CALIFORNIA_CIVIL_RIGHTS_LAWS_CERTIFICATION.pdf
PDF 206 KB Posted
- Attached to
- 26BS0003 - Temporary Relief - Medical Director, Physician, and Physician Assistant Services
- Solicitation number
- 0000039015
- Issued by
- California
About this file
This is a California Civil Rights Laws Certification form issued by the Department of General Services Office of Legal Services for use with state contracts valued at $100,000 or above. The certification applies to contractors submitting bids or proposals to state agencies for contracts executed or renewed after January 1, 2017. Contractors must certify compliance with two primary statutes: the Unruh Civil Rights Act (California Civil Code Section 51) and the Fair Employment and Housing Act (California Government Code Section 12960). The form requires authorized representatives to execute the certification under penalty of perjury, providing the contractor's firm name, federal ID number, authorized signatory information, execution location, and date.
The certification also addresses employer discriminatory policies, requiring contractors to confirm that any internal policies against sovereign nations or peoples recognized by the United States government are not applied in violation of the Unruh Civil Rights Act or Fair Employment and Housing Act. This form serves as a mandatory compliance document for the Veterans Home of California - Barstow's solicitation for Temporary Relief Medical Director, Physician, and Physician Assistant Services. Contractors responding to this opportunity must submit the completed and executed certification as part of their bid package to demonstrate legal and regulatory compliance.
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Text version
DEPARTMENT OF GENERAL SERVICES
OFFICE OF LEGAL SERVICES
STATE OF CALIFORNIA
CALIFORNIA CIVIL RIGHTS LAWS CERTIFICATION
DGS OLS 04 (Rev. 01/17)
Pursuant to Public Contract Code section 2010, a person that submits a bid or proposal to, or otherwise proposes to enter into or renew a contract with, a state agency with respect to any contract in the amount of $100,000 or above shall certify, under penalty of perjury, at the time the bid or proposal is submitted or the contract is renewed, all of the following:
1. CALIFORNIA CIVIL RIGHTS LAWS: For contracts executed or renewed after January 1, 2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of theCivil Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code); and
2. EMPLOYER DISCRIMINATORY POLICIES: For contracts executed or renewed after January 1, 2017, if a Contractor has an internal policy against a sovereign nation or peoples recognized by the United States government, the Contractor certifies that such policies arenot used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing Act (Section 12960 of the Government Code).
CERTIFICATION
I, the official named below, certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
By (Authorized Signature)
Printed Name and Title of Person Signing
Executed in the County of Executed in the State of
Date Executed
Proposer/Bidder Firm Name (Printed) Federal ID Number
| ProposerBidder Firm Name Printed: |
| Federal ID Number: |
| Printed Name and Title of Person Signing: |
| Executed in the County of: |
| Executed in the State of: |
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| Date5_af_date: |
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