DFW1082ext__Bidder_s_Declaration_.pdf
PDF 102 KB Posted
- Attached to
- RFQ-R5-0627-01, Live Catfish
- Solicitation number
- 0000039791
- Issued by
- California
About this file
This is a Bidder Declaration form for the California Department of Fish and Wildlife's RFQ-R5-0627-01 for live catfish procurement related to the Urban Angler Program. The form requires prime bidders to provide their California vendor name, current state certification numbers (if applicable, including Minority Business, Small Business, or Disadvantaged Veteran Business Enterprise designations), and to indicate whether subcontractors will be used for contract performance. If subcontractors are utilized, bidders must list all subcontractors with their contact information, complete addresses, California certification numbers, the specific work or goods they will provide, and the corresponding percentage of the bid price attributable to each subcontractor.
The declaration form serves as a certification mechanism whereby bidders attest under penalty of perjury that all information provided is true and accurate. The form requires the authorizer's printed name, signature, and date of execution. The document includes space for up to four subcontractors and their associated details, with provisions for additional pages if more subcontractors are necessary. This certification process ensures transparency regarding business structure, ownership classifications, and subcontracting arrangements for the state procurement process.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Administrative_Requirements_-_rev._07.09.2026.docx | DOCX document | |
| DFW_1080_Darfur.pdf | ||
| Recycled_Content_Certification.pdf | ||
| RFQ-R5-0627-01_Catfish.docx | DOCX document | |
| std204__Payee_Data_Record_.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
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 .