Darfur-DFW1080.pdf
PDF 442 KB Posted
- Attached to
- RFQ-R2-0626-01, Utility Vehicle
- Solicitation number
- 0000036661
- Issued by
- Sacramento County, California
About this file
This document is a Darfur Contracting Act Certification form issued by the State of California's Department of Fish and Wildlife (DFW), specifically form DFW 1080 revised on 05/15/23. The form is designed to ensure compliance with California Public Contract Code (PCC) § 10478, requiring bidders or proposers to certify their business activities outside the United States. Bidders must complete one of three paragraphs: affirming no international business activities, providing written permission from the Department of General Services (DGS) if they are a "scrutinized" company, or certifying they are not a scrutinized company despite having international business operations.
The certification is mandatory for State Price Schedule (SPS) Applications, with applications being disqualified if the form is not properly completed. Companies must provide their name, Federal ID Number (FEIN), and an authorized signature. The form includes a provision under California Civil Code §1633.5(b) acknowledging that electronic signatures are legally binding. Failure to properly initial and/or certify the appropriate paragraph will result in the disqualification of the application, emphasizing the importance of careful completion of this compliance document.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFQ-R2-0626-01_Utility_Vehicle.pdf | ||
| PCC-CalRecycle_74_(Rev._1_10).pdf | ||
| STD204-Payee_Data_Record.pdf | ||
| Bidder_Dec-DFW1082.pdf |
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Text version
State of California - Department of Fish and Wildlife
DARFUR CONTRACTING ACT CERTIFICATION
DFW 1080 (REV. 05/15/23)
Pursuant to California Code, Public Contract Code (PCC) – PCC § 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 PCC § 10476.
Therefore, to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number (FEIN) 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) FEIN
Printed Name and Title of Person Initialing (option 1 or 2) Date
1. ________ Initials
2. ________ Initials
3. ________ Initials
We do not currently have, or we have not had within the previous three years, business activities or other operations outside of the United States.
OR
We are a scrutinized company as defined in PCC § 10476, but we have received written permission from the Department of General Services (DGS) to submit a bid or proposal pursuant to PCC § 10477(B). A copy of the written permission from DGS is included with our bid or proposal.
OR
We currently have, or we have had within the previous three years, business activities or other operations outside of the United States, but we certify below that we are not a scrutinized company as defined in PCC § 10476.
CERTIFICATION For Number 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 paragraph 3. This certification is made under the laws of the State of California.
With accordance to California Civil Code §1633.5(b), I acknowledge that by providing my electronic signature for this form, I agree that my electronic signature is legal binding equivalent to a handwriting signature. I hereby confirm that my electronic signature represents my execution or authentication of this form, and my intent to be bound by it.
By (Authorized Signature)
Printed Name and Title of Person Signing
Executed in the County and State of Date Executed
NOTE: State Price Schedule (SPS) Applications will be disqualified unless your application includes this form with either paragraph 1 or paragraph 2 initialed or paragraph 3 initialed and certified.
File details come from the government source that posted it. Updated .