Darfur_Contracting_Act_Cert_form.docx
DOCX document 14 KB Posted
- Attached to
- 03-0190 Kiosk and Vending Machine
- Solicitation number
- 03-0190
- Issued by
- California
About this file
This is a Darfur Contracting Act Certification form required by the State of California for the solicitation 03-0190 Kiosk and Vending Machine. The form applies to bidders or proposers that have had business activities or operations outside the United States within the previous three years. Bidders must certify their compliance status regarding "scrutinized company" designations as defined in Public Contract Code section 10476. The solicitation requests three specific items: one Cantaloupe Go Max self-service kiosk, one Cantaloupe Go Plus 100 Bill Acceptor standalone kiosk, and one Jofemar Coffemar Bluetec G23 Countertop Coffee Vending Machine. The solicitation has been amended to address questions from potential bidders, with updated Q&A materials provided.
Bidders must complete one of three certification options by providing their company name, Federal ID Number, and authorized signatures as required. Option 1 allows bidders to certify they have no international business activities; Option 2 permits scrutinized companies that have received written permission from the Department of General Services to proceed with their bid; and Option 3 allows bidders with international operations to certify they are not scrutinized companies, requiring an authorized signature under penalty of perjury. Failure to properly complete and submit this certification form renders a bid ineligible for consideration.
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Other files
| File | Type | Posted |
|---|---|---|
| DGS_PD_843.pdf | ||
| Post-Consumer_Recycled_Content_Certification.pdf | ||
| Attachment__3_-_Delivery_Installation_Instructions.docx | DOCX document | |
| Q_A.docx | DOCX document | |
| Bidder_Declaration.docx | DOCX document | |
| std204.pdf | ||
| DR815_Request_for_Quote.pdf | ||
| Attachment__2_Specifications_Equipment_v.2_11.7.2025_(ja).docx | DOCX document | |
| RFQ_Letterhead.docx | DOCX document | |
| Attachment__1_-_Request_for_Quote_Requirement_Equipment.docx | DOCX document |
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Text version
DARFUR CONTRACTING ACT CERTIFICATION
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 section 10476, Initials 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
| Date Executed |
| Executed in the County and State of |
File details come from the government source that posted it. Updated .