Darfur_DFW1080ext.pdf
PDF 875 KB Posted
- Solicitation number
- 0000030895
- Issued by
- Sacramento County, Sacramento City, California
About this file
The document is a Darfur Contracting Act Certification form from the California Department of Fish and Wildlife. It requires bidders or proposers for state contracts to certify whether they currently or previously had business activities or operations outside of the United States. The contract opportunity is for the procurement of Live Male Ring Neck Pheasants to be used for annual regional hunts in Sacramento County and Sacramento City. The contract is issued by the State of California and the jurisdictions involved are Sacramento County and Sacramento City.
The document outlines three certification options for bidders to select from regarding their business activities outside of the United States. Bidders must initial the applicable paragraph and provide the required supporting documentation if they have had such activities. The certification is made under penalty of perjury. The pricing and other commercial terms of the contract are not detailed in this document.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment_2_Delivery_Instructions_and_Schedule.docx | DOCX document | |
| Bidder_Declaration_DFW1082.pdf | ||
| sellerspermit-EXAMPLE.pdf | ||
| std204.pdf | ||
| NCR-HQ-RFQ-23-W0078.docx | DOCX document |
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Text version
State of California - Department of Fish and Wildlife
DARFUR CONTRACTING ACT CERTIFICATION
DFW 1080 (NEW 02/14/19)
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 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.
By (Authorized Signature)
Printed Name and Title of Person Signing
Date Executed Executed in the County and State of
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.
| 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: |
| Date Executed: |
| Executed in the County and State of: |
| SAVE: |
| PRINT: |
| CLEAR: |
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