Darfur_Contracting_Act_Cert_form.docx
DOCX document 14 KB Posted
- Attached to
- Westley SRRA Southbound (VM)
- Solicitation number
- 03-0813B
- Issued by
- Tuolumne County, California
About this file
This is a Darfur Contracting Act Certification form required by the State of California for bidders and proposers on state and local contract opportunities. The form applies to the Westley SRRA Southbound (VM) informal competitive solicitation for vending machines, which includes four items: one hot drink coffee vending machine, one ice cream vending machine, one snack vending machine, and one drink vending machine. Bidders must complete the certification to verify their eligibility to submit a bid or proposal, particularly regarding any business activities or operations conducted outside the United States during the previous three years.
The form requires bidders to select one of three certification options: certify that they have no business operations outside the United States within the past three years; certify that they are a scrutinized company but have received written permission from the Department of General Services to proceed; or certify that they have international business operations but are not a scrutinized company as defined under Public Contract Code section 10476. Any bidder selecting the third option must provide a signed certification under penalty of perjury from an authorized company official. The form must include the company name, Federal ID Number, printed name and title of the initialing or signing official, date executed, and the county and state where the certification was executed.
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Other files
| File | Type | Posted |
|---|---|---|
| DGS_PD_843.pdf | ||
| RFQ_Letterhead.docx | DOCX document | |
| Attachment__1_-_Request_for_Quote_Requirements__VM_.docx | DOCX document | |
| std204.pdf | ||
| DR815_Request_for_Quote.pdf | ||
| Bidder_Declaration.docx | DOCX document | |
| Post-Consumer_Recycled_Content_Certification.pdf | ||
| Attachment__3_-_Delivery_Installation_Instructions__003_.docx | DOCX document | |
| Attachment__2_Specifications_for_Vending_Machines.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 |
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