Enclosure_C-_Contractor's_Declaration_Form.pdf
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- Attached to
- 2026 On-Call Engineering and Professional Services for Public Works Project within the County of San Mateo
- Solicitation number
- RU403
- Issued by
- San Mateo County, California
About this file
This is a Contractor's Declaration Form for the County of San Mateo, California, related to the 2026 On-Call Engineering and Professional Services for Public Works Projects contract. The form serves as a declaration document that contractors must complete as part of their proposal submission process. The form requires contractors to provide declarations regarding their business status, qualifications, and compliance with various statutory and regulatory requirements applicable to public works projects in California. The declaration form is a standardized document designed to verify that prospective contractors meet the necessary eligibility criteria and have made truthful representations regarding their ability to perform the requested on-call engineering and professional services. The contract opportunity itself targets a commencement date of October 2026 with a five-year term extending through October 2031, subject to negotiation of final agreement terms.
The declaration form requires contractors to attest to various compliance matters, business certifications, and statutory declarations necessary for public works contracting in California. This document is a mandatory component of the proposal submission and ensures that all responding contractors confirm their legal standing, insurance status, and adherence to applicable prevailing wage requirements and other California public works regulations. Contractors must complete and sign the declaration under penalty of perjury, making it a critical document that establishes the contractor's commitment to meeting all contractual and legal obligations associated with the on-call engineering and professional services engagement with the County of San Mateo.
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Text version
Enclosure 1. Contractor’s Declaration Form
County of San Mateo
Contractor’s Declaration Form
I. CONTRACTOR INFORMATION
Contractor Name: Phone:
Contact Person: Fax:
Address:
II. EQUAL BENEFITS (check one or more boxes) Contractors with contracts in excess of $5,000 must treat spouses and domestic partners equally as to employee benefits.
Contractor complies with the County’s Equal Benefits Ordinance by:
offering equal benefits to employees with spouses and employees with domestic partners.
offering a cash equivalent payment to eligible employees in lieu of equal benefits.
Contractor does not comply with the County’s Equal Benefits Ordinance.
Contractor is exempt from this requirement because:
Contractor has no employees, does not provide benefits to employees’ spouses, or the contract is for $5,000 or less.
Contractor is a party to a collective bargaining agreement that began on (date) and expires on (date), and intends to offer equal benefits when said agreement expires.
III. NON-DISCRIMINATION (check appropriate box)
Finding(s) of discrimination have been issued against Contractor within the past year by the Equal Employment Opportunity Commission, Fair Employment and Housing Commission, or other investigative entity. Please see attached sheet of paper explaining the outcome(s) or remedy for the discrimination.
No finding of discrimination has been issued in the past year against the Contractor by the Equal Employment Opportunity Commission, Fair Employment and Housing Commission, or any other entity.
IV. EMPLOYEE JURY SERVICE (check one or more boxes) Contractors with original or amended contracts in excess of $100,000 must have and adhere to a written policy that provides its employees living in San Mateo County up to five days regular pay for actual jury service in the County.
Contractor complies with the County’s Employee Jury Service Ordinance.
Contractor does not comply with the County’s Employee Jury Service Ordinance.
Contractor is exempt from this requirement because:
the contract is for $100,000 or less.
Contractor is a party to a collective bargaining agreement that began on (date) and expires on (date), and intends to comply when the collective bargaining agreement expires.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually.
Signature Name
Date Title
8-7-06 Page 1 of 1
| Contractor’s Declaration Form |
| I. CONTRACTOR INFORMATION |
| III. NON-DISCRIMINATION (check appropriate box) |
| IV. EMPLOYEE JURY SERVICE (check one or more boxes) |
File details come from the government source that posted it. Updated .