DFW1082ext.pdf
PDF 102 KB Posted
- Attached to
- RFQ-WLB-25-L-0018
- Solicitation number
- 0000037815
- Issued by
- California
About this file
This is a Bidder Declaration form (DFW 1082) used by the State of California for contract bidding purposes related to RFQ-WLB-25-L-0018, which requests canvas photo prints for conference rooms. The form requires prime bidders to provide their California vendor name, current state certifications (Minority Business/Small Business/Disabled Veteran Business Enterprise), and indicate whether subcontractors will be utilized for the contract. If subcontractors are employed, bidders must list all subcontractors with their contact information, complete addresses, California certification numbers, specific work elements or goods provided, and the corresponding percentage of the bid price allocated to each subcontractor. The form accommodates up to four subcontractors with designated fields for each entry.
The declaration requires bidders to certify under penalty of perjury that all provided information is true and correct, with signature and date fields for the authorized representative. The form does not address specific pricing terms, set-asides, or other financial requirements; rather, it serves as a standardized certification document to establish bidder eligibility and subcontractor participation for the canvas photo prints procurement. The form was last revised in October 2019 and represents California's requirement for transparency regarding business certifications and subcontracting arrangements in state and local contracting opportunities.
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Other files
| File | Type | Posted |
|---|---|---|
| std204.pdf | ||
| CalRecycle_74_(Revised_01-23)_.pdf | ||
| Sellers-Permit_Example.png | PNG image | |
| DFW1080ext.pdf | ||
| WLB-25-L-0018_Canvas_Prints.docx | DOCX 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 .