DISQUALIFICATION_DISCLOSURE_(4).pdf

This is a Disqualification Disclosure form required by the City of Pasadena, California, in accordance with California Public Contract Code Section 10162, for the Design-Build Services for a Hydrogen Fueling Station project. The form requires prospective bidders to complete a questionnaire under penalty of perjury regarding any disqualification, removal, or prevention from bidding on or completing federal, state, or local government projects due to violations of law or safety regulations. Bidders must indicate whether they, any officer, or any employee with a proprietary interest have experienced such disqualification by checking either "Yes" or "No." If the answer is affirmative, bidders must explain the circumstances and attach supporting documentation to the disclosure form.

This mandatory disclosure is a prerequisite for bidder qualification on the hydrogen fueling station project, which is being conducted under a design-build delivery method with evaluation criteria including project experience, team composition, project approach, financial strength, and safety record. The disqualification disclosure serves as a screening mechanism to ensure that only qualified vendors without prior violations or safety issues are permitted to proceed in the competitive selection process for this California Energy Commission-funded infrastructure project.