DFW_1080_Darfur.pdf
PDF 102 KB Posted
- Attached to
- RFQ-R5-0625-01, Live Catfish
- Solicitation number
- 0000032305
- Issued by
- Los Angeles County, California
About this file
This document is a Bidder Declaration for a state and local contract opportunity in California. The contract seeks the stocking of live catfish for recreational angling in urban lakes. Bidders must indicate whether they will be using subcontractors and provide details on any subcontractors, including the element of work they will perform and the corresponding percentage of the bid price. Bidders must also provide their California vendor name and certification number if applicable. The certification requires the bidder to attest that the information provided is true and correct under penalty of perjury.
The contract opportunity is for the state of California. No additional details are provided on pricing terms, set asides, incumbent contractors, funding requirements, or the contract term and renewal options.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFQ-R5-0625-01.docx | DOCX document | |
| std1000.pdf | ||
| DFW1082ext_(Bidder_s_Declaration).pdf | ||
| std204_(Payee_Data_Record).pdf | ||
| Recycled_Content_Certification.pdf | ||
| RFQ-R5-0625-01_Addendum.doc | DOC document |
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Text version
BIDDER DECLARATION
1. Prime bidder information:
a. What is your California vendor name?
b. Identify your current California Certification(s) number(s):
(MB/SB/DVBE):__________ or None_______(If “None”, proceed to number 2)
c. Will subcontractors be used for this contract? YES ______ NO______(If yes, indicate in the space below the distinct element of work your business will perform in this contract. If no, skip to the certification at the bottom of this page.)
2. If subcontractors will be used, list all subcontractors for this contract in the table below. (Attach additional pages if necessary):
EXAMPLE
Subcontractor Name, Contact Person, Phone Number & Email
Fix it Now John Smith Jr.
(916) 445-1234
JSmithJr@fixitnow.com
Subcontractor complete address
1234 Fix It Pl.
Sacramento, CA
95821
CA Certification Number (MB, SB, DVBE, or None)
SB # 15245
Work performed or good provided for this contract
Office repairs
Corresponding % of bid price
25%
CERTIFICATION: By signing this form (Bidder Declaration), I certify under penalty of perjury that the information provided is true and correct.
Authorizers printed name: _______________________________________ Date: _______________
Authorizers signature: ____________________________________________
(New 10/2019)
DFW 1082
| CA Vendor name: |
| MB/SB/DVBE Certification Number: |
| None chek box: Off |
| Check box yes: Off |
| Check Box No: Off |
| Distinct element of work: |
| Subcontractor information 1: |
| Subcontractor information 2: |
| Subcontractor information 3: |
| Subcontractor information 4: |
| Subcontractor address 1: |
| Subcontractor address 2: |
| Subcontractor address 3: |
| Subcontractor address 4: |
| Subcontractor CA Cert number 1: |
| Subcontractor CA Cert number 2: |
| Subcontractor CA Cert number 3: |
| Subcontractor CA Cert number 4: |
| Work performed 1: |
| Work performed 2: |
| Work performed 3: |
| Work performed 4: |
| percent 1: |
| percent 2: |
| percent 3: |
| percent 4: |
| Authorizers printed name: |
| Date: |
File details come from the government source that posted it. Updated .