About this file

This document is a Darfur Contracting Act Certification form related to a state of California contract opportunity for Vending Machine Relocation, Installation, Removal, Service and Repair services across various counties. The contract requires the selected vendor to provide comprehensive vending machine maintenance and repair services, including coin mechanisms, bill validators, dispensing motors, and other components, for the Department of Rehabilitation's Business Enterprise Program cafeterias, snack bars, and vending facilities located in state, federal, county, and private buildings. Services must be provided 5 days per week, with a 24-48 hour response time, and any work outside normal business hours will be billed at a higher rate. The contract has no specified term length or renewal options.

The contract outlines pricing terms, with parts and materials costs not to exceed 40% of the contractor's wholesale costs, excluding tax. The contractor must maintain a supply of common vending machine parts on their service trucks. The state will not be responsible for storing any contractor property, and the contractor will be liable for any damages caused during the performance of services. The contractor must receive written approval from the Department of Rehabilitation prior to removing any equipment from a location.

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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:

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