DFW1082ext__Bidder_s_Declaration_.pdf
PDF 102 KB Posted
- Attached to
- RFQ-LED-0627-01, Lobster Tags
- Solicitation number
- 0000040670
- Issued by
- California
About this file
This is a Bidder Declaration form (DFW 1082) used by the State of California for contract bidding purposes. The form requires prime bidders to provide their California vendor name and identify any current California Minority Business Enterprise (MBE), Small Business (SB), or Disadvantaged Veterans Business Enterprise (DVBE) certifications. The document is associated with RFQ-LED-0627-01 for Lobster Tags needed for an upcoming lobster season in California.
The Bidder Declaration form serves as a certification instrument for bidders to disclose subcontractor involvement and details. If subcontractors are to be used, bidders must identify each subcontractor's name, contact information, complete address, California certification status, work to be performed, and corresponding percentage of the bid price. The form accommodates up to four subcontractors with space for additional pages as needed. By signing the form, the authorizer certifies under penalty of perjury that all information provided is true and correct. The document does not specify pricing terms, set-asides, award dates, contract terms, or other financial details within its content.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| DFW_1080_Darfur.pdf | ||
| Recycled_Content_Certification.pdf | ||
| std204__Payee_Data_Record_.pdf | ||
| RFQ-LRB-0627-01_Document.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .