Darfur_Contracting_Act_Certification_Form.pdf
PDF 169 KB Posted
- Solicitation number
- S26-33357
- Issued by
- California
About this file
This is a Darfur Contracting Act Certification Form required by the State of California's Department of General Services for companies bidding on state contracts. The form applies to any company that has conducted business activities or operations outside the United States within the previous three years and seeks to bid on Invitation for Bid #S26-33357 for Commercial Exhaust Hood Cleaning System Preventative Maintenance Service and Repair in Los Angeles, Orange, and San Diego Counties. The scope of work involves providing semiannual commercial exhaust hood cleaning, repair, and preventative maintenance services for the Department of Rehabilitation's Business Enterprise Program facilities located in state, federal, and county office buildings, as well as privately owned facilities. Services include disassembly and cleaning of hoods, filters, grease troughs, and ductwork; inspection and replacement of fan belts; degreasing of roof and wall-mounted fans; replacement of hood filters and parts; application of food-safe polish to stainless steel components; and provision of detailed written reports and certificates documenting completed work. The contractor must coordinate with the Business Enterprises Consultant and BEP vendors to minimize business interruption while adhering to safety protocols.
The certification form requires eligible bidders to complete one of two options: Option #1 requires certification under penalty of perjury that the company is not a scrutinized company as defined under Public Contract Code Section 10476, or Option #2 requires submission of written permission from the Department of General Services Director authorizing a scrutinized company to bid on a case-by-case basis if deemed in the best interests of the state. The form mandates completion by an authorized company representative who must provide the company name, Federal ID Number, authorized signature, printed name, and title. All costs for cleaning supplies, equipment, and labor are the contractor's responsibility, and timely service delivery is essential to support ongoing business enterprise operations.
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Other files
| File | Type | Posted |
|---|---|---|
| DGS_CERTIFIED_SB_PARTICIPATION.pdf | ||
| IFB_S26-33357.pdf | ||
| DVBE_INCENTIVE.pdf | ||
| Exhibit_B-1_Rate_Sheet_Alarm_Monitoring_Svcs_C5613264-D.xlsx | XLSX spreadsheet |
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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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