on state contracts. The certification addresses compliance with Public Contracts Code sections 10475-10481, which apply to any company with business activities or operations outside the United States within the previous three years. The related Request for Proposal (RFP # 26CROB-001S) seeks Outreach and Advertising Services for three programs: the California Low-Cost Auto Insurance Program (CLCA), Patient and Provider Protection Act (PPPA), and Life and Annuity Consumer Protection (LACPP) Programs. CDI intends to award one contract for a three-year term with an optional 12-month extension. The proposal submission deadline is March 4, 2026, at 4:00 PM, with a written questions deadline of February 11, 2026, at 5:00 PM.
The certification form requires prospective bidders to declare their status under one of three options: companies without international business activities in the previous three years may certify non-applicability; companies with such activities must certify compliance; or scrutinized companies may provide written permission from the Department of General Services (DGS) authorizing their bid submission on a case-by-case basis when determined to be in the state's best interests. All submissions must include the authorized signature and title of the signatory. No specific pricing information, set-asides, or funding amounts are detailed in this certification document.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| ATTACHMENT_3_-_Cost_Proposal_Worksheet-(FINAL_2-4-26).xlsx | XLSX spreadsheet | |
| 26CROB-001S-RFP_ADV_OUT_(FINAL_2-4-26)_2.pdf | ||
| BMB-008.pdf |
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Text version
STATE OF CALIFORNIA - DEPARTMENT OF INSURANCE
DARFUR CONTRACTING ACT CERTIFICATION
CDI-FBMD-BMB 009 (New 05/2025)
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 (DGS) to submit a proposal.
Please see Public Contracts Code, section 10476 for a definition of scrutinized company.
OPTION #1 - NOT APPLICABLE
If your company has not, within the previous three years, had any business activities or other operations outside of the United States.
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that the prospective proposer/bidder named below has not, within the previous three years, had any business activities or other operations outside of the United States.
Company / Vendor Name (Printed) Federal ID Number
By (Authorized Signature) Date
Printed Name and Title of Person Signing
OPTION #2 – 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.
Company / Vendor Name (Printed) Federal ID Number
By (Authorized Signature) Date
Printed Name and Title of Person Signing
OPTION #3 - WRITTEN PERMISSION FROM DGS
Pursuant to Public Contract Code section 10477(b), the Director of the DGS 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 DGS 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) Federal ID Number
By (Authorized Signature) Date
Printed Name and Title of Person Signing
| Company / Vendor Name 1: |
| Federal ID Number 1: |
| Date 1: |
| Print Name and Title 1: |
| Company / Vendor Name 2: |
| Federal ID Number 2: |
| Date 2: |
| Print Name and Title 2: |
| Company / Vendor Name 3: |
| Federal ID Number 3: |
| Date 3: |
| Print Name and Title 3: |
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