Darfur_Form.pdf
PDF 169 KB Posted
- Solicitation number
- S26-33347
- Issued by
- Sacramento County, San Francisco City, California
About this file
This is a Darfur Contracting Act Certification form required by the State of California Department of General Services for vendors 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. Bidders must certify either that they are not a scrutinized company under Public Contract Code Section 10476, or alternatively provide written permission from the Department of General Services authorizing them to submit a proposal despite being classified as a scrutinized company. The certification is made under penalty of perjury and requires the authorized company representative to sign and provide the company name, Federal ID number, and printed name and title.
The form presents two compliance pathways for eligible vendors. Option 1 allows non-scrutinized companies to complete a straightforward certification that they meet eligibility requirements. Option 2 accommodates scrutinized companies that have received case-by-case written approval from the Department of General Services Director under Public Contract Code Section 10477(b), provided such approval is determined to be in the best interests of the state. Both options require submission of the completed form with bid or proposal documentation. The certification form is applicable to the related In-Person American Sign Language Interpreting Services contract opportunity for the California Department of Rehabilitation, which seeks RID and/or RID-NAD certified interpreters for the Golden Gate Silicon Valley District on an as-needed basis during regular business hours.
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Other files
| File | Type | Posted |
|---|---|---|
| CERTIFIED_SB_PARTICIPATION_FORM.pdf | ||
| DVBE_INCENTIVE_FORM.pdf | ||
| Payee_Data_Record_(STD_204).pdf | ||
| RFQ_25520545_-_Property_Tax_Servicing_RFQ.docx | DOCX document |
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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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