Darfur_Contracting_Act_Certification_Form.pdf
PDF 169 KB Posted
- Solicitation number
- S25-33339
- Issued by
- Los Angeles County, California
About this file
This is a Darfur Contracting Act Certification Form issued by the Department of General Services Procurement Division for the State of California, required for Invitation for Bid (IFB) #S25-33339 for in-person American Sign Language (ASL) interpreting services with the Department of Rehabilitation (DOR) Orange San Gabriel District. The form applies to any company with business activities or operations outside the United States within the previous three years. Eligible bidders must certify either that they are not a scrutinized company under Public Contract Code sections 10475-10481, or alternatively, submit written permission from the Department of General Services authorizing a scrutinized company to bid. The contractor will provide current RID and/or RID-NAD certified ASL interpreters on an as-needed basis for in-person services across the Orange San Gabriel District during standard business hours (Monday through Friday, 8:00 a.m. to 5:00 p.m. Pacific Time), with specific requirements for at least two non-consecutive days per week at the El Monte Branch Office (approximately 8 hours per day) and availability for community events, conferences, meetings, and classroom training sessions.
Interpreters must hold a minimum of one valid and current certification, including Registry of Interpreters for the Deaf (RID) at Comprehensive Skills Certificate (CSC) level or higher, National Interpreting Certification (NIC), and/or Certificate of Interpretation (CI) or Certificate of Translation (CT) from the National Association of the Deaf (NAD) at Level III or above. Bidders must complete the certification form by providing their company name, Federal ID Number, and authorized signature, confirming compliance with applicable California Public Contract Code requirements. The form allows two submission options: standard certification for non-scrutinized companies or submission of written DGS permission for scrutinized companies. All bidders are required to include the completed certification form with their proposal as a condition of eligibility.
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Other files
| File | Type | Posted |
|---|---|---|
| STD204.pdf | ||
| IFB_S25-33339.pdf | ||
| DGS_CERTIFIED_SB_PARTICIPATION.pdf | ||
| DVBE_INCENTIVE.pdf |
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Text version
Public Contract Code Sections 10475 -10481 applies to any company that currently or within the previous three years has had business activities or other operations outside of the United States. For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company that has been granted permission by the Department of General Services to submit a proposal.
If your company has not, within the previous three years, had any business activities or other operations outside of the United States, you do not need to complete this form.
OPTION #1 - CERTIFICATION
If your company, within the previous three years, has had business activities or other operations outside of the United States, in order to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete the certification below.
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that a) the prospective proposer/bidder named below is not a scrutinized company per Public Contract Code 10476; and b) I am duly authorized to legally bind the prospective proposer/bidder named below. This certification is made under the laws of the State of California.
Company/Vendor Name (Printed) Federal ID Number
By (Authorized Signature)
Printed Name and Title of Person Signing
OPTION #2 – WRITTEN PERMISSION FROM DGS
Pursuant to Public Contract Code Section 10477(b), the Director of the Department of General Services may permit a scrutinized company, on a case-by-case basis, to bid on or submit a proposal for a contract with a state agency for goods or services, if it is in the best interests of the state. If you are a scrutinized company that has obtained written permission from the DGS to submit a bid or proposal, complete the information below.
DEPARTMENT OF GENERAL SERVICES
PROCUREMENT DIVISION
STATE OF CALIFORNIA
DARFUR CONTRACTING ACT CERTIFICATION
DGS PD 1 (Rev. 12/19)
Date
We are a scrutinized company as defined in Public Contract Code section 10476, but we have received written permission from the Department of General Services 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.
Company/Vendor Name (Printed) Federal ID Number
By (Authorized Signature)
Printed Name and Title of Person Signing
Date
| OPTION #1 - CERTIFICATION |
| OPTION #2 – WRITTEN PERMISSION FROM DGS |
| Federal ID Number: |
| Printed Name and Title of Person Signing: |
| CompanyVendor Name Printed_2: |
| Federal ID Number_2: |
| Printed Name and Title of Person Initialing: |
| CompanyVendor Name: |
| ADA Instructions: |
| Date of signature: |
| Date of signature 2: |
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