IFB_23-100-03,_Ergonomic_Services.pdf

Contracts Management Unit 1515 S Street, North Building, Suite 500 Sacramento, CA 95811

(916) 322-0720 Fax (916) 327-0568

Governor Gavin Newsom Secretary, Government Operations Agency Amy Tong

Director Eraina Ortega

INVITATION FOR BID

IFB #23-100-03

Ergonomic Services

Notice to Prospective Bidders

You are invited to review and respond to the California Department of Human Resources (CalHR), hereinafter referred to as “Invitation for Bid (IFB) #23-100-03, ERGONOMIC SERVICES. In submitting your bid, you must comply with these instructions found herein.

Note that all agreements entered into with CalHR will include by reference General Terms and Conditions and Contractor Certification Clauses that may be viewed and downloaded at the Internet site: https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services- Resources-List-Folder/Standard-Contract-Language

Bidders are encouraged to carefully read the entire solicitation. The need to verify all documentation and responses prior to the submission of bids is the responsibility of the bidder and cannot be overemphasized. Please ensure insurance requirements and, if applicable, prevailing wages are considered in your bid amounts.

It is the opinion of CalHR that this IFB is complete and without need of explanation. However, if you have questions, or need any clarifying information, the contact person for this IFB is:

Marcos Hernandez Department of Human Resources Administrative Services Division admin.contracts@calhr.ca.gov

Please submit questions, including requests for hard copies of IFB documents, to the email address listed above referencing the IFB number in the subject line of the email. Note that no verbal information given will be binding upon the State unless such information is issues in writing as an official addendum. Questions via phone calls or in person are not accepted.

Any attempt by a bidder to initiate contact with any member of CalHR staff, other than the CalHR Contract Analyst, regarding this IFB may disqualify the Bidder from further consideration.

RESPONSES TO THE IFB MAY BE SUBJECT TO DISCLOSURE PURSUANT TO THE

CALIFORNIA PUBLIC RECORDS ACT. Any trademark or propriety information must be expressly marked as such.

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

ERGONOMIC SERVICES

TABLE OF CONTENTS

A. PURPOSE AND DESCRIPTION OF SERVICES

B. BIDDER MANDATORY QUALIFICATIONS

C. SUBCONTRACTING PROVISIONS

D. BID REQUIREMENT INFORMATION

1. KEY ACTION DATES

2. WRITTEN QUESTIONS

3. SUBMISSION OF BID

4. REJECTION OF BID SUBMISSIONS

5. EVALUATION AND SELECTION

6. AWARD AND PROTEST

7. DISPOSITION OF BIDS

8. PERFORMANCE OF SERVICE

9. TAX DELINQUENT STATUS VERIFICATION

E. PREFERENCE AND INCENTIVE PROGRAMS

1. SMALL BUSINESS ENTERPRISE PREFERENCE PROGRAM

2. DISABLED VETERAN BUSINESS ENTERPRISE INCENTIVE

3. TARGET AREA CONTRACT PREFERENCE ACT

4. APPLYING PREFERENCE AND INCENTIVES

F. REQUIRED ATTACHMENTS

ATTACHMENT 1 - REQUIRED ATTACHMENT CHECKLIST

ATTACHMENT 2 - BID/BIDDER CERTIFICATION SHEET BID/BIDDER CERTIFICATION SHEET

ATTACHMENT 3 - CONTRACTOR CERTIFICATION CLAUSES

ATTACHMENT 4 - DARFUR CONTRACTING ACT CERTIFICATION

ATTACHMENT 5 - PAYEE DATA RECORD, STD 204 & STD 205

ATTACHMENT 6 - BIDDER DECLARATION SHEET, GSPD-05-105

ATTACHMENT 7 - COST SHEET

ATTACHMENT 8 - REFERENCES

ATTACHMENT 9 - CALIFORNIA CIVIL RIGHTS LAWS CERTIFICATION

ATTACHMENT 10 - TARGET AREA CONTRACT PREFERENCE ACT, STD 830 AND DGS/PD 526

ATTACHMENT 11 - SAMPLE AGREEMENT

A. PURPOSE AND DESCRIPTION OF SERVICES

The California Department of Human Resources, hereinafter referred as “CalHR” is soliciting offers for ergonomic evaluation services to be performed in our offices at 1515 S Street Sacramento on an “as needed” basis in accordance with the Scope of Work described in Exhibit A - Scope of Work. All costs for services will be based upon the Offeror’s response and all terms and conditions that are attached.

B. BIDDER MANDATORY QUALIFICATIONS

Each employee who will conduct work under this agreement must have:

A. At least a bachelor’s degree in any field or an associate in safety, health or the environment or a closely related field; or

B. Must be certified by an accredited certification program such as Board of Board of Certification in Professional Ergonomics (BCPE), Board of Certified Safety Professionals (BCSP), Oxford Research Institute, National Commission for Certifying Agencies (NCCA) or American National Standards Institute (ANSI); or

C. At least four (4) years of experience where safety is at least 50%, preventative, professional level with breadth and depth of safety duties and one of the following credentials: Certified Ergonomics Assessment Specialist (CEAS), (CAE), Associate Safety Professionals (ASP), Certified Industrial Hygienist (CIH), Chartered Member of the Institution of Occupational Safety and Health (CMIOSH), Canadian Registered Safety Professional (CRSP), Graduate Safety Practitioner (GSP), SISO Academy, National Examination Board in Occupational Safety and Health (NEBOSH) or International Diploma in Occupational Health and Safety, Diploma in Industrial Safety from Central Labor Institute (CLI)/Regional Labor Institute (RLIs) of the Government of India. Bidder qualifications and licensing requirements, if any, are referenced in Exhibit A, Statement of Work.

C. SUBCONTRACTING PROVISIONS

Subcontracting Provisions, if allowable, are referenced in Exhibit A, Statement of Work.

D. BID REQUIREMENT INFORMATION

1. KEY ACTION DATES

The following dates are set forth for informational and planning purposes only and are subject to change:

ACTION

DATE AND TIME

IFB Available to Prospective Bidders 3/25/2024

Deadline to Submit Questions 4/1/2024 at 3:00 PM (PST)

Responses to Questions 4/3/2024 at 3:00 PM (PST)

Final Date for Submission of Bid 4/8/2024 at 1:00 PM (PST)

Bid Opening 4/8/2024 at 2:00 PM (PST)

Proposed Award Date 4/12/2024

Term Start Date 4/15/2024, or upon approval, whichever is later, Term End Date of Agreement June 30, 2025

2. WRITTEN QUESTIONS

Bidders are solely responsible for understanding the scope of work and all requirements, terms, conditions, evaluation criteria, etc., before submitting a bid. If the language is unclear or ambiguous, it is the Bidder’s responsibility to request clarification or assistance before submitting a bid. Bidders may submit questions via email to admin.contracts@calhr.ca.gov referencing the IFB number in the subject line of the email. To ensure a response, questions must be received by the date given in Key Action Dates.

Question and Answer Sets will be provided to all Bidders without identifying the submitters and will be posted as an official document.

3. SUBMISSION OF BID

a) All bids must be submitted electronically and received by CalHR by the date and time shown in Key Action Dates.

b) Bids must be delivered by emailing admin.contracts@calhr.ca.gov by the proposal submission deadline. It is up to the Bidder to ensure that electronic documents are viewable by CalHR (provide in standard MS Office and/or Adobe formats for example).

c) Bids must bear a signature, on all documents requiring a signature, of a person authorized to bind the bidding firm.

d) It is the Bidder’s responsibility for ensuring that the bid is received by the submission deadline. Any bid received after the scheduled closing time for the receipt of bids will not be considered.

mailto:admin.contracts@calhr.ca.gov

e) All bids shall include the documents identified in Attachment 1, Required Attachment Checklist. Bids not including the proper "required attachments" shall be deemed non-responsive. A non-responsive bid is one that does not meet the basic bid requirements.

f) Bids must be submitted for the performance of all the services described herein. Any deviation from the work specifications will not be considered and will cause a bid to be rejected.

g) Costs incurred for developing bids and in anticipation of award of the agreement are entirely the responsibility of the bidder and shall not be charged to CalHR.

h) An individual who is authorized to bind the bidder contractually shall sign Attachment 2, Bid/Bidder Certification Sheet. The signature shall indicate the title or position that the individual holds in the firm. An unsigned bid will be rejected.

i) A bidder may modify a bid after its submission by withdrawing its original bid and resubmitting a new bid prior to the bid submission deadline. Bidder modifications offered in any other manner, oral or written, will not be considered.

j) A bidder may withdraw its bid by submitting a written withdrawal request to CalHR, signed by the bidder or an authorized agent. A bidder may thereafter submit a new bid prior to the bid submission deadline. Bids may not be withdrawn without cause subsequent to bid submission deadline.

k) CalHR 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.

l) Where applicable, the bidder should carefully examine work sites and specifications.

Bidder shall investigate conditions, character, and quality of surface or subsurface materials or obstacles that might be encountered. No additions or increases to the agreement amount will be made due to a lack of careful examination of work sites and specifications.

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

n) Introduction letters, expensive bindings, colored displays, promotional materials, etc., should not be included in the bid submission. Emphasis should be concentrated on conformance to the IFB instructions, responsiveness to the IFB requirements and completeness and clarity of content.

4. REJECTION OF BID SUBMISSIONS

a) A bid submission not received by the date and time specified in Key Action Dates will be rejected.

b) The bid submission must not contain false or misleading statements, or provide references which do not support an attribute or condition claimed by the Bidder. If, in the opinion of CalHR, such information was intended to mislead CalHR 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 submission.

c) Deviations in the bid submission, whether or not intentional, may cause the bid submission to be non-responsive and not considered for award.

d) Unless previously approved by the State through the written questions process identified in Section 2, any material submitted by any Bidder in the final bid submission that is marked “CONFIDENTIAL” or “PROPRIETARY” will cause the entire bid submission to be deemed non-responsive and rejected.

e) CalHR does not accept alternate contract language from a prospective Contractor. A bid with such language will be considered a counter proposal and will be rejected.

Additionally, the General Terms and Conditions are not negotiable.

f) CalHR is not required to award a contract. CalHR reserves the right to reject any or all bids and to waive informalities and minor irregularities in bids received and to accept all or any portion of a bid, if deemed in the best interest of the State and not contrary to law.

CalHR’ waiver of any immaterial deviation or defect will in no way modify the IFB documents or excuse the contractor from full compliance with the IFB specification, if awarded the contract.

g) A bid may be rejected if it is conditional or incomplete, or if it contains any alterations of form or other irregularities of any kind.

5. EVALUATION AND SELECTION

a) The bid opening will be held via conference call. To receive conference call dial-in instructions contact admin.contract@calhr.ca.gov prior to opening date and time.

b) During the bid opening, CalHR will read aloud and record the Bidder’s Name and their

Grand Total Combined Amount from the Attachment 7, Cost Sheet

c) The CalHR Contract Analyst will further verify and evaluate the bid submissions as described in the IFB to determine lowest responsive responsible bidder. The further review may include, but is not limited to:

1) Validation of References;

2) Cost Sheet calculations have been verified;

3) SB Preferences have been evaluated, confirmed and calculated;

4) DVBE Participation Incentives have been evaluated, confirmed and calculated;

5) Largest tax delinquents eligibility confirmed;

6) Corporate standing has been verified with State of California, Secretary of

State; and

7) Commercially Useful Function (CUF) analysis

8) Verification of required documents mailto:admin.contract@calhr.ca.gov

d) During further review, if any of the required documents are missing, incomplete, modified or contain alterations, the evaluation committee may reject the bid submission as non-responsive.

e) The documents provided by the Contractor in their bid submission enable CalHR to evaluate for responsiveness. CalHR reserves the right to ask clarifying questions during evaluation.

f) CalHR will determine the validity of references and signatory authority of winning bidder prior to awarding contract or posting Notice of Intent to Award.

g) Nothing in this section will require the awarding of the contract if no bids are received offering a contract price that, in the opinion of CalHR, is a reasonable price.

6. AWARD AND PROTEST

a) Contract award, if made, will be awarded to the Bidder whose bid has the lowest responsive responsible submission.

b) In the event of a tie, representatives of CalHR will flip a coin to determine the winning bidder. The coin flip will be witnessed and documented by two (2) or more CalHR employees.

c) Whenever an Agreement is awarded under a procedure which provides for competitive bidding, but the Agreement is not to be awarded to the low bidder, the low bidder shall be notified by email five (5) working days prior to the award of the Agreement.

d) Upon written request by any bidder, notice of the proposed award shall be posted in a public place in the lobby of the CalHR Headquarters at least five (5) working days prior to awarding the Agreement.

e) In addition to the public posting at the above-mentioned lobby, the notice will simultaneously be posted online for the same five (5) business days on the CalHR webpage for this solicitation.

f) If any bidder, prior to the award of Agreement, files a protest with the Department of General Services (DGS), Office of Legal Services, and CalHR on the grounds that the (protesting) bidder is the lowest responsible bidder, the Agreement shall not be awarded until either the protest has been withdrawn or DGS has decided the matter (Public Contract Code§10345).

g) Within five (5) days after filing the initial protest, the protesting bidder shall file with DGS and CalHR a detailed written statement specifying the grounds for the protest. The written protest must be sent to the:

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

A copy of the detailed written protest should be mailed to CalHR, Contracts Manager, 1515 S Street Suite 500N, Sacramento, CA 95811 or emailed to admin.contracts@calhr.ca.gov.

It is suggested that any protest be sent certified or registered mail.

7. DISPOSITION OF BIDS

a) Upon bid opening, all documents submitted in response to this IFB will become the property of the State of California, and will be regarded as public records under the California Public Records Act (Gov. Code § 6250 et seq.) and subject to review by the public.

8. PERFORMANCE OF SERVICE

a) Upon award of the contract, the winning Bidder must provide a Certificate of Insurance (COI) within ten (10) working days from award of contract. This COI will identify the required insurance as indicated in the attached Sample Standard Agreement (STD 213), Exhibit D, Additional Provisions.

b) Upon award of the contract, the winning Bidder agrees to execute the contract on the State’s Standard Agreement (STD 213), including all Exhibits. The Agreement must be signed by an individual authorized to bind the firm contractually.

9. 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 websites 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 Delinquent Tax Payers https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/corporate-income-tax-list.html mailto:OLSProtests@dgs.ca.gov http://www.cdtfa.ca.gov/taxes-and-fees/top500.htm https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/corporate-income-tax-list.html https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/corporate-income-tax-list.html https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/corporate-income-tax-list.html

E. PREFERENCE AND INCENTIVE PROGRAMS

Preference and Incentive Programs are each identified below. When the Bidder satisfies the requirements and requests bid preferences and incentives, the Bidder must clearly identify in their bid submission for which of the programs it qualifies. Denial of those preference or incentive requests is not a basis for rejection of the bid.

1. SMALL BUSINESS ENTERPRISE PREFERENCE PROGRAM

California Government Code (GC) section 14835, et seq., requires a preference be given to Bidders who are California Certified Small Business (SB). The rules and regulations of this law, including the definition of a SB for the delivery of goods and services, are contained in California Code of Regulations, title 2, section 1896 et seq.

a) A 5% preference, (not to exceed $50,000) is available to a certified SB. A Bidder claiming this preference must be certified by the Office of Small Business and Disabled Veteran Enterprise Services (OSDS) as a SB. Questions regarding certification should be directed to the OSDS at (916) 375-4940.

To be considered as a certified SB, the Bidder must have a complete application package on file with the OSDS by 5:00 p.m. on the Deadline for IFB Submission.

Questions regarding the certification approval process should be directed to the OSDS.

A copy of the regulations, instructions and format for claiming the Small Business Preference is available at:

https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement- Division-Services-List- Folder/Certify-or-Re-apply-as-Small-Business- Disabled-Veteran-Business-Enterprise

To claim the Small Business Preference please see Attachment 6, Bidder Declaration

(GSPD-05-105).

NOTE: Pursuant to GC 14837, only a SB who performs a commercially useful function relevant to the Scope of Work included in this IFB may qualify the Bidder for a SB preference.

b) Non-Small Business Subcontractor Preference (if subcontracting is allowable in Exhibit A, Statement of Work):

A 5% preference, (not to exceed $50,000) is available to a non-small business (NS) claiming 25% California-certified small business subcontractor participation. A Bidder claiming this preference must list one or more SB subcontractor(s), whom the Bidder commits to subcontract in an amount of at least twenty-five percent (25%) of the work performed under this contract.

To claim the Small Business Preference please see Attachment 6, Bidder Declaration

(GSPD-05-105).

NOTE: Pursuant to GC 14837, only a SB who performs a Commercially Useful Function (CUF) http://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-mailto:Disabled-Veteran-Business-Enterprise%23@ViewBag.JumpTo relevant to the Scope of Work included in this IFB may be used to qualify the Bidder for the Non-Small Business Subcontractor Preference.

2. DISABLED VETERAN BUSINESS ENTERPRISE INCENTIVE

It is the intent of the California Legislature that every State procurement authority honor California’s disabled veterans by taking all practical actions necessary to meet or exceed the Disabled Veteran Business Enterprise participation goal of a minimum of three percent (3%) of total contract value. The Disabled Veteran Business Enterprise (DVBE) Certification and Outreach Branch program was created for this purpose. Under Senate Bill 115, Section 999.5, an incentive program was established.

CalHR shall waive the DVBE participation requirement for this solicitation. However, pursuant to Military and Veterans Code Section 999.5, subdivision (a), an incentive will be given to a Bidder who provides DVBE participation.

The DVBE Incentive is as follows:

Confirmed DVBE Participation

(Bidder Declaration)

Incentive Amount

5% or Over 5%

4% to 4.99% Inclusive 4%

3% to 3.99% Inclusive 3%

2% to 2.99% Inclusive 2%

1% to 1.99% Inclusive 1%

A Bidder is eligible to receive this additional DVBE incentive if they are a certified DVBE or if a non DVBE Bidder commits to use a certified DVBE(s) as subcontractor(s) (if subcontracting is allowable in Exhibit A, Statement of Work).

c) Certified DVBE Bidder additional incentive considerations:

1) Commit to performing 1% or more of the contract bid value with the prime bidders’ firm or in combination with another DVBE(s)

2) Document DVBE participation on the Bidder Declaration GSPD-05- 105, Attachment 6.

3) At the CalHR’ option a DVBE Bidder working in combination with other DVBE(s) will submit proof of its commitment by submitting a written confirmation from the DVBE(s) identified as a subcontractor on the Bidder Declaration GSPD-05-105. When requested, the written confirmation must be submitted within the timeframe identified in the notification. Failure to submit the written confirmation as specified may be grounds for bid rejection.

d) Non-DVBE Bidder additional incentive considerations:

1) Commit to using certified DVBE(s) for 1% or more of the bid value.

2) Document DVBE participation on the Bidder Declaration GSPD-05- 105, Attachment 6.

3) At the CalHR’ option prior to contract award, a Bidder is to submit proof of its commitment by submitting a written confirmation from each DVBE identified as a subcontractor on the Bidder Declaration GSPD-05-105.

When requested, the document(s) must be submitted within the timeframe identified in the notification. Failure to submit the written confirmation as specified may be grounds for bid rejection.

NOTE: Pursuant to Military and Veterans Code section 995.5, only a DVBE who performs a Commercially Useful Function (CUF) relevant to the Scope of Work included in this IFB may qualify the Bidder or be used to qualify the Bidder for a DVBE participation and/or DVBE incentive.

e) Locating DVBE Subcontractors

1) State Resources: Access the list of all certified DVBEs by using the Department of General Services, Procurement Division (DGS-PD), online certified firm database at: www.caleprocure.ca.gov

To begin your search, click on “Small Business/Disabled Veteran Business Enterprise,” then click “Search for Certified SB/DVBE Firms.” Search by “Keywords” or “UNSPSC Classifications” that apply to the elements of work you want to subcontract to a DVBE.

Check for subcontractor ads that may be placed on the California State Contracts Register (CSCR) for this solicitation prior to the closing date. You may access the CSCR at:

www.caleprocure.ca.gov. For questions regarding the online certified firm database and the CSCR, please call the OSDS at (916) 375-4940 or send an email to:

OSDSHelp@dgs.ca.gov

3. TARGET AREA CONTRACT PREFERENCE ACT

In accordance with California Code, Section 4530, bidders may be eligible for a preference whenever contracts for goods or services are in excess of $100,000 and the bidders meet certain requirements as defined in the California Administrative Code (Title 2, Section 1896 et seq.) regarding labor needed to provide the services being procured. Bidders may receive extra consideration depending on what parts of the preference they claim. Full details can be found on the STD 830 form itself. Bidders desiring to claim this preference must submit a full executed copy of the STD 830 form and

DGS/PD 526.

https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division- Services-List- Folder/Request-a-Target-Area-Contract- Preference#@ViewBag.JumpTo https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0526.pdf

Bidders’ questions regarding this preference are to be directed to:

http://www.caleprocure.ca.gov/ http://www.caleprocure.ca.gov/ mailto:OSDSHelp@dgs.ca.gov http://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-mailto:Preference%23@ViewBag.JumpTo http://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0526.pdf

Department of General Services Dispute Resolution Unit 707 3rd Street, 2nd Floor West Sacramento, CA 95605 tacpa@dgs.ca.gov

4. APPLYING PREFERENCE AND INCENTIVES

a) Preferences and incentives are used for bid tabulation purposes to determine the lowest responsive responsible bidder. Strict adherence to the laws and regulations to apply the preferences and incentives will be followed. If awarded the contract, the preference and/or incentive does not alter the amount of the resulting contract. Please be aware that contracts awarded with applied preferences or incentives will be monitored throughout the life of the contract for compliance to statutory, regulatory and contractual requirements.

b) The SB preference of 5% will be applied when a responsible Bidder that is not a CA certified SB or a NS claiming 25% CA certified SB subcontractor participation submits the lowest responsive responsible bidder proposal. (Note: NS claiming SB subcontractor preference cannot remove an award from a certified SB.)

c) The DVBE incentive will be applied to each qualified Bidder’s verified DVBE participation percentage from the number 1 ranked lowest responsive responsible bidder proposal, regardless if Bidder is an SB/DVBE. If a SB is ranked number 1 after SB preference has been applied, the DVBE incentive is only calculated for Bidders certified as SBs.

d) The TACPA preference will be applied after the SB preference and the DVBE incentive.

mailto:tacpa@dgs.ca.gov

F. REQUIRED ATTACHMENTS

1. Required Attachment Checklist

2. Bid/Bidder Certification Sheet

3. Contractor Certification Clauses

4. Darfur Contracting Act Certification

5. Payee Data Record, STD 204 & STD 205

6. Bidder Declaration Sheet, GSPD-05-105

7. Cost Sheet

8. References

9. California Civil Rights Laws Certification

10. TACPA, STD 830 and DGS/PD 526, if applicable

11. Sample Agreement (reference only)

ATTACHMENT 1 - REQUIRED ATTACHMENT CHECKLIST

A complete bid or bid package will consist of the items identified below. Complete this checklist to confirm the items in your bid. Place a check mark or “X” next to each item that you are submitting to CalHR. For your bid to be responsive, all required attachments must be returned.

Company Name:

ATTACHMENT REQUIRED ATTACHMENT NAME

Attachment 1 YES Required Attachment Checklist

Attachment 2 YES Bid/Bidder Certification Sheet

Attachment 3 YES Contractor Certification Clauses

Attachment 4 YES Darfur Contracting Act Certification

Attachment 5 YES Payee Data Record, STD 204

( & optionally STD 205)

Attachment 6 YES Bidder Declaration Sheet, GSPD-05-105

Attachment 7 YES Cost Sheet

Attachment 8 YES References

Attachment 9 YES California Civil Rights Laws Certification

Attachment 10

YES/NO, if applicable

TACPA, STD 830 and DGS/PD 526

ATTACHMENT 2 - BID/BIDDER CERTIFICATION SHEET BID/BIDDER CERTIFICATION SHEET

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

A. Our all-inclusive bid is submitted as detailed in Attachment 7, Cost 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. Fax Number

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 and DVBE Certification (OSDC) as:

a. California Small Business b. Disabled Veteran Business Enterprise

Yes No Yes No

If yes, enter your service code below: If yes, enter certification number:

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 OSDC, if an application is pending:

IFB 23-100-03

Ergonomic Services

Completion Instructions for Bid/Bidder Certification Sheet

Complete the numbered items on the Bid/Bidder Certification Sheet by following the instructions below.

Item Numbers

Instructions

1, 2, 2a, 3 Must be completed. These items are self-explanatory.

4 Check if your firm is a sole proprietorship. A sole proprietorship is a form of business in which one person owns all the assets of the business in contrast to a partnership and corporation.

The sole proprietor is solely liable for all the debts of the business.

Check if your firm is a partnership. A partnership is a voluntary agreement between two or more competent persons to place their money, effects, labor, and skill, or some or all of them in lawful commerce or business, with the understanding that there shall be a proportional sharing of the profits and losses between them. An association of two or more persons to carry on, as co-owners, a business for profit.

Check if your firm is a corporation. A corporation is an artificial person or legal entity created by or under the authority of the laws of a state or nation, composed, in some rare instances, of a single person and his successors, being the incumbents of a particular office, but ordinarily consisting of an association of numerous individuals.

7 Enter your federal employee tax identification number.

Enter your corporation number assigned by the California Secretary of State’s Office. This information is used for checking if a corporation is in good standing and qualified to conduct business in California.

Complete, if applicable, by indicating the type of license and/or certification that your firm possesses and that is required for the type of services being procured.

10, 11, 12, 13

Must be completed. These items are self-explanatory.

If certified as a California Small Business, place a check in the "Yes" box, and enter your certification number on the line. If certified as a Disabled Veterans Business Enterprise, place a check in the "Yes" box and enter your service code on the line. If you are not certified to one or both, place a check in the "No" box. If your certification is pending, enter the date your application was submitted to OSDC.

IFB #23-100-02

ATTACHMENT 3 - CONTRACTOR CERTIFICATION CLAUSES

A Bidder must complete the Contractor Certification Clauses located at the following internet site:

https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/CCC-042017.pdf

ATTACHMENT 4 - DARFUR CONTRACTING ACT CERTIFICATION

A Bidder must complete the Darfur Contracting Act Certification located at the following internet site:

https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/PD_1.pdf https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/CCC-042017.pdf https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/CCC-042017.pdf http://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/PD_1.pdf

ATTACHMENT 5 - PAYEE DATA RECORD, STD 204 & STD 205

A Bidder must complete the Payee Data Record and the Supplement form (as needed), located at the following internet sites:

https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std205.pdf http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std205.pdf

ATTACHMENT 6 - BIDDER DECLARATION SHEET, GSPD-05-105

A Bidder must complete the Bidder Declaration, located at the following internet site:

https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf

When completing the declaration, if subcontracting is allowable in Exhibit A, Statement of Work, Bidders must identify all subcontractors proposed for participation in the contract. Bidders awarded a contract are contractually obligated to use the subcontractors for the corresponding work identified unless the State agrees to a substitution and it is incorporated by amendment to the contract.

http://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf

Contractor Name-TBD

ATTACHMENT 7 - COST SHEET

Scope Cost

Proactive Ergonomic Assessment Employee with no reported physical discomfort.

Service includes scheduling, 30 to 40-minute onsite assessment time, report writing, email follow-up and ,travel and applicable parking fees. Please Note:

Additional 5 minutes is included in the above time estimate to navigate between floors and cubicle locations at the site.

Per assessment

Preventative Ergonomic Assessment Employees with reported discomfort.

Service includes scheduling, 45 to 60 minutes onsite assessment time, report writing, travel and applicable parking fees. Please Note: Additional 5 minutes is included in the above time estimate to navigate between floors and cubicle locations at the site. Reports includes photographic documentation within the written report.

Per assessment

Follow-up for Preventative Ergonomic Assessment

Service includes scheduling, 20 to 35-minute onsite time, updated report writing, travel and applicable parking fees.

Please Note: Additional 5 minutes is included in the above time estimate to navigate between floors and cubicle locations at the site.

Per hour

Reasonable Accommodation/Workers Compensation Ergonomic Assessment Service includes scheduling, onsite time, report writing, email and/or onsite follow-up

Per assessment

ATTACHMENT 8 - REFERENCES

List three (3) clients served in the past five (5) years for which the bidding firm provided similar services. List the most recent first. References should provide evidence that Contractor meets the minimum qualifications as stated in this IFB and provides similar services as stated in SOW, Exhibit A.

REFERENCE 1

Name of Firm

Street Address City State Zip Code

Contact Person Telephone Number

Email Address

Dates of Service Value or Cost of Service

Brief Description of Service Provided

REFERENCE 2

Street Address City State Zip Code

Contact Person Telephone Number

Email Address

REFERENCE 3

Street Address City State Zip Code

Contact Person Telephone Number

Email Address

ATTACHMENT 9 - CALIFORNIA CIVIL RIGHTS LAWS CERTIFICATION

A Bidder must complete the California Civil Rights Laws Certification located at the following internet site:

https://www.dgs.ca.gov//-/media/Divisions/PD/PTCS/OPPL/SCM/SCM-Link-Docs/california-civil-rights-laws-attachment.docx https://www.dgs.ca.gov/-/media/Divisions/PD/PTCS/OPPL/SCM/SCM-Link-Docs/california-civil-rights-laws-attachment.docx https://www.dgs.ca.gov/-/media/Divisions/PD/PTCS/OPPL/SCM/SCM-Link-Docs/california-civil-rights-laws-attachment.docx

ATTACHMENT 10 - TARGET AREA CONTRACT PREFERENCE ACT, STD 830 and DGS/PD 526

A bidder must complete the Target Area Contract Preference Act, STD 830 and DGS/PD 526, if applicable, located at the following internet site:

DGS TACPA Information:

https://tacpa.dgs.ca.gov/Home/About

Std 830:

https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std830.pdf

DGS/PD 526:

https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0526.pdf https://tacpa.dgs.ca.gov/Home/About http://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0526.pdf

ATTACHMENT 11 - SAMPLE AGREEMENT

Note to Bidders: The following pages represent a sample of the Agreement that will be awarded, if any, from this IFB. Please review it carefully and present any questions in writing to the contact identified for this IFB.

SCO ID:

State of California-Department of General Services

STANDARD AGREEMENT

STD 213 (Rev. 03/2020)

AGREEMENT NUMBER PURCHASING NUMBER (if applicable)

CalHR-7501

1. This Agreement is entered into between the Contracting Agency and the Contractor named below:

CONTRACTING AGENCY NAME

Department of Human Resources

CONTRACTOR NAME

2. The term of this Agreement is:

START DATE

Click here to enter a date.

END DATE

Click here to enter a date.

This Agreement shall not become effective until approved by the Department of Human Resources

3. The maximum amount of this Agreement is:

$ .00 Dollars and Zero Cents

4. The parties agree to comply with the terms and conditions of the following exhibits, which are by this reference mad a part of the

Agreement.

EXHIBITS TITLE PAGES

Exhibit A Scope of Work

Attachment 1 Resumes

Exhibit B Budget Detail and Payment Provisions

Attachment 1 Contractor Rates

Exhibit C* General Terms and Conditions GTC 417

Exhibit D Special Terms and Conditions

Exhibit E Additional Provisions Items shown with an asterisk (*), are hereby incorporated by reference and made part of this agreement as if attached hereto.

These documents can be viewed at https://www.dgs.ca.gov/OLS/Resources

IN WITNESS WHEREOF, THIS AGREEMENT HAS BEEN EXECUTED BY THE PARTIES HERETO.

CONTRACTOR

CONTRACTOR NAME (if other than an individual, state whether a corporation, partnership, etc.)

CONTRACTOR BUSINESS ADDRESS CITY STATE ZIP

PRINTED NAME OF PERSON SIGNING TITLE

CONTRACTOR AUTHORIZED SIGNATURE DATE SIGNED

STATE OF CALIFORNIA

CONTRACTING AGENCY NAME

Department of Human Resources

CONTRACTING AGENCY ADDRESS CITY STATE ZIP

1515 S Street, Suite 500N Sacramento CA 95811

PRINTED NAME OF PERSON SIGNING TITLE

AUTHORIZED SIGNATURE DATE SIGNED

CALIFORNIA DEPARTMENT OF GENERAL SERVICES APPROVAL EXEMPTION, IF APPLICABLE

Sample Contract https://www.dgs.ca.gov/OLS/Resources

EXHIBIT A STATEMENT OF WORK (SOW)

1. OBJECTIVE

The Contractor shall provide the Department of Human Resources (CalHR) with ergonomic services.

2. LOCATION

Services may be performed at, but are not limited to, the following location:

CA Department of Human Resources 1515 S Street, Suite 500N, Sacramento 95811

3. CONTRACTOR TASKS AND RESPONSIBILITIES

The Contractor will provide the following ergonomic service options described below as deemed necessary and appropriate.

Proactive Ergonomic Evaluation (PRO): This service is primarily used as a proactive measure for employees to ensure that their workstation is arranged appropriately to fit their stature and that they have no exposure for musculoskeletal injury. The PRO takes approximately 35 minutes on-site per employee to complete and an additional 35 minutes per employee to document the findings in an Excel report format. The PRO workstation evaluation includes workstation measurements for desktop; chair; and monitor heights to establish the correct fit between the employee and their office furniture; identification of ergonomic risk factors (if any); and the implementation of equipment adjustments (if needed) in the employee’s workstation. Findings, adjustments made, and recommendations of ergonomic tools will be documented in an Excel report.

Preventative Ergonomic Workstation Evaluation (PREE): The PREE provides an in-depth assessment of the employee and their workstation environment. This type of evaluation can identify ergonomic risk factors that may not manifest during the limited ergonomic evaluation, and allows the ergonomic evaluator to more fully investigate the situation and develop employee-specific recommendations to address their risk factors. The Preventative Ergonomic Workstation Evaluation (PREE) takes approximately 45 to 60 minutes for the on-site assessment and an additional 45 to 60 minutes for the written report documenting our findings. Recommended for individuals that have indicated that they are experiencing work-related physical discomfort.

Reasonable Accommodation/Workers Compensation Ergonomic Assessment and Written Report (if needed): The Workers Compensation Ergonomic Assessment takes approximately 60 to 90 minutes for the on-site assessment (depending on the work environments) and an additional 90 to 180 minutes for the written report documenting our findings. The Workers Compensation Ergonomic Assessment is recommended for individuals that have filed a claim and due to work related discomfort and may also be on a return to work program via a physician’s directive. The Workers Compensation Ergonomic Assessment provides an in-depth assessment of the employee and their workstation environment. This type of evaluation will identify the root cause of the ergonomic risk factor exposure to the employee (what caused the injury in the first place) and pinpoint precise and immediate recommendations to mitigate all ergonomic risk factor exposure to the employee as part of the return to work protocol. The report of findings will include all pertinent employee background and history, treatment protocols, medical treatment received, VAS measurements, Functional Limitations, Physicians letter, and all correspondence with the MD, Adjustor, and PT/OT treatment team (as necessary).

Follow-up ergonomic evaluations for current employees who have already received initial evaluation and recommended ergonomic equipment.

Initial ergonomic evaluations and follow-up ergonomic evaluations for new employees once they have received all recommended ergonomic equipment. Most follow-ups take approximately 15 to 30 minutes to perform. With individuals who received an initial evaluation due to physical discomfort, a follow-up may take up to 45 minutes. Report updates to their existing reports take approximately 30 minutes which includes report narrative updates, products updates (if necessary, pdf and report distribution, updating spreadsheet tracking). With individuals who received an initial evaluation due to physical discomfort, a report update may take up to 45 minutes.

4. AUTHORIZED REPRESENTATIVES

The authorized representatives during the term of this Agreement are identified in the tables below. Changes to the Authorized Representatives are allowed without contract amendment via written notice to the representatives identified below.

For service-related inquiries:

CA Department of Human Resources Contractor-TBD

NAME: Robin Long, Contract Manager

NAME: TBD

ADDRESS: 1515 S Street, Suite 500N Sacramento, CA 95811

ADDRESS:

PHONE: (916) 909-3730 PHONE:

EMAIL: robin.long@calhr.ca.gov EMAIL:

For Agreement administrative inquiries:

CA Department of Human Resources Contractor-TBD

NAME: Marcos Hernandez, Contract Analyst

NAME: TBD

ADDRESS: 1515 S Street, Suite 500N Sacramento, CA 95811

ADDRESS:

PHONE: (916) 909-3282 PHONE:

EMAIL: admin.contracts@calhr.ca.gov EMAIL:

mailto:robin.long@calhr.ca.gov

Ergonomic Services Agreement

EXHIBIT B

BUDGET DETAIL AND PAYMENT PROVISIONS

1. INVOICING AND PAYMENT

Contractor shall submit three copies of the invoice to the State only after receiving verbal or written notice of satisfactory completion or acceptance of work by the CalHR Contract Manager. The State will not accept an invoice for work that has not been approved and will return the invoice as a disputed invoice to the Contractor.

Invoices shall be submitted no more often than monthly, in arrears, bearing the contract number.

Small business contractors must identify their certified small business status on the invoice.

Contractor must submit three copies of each invoice to the following address in order to expedite approval and payment:

CalHR Accounting Office Attn: Accounts Payable

1515 S Street, Room 500, North Building Sacramento, California 95811

Undisputed invoices shall be paid within 45 days of the date received by the CalHR Accounting Office.

2. BUDGET CONTINGENCY CLAUSE

It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of no further force and effect. In this event, the State shall have no liability to pay any funds whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be obligated to perform any provisions of this Agreement.

If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State shall have the option to either: cancel this Agreement with no liability occurring to the State, or offer an Agreement Amendment to Contractor to reflect the reduced amount.

CalHR shall not pay any funds to any Contractor during such time as the Budget Act covering that fiscal year has not been approved by the Legislature and signed into law by the Governor.

3. PROMPT PAYMENT CLAUSE

Payment will be made in accordance with, and within the time specified in, Government Code Chapter 4.5, commencing with Section 927. This prompt payment clause shall only apply during such time as there exists a duly enacted Budget Act which authorizes payments for Departmental expenditures

EXHIBIT B-1 COST SHEET

CalHR makes no guarantee, expressed or implied, on the actual amount of services/hours that shall be required for this Agreement, and reserves the right to omit portions or quantities of work, as may be deemed necessary. The rates referenced below shall be binding for the term of the Agreement.

Scope Cost

Proactive Ergonomic Assessment Employee with no reported physical discomfort.

Service includes scheduling, 30 to 40-minute onsite assessment time, report writing, email follow-up and ,travel and applicable parking fees. Please Note:

Additional 5 minutes is included in the above time estimate to navigate between floors and cubicle locations at the site.

Per assessment

Preventative Ergonomic Assessment Employees with reported discomfort.

Service includes scheduling, 45 to 60 minutes onsite assessment time, report writing, travel and applicable parking fees. Please Note: Additional 5 minutes is included in the above time estimate to navigate between floors and cubicle locations at the site. Reports includes photographic documentation within the written report.

Per assessment

Follow-up for Preventative Ergonomic Assessment

Service includes scheduling, 20 to 35-minute onsite time, updated report writing, travel and applicable parking fees.

Please Note: Additional 5 minutes is included in the above time estimate to navigate between floors and cubicle locations at the site.

Per hour

Reasonable Accommodation/Workers Compensation Ergonomic Assessment Service includes scheduling, onsite time, report writing, email and/or onsite follow-up

Per assessment

EXHIBIT C

GENERAL TERMS AND CONDITIONS

The General Terms and Conditions (GTCs) are hereby incorporated by reference and can be accessed by visiting the following links:

Non-IT Services General Terms and Conditions (Rev. 04/2017):

https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/GTC-April-2017-FINAL.pdf https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/GTC-April-2017-FINAL.pdf

EXHIBIT D

SPECIAL TERMS AND CONDITIONS FOR THE DEPARTMENT OF HUMAN

RESOURCES

1. EXCISE TAX:

The State of California is exempt from Federal Excise Taxes, and no payment will be made for any taxes levied on employees' wages.

2. RESOLUTION OF DISPUTES:

In the event of a dispute, Contractor shall file a “Notice of Dispute” with the Director or the Director’s Designee within ten (10) days of discovery of the problem. The State and Contractor shall then attempt to negotiate a resolution of such claim and, if appropriate, process an amendment to implement the terms of any such resolution. If the State and Contractor are unable to resolve the dispute, the decision of the Director or the Director’s Designee shall be final, unless appealed to a court of competent jurisdiction.

1. In the event of a dispute, the language contained within this agreement shall prevail over any other language including that of the bid proposal.

3. PAYMENT RETENTION CLAUSE:

Ten percent of any progress payments that may be provided for under this contract shall be withheld per Public Contract Code Section 10346 pending satisfactory completion of all services under the contract.

4. AGENCY LIABILITY:

The Contractor warrants by execution of this Agreement, that no person or selling agency has been employed or retained to solicit or secure this Agreement upon agreement or understanding for a commission, percentage, brokerage, or contingent fee, excepting bona fide employees or bona fide established commercial or selling agencies maintained by the Contractor for the purpose of securing business. For breach or violation of this warranty, the State shall, in addition to other remedies provided by law, have the right to annul this Agreement without liability, paying only for the value of the work actually performed, or otherwise recover the full amount of such commission, percentage, brokerage, or contingent fee.

5. POTENTIAL SUBCONTRACTORS:

Nothing contained in this Agreement or otherwise shall create any contractual relation between the State and any subcontractors, and no subcontract shall relieve the Contractor of its responsibilities and obligations hereunder. The Contractor agrees to be as fully responsible to the State for the acts and omissions of its subcontractors and of persons either directly or indirectly employed by any of them as it is for the acts and omissions of persons directly employed by the Contractor.