Contractor's_Declaration_Form_JOC_2701-2706_-_General_Construction.pdf
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- Solicitation number
- 2027-RFP-00112
- Issued by
- San Mateo County, San Bernardino City, California
About this file
This is a Contractor's Declaration Form for General Construction Job Order Contracts (JOCs 2701-2706) issued by San Mateo County's Department of Public Works in California. The form must be completed in full and submitted with each bid. The contract opportunity involves up to six contractors selected for general construction services at various County-owned facilities, with work to be performed within a designated area of the County, though the Owner reserves the right to direct contractors to any location or facility under its jurisdiction. The Department intends to award separate Job Order Contracts with an aggregate fiscal obligation not to exceed $6.0 million for each agreement over a maximum individual term of one year, with the apparent lowest, responsive, and responsible bidder selected for each JOC but excluded from consideration for successive contracts. The bid response deadline is December 10, 2026.
The declaration form addresses four compliance areas applicable to contractors based on contract value thresholds. For contracts exceeding $5,000, contractors must demonstrate compliance with the County's Equal Benefits Ordinance by offering equal benefits to employees with spouses and domestic partners, providing cash equivalent payments in lieu of benefits, or documenting an exemption. For contracts exceeding $100,000, contractors must certify compliance with the Employee Jury Service Ordinance, which requires a written policy providing up to five days of regular pay for actual jury service to employees living in San Mateo County. The form also requires contractors to disclose any discrimination findings issued by the Equal Employment Opportunity Commission, Fair Employment and Housing Commission, or other investigative entities within the past year. Contractors must sign the declaration under penalty of perjury, confirming authorization to bind the entity contractually.
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Text version
CONTRACTOR’S DECLARATION FORM
THIS FORM MUST BE COMPLETED IN FULL AND SUBMITTED WITH THE BID
Project: Job Order Contract for JOCs 2701, 2702, 2703, 2704, 2705 and 2706 - Geneal Construction at various County of San Mateo owned facilities
I CONTRACTOR INFORMATION
Contractor Name: Phone:
Contact Person: Fax:
II EQUAL BENEFITS (check one or more boxes)
Contractors with contracts in excess of $5,000 must treat spouses and domestic partners equally as to employee benefits.
Contractor complies with the County’s Equal Benefits Ordinance by:
offering equal benefits to employees with spouses and employees with domestic partners.
offering a cash equivalent payment to eligible employees in lieu of equal benefits.
Contractor does not comply with the County’s Equal Benefits Ordinance.
Contractor is exempt from this requirement because:
Contractor has no employees, does not provide benefits to employees’ spouses, or the contract is for $5,000 or less.
Contractor is a party to a collective bargaining agreement that began on
(date) and expires on (date), and intends to offer equal benefits when said agreement expires.
III NON-DISCRIMINATION (check appropriate box)
Finding(s) of discrimination have been issued against the Contractor within the past year by the Equal
Employment Opportunity Commission, Fair Employment and Housing Commission, or other investigative entity.
Please see attached sheet of paper explaining the outcome(s) or remedy for the discrimination.
No finding of discrimination has been issued in the past year against the Contractor by the Equal Employment
Opportunity Commission, Fair Employment and Housing Commission, or any other entity.
IV EMPLOYEE JURY SERVICE (check one or more boxes)
Contractors with original or amended contracts in excess of $100,000 must have and adhere to a written policy that provides its employees living in San Mateo County up to five days regular pay for actual jury service in the County.
Contractor complies with the County’s Employee Jury Service Ordinance.
Contractor does not comply with the County’s Employee Jury Service Ordinance.
Contractor is exempt from this requirement because:
the contract is for $100,000 or less.
Contractor is a party to a collective bargaining agreement that began on
(date) and expires on (date), and intends to comply when said agreement expires.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually.
Signature Name
Date Title
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