IFB__10209213_QC.pdf

STATE OF CALIFORNIA – CALIFORNIA NATURAL RESOURCES AGENCY GAVIN NEWSOM, Governor

DEPARTMENT OF WATER RESOURCES

715 P STREET, 7th FLOOR P.O. BOX 942836

SACRAMENTO, CA 94236-0001

Rev. 02-27-2025

INVITATION FOR BID

Notice to Prospective Bidders April 2, 2025

You are invited to review and respond to this Invitation for Bid (IFB) number 10209213 for Heavy, Medium, and Light Construction Equipment Rental Services. The anticipated term of this agreement is three (3) years. In submitting your bid, you must comply with these instructions.

Note that all agreements entered into with the Department of Water Resources, hereinafter referred to as the “State”, incorporates, by reference, the State’s General Terms and Conditions (GTC) and Contractor Certification Clauses (CCC) that may be viewed and downloaded at the Department of General Services (DGS) website:

https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List- Folder/Standard-Contract-Language

If you do not have Internet access, a hard copy can be provided by contacting the person listed below.

The CCC package contains clauses and conditions that may apply to your Agreement and to anyone doing business with the State. The Certification will be kept on file in a central location.

Executive Order N-6-22 – Russia Sanctions On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia and Russian entities and individuals. “Economic Sanctions” refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine, as well as any sanctions imposed under state law. By submitting a bid or proposal, Contractor represents that it is not a target of Economic Sanctions. Should the State determine Contractor is a target of Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or entities, that shall be grounds for rejection of the Contractor’s bid/proposal any time prior to contract execution, or, if determined after contract execution, shall be grounds for termination by the State.

Inquiries regarding the processing of this bid should be referred to Jodi Johnston at (661) 858-5678.

Please note that no verbal information given will be binding upon the State unless such information is issued in writing as an official addendum to this solicitation.

Sincerely, Vince Alvidrez Manager, San Joaquin Field Division 4201 Sabodan Street Bakersfield, California 93313

Attachment(s) https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf

IFB# 10209213

TABLE OF CONTENTS

Page Notice of State Program Participation Requirements 4 Bidder Minimum Qualifications 5 Bid Requirements and Information 5 Bid Key Action Dates 5 Questions and Answers 5 Submission of Bid 5 Evaluation and Selection Process 7

Tax Delinquent Status Verification Generative Artificial Intelligence (GenAI) Disclosure

Award and Protest 8 Disposition of Bids 9 Standard Conditions of Service 9 Payee Data Record (Std. 204) 10 Key Employee Policies and Guidelines Notice Acknowledgment (Consultants and Contractors) (DWR 9524a)

Small Business Preference Program 10 Non-Small Business (NSB) Preference Application 14 Bid Checklist 16 Attachment I – Bid Sheet 17 Attachment II – Bid/Bidder Certification Sheet 33 Completion Instructions for Bid/Bidder Certification Sheet 34 Attachment III – Bidder References 35 Attachment IV – Darfur Contracting Act Certification 36 Attachment V – Generative Artificial Intelligence (GenAI) Reporting and Factsheet 37 Attachment VI – California DVBE Program Requirements (DWR 9526) 40 Attachment VII – DVBE Declarations (Std. 843) 42 Attachment VIII – Bidder Declaration (GSPD-05-105) 43 Attachment IX – California Civil Rights Laws Attachment 45 Attachment X – Iran Contracting Act 46 Sample Contract – Standard Agreement (Std. 213) 47 Exhibit A – Scope of Work 48 Attachment 1 – Map, San Joaqin Field Division 51 Exhibit B – Budget Detail and Payment Provisions - Private Entities 53

Attachment 1 – Bid Sheet Placeholder 54 Exhibit C – General Terms and Conditions 55

Exhibit D – Special Terms and Conditions for Department of Water Resources – Over

$10,000 Standard Payable (DWR 9544) 56

Attachment 1 – Recycled Content Certification Form (DWR 9557) 59 Exhibit E – Additional Provisions 61

Attachment 1 – DVBE Activity Report Form (DWR 9553) 67 Attachment 2 – Small Business/DVBE Subcontractor Payment Certification (DWR 9683) 69

NOTICE OF STATE MANDATED SB/DVBE PROGRAM

PARTICIPATION REQUIREMENTS

Disabled Veterans Business Enterprise (DVBE) Information

The Department has determined that Bidders responding to this solicitation must comply with DVBE Program requirements. Instructions for completing DVBE program requirements are found in Attachment VI, DVBE Program Requirements (DWR Form 9526). Please review these instructions carefully. Failure to fulfill the DVBE requirement will render your bid non-responsive and shall be cause for bid rejection.

This solicitation also contains DVBE Incentive language within Attachment VI. The DVBE Incentive offers bidders an incentive calculation when they include DVBE subcontractors in their bid efforts.

Application of the Incentive may place the bidder in line for bid award. Minimum incentive applied will be three (3) percent, not to exceed five (5) percent.

Please review DVBE Incentive Language and form contained within this solicitation for additional information.

Small Business Program Information

If a bidding firm is not a California Certified Small Business and wishes to be considered for the small business calculation preference for this solicitation, bidder application for small business must be received by the Department of General Services, Office of Small and DVBE Business Services (OSDS) by the bid due date by close of business. Bidders seeking small business certification status must also notify the State in writing at the time of bid submission that they have an application for Small Business certification for review and approval at the DGS-OSDS.

Contact the DGS Office of Small Business and DVBE Services (OSDS) at internet website https://www.dgs.ca.gov/PD/About/Page-Content/PD-Branch-Intro-Accordion-List/OSDS/OSDS or call

(916) 375-4940 for certification assistance.

For additional assistance meeting DVBE program requirements or inquiries about Small Business certification, please contact the Department of Water Resources SB/DVBE Program Manager via email SB.DVBE@water.ca.gov.

https://www.dgs.ca.gov/PD/About/Page-Content/PD-Branch-Intro-Accordion-List/OSDS/OSDS mailto:SB.DVBE@water.ca.gov

A. Purpose and Description of Services

Rental of heavy, medium, and light construction equipment on an as-needed basis. See Exhibit A, Scope of Work for complete description of services.

B. Bidder Minimum Qualifications The Contractor must have Certification of Reported Compliance from the California Air Resources Board (CARB). The Contractor’s business must be within a 90 mile radius of the San Joaquin Field Division Operations and Maintenance Center located at:

San Joaquin Field Division

4201 Sabodan Street

C. Bid Requirements and Information

1. BID KEY ACTION DATES

All bidders must adhere to the following time schedule.

IFB available to prospective bidders on April 9, 2025 Technical questions must be submitted by April 23, 2025 at 2:00 PM Answers to technical questions will be disseminated by April 24, 2025 at 2:00 PM Bids must be received by May 8, 2025 at 2:00 PM Bid opening to be held on May 20, 2025 at 10:00 AM Anticipated start date of agreement is September 1, 2025

Bid Openings: Sealed bids will be publicly opened and read at the following location.

Department of Water Resources

2. LOCATION WHERE WORK WILL BE PERFORMED:

Various locations within San Joaquin Field Division (Western Kern County) See Map, San Joaquin Field Division, Exhibit A, Attachment 1.

And 45440 Trevor Avenue, Lancaster, California 93534

3. QUESTIONS AND ANSWERS

Technical questions must be submitted in writing to Jodi.Johnston@water.ca.gov and received by the State on or before 2:00 PM on April 23, 2025. The State’s representatives will provide answers in writing to all potential bidders by 2:00 PM April 24, 2025.

4. SUBMISSION OF BID

a. Bids must be submitted by mail, hand delivery, UPS, express mail, or Federal Express.

i. Bids by USPS, UPS, express mail, or Federal Express must be submitted to:

Attn: Jodi Johnston

ii. Bids by hand delivery, must be submitted to Contract Specialist Jodi Johnston on or before the bid due date and time. Please coordinate a day and time via phone (661) 858-5678 or e-mail Jodi.Johnston@water.ca.gov.

b. All bids must include original signatures on the following documents: Bid/Bidder Certification

Sheet and any other documents specified in the Bid Checklist.

c. Bids not including the documents identified in the Bid Checklist shall be deemed non-responsive and will be rejected.

d. All bids are to be sent to DWR within the time frame indicated in the Time Schedule. Bids received after the due date and time will be returned unopened to the prospective bidder.

e. All bids must be submitted under sealed cover. The sealed cover must be plainly marked with the IFB title and number, must show your firm’s name and address, and must be marked with “DO NOT OPEN.”

f. Bids not submitted under sealed cover will be rejected. A minimum of two signed bids must be submitted. One bid must be submitted in hardcopy. One bid must be submitted in an electronic format (Word and/or PDF File) on a USB Drive. Both bids must be signed and submitted in the same envelope. USB Drives can be returned at the request of the bidder once the solicitation is concluded.

g. Bids must be submitted for the entire service described within the Scope of Work.

Deviations from the specifications will not be considered and will be cause for rejection of the bid.

h. The State does not accept alternate language from a bidder. A bid with such language will be considered a counter proposal and will be rejected. The State’s General Terms and Conditions (GTC) are not negotiable.

i. A bid may be rejected if conditional or incomplete, or if it contains any alterations of form or other irregularities of any kind. The State may waive any immaterial deviation in a bid. The State's waiver of immaterial defect shall in no way modify the IFB document or excuse the bidder from full compliance with the objectives if awarded the Agreement. The State may reject all bids if deemed necessary.

j. Costs for developing bids and preparation of award of the Agreement are entirely the responsibility of the bidder and shall not be chargeable to the State.

k. This IFB must be signed by an individual who is authorized to bind the bidding firm contractually. The signature must indicate the title or position that the individual holds in the firm. An unsigned bid will be rejected.

mailto:Jodi.Johnston@water.ca.gov

l. A bidder may modify a bid after its submission by withdrawal and resubmission before the bid due date. Modification of a bid offered in any other manner, oral or written, will not be considered.

m. A bidder may withdraw their bid by submitting a written request to the State for its withdrawal, signed by the bidder or an agent authorized in accordance with Paragraph l above. A bidder may thereafter submit a new bid before the bid submission deadline. Bids may not be withdrawn after the bid due date. Bids received after the due date and time will be returned unopened to the prospective bidder.

n. DWR may modify the IFB prior to the date fixed for submission of bids by the issuance of an

Addendum to all parties who received a bid package.

o. If all bids are too high, DWR is not required to award an Agreement.

p. Bids are public upon bid opening.

q. Bidders are cautioned not to rely on the State during the evaluation to discover and report all defects and errors in the bid documents. Bidders should carefully proof read documents for errors and adherence to the IFB requirements prior to bid submittal.

r. Where applicable, the bidder should carefully examine the worksite and specifications.

Bidder shall investigate the conditions, character, quality of surface, subsurface materials, or obstacles to be encountered. No additions to the Agreement amount will be made because of failure to thoroughly examine the worksite and specifications.

5. EVALUATION AND SELECTION PROCESS

a. The State will put each bid through a process of evaluation to determine the responsiveness of bidders to the State's needs. The final selection will be made on the basis of the lowest responsible bid meeting the specifications.

b. Bids containing false or misleading statements or providing references that do not support an attribute or condition claimed by the bidder may be rejected. If, in the opinion of the State, information was intended to mislead the State in its evaluation of the bid, and the attribute, condition, or capability is a requirement of this IFB, it will be the basis for rejection of the bid.

c. At the time of bid opening, each bid will be checked for the presence or absence of required information in conformance with the submission requirements of this IFB.

d. Bids submitted that include option years will be evaluated based on the total bid amount for all years provided for the overall bid ranking. However, the total bid amount, for determining the contract amount will not include the option years.

e. The contract will be awarded to the lowest responsible bidder after consideration of any applicable preferences. If there are tied bids, representatives of the State will draw straws to pick the winning bidder. The drawing will be witnessed and documented by two or more State employees.

6. TAX DELINQUENT STATUS VERIFICATION

a. Effective July 1, 2012 Public Contract Code 10295.4, requires state agencies to verify the tax delinquent status of bidders responding to state solicitations.

b. At the time of bid evaluation, prior to contract award and execution, the State will verify all proposing firms and identified subcontractors as not listed as tax delinquent by the Franchise Tax Board and the California Department of Tax and Fee Administration. Any proposing firms or subcontractor listed as tax delinquent shall result in a proposal rejection and will not be considered for contract award. Proposing firms wanting further clarification can refer to the statute above or to the web sites listed below for additional information.

California Department of Tax and Fee Administration – Top 500 Sales Tax and Use Delinquencies in California https://www.cdtfa.ca.gov/taxes-and-fees/top500.htm

Franchise Tax Board – Top 500 Delinquent Tax Payers https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/index.html

7. GENERATIVE ARTIFICIAL INTELLIGENCE (GEN AI) DISCLOSURE

a. The State of California seeks to realize the potential benefits of GenAI, through the development and deployment of GenAI tools, while balancing the risks of these new technologies.

b. Bidder / Offeror must notify the State in writing if it: (1) intends to provide GenAI as a deliverable to the State; or (2), intends to utilize GenAI, including GenAI from third parties, to complete all or a portion of any deliverable that materially impacts: (i) functionality of a State system, (ii) risk to the State, or (iii) Contract performance. For avoidance of doubt, the term “materially impacts” shall have the meaning set forth in State Administrative Manual (SAM) §

4986.2 Definitions for GenAI.

c. Failure to report GenAI to the State may result in disqualification. The State reserves the right to seek any and all relief to which it may be entitled to as a result of such non-disclosure.

d. Upon notification by a Bidder / Offeror of GenAI as required, the State reserves the right to incorporate GenAI Special Provisions into the final contract or reject bids/offers that present an unacceptable level of risk to the State.

e. Government Code 11549.64 defines “Generative Artificial Intelligence (GenAI)” as an artificial intelligence system that can generate derived synthetic content, including text, images, video, and audio that emulates the structure and characteristics of the system’s training data.

8. AWARD AND PROTEST

A bidder may protest the award of a contract on the grounds that it (the bidder) is the lowest responsible bidder meeting the specifications and should therefore be awarded the contract.

A protestant must be able to prove that the awarding agency has committed a material error in the conduct of the bid award process.

http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=10295.4.&lawCode=PCC https://www.cdtfa.ca.gov/taxes-and-fees/top500.htm https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/index.html

Public inspection of all bids will be allowed after the bid opening.

Protests must be received in a timely manner pursuant to Public Contract Code Section 10345, as applicable. In order to be considered timely, a protest must be filed with the State Agency conducting the solicitation and DGS before the contract award is made.

Please note that if the award will be made to other than the low bidder, any protests must be filed within five business days of notice to the low bidder that the contract was awarded to another bidder. If a written request was submitted by a bidder to the State agency requesting that a notice of intent to award be posted, the protest must be filed during the five business days the notice is posted.

Within five business days of filing the protest, the protestant must submit a detailed written statement of protest if the original protest did not contain the complete grounds for the protest.

Both the original protest and/or the detailed statement of protest, if any, must include the IFB number, the name of the State Agency conducting the solicitation, State agency contact person, and protestant’s fax number, if any.

The protest documents may be sent by regular mail, email, courier, or personal delivery to:

Department of General Services

Office of Legal Services Attention: Bid Protest Coordinator

707 Third Street, 7th Floor, Suite 7-330 West Sacramento, CA 95605

Bid Protest Coordinator Email address: OLSProtests@dgs.ca.gov

AND

Contract Specialist Email Address: Jodi.Johnston@water.ca.gov

Upon receipt of the protest, DGS shall send the protestant an acknowledgement letter and thereafter communicate with the parties regarding further disposition of the protest.

9. DISPOSITION OF BIDS

Upon bid opening, all documents submitted in response to this IFB will become the property of the State and will be regarded as public records under the California Public Records Act (Government Code Section 7920 et seq.) and are subject to review by the public. Bids may be returned at the request and expense of the bidder.

D. Standard Conditions of Service

1. Service(s) shall not commence until the Agreement is fully executed and all approvals have been obtained.

2. All performance under the Agreement shall be completed on or before the termination date of the Agreement unless this Agreement is amended to extend the term.

3. No oral understanding or agreement shall be binding on either party.

mailto:OLSProtests@dgs.ca.gov

E. Payee Data Record

1. The Contractor awarded this Agreement must have completed and submitted form STD 204, Payee Data Record, to determine if the Contractor is subject to a seven percent State Income Tax withholding pursuant to California Revenue and Taxation Code Sections 18662, 18805, and 26131.

2. No payment shall be made unless the Payee Data Record form has been completed and returned to the State.

F. Key Employee Policies and Guidelines Notice Acknowledgment (Consultants and

Contractors)

1. The selected contractor awarded this Agreement must complete and submit the form DWR 9524a, Key Employee Policies and Guidelines Notice Acknowledgment. These policies and guidelines communicate expectations for contractors. Every contractor or subcontractors employee is expected to read and understand the material contained within. Primary contractor/subcontractors are responsible to ensure that their employees are aware of and adhere to the policies and guidelines.

G. Small Business Preference Program

1. The Small Business Procurement and Contract Act (Gov. Code Section 14835 et. seq.)

requires that a fair share of the State’s purchases and contracts for goods, information technology services and construction be placed with a certified Small Business (SB) or Micro-Business (MB). The Act mandates that state agencies:

a. Establish participation goals,

b. Provide a 5% small business calculation preference, and

c. Provide the opportunity for bidders to receive a 5% non-small business calculation preference when achieving 25% small business participation through subcontracted efforts.

2. SMALL BUSINESS PREFERENCE

The Small Business preference offers certified SB’s and MB’s a calculation preference in the amount of five percent (5%) of the lowest responsible bid submitted by a bidder who is not a certified small business. The SB preference is used as a calculation for determining the lowest bidder and does not affect the actual price bid.

The State will grant SB’s a five percent (5%) Small Business preference on a bid evaluation when a responsible non-small business (NSB) has submitted the lowest-priced, responsive bid pursuant to the evaluation of a solicitation method when a small business:

a. Includes in its bid a notification to the awarding department that it is a small business or that it has submitted to DGS Office of Small Business & Disabled Veteran Business Enterprise Services (OSDS) a complete application no later than 5:00 p.m. on the bid due date, and is subsequently certified by DGS as a small business; and

b. Submits a timely, responsive bid; and

c. Has been determined to be a responsible bidder.

Bidders having pending Small Business or DVBE Certification applications under review by DGS, concurrent with the bid time frame should contact DGS/OSDS to request an expedite review/approval of their application in order to be considered for the SB preference during the evaluation of this bid.

Contact DGS/OSDS at (916) 375-4940 to obtain information about the application expedite process.

Bidders must notify the State in writing at the time of bid submission that they have an application for Small Business or DVBE certification under review at the DGS Office of Small and Disabled Veteran Business Certification, and that they wish to be considered for the Small Business Preference Calculation.

3. NON-SMALL BUSINESS PREFERENCE

Non-small business bidders will be granted a five percent (5%) non-small business preference on a bid evaluation when a responsible non-small business has agreed to subcontract at least 25 percent of their bid price with a California certified Small Business and if the non-small business bidder’s bid is not the low price bid, or when a proposal has been not been ranked as the highest scored bid pursuant to the evaluation of the solicitation. Responding bidders must:

a. Include in its bid a notification to the awarding department that it commits to subcontract at least twenty-five percent (25%) of its net bid price with one or more California certified small business(s),

b. Submit a timely bid as specified in the bid document,

c. Be determined to be a responsive, responsible bidder and

d. Identify the California certified small business(s) it commits to subcontract with. The bidder shall list certified Small Business subcontractors and include their name, address, phone number, a description of the work to be performed, and the percentage (as specified in the solicitation) per subcontractor.

4. CALCULATING NON-SMALL BUSINESS PREFERENCE

The non-small business (NSB) calculation preference five percent (5%) is used for bid evaluation purposes only. Awards made as a result of the NSB preferences shall be awarded at the bidder’s original bid price. The preference shall be computed as follows:

Bidder A, (Low Bid), non-small business: $125,000 Bidder B, non-small business (subcontracting 25% to a certified small business)

$131,000

Calculation Preference: $125,000 x .05 = $6,250

Bidder B $131,000 Subtract calculated preference - $6,250

Adjusted Bid for Bidder B $124,750

Award is made to Bidder B as the low bidder at the bid price of $131,000.

5. TIES BETWEEN CERTIFIED SMALL BUSINESSES AND DVBE BUSINESSES

In the event of a precise tie between the bid of a small business and the bid of a disabled veteran enterprise that is also a small business, the award shall go to the disabled veteran that is also a small business.

6. MAXIMUM ALLOWABLE PREFERENCES

In no event shall the amount of the small business or non-small business subcontractor preferences awarded on a single bid exceed $50,000, and in no event shall the combined cost of the small business or non-small business subcontractor preference and preferences awarded pursuant to any other provision of law exceed $100,000. The five percent (5%) calculation preference is used for computation purposes only and does not alter or affect the actual bid price or the amount of the executed contract. When a certified small business is the lowest responsive, responsible bidder, then there is no need to compute the small business preference as the small business is the low bidder.

7. COMMERCIALLY USEFUL FUNCTION (Government Code 14837)

A certified small business, micro-business contractor, subcontractor or supplier, must meet commercially useful function requirements under Government Code section 14837(d) (4).

Selected firms must perform a “commercially useful function” relevant to this contract.

The term “small business contractor, subcontractor or supplier” means any person or entity that satisfies the ownership (or management) and control requirements in accordance with Government Code Section 14837 (d) (4) and provides services or goods that contribute to the fulfillment of the contract requirements by performing a commercially useful function. A person or an entity is deemed to perform a “commercially useful function” if that person or entity does all of the following:

1. Is responsible for the execution of a distinct element of the work of the contract.

2. Carries out contractual obligations by actually performing, managing, or supervising the work involved.

3. Performs work that is normal for its business services and functions.

4. Is not further subcontracting a portion of the work that is greater than that expected to be subcontracted by normal industry practices.

5. Is responsible, with respect to products, inventories, materials, and supplies required for the contract, for negotiating price, determining quality and quantity, ordering, installing, and, if applicable, making payment

6. Its role is not an extra participant in the transaction, contract or project through which funds are passed in order to obtain the appearance of DVBE participation.

8. BIDDER CUF REQUIREMENTS

The Department will determine, to the best of its ability, that your firm meets the criteria above for commercially useful function (CUF). In responding to this solicitation, you are confirming that, under Government Code 14837 (d) (4) above, your business provides goods and/or services meet the definition of “commercially useful function”. All bidders are required to provide CUF documentation using the attached State’s Bidder Declaration Form GSPD-05-105, Attachment VIII, included in the solicitation document. When completing the declaration, bidders must identify all subcontractors proposed for participation in the contract. Any bidder awarded a contract is contractually obligated to use the subcontractor for the corresponding work defined unless the State agrees to a substitution.

9. PENDING SMALL BUSINESS CERTIFICATION

If your firm is currently seeking small business certification for small business preference related to this solicitation, you must have: 1) notified DGS/OSDS that you are responding to a solicitation and are seeking an Expedite Review of your small business certification application in relation to the solicitation, 2) provided DGS/OSDS with the bid Key Action Dates page from the bid itself and 3) must have submitted a complete application with all required forms and documentation to DGS/OSDS for review and approval by close of business of the Bid Submittal due date.

Notify the State representatives if, at the time of bid submission, your firm has a pending small business application with the DGS/OSDS. State representatives will verify your certification is pending or has been approved.

H. Disabled Veteran Business Enterprise Program

This solicitation includes DVBE program requirements. Please refer to DWR Form 9526, Attachment VI for instructions about program documentation and compliance.

DWR PROGRAM MANAGER PRE-REVIEW OF DVBE DOCUMENTATION

The Department’s DVBE Program Manager offers a pre-review of a bidder’s DVBE documentation prior to proposal submission. Since non-compliance with the DVBE program is immediate cause for rejection, the State strongly recommends firms interested in bidding take advantage of this opportunity to ensure they are fully compliant with DVBE Program requirements.

Upon satisfactory review of the firm’s DVBE documentation, the DWR Program Manager issues a Notification of Compliance. To request a pre-review of your DVBE documentation, please submit the documentation to the attention of:

SB/DVBE Program Manager Email: SB.DVBE@water.ca.gov

DVBE INCENTIVE PROGRAM

Under California Code of Regulations 1896.99.100, the California DVBE Incentive provides responsive and responsible bidders the opportunity to receive additional incentive calculations.

The incentive is applied at the time of solicitation evaluation when a proposing firm identifies and commits to using a California-certified DVBE subcontractor to provide services or commodities in support of the overall contract. Application of the DVBE Incentive may place the bidder in line for contract award.

The following are key elements of the DVBE Incentive Program:

a. The DVBE Incentive is applied during the evaluation process and is only applied to responsive bids from responsible bidders proposing the percentage(s) of DVBE participation for the incentive(s) specified in the solicitation.

b. DVBE Incentive participation is at the discretion of the bidder and is optional when overall DVBE program requirements are exempt by the State for that solicitation.

c. When requesting the Incentive application, a bidder must complete and return the DVBE

Incentive Application Request included within this solicitation with their proposal at time of submission.

d. Services or commodities provided by the DVBE firm MUST meet the definition of CUF as defined under Military and Veterans Code 999 (B) (i) (ii) and under California Code of Regulations 1896.71 (l). A DVBE firm determined as not meeting CUF regulations will render the responding firm ineligible for the DVBE Incentive application.

ORDER OF EVALUATION

For purposes of evaluation, first Small Business preference will be applied, followed by the DVBE Incentive calculation.

BID CHECKLIST

Please review the following checklist for a list of documents that must be returned with your bid package. Please read the State of California’s General Terms and Conditions (GTC) before signing and submitting your bid package. The State does not accept alternate language from a bidder. A bid with such language will be considered a counter proposal and will be rejected. The GTC’s are not negotiable. Unless otherwise noted, failure to include the required documents will be cause for bid rejection.

DOCUMENTS REQUIRED WITH SUBMISSION OF BID

Attachment I – Bid Sheet (must be signed and include all pages) Attachment II – Bid/Bidder Certification Sheet Attachment III – Bidder References Attachment IV – Darfur Contracting Act Certification Attachment V – GenAI Reporting and Factsheet Attachment IX – California Civil Rights Laws Attachment Attachment X – Iran Contracting Act Copy of current, valid California Business License or equivalent.

Copy of Certification of Reported Compliance from the California Air Resources Board (CARB) Proof of the Contractor’s business and equipment located within 90 miles of the San Joaquin Field Division’s O&M Center.

SMALL BUSINESS PROGRAM

Small Business Certification from Office of Small Business and DVBE Services(OSDS) when prime firm is SB or MB certified Non-Small Business Calculation Preference Request Form (required when prime is requesting Non-Small Business preference consideration) Current Small Business Certification for proposed SB subcontractor (must accompany a bidder’s Non-Small Business Preference request)

DVBE PARTICIPATION PROGRAM

If you are a prime firm, DVBE-certified, you must complete and return: DGS OSDS DVBE certification, Std. 843, the DVBE Declaration; the GSPD-05-105 Bidder Declaration.

Attachment VI, Bidder Certification of DVBE Participation (DWR 9526) CA-certified DVBE Primes – attach certification from DGS/OSDS Attachment VII, DVBE Declaration (Std. 843) Attachment VIII Bidder Declaration (GSPD-05-105) DVBE subcontractor(s) – attach certification from DGS/OSDS DVBE Program Manager’s Notification of Compliance (if obtained in advance from the DVBE Manager)

DOCUMENTS REQUIRED UPON CONTRACTOR SELECTION/BID AWARD

These documents are not required at the time of bid submittal; however these documents will be required of the awarded firm upon contractor selection/bid award.

Contractor Certification Clauses (CCC) (CCC must be signed once a contractor has been selected) Payee Data Record (Std. 204) Certificate(s) of Insurance Key Employee Policies and Guidelines Notice Acknowledgment (Consultants and Contractors) (DWR 9524a)

ATTACHMENT I

BID SHEET

The estimated equipment indicated below will be used solely for computing the cost as a fair and equitable formula to determine the low bidder and is not binding on the contracting agency. However, the actual costs quoted below by the bidder shall be binding for the term of the Agreement.

The bidder hereby agrees to provide all labor, materials, licenses, permits, and transportation necessary to perform all services required for the foregoing titled work in accordance with the Scope of Work, Exhibit A. The rates listed on this Bid Sheet shall include every item of expense, direct and indirect, including taxes incidental to the specified rates.

The bidder is required to bid each item. Failure to indicate a dollar amount in any item will be grounds to reject the entire bid. A zero dollar ($0.00) amount listed for any and all items will be interpreted and understood by the State to mean that the bidder indicating a zero dollar amount shall perform any such services, up to and including the quantity indicated, at no cost to the state.

SECTION : A

# Trucks Day Week Month Delivery & Pickup Fee

A1 Water Truck, 5000 gal, A/C with associated fire hose attachments & hoses (or similar)

A2 Water Truck, 4000 gal, A/C with associated fire hose attachments & hoses (or similar)

A3 Water Truck, 2000 gal, A/C with associated fire hose attachments & hoses (or similar)

A4 Dump Truck, 10 yard, 3 Axle, A/C (or similar) $ $ $ $

A5 Truck, flatbed, 16’, A/C (or similar) $ $ $ $

A6 Truck, Street Broom, Cab, A/C $ $ $ $

A7 Truck, Street Broom, Cab, A/C, water/vacuum $ $ $ $

A8 Hydro Excavator, with jet rodder & attachments, Vactor 2100 + Fan series

Section A Total, Trucks $ $

SECTION : B

# Earth Moving Equipment Day Week Month Delivery & Pickup Fee

B1 Backhoe, CAT 450F, extendable, 4 in 1 bucket, AC, enclosed cab (or similar)

B2 Auger, backhoe, hydraulic, up to 48” $ $ $ $

B3 12” Backhoe bucket (smooth face) $ $ $ $

B4 18” Backhoe bucket (smooth face) $ $ $ $

B5 24” Backhoe bucket (smooth face) $ $ $ $

B6 12” Backhoe bucket (rock type) $ $ $ $

B7 18” Backhoe bucket (rock type) $ $ $ $

B8 24” Backhoe bucket (rock type) $ $ $ $

B9 Compaction Wheel, Backhoe $ $ $ $

B10 Track Dozer, Cat D5 with ripper, enclosed Cab, AC (or similar) $ $ $ $

B11 Track Dozer, Cat D6 with ripper, enclosed Cab, AC (or similar) $ $ $ $

B12 Track Dozer, Cat D7 with ripper, enclosed Cab, AC (or similar) $ $ $ $

B13 Track Dozer, Cat D8 with ripper, enclosed Cab, AC (or similar) $ $ $ $

B14 Wheel Loader, Cat 980, AC, 6 yard bucket (or similar) $ $ $ $

B15 Wheel Loader, Cat 950, AC, 4.5 yard bucket (or similar) $ $ $ $

B16 Wheel Loader, Cat 930, AC, 3 yard bucket (or similar) $ $ $ $

B17 Excavator, Cat 345CL, enclosed cab, AC (or similar) $ $ $ $

SECTION : B (Continued)

Pickup Fee

B18 Hydraulic breaker for CAT 345 (or similar) $ $ $ $

B19 Excavator, Cat 322CL, Long reach, enclosed cab, AC (or similar)

B20 Excavator, Cat 320, enclosed cab, AC (or similar) $ $ $ $

B21 Hydraulic breaker for Cat 320 (or similar) $ $ $ $

B22 Thumb for Cat 320 (or similar) $ $ $ $

B23 Motor Grader, Cat 140, 14’ moldboard, Ripper, All Wheel Drive, enclosed cab, AC (or similar)

B24 Scraper, Cat 623, enclosed Cab, AC (or similar) $ $ $ $

B25 Scraper, Cat 615, enclosed Cab, AC (or similar) $ $ $ $

B26 Mini Backhoe (2 WD) $ $ $ $

B27 Mini Backhoe (4 WD) $ $ $ $

B28 12” Mini Backhoe bucket (smooth face) $ $ $ $

B29 12” Mini Backhoe bucket (rock type) $ $ $ $

B30 Mid-size Backhoe (2WD) $ $ $ $

B31 Mid-size Backhoe (4 WD) $ $ $ $

B32 Auger, backhoe, hydraulic, up to 48” $ $ $ $

B33 12” Backhoe bucket (smooth face) $ $ $ $

B34 18” Backhoe bucket (smooth face) $ $ $ $

SECTION : B (Continued)

Pickup Fee

B35 24” Backhoe bucket (smooth face) $ $ $ $

B36 12” Backhoe bucket (rock type) $ $ $ $

B37 18” Backhoe bucket (rock type) $ $ $ $

B38 24” Backhoe bucket (rock type) $ $ $ $

B39 Mid-size Backhoe Compaction Wheel $ $ $ $

B40 Mini Excavator 2000-3500lb $ $ $ $

B41 Mini Excavator 6000-7500lb $ $ $ $

B42 Auger, mini excavator, hydraulic, up to 48” $ $ $ $

B43 Mini Skid Steer, Ride on $ $ $ $

B44 Skid Steer Loader 999lb and under $ $ $ $

B45 Skid Steer Loader 1000lb-1499lb $ $ $ $

B46 Skid Steer Loader Track 1100lb- 1500lb $ $ $ $

B47 Auger, skid steer, hydraulic, up to 48” $ $ $ $

B48 Wheel Excavator , Cat M316 (or similar) $ $ $ $

Section B Total, Earth Moving Equipment $ $

SECTION : C

# Air Equipment Day Week Month Delivery & Pickup Fee

C1 Compressor (trailered) – 185 CFM (or Similar) $ $ $ $

C2 Compressor (trailered) – 375 CFM (or Similar) $ $ $ $

C3 Compressor (trailered) – 650 CFM (or Similar) $ $ $ $

C4 Air Compressor, 750 cfm, trailered, with 5/8” air hoses up to 100’, Chicago fitting (or Similar)

C5 Air Compressor, 915 cfm, trailered, with 5/8” air hoses up to 100’, Chicago fitting (or Similar)

C6 Compressor (skid mount) - 185 CFM (Electric) 480 volt 3 phase (or Similar)

C7 Air Scrubber, For Compressor Indoor Use $ $ $ $

C8 Air hose, 1/2” X 50’ with Chicago Fittings $ $ $ $

C9 Air Hose, 5/8” X 50’ with Chicago Fittings $ $ $ $

C10 Rivet Buster, 30 lb. with various attachments $ $ $ $

C11 Jack Hammer, 30 lb. $ $ $ $

C12 Jack Hammer, 60 lb. $ $ $ $

Section C Total, Air Equipment $ $

SECTION : D

# Aerial Equipment Day Week Month Delivery & Pickup Fee

D1 Articulated Boom Lift, W/Jib, Electric, 40'-49’ (or Similar) $ $ $ $

D2 Articulated Boom Lift, W/Jib, Combustion, 40'-49' (or Similar) $ $ $ $

D3 Articulated Boom Lift, W/Jib, Electric, 50’-59’ (or similar) $ $ $ $

D4 Articulated Boom Lift, W/Jib, Combustion, 50’-59’ (or similar) $ $ $ $

D5 Articulated Boom Lift, W/Jib, Electric, 60’-69’ (or SImilar) $ $ $ $

D6 Articulated Boom Lift, W/Jib, Combustion, 60’-69’ (or similar) $ $ $ $

D7 Articulated Boom Lift, W/Jib, Combustion, 80’-89’ (or similar) $ $ $ $

D8 Articulated Boom Lift, W/Jib, Combustion, 125’ (or similar) $ $ $ $

D9 Straight Boom, Combustion, 40’- 49’ (or similar) $ $ $ $

D10 Straight Boom, Electric, 40’-49’ (or similar) $ $ $ $

D11 Straight Boom, Combustion, 60’- 69’ (or similar) $ $ $ $

D12 Straight Boom, Electric, 60’-69’ (or similar) $ $ $ $

D13 Straight Boom, Combustion, 80’- 89’ (or similar) $ $ $ $

D14 Straight Boom, Combustion, 100’- 125’ (or similar) $ $ $ $

D15 Scissor Lift, Electric, 14’-20’ (or similar) $ $ $ $

SECTION : D (Continued)

# Aerial Equipment Day Week Month Delivery & Pickup Fee

D16 Scissor Lift, Electric, 21’-30’ (or similar) $ $ $ $

D17 Scissor Lift, Electric, 35’-45’ (or similar) $ $ $ $

D18 Scissor Lift, Rough Terrain, 25’- 28’ (or similar) $ $ $ $

D19 Scissor Lift, Rough Terrain, 29’- 39’ (or similar) $ $ $ $

D20 Scissor Lift, Rough Terrain 40’- 49’ (or similar) $ $ $ $

D21 One Man Lift, Drivable, Electric 12’-15’ (or similar) $ $ $ $

D22 One Man Lift, Drivable, Electric, 20’-24’ (or similar) $ $ $ $

Section D Total, Aerial Equipment $ $

SECTION : E

# Forklifts Day Week Month Delivery & Pickup Fee

E1 Forklift, Industrial, 5000lb-6000lb Gas/Propane/Diesel (or similar) $ $ $ $

E2 Forklift, Industrial, 6001lb-7000lb Gas/Propane/Diesel (or similar) $ $ $ $

E3 Forklift, Industrial, 7001lb-8000lb Gas/Propane/Diesel (or similar) $ $ $ $

E4 Forklift, Electric, With Charger, 3000lb-4000lb (or similar) $ $ $ $

SECTION : E (Continued)

# Forklifts Day Week Month Delivery & Pickup Fee

E5 Forklift, Electric, With Charger, 4001lb-5000lb (or similar) $ $ $ $

E6

Telehandler, Max Lift Capacity 5500lb, Max Lift Height 18ft 10in, Max Forward Reach 11ft 3in, Capacity at Max Height 4400lb, Capacity at Max Reach 1900lb (or similar)

E7

Telehandler, Max Lift Capacity 10,000lb, Outriggers Up Max Lift Height 55ft, Maximum Lift Height 55ft, Maximum Reach 42ft (or similar)

E8 Forklift, Industrial, 5001lb-10,000lb Gas/Propane/Diesel (or similar) $ $ $ $

E9 Forklift, Industrial, 10,001lb-15,000lb Gas/Propane/Diesel (or similar) $ $ $ $

Section E Total, Forklifts $ $

SECTION : F

# Compaction Equipment Day Week Month Delivery & Pickup Fee

F1 Roller, Cat 563, soil compactor, single drum, 84” (or similar) $ $ $ $

F2 Roller, Cat 534, double drum, 78” (or similar) $ $ $ $

F3 Roller, multi wheel, pneumatic, Ride on (or similar) $ $ $ $

F4 Roller, Padfoot, 66”, ride on (or similar) $ $ $ $

F5 Tamper, Rammer Type – 160- 175lb, (4 cycle) $ $ $ $

S SECTION : F (Continued)

# Compaction Equipment Day Week Month Delivery & Pickup Fee

F6 Plate Compactor – Vibratory, 140lb $ $ $ $

F7 Plate Compactor – Vibratory, 200lb $ $ $ $

F8 Plate Compactor – Vibratory, Reversible, 700lb 24” $ $ $ $

F9 Plate Compactor – Vibratory, Reversible, 1000lb 28” $ $ $ $

F10 Roller – Walk behind (Padded or Smooth) $ $ $ $

F11 Trench Compactor – Remote Control $ $ $ $

F12 Roller, Single Drum, Padded (Sheep’s Foot) $ $ $ $

F13 Roller, Single Drum, Smooth (Ride

on) $ $ $ $

F14 Roller, Double Drum, 36” (Ride

on) $ $ $ $

F15 Roller, Double Drum, 52” (Ride

on) $ $ $ $

Section F Total, Compaction Equipment $ $

SECTION : G

# Skidsteer & Skiploaders Day Week Month Delivery & Pickup Fee

G1 Skiploaders, 4WD, 4 in 1 bucket with Gannon Scraper, AC, and enclosed cab (or similar)

G2 Skid steer, Track type, enclosed cab, AC, up to 4000lb capacity (or similar)

G3 Breaker, Skid steer, hydraulic $ $ $ $

G4 Auger, skid steer, hydraulic, up to 48” $ $ $ $

Section G Total, Skidsteer & Skiploaders $ $

SECTION : H

# Trailers Day Week Month Delivery & Pickup Fee

H1 Office, trailer, portable, 8’ X 20’, A/C & Heating, with access stairs $ $ $ $

H2 Office, trailer, portable, 10’ X 44’, A/C & Heating, with access stairs $ $ $ $

H3 Office, ground level, portable, 8’ X 20’, A/C & Heating, including set up $ $ $ $

H4 Trailer, flatbed, 45’, commercial $ $ $ $

H5 Trailer, Equipment, tilt bed, up to 10 ton capacity, air brakes, pintal hitch

Section H Total, Trailers $ $

SECTION : I

# Concrete Equipment Day Week Month Delivery & Pickup Fee

I1 Mixer, 9 cu ft., Tow Behind $ $ $ $

I2 Concrete Bucket, 2 yd. $ $ $ $

I3 Vibrator, Flex-Shaft, 15’ $ $ $ $

I4 Saw, Concrete, 16” $ $ $ $

I5 Blade, Concrete, Diamond, High Speed 14”-16” $ $ $ $

I6 Saw, Concrete, Walk behind, 14”- 30” Gas or Diesel $ $ $ $

I7 Scarifier, Concrete, Gas $ $ $ $

I8 Power Trowel, 36” Walk Behind $ $ $ $

I9 Power Trowel, 48” Walk Behind $ $ $ $

I10 Core Drill, 3-4 Speed $ $ $ $

I11 Diamond Core Bits up to 16” $ $ $ $

Section I Total, Concrete Equipment $ $

SECTION : J

# Pressure Washers Day Week Month Delivery & Pickup Fee

J1 13 HP, 3500 PSI, Cold, Portable (or similar $ $ $ $

J2 20 HP, 3500 PSI, 200 Degree, Diesel, Towable (or similar) $ $ $ $

Section J Total - Pressure Washers $ $

SECTION : K

# Welders & Generators Day Week Month Delivery & Pickup Fee

K1 2500 watt, portable (or similar) $ $ $ $

K2 3600 watt, portable (or similar) $ $ $ $

K3 100 KW, Towable, Diesel with containment, associated power cables to 200’ (or similar)

K4 125 KW, Towable, Diesel with containment, associated power cables to 200’ (or similar)

K5 250 KW, Towable, Diesel with containment with associated power cables to 200’ (or similar)

K6 300 KW, Towable, Diesel with containment with associated power cables to 200’ (or similar)

K7 Generator, 500 KW, diesel with associated power cables to 200’ $ $ $ $

K8 Generator, 750 KW, diesel with associated power cables to 200’ $ $ $ $

K9 Welder, 200 AMP Capacity, Towable, ARC/STICK $ $ $ $

K10 Welder, 300 AMP Capacity, Towable, ARC/STICK $ $ $ $

Section K Total, Generators $ $

SECTION : L

# Cranes Day Week Month Delivery & Pickup Fee

L1 Crane, Boom Truck, hydraulic, up to 17 ton (without operator) $ $ $ $

L2 Crane, Boom Truck, hydraulic, up to 25 ton (without operator) $ $ $ $

L3 Crane, Rough Terrain, up to 40 ton (without operator) $ $ $ $

L4 Crane, Rough Terrain, up to 55 ton (without operator) $ $ $ $

L5 Crane, Rough Terrain, up to 75 ton (without operator) $ $ $ $

Section L Total, Cranes $ $

SECTION : M

# Miscellaneous Equipment Day Week Month Delivery & Pickup Fee

M1 Hydro Excavator, Trailer Mount, Ditch Witch HX30 (or similar) $ $ $ $

M2 Light Tower With 4 Lights (or similar) $ $ $ $

M3 Arrow Boards, Tailer Mounted, 48"x96" (or similar) $ $ $ $

M4 Message Boards, Trailer Mounted, 92"x54" (or similar) $ $ $ $

M5 Air Circulator, 19,000 CFM, 48" Electric (or similar) $ $ $ $

M6 Dust Collector, 6000 CFM, Electric (or similar) $ $ $ $

M7 Trencher, Ride-on, 40 HP, Up to 10" Width (or similar) $ $ $ $

SECTION : M (Continued)

# Miscellaneous Equipment Day Week Month Delivery & Pickup Fee

M8 Trencher, Ride-on, Up to 12" Width, Ditch Witch M314 (or similar) $ $ $ $

M9 Trencher, Walk Behind, 2'-3', With Trailer (or similar) $ $ $ $

M10 Trencher, Walk Behind, 4”-6” Width, With Trailer (or similar) $ $ $ $

M11 Sand Blast Pot, 8 Ton portable (towable), with 4 hose hook-ups (or similar)

M12 Wood Chipper, Trailer Mount, 50HP or greater (or similar) $ $ $ $

M13 Sealant Melter/Applicator, Crack Seal Machine, Trailer Mounted $ $ $ $

M14 Fuel Tank, Trailer Mounted, Diesel, 500 Gallon $ $ $ $

M15 Stump Grinder, Walk Behind $ $ $ $

Section M Total, Miscellaneous Equipment $ $

SECTION : N

# Floor Equipment Day Week Month Delivery & Pickup Fee

N1 Scrubber, walk behind, 32” path (or similar) $ $ $ $

N2 Sweeper/Scrubber, Ride on $ $ $ $

Section N Total, Floor Equipment $ $

SECTION : O

# Pumps Day Week Month Delivery & Pickup Fee

O1 Pump, Trash, 4", Gas, Portable, With Draft/Discharge Hoses $ $ $ $

O2 Pump, Trash, 6", Diesel, Trailer Mounted, With Draft/Discharge Hoses (or similar)

O3 Pump, Transfer, 6", Diesel, Trailer Mounted, With Draft/Discharge Hoses (or similar)

Section O Total, Pumps $ $

SECTION : P

# Water Demineralizer Day Week Month Delivery & Pickup Fee

P1 Demineralizer, Purtec Industrial Water P404X 14", Mixed Bed with Inlet/Outlet/Crossover Hoses (or similar)

Section P Total, Water Demineralizer $ $

SECTION : Q

# Refuel / Refill Charges Type Per Gallon Charge

Q1 Refuel Charge (Per 1 Gallon) Gas $

Q2 Refuel Charge (Per 1 Gallon) Diesel $

Q3 Refuel Charge (Per 1 Gallon) Diesel (RED) $

Q4 Refuel Charge (Per 1 Gallon) Propane $

Q5 Refill Charge (Per 1 Gallon) DEF (Diesel Exhaust Fluid) $

Section Q Total, Refuel/Refill Charges $

SECTION : R

# Labor Rate Hourly Rate Total

R1 Labor Rate for Training $ X100 = $$

Sub 1 SUBTOTAL Sections A-P (column 3 only, Monthly Rates) $

2 SUBTOTAL Sections A-P (column 4 only, Delivery/Pickup Fee) $

3 SUBTOTAL Sections Q - R $

GRAND TOTAL = (Sub 1, Sub 2, & Sub 3 Combined) $

NO GUARANTEE OF WORK UNDER THIS CONTRACT.

In the event of computational error, unit prices will prevail over extended totals. The State will check bid calculations and recalculate bid totals.

Company Name

Printed Name and Title of Bidder

Signature of Bidder

Date

I certify under penalty of perjury under the laws of the State of California, the foregoing is true and correct.

ATTACHMENT II

BID/BIDDER CERTIFICATION SHEET

This Bid/Bidder Certification Sheet must be signed and returned along with all the required attachments as an entire package in duplicate with original signatures. The bid must be transmitted in a sealed envelope in accordance with IFB instructions.

Do not return Bid Requirements and Information or the Sample Agreement.

A. Our all-inclusive bid is submitted as detailed in Attachment I, Bid Sheet.

B. All required attachments are included with this certification sheet.

C. The signature affixed hereon and dated certifies compliance with all the requirements of this bid document. The signature below authorizes the verification of this certification. An unsigned Bid/Bidder Certification Sheet may be cause for rejection.

1. Company Name 2. Telephone Number 2a. Email

3. Address

Indicate your organization type:

4. Sole Proprietorship 5. Partnership 6. Corporation Indicate the applicable employee and/or corporation number:

7. Federal Employee ID No. (FEIN) 8. California Corporation No.

9. Indicate applicable license and/or certification information:

10. Bidder’s Name (Print) 11. Title

12. Signature 13. Date

14. Are you certified with the Department of General Services, Office of Small Business Certification and Resources (OSDS) as:

a. California Small Business Yes No If yes, enter certification number:

a. Disabled Veteran Business Enterprise Yes No If yes, enter your service code below:

NOTE: A copy of your Certification is required to be included if either of the above items is checked “Yes”.

Date application was submitted to OSDS, if an application is pending:

Completion Instructions for…