Darfur_Contracting_Act_Cert_form.docx

DOCX document 14 KB Posted

Attached to
06-0418 Federal Office Building Los Angeles
Solicitation number
03-041825
Issued by
California

About this file

This is a Darfur Contracting Act Certification form required by the State of California for bidders and proposers on the 06-0418 Federal Office Building Los Angeles informal competitive solicitation. The solicitation seeks two items: one digital mirrorless or DSLR camera and one dye-sublimation or thermal photo printer. Bidders with business activities or operations outside the United States within the previous three years must complete the certification form to establish eligibility. The form requires bidders to select one of three options: certify they have no international operations, declare scrutinized company status with written DGS permission, or certify they have international operations but are not a scrutinized company as defined under Public Contract Code section 10476.

The certification must be completed by an authorized company representative and include the company name, Federal ID number, and signature of the authorized official under penalty of perjury. Bidders selecting options one or two need only provide initials, while those selecting option three must provide a full certification signature with date and location of execution. No other pricing terms, set-asides, incumbents, or funding information is detailed in this certification document.

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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 .