BMB-009.pdf
PDF 139 KB Posted
- Attached to
- 25ALSB-186S Hard Card Fingerprint IFB
- Solicitation number
- 0000039142
- Issued by
- California
About this file
This is a Darfur Contracting Act Certification form issued by the State of California Department of Insurance (CDI-FBMD-BMB 009, revised May 2025) that applies to companies bidding on or submitting proposals for California state contracts. The form addresses compliance requirements under Public Contracts Code sections 10475-10481, which mandate that any company with business activities or operations outside the United States within the previous three years must certify its eligibility to participate in state contracting. The document provides no specific information regarding products, services, quantities, response dates, award dates, or contract terms, as it functions solely as a compliance certification instrument rather than a procurement specification document.
The certification form presents three compliance pathways for prospective bidders: Option 1 allows companies with no international business activities in the past three years to certify non-applicability; Option 2 requires companies with international operations to provide certification of their status; and Option 3 applies to scrutinized companies that have obtained prior written permission from the Department of General Services (DGS) to submit proposals on a case-by-case basis. The form requires authorized signatures, Federal ID numbers, and documentation of company names for up to three entities. No pricing terms, set-asides, incumbent information, or funding details are specified in this certification document, as it serves exclusively to establish bidder eligibility and compliance with California state contracting regulations.
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Other files
| File | Type | Posted |
|---|---|---|
| BMB-008.pdf | ||
| 25ALSB-186S_Hard_Card_Fingerprint_IFB_FINAL.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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