DGS_OLS_04_Civil_Rights_Law_Form.pdf
PDF 182 KB Posted
- Attached to
- 25NC0665 Broadband Equity, Access and Deployment (BEAD) Program Administration and Oversight
- Solicitation number
- 0000039982
- Issued by
- San Francisco County, San Francisco City, California
About this file
This is a Civil Rights Laws Attachment form issued by the California Department of General Services (DGS), Office of Legal Services, required for state contracts valued at $100,000 or above. The form serves as a certification document that bidders and contractors must complete and submit under penalty of perjury when submitting bids, proposals, or entering into contract renewals with state agencies. The form requires authorized representatives of the proposing firm to certify compliance with two primary California civil rights statutes: the Unruh Civil Rights Act (Civil Code Section 51) and the Fair Employment and Housing Act (Government Code Section 12960), for all contracts executed or renewed after January 1, 2017.
The certification document also requires contractors to declare compliance regarding any internal policies concerning sovereign nations or peoples recognized by the United States government, certifying that such policies are not applied in violation of the Unruh Civil Rights Act or the Fair Employment and Housing Act. The form includes signature blocks requiring the authorized signatory to provide their printed name, title, the county and state where the document is executed, the execution date, the proposer or bidder firm name, and federal identification number. This attachment is a mandatory compliance requirement for participation in state contracting opportunities meeting the $100,000 threshold.
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Text version
STATE OF CALIFORNIA DEPARTMENT OF GENERAL SERVICES
CALIFORNIA CIVIL RIGHTS LAWS ATTACHMENT OFFICE OF LEGAL SERVICES
DGS OLS 04 (Rev. 01/17)
Pursuant to Public Contract Code section 2010, a person that submits a bid or proposal to, or otherwise proposes to enter into or renew a contract with, a state agency with respect to any contract in the amount of $100,000 or above shall certify, under penalty of perjury, at the time the bid or proposal is submitted or the contract is renewed, all of the following:
1. CALIFORNIA CIVIL RIGHTS LAWS: For contracts executed or renewed after January 1, 2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of theCivil Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code); and
2. EMPLOYER DISCRIMINATORY POLICIES: For contracts executed or renewed after January 1, 2017, if a Contractor has an internal policy against a sovereign nation or peoples recognized by the United States government, the Contractor certifies that such policies arenot used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing Act (Section 12960 of the Government Code).
CERTIFICATION
I, the official named below, certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
By (Authorized Signature)
Printed Name and Title of Person Signing
Executed in the County of Executed in the State of
Date Executed
Proposer/Bidder Firm Name (Printed) Federal ID Number
| ProposerBidder Firm Name Printed: |
| Federal ID Number: |
| Printed Name and Title of Person Signing: |
| Executed in the County of: |
| Executed in the State of: |
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| Date5_af_date: |
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