DPR_398__P23CA006_San_Elijo_Camp_Store.xlsx

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P23CA006 San Elijo State Beach Camp Store
Solicitation number
0000032367
Issued by
San Diego County, California

About this file

This document is a Request for Proposals (RFP) issued by the California Department of Parks and Recreation for a 10-year concession contract to operate a camp store and restaurant at the San Elijo State Beach Campground in San Diego County, California. The contract will include operating a camp store and food services within the campground. An optional pre-proposal meeting is scheduled for August 29, 2024, and Letters of Intent and questions are due by September 27, 2024. Proposals must be submitted by November 14, 2024. The contract term is 10 years, with potential for renewal options.

The RFP requires proposers to offer a minimum annual rent of $135,000 or 13% of gross receipts, whichever is greater. Proposers must provide detailed information on their operational, facility, and interpretive plans, as well as extensive financial information including development costs, business financials, and financial proformas. Small businesses and Disabled Veteran Business Enterprises are encouraged to submit proposals.

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Cover Page

CONCESSION PROPOSAL

DPR 398

San Elijo State Beach Concession Opportunity

Pre-Proposal Meeting

San Elijo State Beach Campground

2050 S Coast Hwy 101 Cardiff, CA 92007

August 29, 2024 • 3:00 PM

DEPARTMENT OF PARKS AND RECREATION
Partnerships Division - Concessions Program
715 P Street, 13th Floor
Sacramento, CA 95814
www.parks.ca.gov/concessions

DPR 398 (Rev. 3/2018) http://www.parks.ca.gov/concessions

State of California - Natural Resource Agency
DEPARTMENT OF PARKS AND RECREATION

PROPOSER QUESTIONNAIRE

An electronic version of this questionnaire may be requested from the State Park office issuing this Request for Proposal (RFP).

The Proposer Questionnaire, DPR 398, is a required document and must be completed in order for the proposal to be considered a responsive proposal for the concession opportunity being offered.

This questionnaire, along with any supplemental information provided, is used to determine the final award of the contract. Therefore, it is critical that the answers and any supplemental information/materials be as detailed and complete as possible.

The Proposer Questionnaire consists of the following sections:

I.PROPOSER INFORMATION
A.Proposer Identification
B.Business Information
C.Individual Information
D.Business References

II. THE PROPOSAL

III.FINANCIAL INFORMATION
A.Concession Development
B.Business Financial Statement
C.Financial References and Credit Worthiness
D.Financial Proforma
IV.CERTIFICATION AND AUTHORIZATION
A.Authorization to Release Information
B.Labor Law Compliance Certification
C.Authorization to Release Tax Returns
D.Proposer Certification

V. PRIVACY NOTICE

The Proposer shall submit one original and one digital copies of the Proposer Questionnaire and supplemental information/materials to the appropriate State Park office. The Proposer Questionnaire should be organized in the order of the sections above. Section II, The Proposal, should be available in Microsoft Word format, or comparble format, upon request.

Note: Each section of the Proposer Questionnaire, including all items within each section, must be answered fully. You may include additional pages as needed and furnish additional information. However, you should not delete, leave blank, or fail to answer any items in the Proposer Questionnaire. Questions that are not applicable should be so indicated.
Additional instructions for completion of these documents are located within the RFP.

DPR 398 (Rev. 3/2018) Page 1 of 16

I. PROPOSER INFORMATION
A. PROPOSER IDENTIFICATION
CONCESSION INFORMATION
CONCESSION NAME:
(Exactly as it is to appear on the Concession Contract)
ADDRESS:
CITY/ STATE/ ZIP CODE:
PHONE NUMBER:FAX NUMBER:
EMAIL ADDRESS:
SMALL BUSINESS OR DVBE:Yes (Number:)No(Must include a copy of certification)

FEDERAL ID NUMBER: - No Federal ID Number, use Social Security Number below

CONCESSION PROPOSER'S INFORMATION
NAME:
Contact information is the same as above.
ADDRESS:
CITY/ STATE/ ZIP CODE:
PHONE NUMBER:FAX NUMBER:
EMAIL ADDRESS:

SOCIAL SECURITY NUMBER: - -

POINT OF CONTACT

All correspondence from the Department of Parks and Recreation to the proposer will be with ONE Contact Person. The individual designated as the Contact Person will be responsible for disseminating information to the other members of the proposing entity.
NAME:
ADDRESS:
CITY/ STATE/ ZIP CODE:
PHONE NUMBER:FAX NUMBER:
EMAIL ADDRESS:

DPR 398 (Rev. 3/2018) Page 2 of 16

B. BUSINESS INFORMATION

BUSINESS TYPE
Check the one box below that describes your type of business and complete/provide the associated information requested. If appropriate, provide an organization chart of your business.
SOLE PROPRIETORSHIP: Owned and operated by a single individual. If operating under a business name, provide proof of fictitious business name. Provide proof that business can operate within California.
PARTNERSHIP: Provide a complete copy of the Partnership Agreement. To qualify as a responsive proposer, the Partnership Agreement must be executed and binding upon each of the parties. Provide proof that Partnership can operate within California.
1. Date partnership established:
2. Is the Partnership Agreement recorded?Yes, Date:No
3. Has the partnership done business in California?Yes, Dates:No
4. Please list all partners' names. If more space is needed, please attach an additional sheet to complete.
PARTNER NAMESADDRESSESNo. OF
SHARESGENERAL (G)

or LIMITED (L)

GL
GL
GL
GL
JOINT VENTURE: Provide a complete copy of the Joint Venture Statement/Agreement. To qualify as a responsive proposal, the Joint Venture Statement/Agreement must be executed and binding upon each of the parties. Provide proof that Joint Venture can operate within California.
1. Date joint venture established:
2. Is the Joint Venture Statement/Agreement recorded?Yes, Date:Where:No
3. Has the joint venture done business in California?Yes, Dates:No
4. Please list all joint venturers. If more space is needed, please attach an additional sheet to complete.
JOINT VENTURER NAMES AND SHARE ALLOCATIONSADDRESSES
LIMITED LIABILITY COMPANY (LLC): Attach a copy of Articles of Organization with California Secretary of State seal and the Statement of Information, identifying the managing member(s) of the Organization. Provide proof that LLC can operate within California.
1. Date LLC was established:
2. Is the LLC authorized to do business in California?YesNo
3. Has the LLC done business in California?Yes, Dates:No
4. Please list all LLC managing members. If more space is needed, please attach an additional sheet to complete.
LLC MANAGING MEMBERS NAMES
AND SHARE ALLOCATIONSADDRESSES
CORPORATION: Attach a Corporate Resolution indicating the officers authorized to contract on behalf of the corporation. The Corporate Resolution shall contain the corporate seal and be certified by the Secretary of the corporation. To qualify as a responsive proposer, the corporation shall be in good standing and provide proof they they can operate within California.
1. Date incorporated:
2. Place incorporated:
3. Is the corporation authorized to do business in California?YesNo
4. How is the corporation held?Publicly (Explain how and where stock is traded in the space below.)Privately
5. For publicly held corporations, attach a copy of the most current Annual Report.
(Corporation Information continues on next page.)

DPR 398 (Rev. 3/2018) Page 3 of 16

B. BUSINESS INFORMATION (continued)

CORPORATION (continued)
6. Complete the information below:AUTHORIZEDISSUEDOUTSTANDING
Number of voting shares:
Number of non-voting shares:
Number of shareholders:
Value per share of common stock:Date:Par:Book:Authorized:
7. Complete the information below for each officer and director of the corporation, and the two shareholders who are not a
corporation officer or director, but owns the largest number of voting shares and non-voting shares of corporation stock. If more space is needed, please attach an additional sheet.
NAMETITLEADDRESSVOTING SHARESNON-VOTING SHARES
8. Has a surety or bonding company ever been required to perform on the default of the corporation within the last ten (10)
years?
Yes (Provide the information below for each default. Attach additional sheet if needed.)No (Proceed to question 9)
Surety/Bonding Company Name:
Bond Date:
Bond Amount:
Explain the circumstances surrounding each default and actions taken by the surety or bonding company.
9. Has the corporation ever been adjudicated bankrupt or involved in pending bankruptcy matters?
Yes (Enter dates, court jurisdictions, and amounts of liabilities and assets below.)No (Proceed to question 10)
10. Is the corporation presently a party to any pending litigation, liens, or claims for monetary compensation that has the
potential to exceed insurance coverage or must be paid with company assets?
Yes (Enter detailed information for each legal action below.)No (Proceed to question 11)
11. Is the corporation subject to any outstanding claims, liens, or judgements which exceeded insurance coverage or must be
paid with company assets?
Yes (Enter detailed information for each claim, lien, or judgement below.)No (Proceed to question 12)
12. Has the corporation defaulted on, been terminated for non-performance or breach of contract, or voluntarily abandoned or
forfeited rights under a contract for services or concessions contract?
Yes (Enter an explanation of the circumstances and outcomes of each event below.)No

DPR 398 (Rev. 3/2018) Page 4 of 16

C. INDIVIDUAL INFORMATION
If more than one individual is listed as a contract holder (partnerships, members of joint ventures, officers of corporations) then each individual must provide the information below. Copies of this section should be duplicated as needed for completion.
PERSONAL HISTORY
LEGAL NAME:SOCIAL SECURITY No:--
RESIDENCE ADDRESS:PHONE NUMBER:
CITY/ STATE/ ZIP CODE:
BUSINESS ADDRESS:PHONE NUMBER:
CITY/ STATE/ ZIP CODE:
1. Have you individually, as a partner, joint venturer, or as officer of a corporation had a bond or surety canceled or forfeited
within the last ten (10) years?
Yes (Provide information below)No (Proceed to question 2)
Bond Company Name:
Bond Date:
Bond Amount:
Explain the reason for each cancellation or forfeiture below.
2. Have you individually, as a partner, joint venturer, or officer of a corporation been involved in, pleaded guilty or no contest
to, or been convicted of committing any crime (other than minor traffic violations)?
Yes (Please explain below. List dates, violations and/or crimes, and locations.)No (Proceed to question 3)
3. Have you, your spouse, or any business that you owned in which you were an officer or had interest in ever declared
bankruptcy, been declared insolvent or bankrupt, filed for bankruptcy, or reorganization under Federal or State laws?
Yes (Enter dates, court jurisdictions, and amounts of liabilities and assets below.)No (Proceed to question 4)
4. Are you individually, or any partnership or joint venture in which you have been party, currently involved in any pending
litigation?
Yes (Enter dates, violations, and locations below.)No
WORK EXPERIENCE:
Attach a resume and narrative as necessary.
CERTIFICATION: I hereby certify under penalty of perjury that all responses stated above regarding my personal history and work experience are true to the best of my knowledge and belief, and I understand and agree that any misstatement or omission of any material fact may cause forfeiture on my part of all rights to the proposed contract to be awarded by the State of California.
SIGNATURE:DATE:

DPR 398 (Rev. 3/2018) Page 5 of 16

D. BUSINESS REFERENCES
Proposers must submit a minimum of three (3) business references. It is important to name references who will verify and support the experience listed in this proposal, and a contact person who is familiar with the Proposer's business relationship.
REFERENCE NO. 1
NAME/FIRM:
ADDRESS:
CONTACT PERSON:PHONE NUMBER:
TYPE OF BUSINESS RELATIONSHIP:
LENGTH OF ASSOCIATION:
REFERENCE NO. 2
NAME/FIRM:
ADDRESS:
CONTACT PERSON:PHONE NUMBER:
TYPE OF BUSINESS RELATIONSHIP:
LENGTH OF ASSOCIATION:
REFERENCE NO. 3
NAME/FIRM:
ADDRESS:
CONTACT PERSON:PHONE NUMBER:
TYPE OF BUSINESS RELATIONSHIP:
LENGTH OF ASSOCIATION:

DPR 398 (Rev. 3/2018) Page 6 of 16

II. THE PROPOSAL

Include a seperate sheet for each of the checked sections below within your proposal. All of the selected sub-sections are required components and must be fully addressed. The proposal shall be organized as outlined on page 1. Documents should be available in Microsoft Word format, or comprable format, upon request. For additional information for each sub-section refer to the Request for Proposal (RFP) or the Proposal Resource Document provided by the State.

A. RENTAL OFFER

The Proposer is required to make a rental offer based on the Minimum Rent to be paid to the State. The Minimum Rent is a set Rental Guarantee amount or a Minimum Percentage of Gross Receipts, whichever is greater.
For this proposed concession, the Minimum Rent to be paid to the state is the greater of either:
The rental guarantee of $$135,000per year OR13%percent of gross receipts.
Official section to be completed by the State.

The proposer must offer a Rental Guarantee and Minimum Percentage of Gross Receipts that is at least equal to the amounts provided by the State in the section above but can be more. By submitting an offer, the Proposer understands and agrees to the provisions set forth for Minimum Rent.

A minimum annual rent of $per year ORpercent of gross receipts,
whichever is greater.
B. OPERATION PLAN
Executive SummaryMarketing and Advertising
Vision/Mission StatementCommunity Involvement Program(s)
Organizational StructureProducts, Merchandise, and Services
Transition/Business Start-up PlanPrices and Pricing Policies
Maintenance and HousekeepingConservation and Recycling
Customer Service PlanAccessibility
Employee Staffing and Training Plan(s)Healthy Foods
Safety and SecurityOther:
C. FACILITY PLAN (Facilities, Furnishings, and Equipment)
Furnishings: equipment, décor, layout, etc.Implementation: timeline for completion
Facility Development: proposed improvementsCost Estimates: breakdown for the facility plan
Accessibility: plan to remove any physical barriers to accessibility
D. INTERPRETIVE PLAN
Proposer's Relevant Experience
Business' Ambiance
Camp Store Interpretive Programs and Activities: integrated with the concession activities, reflecting the interpretive period
Other:

E. SUPPLEMENTAL INFORMATION

DPR 398 (Rev. 3/2018) Page 7 of 16

III. FINANCIAL INFORMATION
A. CONCESSION DEVELOPMENT
Document your ability to successfully initiate and operate the proposed concession in a financially responsible manner. Do not alter the formats below in any way. You must respond to each item in the order listed with the information requested or enter N/A. Round figures to the nearest dollar.
Provide sufficient documentation for the source of funding that will be used to undertake the project, including, but not limited to, funds from an individual, parent company, third party, and loans. Sufficient documentation may consist of balance sheets, income statements, or other supporting documentation that demonstrates these funds are available and unconditionally committed to this concession project.

CONCESSION DEVELOPMENT COST ESTIMATE

PRELIMINARY PLANNING AND DESIGN
CONSTRUCTION OF INTERIOR IMPROVEMENTS/FIXTURES
EQUIPMENT/FURNISHINGS
AUTOS/TRUCKS
STOCK/INVENTORY
LICENSES & PERMITS
PREPAID EXPENSES
OTHER COSTS:

* TOTAL DEVELOPMENT COSTS* $ -

PROPOSED MEANS TO FINANCE CONCESSION
CONCESSIONAIRE SUPPLIED CAPITAL
SHORT TERM LOANS (1 year or less)
LONG TERM LOANS (more than 1 year)
SUPPLIER CREDIT
OTHER FINANCING:

* TOTAL FINANCING* $ - ***

*** Must meet or exceed "Total Development Costs" amount

DPR 398 (Rev. 3/2018) Page 8 of 16

B. BUSINESS FINANCIAL STATEMENT

Provide a full and detailed representation of the true condition of your business' assets, liabilities, and net worth. If more than one individual is listed as a contract holder (partnerships, members of joint ventures, and officers of corporations) each individual must provide complete a copy of the Business Financial Statement.
In addition to completing the Business Financial Statement, you may provide copies of Internal Revenue forms that are filed with the Internal Revenue Service, where applicable.
You must respond to each item in the order listed with the information requested or enter N/A. Round figures to the nearest dollar.
CONCESSION NAME:AS OF:
PROPOSER'S NAME:(Date)

ASSETS

Current Assets
CASH ON HAND IN BANK
ACCOUNTS RECEIVABLE:
Current
Over 30 Days
Over 60 Days
NOTES RECEIVABLE DUE WITHIN 1 YEAR
MERCHANDISE INVENTORY: Cost/Market
OTHER CURRENT ASSETS:
Total Current Assets$ -
Long Term Assets
NOTES RECEIVABLE DUE AFTER 1 YEAR
LAND AND BUILDINGS (at cost)
<Less> Reserve For Depreciation
FIXTURES AND EQUIPMENT (at cost)
<Less> Reserve For Depreciation
PREPAID EXPENSES/DEFERRED CHANGES
OTHER LONG TERM ASSETS:

Total Long Term Assets $ -

TOTAL ASSETS$ -
(Business Financial Statement continues on next page.)

DPR 398 (Rev. 3/2018) Page 9 of 16

Enter positive numbers. Numbers entered will automatically be subtracted in total.

B. BUSINESS FINANCIAL STATEMENT (continued)

LIABILITIES
Current Liabilities
ACCOUNTS PAYABLE (past due)
ACCOUNTS PAYABLE (current)
NOTES PAYABLE DUE WITHIN 1 YEAR:
To WhomSecured by
NOTES & ACCOUNTS PAYABLE TO PARTNERS, DIRECTORS, OFFICERS, OR STOCKHOLDERS
ACCRUED LIABILITIES (interest, rental, payroll, etc.)
ACCRUED FEDERAL & STATE TAXES
OTHER CURRENT LIABILITIES:
Total Current Liabilities$ -
Long Term Liabilities
NOTES PAYABLE DUE AFTER 1 YEAR:

OTHER LIABILITIES:

Total Long Term Liabilities $ -

TOTAL LIABILITIES$ -
NET WORTH
CAPITAL STOCK (if corporation)
OWNER CAPITAL
TOTAL NET WORTH$ -

TOTAL LIABILITIES & NET WORTH $ -

DPR 398 (Rev. 3/2018) Page 10 of 16

C. FINANCIAL REFERENCES AND CREDIT WORTHINESS
Proposers must submit a minimum of three (3) financial references. At least two of the three references must be banks and/or savings and loan institutions. The contact person named should be someone who is familiar with the financial aspects of the business.
REFERENCE NO. 1
NAME/FIRM:
ADDRESS:
CONTACT PERSON:PHONE NUMBER:
ACCOUNT TYPES & NUMBER(S):
TYPE OF BUSINESS RELATIONSHIP:
LENGTH OF ASSOCIATION:
REFERENCE NO. 2
NAME/FIRM:
ADDRESS:
CONTACT PERSON:PHONE NUMBER:
ACCOUNT TYPES & NUMBER(S):
TYPE OF BUSINESS RELATIONSHIP:
LENGTH OF ASSOCIATION:
REFERENCE NO. 3
NAME/FIRM:
ADDRESS:
CONTACT PERSON:PHONE NUMBER:
ACCOUNT TYPES & NUMBER(S):
TYPE OF BUSINESS RELATIONSHIP:
LENGTH OF ASSOCIATION:
CREDIT WORTHINESS
Proposer must present evidence of credit worthiness. Evidence shall include, at a minimum, a credit report issued by a nationally recognized credit bureau within 60 days of the proposal due date.
(Any unfavorable information listed on said reports must be explained in the section below or an additional sheet.)

DPR 398 (Rev. 3/2018) Page 11 of 16

D. FINANCIAL PROFORMA
Complete all aspects of this proforma as they apply to your proposed concession operation. Round figures to the nearest dollar.
ITEMYEAR 1YEAR 2YEAR 3YEAR 4YEAR 5
GROSS PROFIT
Gross Sales
Camp Store
Food & Beverage
Total Gross Sales (1)$ -$ -$ -$ -$ -
<Less> Cost of Goods Sold (2)
TOTAL GROSS PROFIT$ -$ -$ -$ -$ -
OPERATING EXPENSES
Variable Operating Expenses
Salaries & Payroll Related
Taxes & Licenses (other than sales income)
Insurance
Advertising
Maintenance & Repairs
Utilities (including telephone)
Legal & Accounting
Depreciation
Rent to State
Interest
Supplies & Material
Administrative Overhead
Travel & Transportation
Other:
Other:
Other:
Other:
Total Variable Operating Expenses$ -$ -$ -$ -$ -
Fixed Operating Expenses
Facility Improvements
Equipment Purchases
Amortization
Depreciation
Performance Bond
Total Fixed Operating Expenses$ -$ -$ -$ -$ -
TOTAL OPERATING EXPENSES (3)$ -$ -$ -$ -$ -
NET INCOME$ -$ -$ -$ -$ -
(before income taxes)
(1) EXPLAIN HOW YOU ARRIVED AT THE PROJECTED TOTAL GROSS SALES.

(2) EXPLAIN HOW YOU CALCULATED COST OF GOODS SOLD.

(3) EXPLAIN HOW YOU CALCULATED TOTAL OPERATING EXPENSES.

PREPARER SIGNATURE TITLE DATE

PRINTED NAME PHONE NUMBER EMAIL ADDRESS

ADDRESS CITY/STATE/ZIP CODE

DPR 398 (Rev. 3/2018) Page 12 of 16

Enter positive numbers in this row. Numbers entered will automatically be subtracted.

Page 12a

D. FINANCIAL PROFORMA
Complete all aspects of this proforma as they apply to your proposed concession operation. Round figures to the nearest dollar.
ITEMYEAR 6YEAR 7YEAR 8YEAR 9YEAR 10
GROSS PROFIT
Gross Sales
Camp Store
Food & Beverage
Total Gross Sales (1)$ -$ -$ -$ -$ -
<Less> Cost of Goods Sold (2)
TOTAL GROSS PROFIT$ -$ -$ -$ -$ -
OPERATING EXPENSES
Variable Operating Expenses
Salaries & Payroll Related
Taxes & Licenses (other than sales income)
Insurance
Advertising
Maintenance & Repairs
Utilities (including telephone)
Legal & Accounting
Depreciation
Rent to State
Interest
Supplies & Material
Administrative Overhead
Travel & Transportation
Other:
Other:
Other:
Other:
Total Variable Operating Expenses$ -$ -$ -$ -$ -
Fixed Operating Expenses
Facility Improvements
Equipment Purchases
Amortization
Depreciation
Performance Bond
Total Fixed Operating Expenses$ -$ -$ -$ -$ -
TOTAL OPERATING EXPENSES (3)$ -$ -$ -$ -$ -
NET INCOME$ -$ -$ -$ -$ -
(before income taxes)
(1) EXPLAIN HOW YOU ARRIVED AT THE PROJECTED TOTAL GROSS SALES.

(2) EXPLAIN HOW YOU CALCULATED COST OF GOODS SOLD.

(3) EXPLAIN HOW YOU CALCULATED TOTAL OPERATING EXPENSES.

PREPARER SIGNATURE TITLE DATE

PRINTED NAME PHONE NUMBER EMAIL ADDRESS

ADDRESS CITY/STATE/ZIP CODE

DPR 398 (Rev. 3/2018) Page 12 of 16

Enter positive numbers in this row. Numbers entered will automatically be subtracted.

IV. CERTIFICATION AND AUTHORIZATION
A. AUTHORIZATION TO RELEASE INFORMATION

To Whom It May Concern:

I/my company have (has) submitted a proposal to the State of California, Department of Parks and Recreation, for a concession operation. I hereby authorize you to release or discuss any or all information in your possession pertaining to me as requested by an employee or representative of the State of California, Department of Parks and Recreation, in connection with or to verify information submitted by me in the above referenced proposal.

CONCESSION/BUSINESS NAME

PRINTED NAME POSITION/TITLE

SIGNATURE DATE SIGNED

B. LABOR LAW COMPLIANCE CERTIFICATION

I hereby certify that:
PROPOSER NAME:
FEDERAL ID NUMBER:
(Sole Proprietors use SSN)
ADDRESS:
CITY/STATE/ZIP CODE:

has not had more than one, final, unappealable finding of contempt of court by a federal court issued against the Proposer for any violation of National Labor Relations Act provisions within the two-year period immediately preceding the “cutoff” date for acceptance of proposals under this Request for Proposals prospectus.

Additionally, I, the signatory, do hereby swear that I am duly authorized to legally execute the certification described above on behalf of the proposer. I am fully aware that this certification, executed on the date below is made under penalty of perjury under the laws of the State of California.

PRINTED NAME POSITION/TITLE

SIGNATURE DATE SIGNED

DPR 398 (Rev. 3/2018) Page 13 of 16

C. AUTHORIZATION TO RELEASE TAX RETURNS

Complete the section below which applies to your business.

PROPOSER OTHER THAN CORPORATION
Note: The Proposer may be required to complete IRS Forms 8821, 2848, 4506 or 4506A if this authorization is insufficient to obtain the necessary tax returns.
To disclose tax returns and return information in accordance with Internal Revenue Code Section 6103(c),
I/we,, authorize the Internal Revenue Service and its agents to
disclose all schedules and forms included in Form 1040 and/or U.S. Individual Income Tax Return or the RTVUE transcripts for all schedules and forms included in Form 1040 and/or U.S. Individual Income Tax Return, for the last previous three years, to the State of California, Department of Parks and Recreation.

If the returns at issue were filed jointly, either party whose name appears on them may authorize disclosure, and the Social Security Number of the spouse of the person signing this form should be included below.

PRINTED NAME SIGNATORY'S SOCIAL SECURITY NUMBER

ADDRESS CITY/STATE/ZIP CODE

SIGNATURE DATE SIGNED

SPOUSE'S NAME (if applicable) SPOUSE'S SOCIAL SECURITY NUMBER (if applicable)

IMPORTANT: The signature on this form must be notarized or the authorization must be accompanied with a photocopy of the signatory's driver's license or comparable identification.

CORPORATIONS
Note: The Proposer may be required to complete IRS Forms 8821, 2848, 4506 or 4506A if this authorization is insufficient to obtain the necessary tax returns.
To disclose tax return(s) and return information in accordance with Internal Revenue Code Section 6103(c) and pursuant to Section 6103(e)(1)(D) of the Internal Revenue Code, I, the signatory, have a legal right to the access of returns and return information of:
CORPORATION NAME:
FEDERAL EMPLOYER ID NUMBER:
ADDRESS:
CITY/STATE/ZIP CODE:
and hereby authorize the Internal Revenue Service and its agents to disclose all of the corporation's schedules and forms included in Form 1120 and/or U.S. Corporation Income Tax Return and/or Form 941 and/or Employer's quarterly Federal Tax Return and/or Form 940 and/or Employer's Annual Federal Unemployment Tax Return and/or the RTVUE transcripts for all of the said documents, for the last previous three years, to the State of California, Department of Parks and Recreation.

The signatory must be the corporation's authorized officer or other person who has a legal right to execute this authorization under Internal Revenue Code Section 6103(1)(D).

PRINTED NAME

ADDRESS CITY/STATE/ZIP CODE

SIGNATURE DATE SIGNED

IMPORTANT: Proof of the signatory’s legal right to execute this authorization must be furnished with this form. Generally, a written statement by the signatory (an officer of the corporation), on corporate letterhead stationery, to the effect that he/she has authority to legally bind the corporation is sufficient to permit disclosure.

DPR 398 (Rev. 3/2018) Page 14 of 16

D. PROPOSER CERTIFICATION

I/We am (are) personally acquainted with the premises of the subject concession and I/we have read, understand and agree with the terms and conditions specified in this RFP document, including the Sample Concession Contract.

I/We meet the required experience qualifications and/or currently employ a Concession Manager who meets the required Proposer qualifications.

I/We have the necessary financial resources to equip and operate the concession and perform the proposed capital investments, and I/we have enclosed a cashier’s check or Proposer's Bond in the required amount, payable to the Department of Parks and Recreation, as a guarantee that, in the event my/our proposal is accepted and approved by the State, I/we will:

1. Execute and complete the Concession Contract, incorporating this proposal and all the terms and conditions contained in the RFP. The Concession Contract will then be executed by the State upon approval by the appropriate State Approval Agencies;

2. Provide the Performance Bond as required by the Concession Contract upon execution of the Contract by State; and

3. Provide the proposed guarantees, including rent, capital investments, equipment, and management and operation services.

I/We hereby certify that all responses and information provided in connection with this proposal are true to the best of my/our knowledge and belief, and I/we understand and agree that any misstatement or omission of any material fact may cause forfeiture on my/our part of all rights to the proposed agreement to be awarded by the State of California.

I/We hereby respectfully submit this proposal, including all required documents and statements. I/We represent that the signatories hold the positions set forth below their signatures and are authorized to execute this proposal.

If the proposal is made by a sole proprietor, this form shall be signed with the full name of the Proposer. If it is made by a partnership, a limited partnership, or a joint venture, it shall be signed with the full name of each partner or member thereof. If it is made by a corporation, it shall be signed by: (1) the President, any Vice President, or the Chairman of the Board; and (2) by the Corporation Secretary, any Assistant Secretary, Chief Financial Officer, or any Assistant Treasurer.

PRINTED NAME PHONE NUMBER FAX NUMBER

ADDRESS CITY/STATE/ZIP CODE

SIGNATURE POSITION/TITLE AND/OR FUNCTION DATE SIGNED

PRINTED NAME PHONE NUMBER FAX NUMBER

ADDRESS CITY/STATE/ZIP CODE

SIGNATURE POSITION/TITLE AND/OR FUNCTION DATE SIGNED

PRINTED NAME PHONE NUMBER FAX NUMBER

ADDRESS CITY/STATE/ZIP CODE

SIGNATURE POSITION/TITLE AND/OR FUNCTION DATE SIGNED

DPR 398 (Rev. 3/2018) Page 15 of 16

V. PRIVACY NOTICE

Section 1798.17 of the Civil Code requires this notice be provided when collecting personal information from individuals. Each individual has the right to review information maintained by this department unless exempted by law.

OFFICIAL RESPONSIBLE

Program Manager, Concessions Program Office
California Department of Parks and Recreation
715 P Street, 13th Floor
SACRAMENTO, CA 95814
(916) 653-7733

AUTHORITY

Public Resources Code Section 5080.08(a) and 5080.08(b)

PURPOSE

The information will be used for the purposes of evaluation to determine capabilities of proposers to perform the contract and to determine the best responsible proposer if an award is made.

PROVIDING INFORMATION

All information requested is mandatory.

EFFECTS OF NOT PROVIDING INFORMATION

If the requested information is not provided, the proposal will be determined to be not responsive and will be rejected.

KNOWN OR FORESEEABLE DISCLOSURES OF INFORMATION PURSUANT TO CIVIL CODE SECTIONS 1798.24, SUBDIVISIONS (e) OR (f)

Disclosure may be made to the Department of General Services, Office of the Attorney General, Department of Finance, California State Auditor's Office, or the Department of Parks and Recreation Audits Office.

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File details come from the government source that posted it. Updated .