_DARFUR__DFW1080ext.pdf

957 KB Posted

Attached to
RFQ-2026-CR4-GBH-001
Solicitation number
0000039041
Issued by
California

About this file

Written by GovTribe AI ·

This is a Darfur Contracting Act Certification form issued by the State of California Department of Fish and Wildlife for compliance with Public Contract Code sections 10476-10478. The form applies to the Request for Quotation RFQ-2026-CR4-GBH-001 for the purchase of 2,005 male 16-week-old ring-necked pheasants to support upland game program special pheasant hunts in fiscal year 2026/27. All bidders and proposers must complete this certification form to be eligible for submission; failure to include the form with proper initials or certification will result in disqualification of State Price Schedule applications.

Bidders must certify one of three conditions: (1) that the company has no business activities or operations outside the United States in the current period or previous three years; (2) that the company is a scrutinized company as defined in PCC 10476 but has received written permission from the Department of General Services to submit a bid; or (3) that despite having international business activities, the company is not a scrutinized company under PCC 10476. Option 3 requires a formal certification under penalty of perjury by an authorized company representative, with acknowledgment that electronic signatures are legally binding under California Civil Code 1633.5(b). The form must be completed with the company name, Federal Employer Identification Number, and the signature or initials of an authorized representative along with the execution date and county/state.

View the file

Other files

File Type Posted
STD204.pdf PDF
Bidder_Declaration_DFW1082ext.pdf PDF
RFQ_Pheasant_Requirements.pdf PDF
CalRecyle_74.pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

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.

https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10478.

https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10476.

https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10476.

http://www.dgs.ca.gov/dgs/Home.aspx https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10477.

https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10476.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fleginfo.legislature.ca.gov%2Ffaces%2Fcodes_displaySection.xhtml%3FsectionNum%3D1633.5%26lawCode%3DCIV&data=05%7C01%7CLucia.Rodriguez%40wildlife.ca.gov%7Cf7d61fe8902f4fc2ddc908db44de0a8a%7C4b633c25efbf40069f1507442ba7aa0b%7C0%7C0%7C638179492686187568%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=SgmSIctaufa78R%2BCFlJqmUDsiiE%2FYw%2FCR%2BZhi4%2BcxQ0%3D&reserved=0

OR
OR
CompanyVendor Name Printed:
FEIN:
Printed Name and Title of Person Initialing option 1 or 2:
Date:
Initials:
Initials_2:
Initials_3:
Printed Name and Title of Person Signing:
Executed in the County and State of:
Date Executed:
SAVE:
PRINT:
CLEAR:

File details come from the government source that posted it. Updated .