California_Civil_Rights_Laws_Certification.pdf
PDF 206 KB Posted
- Attached to
- 26LS0005 - Temporary Relief Physician Services
- Solicitation number
- 0000039962
- Issued by
- Los Angeles County, California
About this file
This is a California Civil Rights Laws Certification form issued by the Department of General Services, Office of Legal Services, applicable to state contracts valued at $100,000 or above. The certification document pertains to contract opportunity 26LS0005 for Temporary Relief Physician Services at the Veterans Home of California - Lancaster. The form requires contractors to certify compliance with the Unruh Civil Rights Act and the Fair Employment and Housing Act for all contracts executed or renewed after January 1, 2017.
The certification mandates that bidders and contractors attest under penalty of perjury to their adherence to California civil rights statutes governing non-discrimination. Additionally, contractors must certify that any internal policies regarding sovereign nations or peoples recognized by the United States government are not applied in violation of the aforementioned civil rights laws. The form requires completion by an authorized representative with signature, printed name, title, county and state of execution, date, proposer firm name, and federal identification number before submission of a bid or proposal.
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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: |
| Text2: |
| Text3: |
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| Date5_af_date: |
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