Darfur_Form.pdf
PDF 169 KB Posted
- Solicitation number
- S26-33409
- Issued by
- Los Angeles County, California
About this file
This is a Darfur Contracting Act Certification Form from the State of California's Department of General Services, Procurement Division, applicable to the Invitation for Bid #S26-33409 for Office Moving Services in Greater LA Districts. The form establishes compliance requirements for companies with business activities or operations outside the United States within the previous three years seeking to bid on California state contracts. Bidders must certify either that they are not a scrutinized company as defined under Public Contract Code Section 10476, or provide written permission from the Department of General Services if they are a scrutinized company. The office moving services contract requires contractors to provide comprehensive moving services including furniture installation and removal, equipment and supply transportation, disassembly and reassembly of modular furniture, pad-wrapping of sensitive equipment, secured storage, and removal of surplus property and packing materials. Work may be conducted outside standard business hours and on weekends as needed, with pricing submitted on a not-to-exceed basis reflecting the contractor's standard rates.
The certification form requires submission of the company name, Federal ID Number, authorized signature, and printed name and title of the signatory. Contractors must understand that all prices in their bid submissions cannot exceed their established rates, with costs calculated on hourly and mileage bases that do not include third-party charges such as parking fees or fuel surcharges. The form permits two options for compliance: direct certification that the company is not scrutinized, or submission of written permission from the Department of General Services for scrutinized companies if deemed in the state's best interest. The certification is made under penalty of perjury under California law, and the authorizing official must be duly authorized to legally bind the prospective bidder.
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Other files
| File | Type | Posted |
|---|---|---|
| CERTIFIED_SB_PARTICIPATION_FORM.pdf | ||
| IFB___S26-33409.pdf | ||
| DVBE_INCENTIVE_FORM.pdf | ||
| Payee_Data_Record__STD_204_.pdf |
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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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