CDFW_1080_DAFUR.pdf
PDF 957 KB Posted
- Attached to
- RFQ-R3-NSMWA Riding Lawn Mower
- Solicitation number
- 0000038124
- Issued by
- California
About this file
This is a Darfur Contracting Act Certification form (DFW 1080, Revised 05/15/23) issued by the State of California Department of Fish and Wildlife for use in conjunction with the RFQ-R3-NSMWA Riding Lawn Mower procurement. The form is a mandatory compliance document required for all bidders and proposers participating in this contract opportunity. Bidders must certify their international business activities status by selecting one of three options: confirming they have no business operations outside the United States in the previous three years, declaring they are a scrutinized company with written Department of General Services approval to bid, or certifying they have international business activities but are not a scrutinized company as defined under Public Contract Code Section 10476. The form requires completion of company name, Federal Employer Identification Number (FEIN), and the printed name and title of the authorized representative initialing or signing the certification.
Failure to submit this form with either paragraph one or two initialed, or paragraph three both initialed and certified under penalty of perjury, will result in disqualification of the bid or proposal from consideration. For bidders selecting paragraph three, certification must be executed by an authorized official with legal authority to bind the prospective proposer, and electronic signatures are accepted with the same legal validity as handwritten signatures under California Civil Code 1633.5(b). This compliance requirement applies to all bidders regardless of their international business status and serves as a prerequisite screening mechanism for participation in California Department of Fish and Wildlife procurements.
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Other files
| File | Type | Posted |
|---|---|---|
| std204.pdf | ||
| RFQ-R3-NSMWA_Riding_Lawn_Mower.pdf | ||
| NonIT-General-ProvisionsGoods.pdf | ||
| CDFW1082_Bidder_Dec.pdf | ||
| Bidders_Instructions_(1).pdf |
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Text version
State of California - Department of Fish and Wildlife
DARFUR CONTRACTING ACT CERTIFICATION
DFW 1080 (REV. 05/15/23)
Pursuant to California Code, Public Contract Code (PCC) – PCC § 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 PCC § 10476.
Therefore, to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number (FEIN) 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) FEIN
Printed Name and Title of Person Initialing (option 1 or 2) Date
1. ________ Initials
2. ________ Initials
3. ________ Initials
We do not currently have, or we have not had within the previous three years, business activities or other operations outside of the United States.
OR
We are a scrutinized company as defined in PCC § 10476, but we have received written permission from the Department of General Services (DGS) to submit a bid or proposal pursuant to PCC § 10477(B). A copy of the written permission from DGS is included with our bid or proposal.
OR
We currently have, or we have had within the previous three years, business activities or other operations outside of the United States, but we certify below that we are not a scrutinized company as defined in PCC § 10476.
CERTIFICATION For Number 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 paragraph 3. This certification is made under the laws of the State of California.
With accordance to California Civil Code §1633.5(b), I acknowledge that by providing my electronic signature for this form, I agree that my electronic signature is legal binding equivalent to a handwriting signature. I hereby confirm that my electronic signature represents my execution or authentication of this form, and my intent to be bound by it.
By (Authorized Signature)
Printed Name and Title of Person Signing
Executed in the County and State of Date Executed
NOTE: State Price Schedule (SPS) Applications will be disqualified unless your application includes this form with either paragraph 1 or paragraph 2 initialed or paragraph 3 initialed and certified.
https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10478.
https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10476.
https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10476.
http://www.dgs.ca.gov/dgs/Home.aspx https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10477.
https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC§ionNum=10476.
https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fleginfo.legislature.ca.gov%2Ffaces%2Fcodes_displaySection.xhtml%3FsectionNum%3D1633.5%26lawCode%3DCIV&data=05%7C01%7CLucia.Rodriguez%40wildlife.ca.gov%7Cf7d61fe8902f4fc2ddc908db44de0a8a%7C4b633c25efbf40069f1507442ba7aa0b%7C0%7C0%7C638179492686187568%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=SgmSIctaufa78R%2BCFlJqmUDsiiE%2FYw%2FCR%2BZhi4%2BcxQ0%3D&reserved=0
| OR |
| OR |
| CompanyVendor Name Printed: |
| FEIN: |
| Printed Name and Title of Person Initialing option 1 or 2: |
| Date: |
| Initials: |
| Initials_2: |
| Initials_3: |
| Printed Name and Title of Person Signing: |
| Executed in the County and State of: |
| Date Executed: |
| SAVE: |
| PRINT: |
| CLEAR: |
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