EXHIBIT 14 - GENERAL CERTIFICATIONS.pdf
PDF 144 KB Posted
- Attached to
- Exhaust Tube Assembly
- Solicitation number
- SD143358
- Issued by
- California
About this file
This document is Exhibit 14 - General Certifications, a mandatory certification form required by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for bidders and proposers on state and local contract opportunities. The certification form must be completed by all bidders/proposers and first-tier subcontractors with proposals exceeding $100,000. Bidders must respond affirmatively or negatively to four specific certification requirements, with detailed explanations required for any negative responses. The form must be executed under penalty of perjury and signed by an authorized company official, including the date, city, state, company name, and title of the signatory.
The four mandatory certifications address nondiscrimination in employment practices in compliance with California's Fair Employment and Housing Act; Iran investment activities screening for contracts valued at $1,000,000 or more; prohibition of fraudulent use of Disadvantaged Business Enterprise (DBE) fronts and pass-through subcontracts; and compliance with California Labor Code whistleblower protection provisions. Any indication of fraud, waste, abuse, or mismanagement must be reported to LACMTA's Small Business Diversity and Labor Compliance Office, the LACMTA Inspector General Office, or the U.S. Department of Transportation Office of Inspector General through specified contact numbers and addresses provided in the document.
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Text version
______________________ BIDDER/PROPOSER:
GENERAL CERTIFICATIONS
The Bidder/Proposer and first-tier subcontractors proposing over one hundred thousand dollars ($100,000) shall respond either "Yes" or "No" to each of the following where indicated. If the Bidder/Proposer's response is "No", a full explanation shall be provided in the space following the last item.
1.0 CERTIFICATE OF NONDISCRIMINATION Yes No
The Bidder/Proposer hereby certifies: that it does not unlawfully discriminate against any employee or applicant for employment with regard to race, sex, color, religion, ancestry, national origin, marital status, age (over 40), or disability (including AIDS, and cancer-related medical condition); that it is in compliance with all applicable Federal, state, and local directives and executive orders regarding nondiscrimination in employment; and that it agrees to pursue positively and aggressively the principle of equal opportunity in employment. The Bidder/Proposer and its Subcontractors shall comply with the provisions of the Fair Employment and Housing Act Gov. Code § 12900 and the applicable regulations promulgated thereunder. The Bidder/Proposer agrees specifically to adhere to the following:
A. State in all solicitations or advertisements for employees that the Bidder/Proposer will consider all qualified applicants for employment without regard to race, sex, color, religion, ancestry, national origin, marital status, age (over 40), or disability (including AIDS, and cancer-related medical condition).
2.0 IRAN INVESTMENT ACTIVITIES Yes No
If this Contract is one for goods or services of $1,000,000 or more, the Bidder/Proposer certifies that it is not identified on a list created pursuant to subdivision (b) of Section 2203 of the Public Contract Code as a person engaging in investment activities in Iran described in subdivision (a) of Section 2202.5 of the Public Contract Code, or as a person described in subdivision (b) of Section 2202.5 of the Public Contract Code, as applicable.
3.0 FRAUDULENT USE OF DBE FRONTS Yes No
Only certified Disadvantaged Business Enterprises are eligible to participate in LACMTA contracts as DBEs. The Bidder/Proposer certifies that it has not knowingly and willfully used “fronts” as defined in section 100.6 of LACMTA’s Contract Compliance Manual (Federal) to meet the DBE goal established for this contract. The use of “fronts” and “pass through” Subcontracts to non-disadvantaged firms may constitute a criminal violation1.
4.0 WHISTLEBLOWER REQUIREMENTS Yes No
The Bidder/Proposer certifies that it will comply with, and take no action, or adopt any rule, regulation or policy which is contrary to, the provisions set forth in California Labor Code § 1102.5.
______________________ BIDDER/PROPOSER:
A full explanation of all "No" answers shall be provided below:
Bidder/Proposer hereby declares under the penalty of perjury under the laws of the State of California that the certifications made above in No. 1-4 are true and correct.
Executed on , 20 , at , (Date) (City) (State)
Company Name Signature of Authorized Official Title
1 Any indication of fraud, waste, abuse, or mismanagement of these funds should be immediately reported to the LACMTA Small Business Diversity and Labor Compliance Office, at (213) 922-6000; the LACMTA Inspector General Office at (213) 344-7300 or the toll free hotline number (800) 221-1142; or to the Office of Inspector General, U.S. Department of Transportation at the toll-free hotline number (800) 424-9071; or to the following field office: 201 Mission Street, Suite 2210; San Francisco, CA 94105-1926;
(415) 744-3133.
| 1.0 CERTIFICATE OF NONDISCRIMINATION Yes No |
| 2.0 IRAN INVESTMENT ACTIVITIES Yes No |
| 3.0 FRAUDULENT USE OF DBE FRONTS Yes No |
| 4.0 WHISTLEBLOWER REQUIREMENTS Yes No |
| CERTIFICATE OF NONDISCRIMINATION: Off |
| IRAN INVESTMENT ACTIVITIES: Off |
| FRAUDULENT USE OF DBE FRONTS: Off |
| WHISTLEBLOWER REQUIREMENTS: Off |
| A full explanation of all No answers shall be provided below: |
| Date: |
| 20: |
| City: |
| State: |
| Company Name: |
| Title: |
| BIDDERPROPOSER: |
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