CC6619AAB__BID.doc

STATE OF CALIFORNIA

THE RESOURCES AGENCY

CALIFORNIA CONSERVATION CORPS

Region I

IFB #C6619AAB

On-Site Counseling Services Tahoe Center 1949 Apache Avenue South Lake Tahoe, CA 96150 Bid Submittal Deadline:

May 20, 2016 @ 2pm

BIDS NOT RECEIVED BY THE DATE, TIME AND PLACE SPECIFIED

WILL NOT BE ACCEPTED AND WILL BE RETURNED

TO THE BIDDER MARKED “LATE RESPONSE.”

You are invited to review and respond to this Invitation for Bid (IFB), titled #C6619AAB; On-Site Counseling Services. In submitting your bid, you must comply with these instructions.

All potential bidders must be registered on Department of General Services Fi$CAL Note that all agreements entered into with the State of California will include by reference General Terms and Conditions and contractor Certification clauses that may be view and downloaded at Internet site www.ols.dgs.ca.gov/ Standard+Language. If you do not have internet access, a hard copy can be provided by contacting the person listed below.

In the opinion of the California Conservation Corps, this Invitation for Bid is compete and without need of explanation. However, if you have questions, or should you need any clarifying information; all questions MUST be submitted via the Question and Answer option on BidSync.

TABLE OF CONTENTS

Pages

NOTICE TO CONTRACTORS

3-4 Bid Submission Description and Location of Work

Where to Obtain Bid Packages

Estimated Cost

Term of Agreement License Required

Key Action Dates Contacts

SCOPE OF WORK

5-9 Purpose Background

Scope of Work Specifications Confidentiality of Data Rights in Data

Monitoring the Contract

Payment Provisions

Standard Agreement, Std. 213

INSTRUCTIONS TO BIDDERS ……………………………………………………………………………………..10-12

REQUIRED ATTACHMENT CHECK LIST (ATTACHMENT 1)

PROPOSAL/PROPOSER CERTIFICATION SHEET (ATTACHMENT 2)……………………………………...14-15

COST SHEET/BID FORM (ATTACHMENT 3)………………………………………………………………..……16-17

BIDDER REFERENCES (ATTACHMENT 4)

SMALL BUSINESS CERTIFICATION (ATTACHMENT 5)…………………………………………………....…19-20

DISABLED VETERAN BUSINESS ENTERPRISE (DVBE) PARTICIPATION (ATTACHMENT 6)…………21-28

DARFUR CONTRACTING ACT (ATTACHMENT 7) …………………………………………………………………29

PAYEE DATA RECORD (STD. 204) (ATTACHMENT 8) ……………………………………………………………30

CONTRACTOR CERTIFICATION CLAUSE (ATTACHMENT 9) ……………………………………………….31-34

SAMPLE STANDARD AGREEMENT

35-37

NOTICE TO CONTRACTORS

1. Bid Submission

Sealed bids will be received BY MAIL at, or they may be HAND DELIVERED or overnight

EXPRESSED to:

California Conservation Corps

Tahoe Center 1949 Apache Avenue South Lake Tahoe, CA 96150 Attention: Melissa Kibbee, BSO and must read:

DO NOT OPEN:

Until 2:00 p.m. on May 20, 2016 or they may be HAND DELIVERED or overnight

EXPRESSED to:

California Conservation Corps

Tahoe Center 1949 Apache Avenue South Lake Tahoe, CA 96150 Attention: Melissa Kibbee, BSO and must read

DO NOT OPEN:

Until 2:00 p.m. on May 20, 2016 at which time and place they will be publicly opened and read for the work described below: Any bids received after the date and time shown above will be returned to the sender unopened.

2. Description and Location of Work: Provide On-Site Counseling, including, but not limited to: individual, group counseling, staff consultation and/or training and report writing and statistics. All the counseling will be conducted for the Corpsmembers located at the Tahoe Center, 1949 Apache Avenue, South Lake Tahoe.

3. Where to Obtain Bid Packages:

All bidders are asked to register as a bidder on Ca Dept of General Services BidSync Program, so all communication (Questions/Answers, etc,) can be accessible to all bidders. The IFB and bid package can be downloaded from the BidSync Program at http://www.bidsync.com.

Bid packages may also be obtained without charge: BY WRITING to California Conservation Corps (CCC), Attn: Contracts Officer, 1719 24th Street, Sacramento, CA 95816. The CCC will mail entire bid package via U.S. Postal Service, first class mail. The CCC will not pay additional charge for mailing, such as express mail, overnight delivery, etc.

4. Estimated Cost:

An estimated amount of $ 20,000.00 has been budgeted by the California Conservation Corps for this contract.

5. Term of Agreement:

It is anticipated that this contract will begin “Upon Approval” or July 1, 2016 through June 30, 2018. The actual starting date of the contract is contingent upon approval of the agreement by the CCC and any other control agencies as necessary.

6. License Required:

Current licensed Clinical Social Worker, Licensed Clinical Psychologist, Marriage Family and Child Therapist, or Licensed Clinical Psychiatrist. Licensing must be included with the bidder’s bid proposal.

7. Key Action Dates:

April 18, 2016

Advertisement Registered on FI$Cal May 20 2016 @ 2:00 p.m.

Final Date and Time to Receive Bids May 20, 2016 @ 2:00 pm.

Open Sealed Bids

July 1, 2016

Date Anticipated for Contract to Begin

8. Contacts: Questions regarding the processing of these documents should be directed to the bid advertisement on FI$Cal

SCOPE OF WORK

Purpose

The On-Site Counseling Program is a means of providing individual counseling, group counseling and staff consultation for Corpsmembers 18-25 years of age located at the Tahoe Center, 1949 Apache Avenue, South Lake Tahoe, California.

Background

The California Conservation Corps is a work ethic program with a dual mission: the employment and development of young people, and the conservation and enhancement of the state's natural resources. The On-Site Counseling Program is a component of a comprehensive Corpsmember development program which includes; programs in work learn, literacy, career development, conservation awareness, community activism and basic education. The On-Site Counseling program began in May of 1990. These counseling services are an effort to assist Corpsmembers, who are age 18-25, in exploring how they can contribute to their personal development.

In coordination with the service district Corpsmember Development staff (CD), the counselor provides counseling to Corpsmembers. Growing from that core element, the on-site counselor provides an expanded array of services such as; individual and group counseling, support groups, education and personal development classes/workshops (such as sexual assault prevention), peer leadership development, peer counseling, staff consultation and training, identifying and engaging Corpsmembers into the counseling program and referral to community services. In other words, the on-site counselor will work in conjunction with the CD and center staff in developing the overall design of the center on-site counseling program.

It is expected that the counselor will address Corpsmember problems on three levels: crisis intervention, case management, and education. Due to the limited amount of counseling hours available, it would be impractical to use a counselor's time to provide Corpsmembers with lengthy and intensive therapy. Therefore, the approach needs to be one of short-term crisis counseling, education and linking Corpsmembers with community resources for longer term care, and education/support activities, with the Contractor monitoring progress.

Scope of Work Expectations The contractor is expected to provide the following:

Provide between 4 to 6 hours of professional services per week, including individual and group counseling, as well as staff consultation, for young adults between the ages of 18 and 25 (Hours of professional services provided each week fluctuate and can exceed 10 hours, depending on the hourly rate and available counseling funds and possibly during fire or spike season or other declared emergencies no hours.) Hourly charges shall not include travel time.

Service breakdown as follows:

75% Individual counseling on anger management, stress reduction, depression, cultural diversity, alcohol, tobacco, and other drug related issues, etc. (this includes corpsmember referrals to community resources when necessary);

15% Group counseling when appropriate;

5% Staff consultation and/or training;

5% Report writing and statistics.

Contractor shall be expected to provide program data to the CCC on a monthly basis, using the CCC Counseling Program Individual Contact Report (Exhibit A) and the CCC Counseling Program Group Contact Report (Exhibit B).

Contractor will be available to work with CCC staff to seek bilingual services (Spanish and English) to accommodate non-English speaking corpsmembers.

Contractor will provide a time-based ,visual reference of management referred employees to note progress or non-progress of counseling efforts regarding the referred issue. This will not contain any patient confidential information.

Work Location

It is anticipated that most services shall be provided at the California Conservation Corps Tahoe Center, 1949 Apache Avenue, South Lake Tahoe, California.

Work Hours

The Contractor shall provide between four and six hours of professional services (as identified above) per week for 40 weeks of the year, not to exceed six hours per week. Counseling hours may be flexible but will generally occur during the evening hours during weekdays. Some weekend hours may also be scheduled depending on the needs of the Center and the availability of the Contractor.

Term

The term of this agreement shall be “Upon Approval” through June 30, 2018.

CCC Policies Related to Corpsmembers

Contractor agrees that he/she shall be required to abide by all CCC policies regarding staff relationships with corpsmembers including the Fraternization, Nepotism, Sexual Harassment and EEO/Discrimination Policies.

Intern Use

The Contractor may utilize the services of a Marriage and Family Therapist Intern who is currently registered through the California Board of Behavioral Sciences. In the case of an Intern providing some of the counseling services, the Counselor will provide no less than 30% percent of the services and the Intern will provide no more than 70% of the services. Counseling services provided by an Intern may be billed at no more than 75% of the Contractor’s hourly rate. If the Intern accompanies the Contractor to provide services, only the Contractor’s time may be billed.

If Counselor elects to use an Intern to provide for 70% or less of the services, then the regulations pertaining to the supervision of that registered intern or trainee, apply. For example, a licensed MFCC cannot charge the intern or trainee for supervision, they need to have 2 years as a licensed MFCC in order to supervise the intern, the intern must be registered through the BBSE and the supervisor must provide the intern with either one hour of individual supervision or two hours of group supervision per week. Likewise, regulations which cover Intern positions for a LCSW, a Psychologist or a Psychiatrist, must be followed.

EXHIBIT A

California Conservation Corps

Region I Contract # C6619AAB

Tahoe Center Counseling Program

Individual Contact Report

Amount of time Spent:_________ Date of Service:_________

(Circle location of Service) (15 minute increments)

Sex: Male/ Female

Age:________ # of months in the CCC: __________

(Circle one)

Type of Referral: (Circle one)

Self Referral

Staff Referral

Program Referral

Is this a new client: Yes/ No

If this in not a new client, is this a new issue?: Yes/ No

Type of problems presented by the Corpsmember (Circle all that apply)

1. Alcohol

13. Stress Related

2. Alcohol/ Family

14. Job Related

3. Drug (Specify) ____________

15. Interpersonal

4. Drug/ Family

16. Financial

5. Poly Drug(Specify) ____________

17. Legal

6. Emotional

18. Smoking

7. Psychiatric

19. Weight

8. Martial

20. Career

9. Family

21. Self Esteem

10. Physical Abuse

22. Other (Specify)___________________

11. Sexual Abuse

23. CCC/ ADP Referral

12. Emotional Abuse

Type of problems diagnosed by counselor (Circle all that apply)

5. Poly Drug (Specify) ____________

12. Emotional Abuse CCC 131A

Note: This form is to be submitted monthly with invoice.

EXHIBIT B

California Conservation Corps

Region I Contract # C4619AAG

Counseling Program

Group Contact Report

Amount of time Spent:_________ Date of Service:_________

(Circle location of Service) (15 minute increments)

Number of Males in Group: _____

Type of Referral: (Circle one) Number of Female in Group: _____

Self Referral

Staff Referral

Program Referral

Focus of Group Workshop (Circle all that apply)

5. Poly Drug (Specify) ____________

23. CCC/ ADP Referral

12. Emotional Abuse

Comments:

CCC 131B

CONFIDENTIALITY OF DATA

Client records and case notes are recognized as confidential.

The Contractor, its employees, agents or subcontractors:

G Shall protect from unauthorized disclosure names and other identifying information concerning persons either receiving services pursuant to this contract or persons whose names or identifying information become available or are disclosed to the Contractor, his/her employees, agents or subcontractors as a result of services performed under this agreement, except for statistical information not identifying any such person.

G Shall not use such identifying information for any purpose other than carrying out the Contractor’s obligations under this agreement.

G Shall promptly transmit to the CCC all requests for disclosure of such identifying information not emanating from the client or person.

G Shall not disclose, except as otherwise specifically permitted by this agreement or authorized by the client, any such identifying information to anyone other than the CCC without prior written authorization from the CCC.

For the purposes of this article, identity shall include, but not be limited to name, identifying number, symbol, or other identifying particular assigned to the individual, such as finger or voice print or a photograph.

RIGHTS IN DATA

All materials developed under the terms of this agreement will become the property of the CCC. The CCC reserves the exclusive right to copyright such material and to publish, disseminate and otherwise use materials developed under the terms of this agreement.

MONITORING THE CONTRACT

The staff interaction and the report writing and statistics which comprise 5% of the resulting contract, will be used for monitoring the performance of the contractor. An informal evaluation form may be developed in an effort to get feedback from Corpsmembers regarding services received.

PAYMENT PROVISIONS

The contractor may invoice the center NO MORE frequently than monthly in arrears for services performed. Payments will be made in arrears on a monthly basis upon receipt of an itemized invoice.

The contractor shall maintain accounting records and other evidence pertaining to costs incurred, with the provision that they shall be kept available by the contractor during the contract period and thereafter for three full years from the date of the final payment. The CCC or its designee must be permitted to audit, review, and inspect the contractor's activities, books, documents, papers and records during progress of the work and for three years following final payment.

STANDARD AGREEMENT, STD. 213, AND STANDARD PROVISIONS

See attached Sample Standard Agreement, STD. 213

See attached Special Provision 1, For Agreements Written prior to the Approval of the Budget

INSTRUCTIONS TO BIDDERS

SUBMISSION OF BID

A. All bids must be submitted under sealed cover and sent to California Conservation Corps by the dates and time shown in Section 1, Key Action Dates. The sealed cover must be plainly marked with the IFB number and title, must show your firm name and address, and must be marked with “Do not Open”, as shown in the following example:

Tahoe Center 1949 Apache Avenue South Lake Tahoe, CA 96150

Attention: Melissa Kibbee, BSO Bid Submittal Deadline: May 20, 2016@ 2pm Bids not submitted under sealed cover may be rejected. A TOTAL of two (2) copies of the bid must be submitted.

B. All bids shall include the documents identified in Section 2, Required Attachment Checklist. Bids not including the proper “required attachments” shall be deemed non-responsive. A non-responsive bid is one that does not meet the basic bid requirements C. All documents requiring a signature must bear an original signature of a person authorized to bind the bidding firm.

D. Bids must be submitted for the performance of all the services described herein. Any deviation from the work specifications will not be considered and will cause a bid to be rejected.

E. A bid may be rejected if it is conditional, or if it contains any alterations of form or other irregularities of any kind. The State may reject any or all bids and may waive an immaterial deviation in a bid. The State’s waiver of an immaterial deviation shall in no way modify the IFB document or excuse the bidder for full compliance with all requirements if awarded the agreement.

F. Costs incurred for developing bids and in anticipation of award of the agreement are entirely the responsibility of the bidder and shall not be charged to the State of California.

G. A bidder may withdraw its bid by submitting a written withdrawal request to the State, signed by the bidder or an authorized agent. A bidder may thereafter submit a new bid prior to the bid submission deadline. Bids may not be withdraw without cause subsequent to bid submission deadline.

H. The awarding agency may modify the IFB prior to the date fixed for submission of bids by the issuance of an addendum to all parties who received a bid package.

I. The awarding agency reserves the right to reject all bids. The agency is not required to award an agreement.

J. Before submitting a response to this solicitation, bidders should review, correct all errors and confirm compliance with the IFB requirements.

K. Where applicable, bidder should carefully examine work sites and specifications.

L. The State does not accept alternate contract language from a prospective contractor. A bid with such language will be considered a counter proposal and will be rejected. The State’s General Terms and Conditions (GTC are not negotiable.

M. No oral understanding or agreement shall be binding on either party.

Evaluation and Selection A. At the time of bid opening, each bid will be checked for the presence or absence of required information in conformance with the submission requirements of this IFB.

B. The State will evaluate each bid to determine its responsiveness to the published requirements.

C. Bids that contain false or misleading statements, or which provide references which do not support an attribute or condition claimed by the bidder, may be rejected.

D. Award made will be the lowest responsive responsible bidders.

Award and Protect

A. Whenever an agreement is awarded under a procedure, which provides for competitive bidding, but the agreement is not to be awarded to the low bidder, the low bidder shall be notified by telegram, electronic facsimile transmission, overnight courier or personal delivery five (5) working days prior to the award of the agreement.

B. Upon written request by any bidder, notice of the proposed award shall be posted in a public place in the office of the awarding agency at least five (5) working days prior to awarding the agreement.

C. If the bidder, prior to the award of agreement files a written protest with the Department of General Services, Office of Legal Services, 707 Third Street, 7th Floor, suite 7-330, West Sacramento, CA 95605 and the California Conservation Corps on the grounds that the (protesting) bidder is the lowest responsive responsible bidder, the agreement shall not be awarded until either the protest has been withdrawn or the Department of General Services has decided the matter.

D. Within five (5) days after filing the initial protest, the protesting bidder shall file with the Department of General Services and the awarding agency a detailed written statement specifying the grounds for the protest. The written protest must be sent to the Department of General Services, Office of Legal Services, 707 Third Street, 7th Floor, Suite 7-330, West Sacramento, CA 95605. A copy of the detailed written statement should be mailed to the awarding agency. It is suggested that you submit any protest by certified or registered mail.

E. Upon resolution of the protest and award of the agreement, contractor must complete and submit to the awarding agency the Payee Data Record (STD 204), to determine if the Contractor is subject to state income tax withholding pursuant to California Revenue and Taxation Code Sections 18662 and 26131. This form can be found on the Internet at www.osp.dgs.ca.gov under the heading FORMS MANAGEMENT CENTER. No payment shall be made unless a completed STD 204 has been returned to the awarding agency.

Disposition of Bids A. Upon bid opening all documents submitted in response to this IFB will become the property of the State of California, and will be regarded as public records under the California Public Records Act (Government Code Section 6250 et seq.) and subject to review by the public.

B. Bid packages may be returned only at the bidder’s expense, unless such expense is waived by the awarding agency.

PREFERENCE PROGRAMS

1. Small Business Preference: www.pd.dgs.ca.gov Section 14835 et. seq. of the California Government Code requires that a five (5) percent preference be given to bidders who qualify as a certified small business. The rules and regulations of this law, including the definition of a small business for the delivery of services, are contained in Title 2, California Code of Regulations, Section 1896, et. seq. A copy of the regulations is available upon request. To claim the small business preference, which may not exceed $50,000 for any bid, your firm must have its principal place of business located in California, have a complete application (including proof of annual receipts) on file with the State Office of Small Business Certification and Resources by 5:00 p.m. on the date bids are opened, and verified by such office. Questions regarding the preference approval should be directed to that office at (916) 322-5060. Certification of Small Business status must be included with the Bid Form.

2. Disabled Veteran Enterprise Program (DVBE) requirements

An explanation of the Disabled Veteran Enterprise Program (DVBE) requirements can be found at the internet web site www.pd.dgs.ca.gov/dvbe . Select “DVBE Resource Packet” under “Quick Links”.

The DVBE package and the required submittal forms can be found at the Internet website www.pd.dgs.ca.gov, select “DVBE participation Program” under “Quick Links”, then select DVBE participation solicitation package Attachment and Summary.

DVBE participation for IFB #C6619AAB is optional.

ATTACHMENT 1

Required Attachment Check List A complete bid or bid package will consist of the items identified below.

Complete this checklist to confirm the items in your bid. Place a check mark or “X” next to each item that you are submitting to the State. For your bid to be responsive, all required attachments must be returned. This checklist should be returned with your bid package also.

Attachment Attachment Name/Description Attachment 1 Required Attachment Check List (REQUIRED) Attachment 2 Proposal/Proposer Certification Sheet (MANDATORY) Attachment 3 Cost Sheet (MANDATORY) Attachment 4 Bidder References (MANDATORY) Attachment 5

SMALL BUSINESS & NON-SMALL BUSINESS PREFERENCE (OPTIONAL)

Attachment 6 Disabled Veteran Business Enterprise Participation Forms and Instructions (OPTIONAL)

Attachment 7 Darfur Contracting Act 2008(MANDATORY) Attachment 8 Payee Data Record (STD 204) (if currently not on file) (MANDATORY) Attachment 9 Contractor Certification Clauses (CCC) 307* (MANDATORY) _____ as Attachment 10 *Copy of current MFT License, through the CA Board of Behavioral Sciences. (MANDATORY) _____ as Attachment 11

* Copy of Resume illustrating a minimum of three (3) years experience providing individual and group counseling to young adults between the ages of 18 and 25. (MANDATORY)

ATTACHMENT 2

PROPOSAL/PROPOSER CERTIFICATION SHEET

This Proposal/Proposer Certification Sheet must be signed and returned along with all the "required attachments" as an entire package in duplicate with original signatures.

An Unsigned Proposal/Proposer Certification Sheet

May Be Cause for Rejection

3. Address

Indicate your organization type:

4. FORMCHECKBOX

Sole Proprietorship

5. FORMCHECKBOX

Partnership

6. FORMCHECKBOX

Corporation

Indicate the applicable employee and/or corporation number:

7. Federal Employee ID No. (FEIN)

8. California Corporation No.

9. Indicate applicable license and/or certification information:

14. Are you certified with the Department of General Services, Office of Small Business Certification and Resources (OSBCR) as:

a. California Small Business Yes FORMCHECKBOX No FORMCHECKBOX

If yes, enter certification number:

b. Disabled Veteran Business Enterprise Yes FORMCHECKBOX No FORMCHECKBOX

If yes, enter your service code:

c. Non-Small Business Subcontractor Preference Yes FORMCHECKBOX No FORMCHECKBOX

NOTE: A copy of your Certification is required to be included if either of the above items is checked “Yes”.

Date application was submitted to OSDS , if an application is pending:

Completion Instructions for Proposal/Proposer Certification Sheet Complete the numbered items on the

Proposal/Proposer Certification Sheet by following the instructions below.

Complete, if applicable, by indicating the type of license and/or certification that your firm possesses and that is required for the type of services being procured.

10,11

12, 13, Must be completed. These items are self-explanatory.

If certified as a California Small Business, place a check in the "yes" box, and enter your certification number on the line. If certified as a Disabled Veterans Business Enterprise, place a check in the "Yes" box and enter your service code on the line. If you are not certified to one or both, place a check in the "No" box. If your certification is pending, enter the date your application was submitted to OSBCR.

ATTACHMENT 3

Cost Sheet

On-Site Counseling Services

IFB NO. C6619AAB

Contractors bidding this project shall be properly licensed in the State of California in the classification as designed in the Notice to Contractors and shall satisfy the State as to their license qualifications.

The undersigned has carefully checked all figures and understands that the State will not be responsible for any errors or omission on the part of the undersigned in making up this bid.

Having been completely familiar with all conditions affecting the cost of work at the place where the work is to be done, these specifications and other contract documents prepared and issued therefore, the Contractor hereby proposes and agrees to provide all services as outlined in the Invitation for Bid as follows:

Contractor Name:

Telephone:

Fax Number:

Federal I.D. # or SSN:

Hourly Amount for Counseling $ Hourly Amount for Interns $

Authorized Signature:

Title:

Date:

ARE YOU CLAIMING PREFERENCE AS A SMALL BUSINESS? YES NO

If YES, please attach a copy of your certification letter from the

Office of Small Business Certification and Resources.

Bid Form Attachment

LIST OF PROPOSED KEY PERSONNEL AND INTERNS/TRAINEES

NAME

LICENSE NO./INTERN

ATTACHMENT 4

Bidder References Submission of this attachment is MANDATORY. Failure to complete and return this attachment with your bid will cause your bid to be rejected and deemed nonresponsive.

List below three (3) references for services performed within the last five years, which are similar to the scope of work to be performed in this contract.

REFERENCE 1

Name of Firm:

Street Address:

Contact Person:

Telephone Number:

Dates of Service:

Brief Description of Service Provided:

REFERENCE 2

REFERENCE 3

ATTACHMENT 5

Small Business Certification

State of California (Revised 02/2003)

DOCUMENT 00454-1

LIST OF CERTIFIED SMALL BUSINESS SUBCONTRACTOR(S)

COMPLETION INSTRUCTIONS

PLEASE READ THESE INSTRUCTION CAREFULLY

IN ORDER TO GRANT A FIVE PERCENT (5%) NON-SMALL BUSINESS SUBCONTRACTOR PREFERENCE TO A NON-SMALL BUSINESS, THE BIDDER MUST COMPLETE ATTACHMENT VIII - THE CERTIFIED SMALL BUSINESS SUBCONTRACTOR SUMMARY (CSBSS) FORM 00454-2. THIS FORM MUST BE COMPLETED BY THE NON-SMALL BUSINESS BIDDER AND RETURNED TO THE AWARDING AGENCY NO LATER THAN FORTY-EIGHT (48) HOURS AFTER THE TIME OF RECEIPT OF BIDS. IF THE BIDDER FAILS TO RETURN THE COMPLETED FORM 00454-2 WITHIN 48 HOURS, THE CLAIM FOR SMALL BUSINESS PREFERENCE WILL BE DENIED.

CSBS COMPANY NAME – list the name(s) of the certified small business subcontractor(s) to be used to complete this project.

CSBS COMPANY ADDRESS – list the address(es) of the certified small business subcontractor(s) to be used to complete this project.

CSBS COMPANY TELEPHONE NUMBER – list the telephone number(s) of the certified small business subcontractor(s) to be used to complete this project.

CSBS PERCENTAGE (%) OR DOLLAR ($) AMOUNT – list the percentage(s) or dollar amount(s) that will be given to the certified small business subcontractor(s) used to complete this project.

DESCRIPTION OF WORK – identify the proposed work including services or materials to be performed by the certified small business subcontractor(s) to complete this project.

TO OBTAIN THE 5% NON-CERTIFIED SMALL BUSINESS PREFERENCE, THE LISTED SUBCONTRACTOR(S) AND/OR SUPPLIER(S) FIRM(S) MUST BE FORMALLY CERTIFIED BY THE OFFICE OF SMALL BUSINESS AND DVBE CERTIFICATION (OSDC) AS A SMALL AND/OR MICROBUSINESS.

Prime contractors must ask Subcontractor/Supplier to provide them with a copy of their OSDC certification letter, to be submitted with the bid.

Continued BIDDER NAME ____________________________________ PROJECT WORK ORDER NUMBER _______________

STATE OF CALIFORNIA

CERTIFIED SMALL BUSINESS SUBCONTRACTOR(S) SUMMARY

Listed hereinafter is the name of business, address, telephone number, dollar amount or percentage of all certified subcontractors who will be employed, and the description of the work which each will perform if the contract is awarded to this bidder. Bidders must get a copy of the OSDC Certification letter from each Certified Small Business Contractor listed, and attach it to this form.

Failure to list name of business, address, telephone number, description of work to be performed and dollar amount or percentage of work for each subcontractor may be cause for denial of the non-small business subcontractor preference.

(If further space is required for the List of Proposed Subcontractors, additional sheets showing the required information, as indicated below, shall be attached hereto and made a part of the Bid).

CERTIFIED SMALL BUSINESS (CSB) SUBCONTRACTOR

(Name of Business)

CSB

SUBCONTRACTOR

(Address)

CSB SUBCONTRACTOR

(Telephone Number)

CSB SUBCONTRACTOR

($ or % Amount)

CSB SUBCONTRACTOR

(Type of Work, Service or Materials)

CSB CERT.

(PROVIDE NO. & ATTACH COPY OF

OSDC LETTER

ATTACHMENT 6

DISABLED VETERAN BUSINESS ENTERPRISE (DVBE) PARTICIPATION

DVBE INCENTIVE PROGRAM

1. A DVBE Incentive will be granted to Bidders achieving DVBE Participation of 1% or more of their bid total, in accordance with Section 999.5(a) and (d) of the Military and Veterans Code, and California Code of Regulations §1896.98 et seq.

2. The DVBE Incentive will be applied during the bid evaluation process and will only be applied to responsive bids. Any Small Business Preference will be calculated prior to the DVBE Incentive calculation.

3. A certified Small Business may only be displaced by another certified Small Business with a higher percentage of DVBE participation and a lower adjusted bid price.

A certified Small Business cannot be displaced by a Non-Small Business. When applying the DVBE Incentive program, bidders claiming the “Non - Certified Small Business Sub-contractor Preference” are considered a Non-Small Business.

· Bidders that achieve a DVBE Participation of 1% or more will have the DVBE Incentive applied to their bid in an attempt to displace the apparent low bidder. The percentage of DVBE Incentive will be equal to the percentage of DVBE participation, and subject to a minimum of 1% and a maximum of 5%.

· Each Bidder’s DVBE Incentive percentage will be computed and subtracted from the lowest responsive bid amount. Calculations to determine adjusted bid price are for consideration only and the Contract will be awarded for the Bidder’s actual bid amount.

PROGRAM REQUIREMENTS

Public Contract Code Section 10115 establishes a contract participation goal of at least three percent (3%) for Disabled Veteran Business Enterprise (DVBE) for State agencies. DVBE participation requirements are optional for this contract. This bid package provides information for the DVBE Participation Program.

PLEASE READ THESE INSTRUCTIONS CAREFULLY

For assistance with using the DVBE participation program, please contact:

Jennifer Reed, Contracts Officer California Conservation Corps

1719 24th Street

Sacramento, CA 95816

Phone: (916) 341-3132 Fax: (877) 315-4881 The Office of Small Business and DVBE Certification (OSDC) offers program information and may be reached at:

Department of General Services

Office of Small Business and DVBE Certification (OSDC)

707 3RD Street, Suite 1-400

West Sacramento, CA 95605

Homepage: http://www.pd.dgs.ca.gov/osbcr 24-hour information and document request system: (916) 322-5060

Receptionist: (916) 375-4940

FAX: (916) 375-4950

INSTRUCTIONS FOR

DVBE PARTICIPATION PROGRAM COMPLIANCE

Before you begin to prepare your bid response, you will need to determine which option you will document to use the DVBE Participation Program.

Commitment to Contract Participation – Meet or exceed the 3% goal for DVBE participation for this Bid by one of the following two (2) ways:

DVBE Bidder - If you are a DVBE bidder, agree to perform at least 3% of the contract bid amount or value with your firm or in combination with other DVBE firms. You must write that commitment on Attachment II, Disabled Veteran Business Enterprise Participation Summary 840 Form, Document 00452-2. For instructions on how to complete this document see Attachment I, Disabled Veteran Business Enterprise Participation Summary, Completion Instructions, Document 00452-1.

Non-DVBE Bidder - If you are a non-DVBE bidder, agree to use other firms for at least 3% of the contract bid amount or value. You must write that commitment on Attachment II, Disabled Veteran Business Enterprise Participation Summary (STD 840) Form, Document 00452-2. For instructions on how to complete this document see Attachment I, Disabled Veteran Business Enterprise Participation Summary, Completion Instructions, Document 00452-1.

DVBE Certification: OSDC-DVBE certification is the only acceptable certification. To verify if a contractor is certified refer to the OSDC web-site at http://www.pd.dgs.ca.gov/osbcr. Bidders must provide certification verification for each participating DVBE bidder, subcontractor, and/or supplier.

Please Note: the DVBE Good Faith Effort is no longer allowed in any State contracting solicitations as of July 28, 2009 per Assembly Bill 21. Bidders are now required to commit to using a DVBE for at least 3% of their bid amount.

DVBE Notifications Each listed DVBE must be utilized for the specific nature of work, as indicated in your Bid Proposal. It is the prime contractor’s responsibility to keep all DVBE’s informed, and to give them reasonable notification of the time frame in which their participation will take place on the project.

The listed DVBE will also receive State notification of the award and the official start of the project. They will be instructed to contact the Prime contractor who listed them, if they have not heard from him/her within a reasonable period of time, to discuss their expected performance under the contract.

In the event the contract is amended to increase the amount, Contractors are required to comply with the State’s DVBE participation requirements for the amended amount. To insure that the listed DVBE is being utilized to the full amount of the commitment, a reminder notice will be sent to the Prime contractor mid-way through the contract.

Contract Audits Contractor agrees that the State or its delegate will have the right to review, obtain, and copy all records pertaining to performance of the contract, including but not limited to reports of payments made to subcontractors during the term of the contract. Contractor agrees to provide the State or its delegate access to its premise, upon reasonable notice, during normal business hours for the purpose of interviewing employees and inspecting and copying such books, records, accounts, and other material that may be relevant to a matter under investigation for the purpose of determining compliance with this requirement. Contractor further agrees to maintain such records for a period of three (3) years after final payment under the contract.

ANSWERS TO FREQUENTLY ASKED QUESTIONS:

The following questions are among the most frequently asked regarding DVBE requirements:

Q: If I am awarded the contract, either with partial or full goal attainment documented, am I required to use the subcontractor/supplier proposed in my bid?

A: Yes, unless you have requested and received approval from the State for substitution. Written requests should include the person’s or firm’s name to be substituted, the substitution reason, the reason a non-DVBE subcontractor is proposed, if applicable and describe the business to be substituted including its business status as a sole proprietorship, partnership, corporation or other entity and the certification status of the firm, if any. See Title 2, California Code of Regulations, Section 1896.64 (c) & (d) for substitution criteria.

The request and the State’s approval or disapproval is not construed as an excuse for non-compliance with any other provision of the law, including but not limited to the Subletting and Subcontracting Fair Practices Act, or any other contract requirements relating to substitution of subcontractors. Failure to adhere to at least the DVBE participation proposed by the successful Contractor may be cause for contract termination and recovery of damages under the rights and remedies due the State for default section of the contract(s) and any other penalties provided for by statute.

Q: Who notifies the subcontractor when an award is made?

A: Upon award to a prime Contractor, the Awarding Department notifies listed subcontractors of their contract participation. Primes are encouraged to notify their listed subcontractors immediately after an award is made to formalize their business agreements.

Q: What happens to bids considered non-responsive to the DVBE Participation Program requirements?

A: DVBE Participation is not required for this IFB, but can be used as an option in the bid submission.

Q: If I am a disabled veteran business enterprise, can I meet the 3% contract goals as a single company?

A: Yes.

Q: If my submitted bid meets the contract goal and the State decides to make multiple awards to the bid/contract, could my bid be considered non-responsive?

A: No. The State’s decision to make multiple awards will not jeopardize bid compliance.

ATTACHMENT I

DOCUMENT 00452-1

DISABLED VETERAN BUSINESS ENTERPRISE (DVBE)

PARTICIPATION SUMMARY

COMPLETION INSTRUCTIONS

ATTACHMENT II, FORM 00452-2 MUST BE COMPLETED. IF NO PARTICIPATION IS OBTAINED, STATE “NONE.”

TYPE OF WORK – identify the proposed work to be performed by the DVBE prime contractor or DVBE subcontractor(s).

DVBE COMPANY NAME – list the name of the company proposed for DVBE participation. If the prime contractor is a DVBE, the name MUST be listed for participation.

DVBE IS CONTRACTING WITH – list the name of the department or company with which the company listed is contracting (Prime Contractor’s Name).

DOLLAR AMOUNT TO DVBE – the total participation dollar amount given to the DVBE for this bid.

PERCENTAGE TO DVBE – the total percentage given to the DVBE for this bid.

DVBE CERTIFICATION – to obtain DVBE participation credit, the Prime Contractor or Subcontractor/Supplier firm must be formally certified by the Office of Small Business and DVBE Certification (OSDC) as a DVBE. Provide OSDC certification number and a copy of the certification letter for the Prime or Subcontractor/Supplier. (Prime should ask Subcontractor/Supplier to provide them with a copy of their OSDC certification letter)

ATTACHMENT II

BIDDERS NAME ___________________________

STATE OF CALIFORNIA

DISABLED VETERAN BUSINESS

ENTERPRISE PARTICIPATION SUMMARY

Form 840 02/2003

See completion instructions on prior page.

TYPE OF WORK

(Service or Materials)

IS CONTRACTING WITH

(Contractor’s Name)

DOLLAR AMOUNT

TO DVBE

PERCENTAGE

TO DVBE

DVBE CERT.

PROVIDE NO.

& ATTACH COPY OF

OSDC LETTER)

DVBE PARTICIPATION SUMMARY 00452-2

ATTACHMENT 7

DARFUR CONTRACTING ACT

Pursuant to Public Contract Code section 10478, if a bidder or proposer currently or within the previous three years has had business activities or other operations outside of the United States, it must certify that it is not a “scrutinized” company as defined in Public Contract Code section 10476.

Therefore, to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete only one of the following three paragraphs (via initials for Paragraph # 1 or Paragraph # 2, or via initials and certification for Paragraph # 3):

Company/Vendor Name (Printed)

Federal ID Number

Printed Name and Title of Person Initialing (for Options 1 or 2)

1. _____ We do not currently have, and have not had within the previous

Initials three years, business activities or other operations outside of the United States.

OR

2. _____ We are a scrutinized company as defined in Public Contract Code

Initials section 10476, but we have received written permission from the Department of General Services (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.

OR

3. _____ We currently have, or we have had within the previous three years, Initials business activities or other operations outside of the United States, + certification but we certify below that we are not a scrutinized company below as defined in Public Contract Code section 10476.

CERTIFICATION For # 3.

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective proposer/bidder to the clause listed above in # 3. This certification is made under the laws of the State of California.

By (Authorized Signature)

Printed Name and Title of Person Signing

ATTACHMENT 8

PAYEE DATA RECORD (STD 204)

This form must be obtained from the Office of State Publishing website stated below. The form should be downloaded and completed, signed and returned with your bid package.

http://www.osp.dgs.ca.gov/StandardForms/Fill+and+Print+Standard+eForms.htm

Enter 204 in the box “Enter a Form No.:”

If you do not have Internet capabilities, please contact the following person to obtain a form:

Contract Management Section

California Conservation Corps

(916) 341-3132

ATTACHMENT 9

Contractor Certification Clause

CCC-307

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to the clause(s) listed below. This certification is made under the laws of the State of California.

Contractor/Bidder Firm Name (Printed)

Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

CONTRACTOR CERTIFICATION CLAUSES

1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with the nondiscrimination program requirements. (Gov. Code §12990 (a-f) and CCR, Title 2, Section 8103) (Not applicable to public entities.)

2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free workplace by taking the following actions:

a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations.

b. Establish a Drug-Free Awareness Program to inform employees about:

1) the dangers of drug abuse in the workplace;

2) the person's or organization's policy of maintaining a drug-free workplace;

3) any available counseling, rehabilitation and employee assistance programs; and,

4) penalties that may be imposed upon employees for drug abuse violations.

c. Every employee who works on the proposed Agreement will:

1) receive a copy of the company's drug-free workplace policy statement; and,

2) agree to abide by the terms of the company's statement as a condition of employment on the Agreement.

Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and Contractor may be ineligible for award of any future State agreements if the department determines that any of the following has occurred: the Contractor has made false certification, or violated the certification by failing to carry out the requirements as noted above. (Gov. Code §8350 et seq.)

3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor certifies that no more than one (1) final unappealable finding of contempt of court by a Federal court has been issued against Contractor within the immediately preceding two-year period because of Contractor's failure to comply with an order of a Federal court, which orders Contractor to comply with an order of the National Labor Relations Board. (Pub. Contract Code §10296) (Not applicable to public entities.)

4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO REQUIREMENT: Contractor hereby certifies that contractor will comply with the requirements of Section 6072 of the Business and Professions Code, effective January 1, 2003.

Contractor agrees to make a good faith effort to provide a minimum number of hours of pro bono legal services during each year of the contract equal to the lessor of 30 multiplied by the number of full time attorneys in the firm’s offices in the State, with the number of hours prorated on an actual day basis for any contract period of less than a full year or 10% of its contract with the State.

Failure to make a good faith effort may be cause for non-renewal of a state contract for legal services, and may be taken into account when determining the award of future contracts with the State for legal services.

5. EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not an expatriate corporation or subsidiary of an expatriate corporation within the meaning of Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the State of California.

6. SWEATFREE CODE OF CONDUCT:

a. All Contractors contracting for the procurement or laundering of apparel, garments or corresponding accessories, or the procurement of equipment, materials, or supplies, other than procurement related to a public works contract, declare under penalty of perjury that no apparel, garments or corresponding accessories, equipment, materials, or supplies furnished to the state pursuant to the contract have been laundered or produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor. The contractor further declares under penalty of perjury that they adhere to the Sweatfree Code of Conduct as set forth on the California Department of Industrial Relations website located at www.dir.ca.gov, and Public Contract Code Section 6108.

b. The contractor agrees to cooperate fully in providing reasonable access to the contractor’s records, documents, agents or employees, or premises if reasonably required by authorized officials of the contracting agency, the Department of Industrial Relations, or the Department of Justice to determine the contractor’s compliance with the requirements under paragraph (a).

7. DOMESTIC PARTNERS: For contracts over $100,000 executed or amended after January 1, 2007, the contractor certifies that contractor is in compliance with Public Contract Code section 10295.3.

DOING BUSINESS WITH THE STATE OF CALIFORNIA

The following laws apply to persons or entities doing business with the State of California.

1. CONFLICT OF INTEREST: Contractor needs to be aware of the following provisions regarding current or former state employees.