Contractor's_Declaration_Form_JOC_2712_and_2713_-_Flooring.pdf
PDF 127 KB Posted
- Solicitation number
- 2027-RFP-00201
- Issued by
- San Mateo County, California
About this file
This is a Contractor's Declaration Form for Flooring Job Order Contracts (JOC 2712 and 2713) issued by San Mateo County's Department of Public Works for Class C15 Licensed contractors. The form requires contractors to provide complete information including contractor name, contact person, phone number, and fax number. Proposals are due December 10, 2026, with the Department intending to award up to two contractors, each with an aggregate fiscal obligation not to exceed $2.0 million and a maximum individual term of one year. The scope of work consists of providing all labor, materials, tools, appurtenances, and equipment for flooring services as directed by the Director of Public Works or designee at various County-owned facilities, though work may be required at any location or facility under County jurisdiction. Separate job orders are issued by Notice to Proceed as warranted, and work is priced under a Construction Task Catalog with a JOC System License and Fee Agreement. The apparent lowest, responsive, and responsible bidder is selected for each JOC but is excluded from consideration for successive contracts.
The form mandates contractor compliance with several San Mateo County ordinances as conditions of award. Contractors with contracts exceeding $5,000 must comply with the Equal Benefits Ordinance by offering equal benefits to employees with spouses and domestic partners or providing cash equivalent payments. Contractors with original or amended contracts exceeding $100,000 must comply with the Employee Jury Service Ordinance, providing up to five days of regular pay for San Mateo County jury service. The form also requires declaration of any discrimination findings issued within the past year by the Equal Employment Opportunity Commission, Fair Employment and Housing Commission, or other investigative entities. Contractors must execute the declaration under penalty of perjury, confirming authorization to bind the entity contractually.
View the file
Other files
Show all 23
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
CONTRACTOR’S DECLARATION FORM
THIS FORM MUST BE COMPLETED IN FULL AND SUBMITTED WITH THE BID
Project: Job Order Contract for JOCs 2712 and 2713 - Flooring at various County of San Mateo 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
File details come from the government source that posted it. Updated .