DFW_1080.pdf

854 KB Posted

Attached to
RFQ 24-136 Fillmore Hatchery Trout Eggs
Solicitation number
0000034633
Issued by
Ventura County, California

About this file

Written by GovTribe AI ·

The document is a Darfur Contracting Act Certification form from the State of California's Department of Fish and Wildlife (DFW), designed to ensure compliance with California Public Contract Code (PCC) § 10478. This form requires bidders or proposers to certify their business activities outside the United States within the previous three years, specifically addressing whether they are a "scrutinized" company as defined in PCC § 10476.

The certification form provides three mutually exclusive options for vendors: (1) affirm no business activities outside the United States in the past three years, (2) confirm receipt of written permission from the Department of General Services (DGS) if classified as a scrutinized company, or (3) certify that while having international business activities, the company is not a scrutinized company. Failure to complete this form correctly will result in disqualification from State Price Schedule (SPS) Applications. The document requires the company's name, Federal ID Number, and an authorized signature certifying compliance under penalty of perjury.

View the file

Other files

File Type Posted
std204.pdf PDF
RFQ_24-136_Fillmore_Hatchery_Trout_Eggs.docx DOCX document
std1000.pdf PDF
std205.pdf PDF
DFW_1082.pdf PDF
Recycled_Content_Certification.pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

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

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.

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.

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

1. ________

Initials

2. ________ Initials

3. ________ Initials https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10478.

https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10476.

https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10476.

http://www.dgs.ca.gov/dgs/Home.aspx https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10477.

https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PCC&sectionNum=10476.

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:

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