IFB_MBC-25-02_Scanning_Services.pdf

INVITATION FOR BID

IFB MBC-25-02

Scanning Services

Notice to Prospective Bidders

February 10, 2026

To all Prospective Bidders:

You are invited to review and respond to this Invitation for Bid (IFB) MBC-25-02, entitled Scanning Services. In submitting your bid, you must comply with the instructions found herein.

Note that all agreements entered into with the State of California will include by reference General Terms and Conditions (GTC-04/2017) and Contractor Certification Clauses (CCC-04/2017) that may be viewed and downloaded at Internet site 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 obtained by contacting the person listed below.

In the opinion of the Medical Board of California (MBC), this IFB is complete and without need of explanation. However, if you have questions, or should you need any clarifying information, the contact person for this IFB is:

Achim Berras Department of Consumer Affairs

Business Services Office, Contracts Unit 1625 North Market Boulevard, Suite S-103

Sacramento, CA 95834 Achim.Berras@dca.ca.gov

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

Contract Administrator Department of Consumer Affairs 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 mailto:Achim.Berras@dca.ca.gov

TABLE OF CONTENTS

GENERAL INFORMATION

I. Purpose and Description of Services II. Term of Agreement III. Contact Person IV. Minimum Qualifications For Bidders V. Time Schedule VI. Written Questions or Inquiries VII. Submission of Bid VIII. Prohibition on Tax Delinquents IX. Loss Leader X. Evaluation and Selection Process XI. Award and Protest XII. Disposition of Bids XIII. Agreement Execution and Performance XIV. Bid Submission Requirements XV. Darfur Contracting Act Of 2008 XVI. Small Business Enterprise Preference XVII. Target Area Contract Preference Act (TACPA) XVIII.Disabled Veteran Business Enterprise Program (DVBE) Participation XIX. DVBE Incentive Option

ATTACHMENTS

Bidder Cost Sheet – Contract Years 1-3 Attachment 1 – Bidder Certification Sheet Attachment 2 – Bidder References Attachment 3 – Bidder Declaration Form Attachment 4 – Payee Data Record (STD 204) Attachment 5 – Contractor Certification Clauses Attachment 6 – Darfur Contracting Act Attachment 7 – IFB Checklist Attachment 8 – Small Business (SB) Preference Sheet & DVBE Incentive Instructions Attachment 9 – California Civil Rights Laws Certification Attachment 10 – Target Area Contract Preference Act (TACPA)

CONTRACT EXHIBITS

Exhibit A – Scope of Work Exhibit A, Attachment I – Medical Board of California Office Sites Exhibit A, Attachment II – Authorization for Release of Medical Information Exhibit A, Attachment III – Certification of Records Exhibit A, Attachment IV – Kaiser Authorization of Release of Information Exhibit A, Attachment V – Confidentiality Agreement Exhibit B – Budget Detail Payment and Provisions Exhibit B.1 – Cost Sheet Exhibit C – General Terms and Conditions Exhibit D – Special Terms and Conditions Exhibit E – Additional Terms and Conditions

I. PURPOSE AND DESCRIPTION OF SERVICES:

The Department of Consumer Affairs (DCA), Medical Board of California (MBC) is inviting responses from qualified, certified vendors to provide scanning services with on-site digitized photocopy and scanning services, to copy confidential medical records, diagnostic images, charts, depositions, and court documents.

The Board will consider offers from bidders who:

1. Meet the minimum qualifications as indicated in Article IV. Minimum Qualifications for

Bidders.

2. Can assist the Board in meeting its goals and objectives as indicated in the attached scope of work

3. Will maintain confidentiality of the data and reports.

II. TERM OF THE AGREEMENT:

DCA/MBC anticipates that the effective term of this agreement will be April 1, 2026 (or upon approval, whichever occurs later) through March 31, 2029.

III. CONTACT PERSON:

Responses and questions regarding bid requirements and information will be sent or directed to:

Business Services Office – Contracts Unit Attn: Achim Berras 1625 North Market Blvd., Suite S-103

Achim.Berras@dca.ca.gov

IV. MINIMUM QUALIFICATIONS FOR BIDDERS:

The following are the minimum qualifications for Bidders that respond to this IFB. Bidders must clearly demonstrate that these minimum qualifications are met in the Bidder Certification Sheet (Attachment 1) that will be included in the Bidder’s response to this IFB:

1. Must be in good standing and registered with the California Secretary of State and licensed to do business in the State of California.

2. Must have minimum of at least two (2) years of experience providing this type of service and must be able to provide three (3) references with at least one (1) being a state government or city/county entity.

V. TIME SCHEDULE:

Listed below are important dates and times by which specific actions must be taken or completed. If DCA/MBC finds it necessary to change any of these dates, it will be accomplished via an addendum to the IFB. Any dates that follow the final date for bid submission are only approximate and may be adjusted by DCA/MBC as conditions require without addendum to this IFB.

*Notice of intent to attend the Public Bid Opening will be sent to Achim.Berras@dca.ca.gov within 2 days of the response to written questions in order for DCA to secure a large enough conference room to accommodate all requests.

VI. WRITTEN QUESTIONS OR INQUIRIES:

Questions and issues regarding this IFB must be submitted electronically via e-mail to Achim Berras at Achim.Berras@dca.ca.gov by the date indicated in Article V – Time Schedule. Questions received after this date will only be addressed at DCA/MBC discretion.

If substantive changes to this IFB are deemed appropriate by the DCA/MBC as a result of questions received, an addendum will be issued. The addendum will become part of the

IFB.

This IFB may only be changed by written addendum. Any verbal representations made by the DCA/MBC staff are not binding on either the DCA/MBC or the bidder and cannot be interpreted as modifications or clarifications to this IFB.

VII. SUBMISSION OF BID:

1. Bids can be submitted electronically via e-mail to Achim Berras at Achim.berras@dca.ca.gov or they can be sent in a sealed envelope to the Department of Consumer Affairs, Contracts Unit by the date and time specified in the Article V – Time Schedule. The sealed envelope must be plainly marked “BID for IFB Scanning Services – IFB MBC-25-02, Attention: Achim Berras, Contracts Unit - DO NOT OPEN” and delivered to the address stated below.

Attn: Achim Berras

1625 N. Market Blvd., Suite S-103

Event Date/Time

IFB available to Bidders February 10, 2026

Final Date for submission of Written Questions February 19, 2026 @ 12:00pm

Response to Written Questions February 24, 2026

Final Date for Bid Submission Wednesday, March 4, 2026 @ 12:00pm

Public Bid/Cost Opening Thursday, March 5, 2026 @ 9:00am

Anticipated Agreement Start Date April 1, 2026 (or upon approval) mailto:Achim.Berras@dca.ca.gov mailto:Priscilla.Navarro@dca.ca.gov

Bids that are mailed in or physically delivered must have one (1) copy clearly labeled “MASTER” (bearing original wet or electronic signatures) and one (1) copy labeled “COPY” on the bid. Bids not clearly marked and not submitted in a sealed envelope will be rejected. If discrepancies are found between the MASTER and the COPY, the “MASTER” bid will prevail over all others.

Any bid mailed in, or hand delivered must be received and time stamped on or before the date and time specified in the Time Schedule identified in Article V, to be considered timely delivery. It is the policy of the Department of Consumer Affairs (DCA) to make every effort to ensure that all bids have been received and properly time stamped;

however, bidders are ultimately responsible for ensuring timely receipt of their bid.

Bidders may verify receipt of their bid by contacting the person identified in the cover letter of this IFB.

2. All bids will include the documents identified on the IFB Checklist (Attachment 7). Bids not including the proper "Required Attachments" or that do not meet the basic bid requirements will be deemed non-responsive. A non-responsive bid is one that does not meet the basic bid requirements and is justification for rejection.

3. All documents requiring a signature can be signed electronically or via original, blue, wet-ink signature of a person authorized to bind the bidding firm.

4. 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.

5. 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. DCA may reject any or all bids and may waive any immaterial deviation in a bid. The DCA’s waiver of immaterial defect will in no way modify the IFB document or excuse the bidder from full compliance with all requirements if awarded the agreement.

6. Costs incurred for developing bids and in anticipation of award of the agreement are entirely the responsibility of the bidder and will not be charged to DCA.

7. An individual who is authorized to bind the bidding firm contractually must sign the Bidder Certification Sheet (Attachment 1). The signature must indicate the title or position that the individual holds in the firm. An unsigned bid will be rejected.

8. 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.

9. A bidder may withdraw its bid by submitting a written withdrawal request to the State, 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 the bid submission deadline.

10. The DCA 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.

11. The DCA reserves the right to reject all bids. The DCA reserves the right to reject any bid that it deems not cost reasonable or for any other reason it deems a bid does not meet the requirements of this IFB. The DCA is not required to award an agreement as a result of this IFB.

12. Before submitting a response to this solicitation, bidders should review, correct all errors, and confirm compliance with the IFB requirements.

13. The DCA does not accept alternate agreement language from a prospective contractor.

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.

14. No oral understanding or oral agreement will be binding on either party.

15. “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.

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” will have the meaning set forth in State Administrative Manual (SAM) § 4986.2 Definitions for GenAI.

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 nondisclosure.

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.

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.”

VIII. PROHIBITION ON TAX DELINQUENTS:

1. Pursuant to Public Contract Code section 10295.4, persons or companies identified as the largest tax delinquents by the Franchise Tax Board (FTB) or the California Department of Tax and Fee Administration (CDTFA) will be disqualified from bidding and ineligible to enter into any agreement with the state for non-IT goods or services.

Any agreement entered into in violation of section 10295.4 is void and unenforceable.

2. Prior to executing any state agreement or renewal for non-IT goods or services, the DCA/MBC will verify that the proposed awardee(s) is not on a prohibited list by checking both the FTB and CDTFA websites.

IX. LOSS LEADER:

It is unlawful for any person engaged in business within this state to sell or use any article or product as a “loss leader” as defined in Section 17030 of the Business and Professions Code.

X. EVALUATION AND SELECTION PROCESS:

1. Each bid will be checked for the presence or absence of required information in conformance with the submission requirements of this IFB.

2. The DCA will evaluate each bid to determine its responsiveness to all IFB requirements. All bidders must meet the minimum qualifications, as stated in Article IV – Minimum Qualifications for Bidders and provide all of the required attachments as outlined in the Attachment 7 – IFB Checklist to be considered responsive.

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

4. The final selection will be made based on the lowest responsive bid. In the event of a tie in the bid amount, a tiebreaker will be decided by a coin toss observed by witnesses. Affected bidders will be invited to witness the coin toss.

XI. AWARD AND PROTEST:

1. Award of Contract:

The contract will be awarded based on the responsive/responsible bidder submitting the lowest average Grand Total for on-site digital scanning services stated on the Bidder’s Cost Sheet.

Award if made will be made within ninety (90) days (if no protest of the award is received) after the scheduled date for the Intent to Award. If a protest is received, the Award, if made, will be after the protest is resolved.

Whenever an agreement is awarded under a procedure that provides for competitive bidding, but the agreement is not to be awarded to the low bidder, the low bidder will be notified by telegram, electronic facsimile transmission, overnight courier, or personal delivery five (5) working days prior to the award of the agreement.

2. Protest:

All protests must be made in writing, signed by an officer of the company or individual authorized to do so and submitted within five (5) working days of the State’s posting of its intent to award. An original copy of the protest must be mailed (i.e. certified mail with return receipt requested) to:

Department of General Services Office of Legal Services Attention: Bid Protest Coordinator 707 3rd Street, 7th Floor, Suite 7-330 West Sacramento, CA 95605

Email: OLSProtests@dgs.ca.gov

A copy of the protest must also be mailed (certified or registered recommended) to:

Attn: Achim Berras 1625 N. Market Blvd., Suite S-103

Within five (5) working days of filing a protest, the bidder must submit a complete written statement specifying the grounds of the protest to the same aforementioned individuals.

The protestor must provide facts and evidence to support its claim.

XII. DISPOSITION OF BIDS:

1. 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 (Government Code Section 7920.0000 et seq.) and subject to review by the public.

2. Bid packages may be returned only at the bidder's expense, unless such expense is waived by the DCA.

XIII. AGREEMENT EXECUTION AND PERFORMANCE:

1. Performance will start on the date set by the DCA and the Contractor, after all approvals have been obtained and the agreement is fully executed. The agreement will be executed only upon the State's acceptance of the Contractor's certificates of insurance, bonds, licenses, and permits, when such items are required. Should the Contractor fail to commence work at the agreed upon time, the DCA, upon five (5) days written notice to the Contractor, reserves the right to terminate the Agreement.

In addition, the Contractor will be liable to the State for the difference between Contractor's bid price and the actual cost of performing work by the second lowest bidder or by another Contractor.

2. The lowest responsive bidder will enter into an Agreement with the State, which will be prepared on a State of California Standard Agreement.

3. All performance under this agreement will be completed on or before the termination date of the Agreement.

4. Should it become necessary to modify the terms of the resulting contract, those modifications may be made through a written amendment to the contract to the extent allowable by State Contracting Manual (SCM), Volume 1, Chapter 5, section mailto:OLSProtests@dgs.ca.gov

5.81. A contract amendment will not be effective unless in writing and until fully executed by both parties.

5. The Agreement will not include a hard copy of the General Terms and Conditions (Exhibit C, GTC-04/2017), they will be incorporated by reference and made part of this Agreement and can be viewed here: https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of- Legal-Services-Resources-List-Folder/Standard-Contract-Language

XIV. BID SUBMISSION REQUIREMENTS:

The bid submission package must include the following required forms fully completed and signed where applicable:

1. BIDDER’S COST SHEET – CONTRACT YEARS 1 – 3 – must be completed and submitted with an original or electronic signature by the individual legally authorized to bind the bidder. The cost sheet must contain the proposed bid cost for the Total Cost.

2. ATTACHMENT 1 – BIDDER CERTIFICATION SHEET - This Bid/Bidder Certification

Sheet must be signed and returned along with all the "required attachments" as an entire package.

3. ATTACHMENT 2 – BIDDER REFERENCES – must provide three references for services performed within the last five (5) years, which are similar to Exhibit A, Scope of Work to be performed in this contract.

4. ATTACHMENT 3 – BIDDER DECLARATION FORM (GSPD-05-105) – must be completed and submitted with an original or electronic signature.

5. ATTACHMENT 4 – PAYEE DATA RECORD – must be completed with an original or electronic signature.

6. ATTACHMENT 5 – CONTRACTOR CERTIFICATION CLAUSES – must be signed and dated with an original or electronic signature.

7. ATTACHMENT 6 - DARFUR CONTRACTING ACT CERTIFICATION FORM – must be fully completed, signed, and dated with an original or electronic signature.

8. ATTACHMENT 7 – IFB CHECKLIST – is to be used to confirm compliance with the bid submission requirements. The checklist must be fully completed and submitted as the cover to your bid package.

XV. DARFUR CONTRACTING ACT OF 2008:

Effective January 1, 2009, all Invitations for Bids (IFB) or Requests for Proposals (RFP) for goods or services must address the requirements of the Darfur Contracting Act of 2008 (Act). (Public Contract Code sections 10475, et seq.; Stats. 2008, Ch. 272.) The Act was passed by the California Legislature and signed into law by the Governor to preclude State agencies generally from contracting with “scrutinized” companies that do 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 business in the African nation of Sudan (of which the Darfur region is a part), for the reasons described in Public Contract Code section 10475.

A scrutinized company is a company doing business in Sudan as defined in Public Contract Code section 10476. Scrutinized companies are ineligible to, and cannot, bid on or submit a proposal for a contract with a State agency for goods or services. (Public Contract Code section 10477(a).)

Therefore, Public Contract Code section 10478 (a) requires a company that currently has (or within the previous three years has had) business activities or other operations outside of the United States to certify that it is not a “scrutinized” company when it submits a bid or proposal to a State agency (See # 1 on Attachment 6).

A scrutinized company may still, however, submit a bid or proposal for a contract with a State agency for goods or services if the company first obtains permission from the Department of General Services (DGS) according to the criteria set forth in Public Contract Code section 10477(b) (See #2 on Attachment 6).

XVI. SMALL BUSINESS ENTERPRISE PREFERENCE:

Overview: Current law encourages state departments to first consider a Small Business Enterprise (Small)/Microbusiness Enterprise (Micro) for contracting opportunities. The DCA is committed to supporting Small/Micro business participation in state contracting and seeks to use certified Small/Micro businesses whenever possible.

The State of California provides a five percent (5%) preference to Small/Micro Business proposers. This 5% preference is also provided to Non-Small Businesses that commit to subcontract, with one or more California-certified Small/Micro businesses, at least 25% of the net bid price, as specified below. The standard contract language for the preference programs can be found at Apply For or Re-apply as Small Business, Disabled Veteran Business Enterprise. For the purposes of this section, the definitions specified in Title 2, California Code of Regulations (CCR), §1896.4 will apply unless otherwise noted.

Questions regarding certification of small businesses should be directed to the Office of Small Business and DVBE Services (OSDS) at (916) 375-4940. See below for an example of how a Small Business preference is applied.

Bidder A B C Responsive & Responsible Y Y Y

SB Preference and Claiming SB None SB

Net Bid Amount $32,995 $31,900 $32,500 Initial Ranking 3 1 2 SB Preference Amount* $1,595 0 $1,595

Evaluated Bid Price $31,400 $31,900 $30,905

Re-Ranking 2 3 1 https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Apply-for-or-Re-apply-as-Small-Business-Disabled-Veteran-Business-Enterprise https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Apply-for-or-Re-apply-as-Small-Business-Disabled-Veteran-Business-Enterprise

*Note: the 5% SB preference is calculated from the lowest net bid received (0.05 x = $) and that value is then applied to all SB bids.

XVII. TARGET AREA CONTRACT PREFERENCE ACT (TACPA) (if applicable):

Refer to https://www.documents.dgs.ca.gov/DGS/FMC/PDF/std830.pdf for more information.

XVIII. DISABLED VETERAN BUSINESS ENTERPRISE PROGRAM (DVBE) PARTICIPATION:

Section 10115 et seq. of the Public Contract Code, and Section 999 et seq. of the Military and Veterans Code requires a goal of three percent (3%) for Disabled Veteran Business Enterprise (DVBE) participation for all contracts on an agency-wide basis of $25,000.00 and over unless exempted due to the services provided.

DVBE participation requirements are being waived for this IFB.

XIX. DVBE INCENTIVE OPTION:

The State is committed to achieving legislatively established goals for the participation of DVBEs in all state contracts and seeks to use certified DVBE business whenever possible. Therefore, the State requests your voluntary participation in reporting any certified DVBEs including yourself, that will be used in the performance of this Agreement. An explanation of the Disabled Veteran Business Enterprise Program (DVBE) requirements can be found at the Internet web site:

Apply For or Re-apply as Small Business, Disabled Veteran Business Enterprise https://www.documents.dgs.ca.gov/DGS/FMC/PDF/std830.pdf https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Apply-for-or-Re-apply-as-Small-Business-Disabled-Veteran-Business-Enterprise

BIDDER’S COST SHEET – CONTRACT YEARS 1 – 3

Contract Term: April 1, 2026 – March 31, 2029

The Bidder proposes and agrees to perform in accordance with Exhibit A, Scope of Work.

The total cost indicated below is not binding on the contracting agency. However, the actual rates quoted by the Bidder will be binding for the term of the Agreement.

Please note that the winning Bidder’s Cost Sheet will be incorporated in the final contract.

Bids will include the cost of providing photocopying services for the entire term of the contract.

Price of Service Provided Cost per page/copy per month

Estimated Quantity

(per year or per month)

X Months (Unless specified) Cost

Basic Site charge – Includes travel, overhead, one-time basic site charge or multiple requests at one location, x-ray pickup delivery, certification, medical record retrieval fee, and costs related to pagination and digitalization documents in pdf format secure website.

$ per visit 20 per month X 36 $

Photocopying/Scanning paper records (letter and legal size) – Includes cost for paper and costs related to shipping paper records to the MBC.

$ 3,000 per month X 36 $

Additional Legal size paper record $ 2,000 per month X 36 $ Copying radiological records (sizes include (11” X 14”, 14’X 17”) – includes cost for paper and costs related to shipping paper records to MBC.

5 (combined sizes)

1 per month X 36 $

Copying audio tapes to CD includes 30– 90-minute audio recordings, cost of CD’s and shipping

$ 5 per year X 3 years $

On- site X-ray Duplication Film to film or Film to CD $ 1 per month X 36 $

On-Site Document Scanning $ 1 per month X 36 $ Next Day Turnaround $ 1 per month X 36 $

Total Agreement Amount $

DCA does not expressly or by implication agree that the actual amount of work will correspond with any estimation provided in this Agreement and reserves the right to omit portions of the estimated amount of work as may be deemed necessary or advisable by DCA. The estimates listed above are a good faith estimate and are not a guarantee of business and is subject to change depending on need. The amounts indicated above will be used solely for the purpose of encumbering funds. DCA makes no guarantee, expressed or implied, for the actual amount of work to be performed. However, the rates contained in Exhibit B will be binding for the term of this Agreement.

The DCA/MBC reserves the right to make mathematical corrections to Cost Sheet and/or contact the bidder for clarification purposes.

I hereby certify that I am authorized to sign this Cost Sheet and warrant that the cost shown above is accurate and represents an unconditional offer to the Department of Consumer Affairs.

Bid form(s) must be completed in its entirety.

An unsigned bid form may result in disqualification.

Questions regarding completion of this form should be brought to the attention of:

Achim.berras@dca.ca.gov

Signature

Date Signed

Printed Name Title

Legal Business Name

Federal I.D. Number

ATTACHMENT 1

BIDDER CERTIFICATION SHEET

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

By signing this certification, the bidder certifies that:

A. An all-inclusive bid is submitted as detailed in the Bidder Cost Sheet, (Attachment 1).

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

C. Bidder or Bidder’s employees must have minimum of at least two (2) years of experience providing services as described in Exhibit A, Scope of Work and must be able to provide three (3) references with at least one (1) being a state government or city/county entity.

D. The signature affixed hereon and dated certifies compliance with all the requirements of this bid document and authorizes the verification of any part of this bid.

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 & DVBE Services (OSDC) as:

a. Small Business Enterprise Yes No

If yes, enter certification number:

b. 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 OSDC, if an application is pending:

Completion Instructions for Bidder Certification Sheet (ATTACHMENT 1 - cont’d)

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

Item Numbers Instructions

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

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 people to place their money, effects, labor, and skill, or some or all of them in lawful commerce or business, with the understanding that there will be a proportional sharing of the profits and losses between them. An association of two or more people 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 to check 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 Veteran 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.

ATTACHMENT 2

BIDDER REFERENCES

Submission of this attachment is mandatory. Failure to complete and return this attachment with your bid may cause your bid to be rejected and deemed nonresponsive.

List below three references for services performed within the last five (5) years, which are similar to the scope of work to be performed in this contract.

REFERENCE 1

Name of Firm Street Address City State Zip Code Contact Person Telephone Number 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

REFERENCE 3

Street Address City State Zip Code Contact Person Telephone Number

ATTACHMENT 3 – BIDDER DECLARATION

ATTACHMENT 4 - PAYEE DATA RECORD

ATTACHMENT 5

Contractor Certification Clause (04/2017)

CERTIFICATION

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to the clause(s) listed below. This certification is made under the laws of the State of California.

Contractor/Bidder Firm Name (Printed)

Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date Executed Executed in the County of

CONTRACTOR CERTIFICATION CLAUSES

STATEMENT OF COMPLIANCE:

Contractor has, unless exempted, complied with the nondiscrimination program requirements.

(GC 12990 (a-f) and CCR, Title 2, Section 8103) (Not applicable to public entities.)

DRUG-FREE WORKPLACE REQUIREMENTS:

Contractor will comply with the requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free workplace by taking the following actions:

a) Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations.

b) Establish a Drug-Free Awareness Program to inform employees about:

1. the dangers of drug abuse in the workplace;

2. the person's or organization's policy of maintaining a drug-free workplace;

3. any available counseling, rehabilitation and employee assistance programs;

and, penalties that may be imposed upon employees for drug abuse violations.

c) Provide that every employee who works on the proposed Agreement will:

1. receive a copy of the company's drug-free policy statement; and,

2. agree to abide by the terms of the company's statement as a condition of employment on the Agreement.

Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and Contractor may be ineligible for award of any future State agreements if the department determines that any of the following has occurred:

(1) the Contractor has made false certification or violated the certification by failing to carry out the requirements as noted above. (GC 8350 et seq.)

NATIONAL LABOR RELATIONS BOARD CERTIFICATION:

Contractor certifies that no more than one (1) final unappealable finding of contempt of court by a Federal court has been issued against Contractor within the immediately preceding two-year period because of Contractor's failure to comply with an order of a Federal court which orders Contractor to comply with an order of the National Labor Relations Board. (PCC 10296) (Not applicable to public entities.)

CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO

REQUIREMENT:

Contractor hereby certifies that contractor will comply with the requirements of Section 6072 of the Business and Professions Code, effective January 1, 2003.

Contractor agrees to make a good faith effort to provide a minimum number of hours of pro bono legal services during each year of the contract equal to the lessor of 30 multiplied by the number of full time attorneys in the firm’s offices in the State, with the number of hours prorated on an actual day basis for any contract period of less than a full year or 10% of its contract with the State.

Failure to make a good faith effort may be cause for non-renewal of a state contract for legal services and may be taken into account when determining the award of future contracts with the State for legal services.

EXPATRIATE CORPORATIONS:

Contractor hereby declares that it is not an expatriate corporation or subsidiary of an expatriate corporation within the meaning of Public Contract Code Section 10286 and 10286.1 and is eligible to contract with the State of California.

SWEATFREE CODE OF CONDUCT:

a. All Contractors contracting for the procurement or laundering of apparel, garments or corresponding accessories, or the procurement of equipment, materials, or supplies, other than procurement related to a public works contract, declare under penalty of perjury that no apparel, garments or corresponding accessories, equipment, materials, or supplies furnished to the state pursuant to the contract have been laundered or produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor. The contractor further declares under penalty of perjury that they adhere to the Sweat free Code of Conduct as set forth on the California Department of Industrial Relations website and Public Contract Code Section 6108.

b. The contractor agrees to cooperate fully in providing reasonable access to the contractor’s records, documents, agents or employees, or premises if reasonably required by authorized officials of the contracting agency, the Department of Industrial Relations, or the Department of Justice to determine the contractor’s compliance with the requirements under paragraph (a).

http://www.dir.ca.gov/

DOMESTIC PARTNERS:

For contracts of $100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.3.

GENDER IDENTITY:

For contracts of $100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.35.

DOING BUSINESS WITH THE STATE OF CALIFORNIA

The following laws apply to persons or entities doing business with the State of California.

CONFLICT OF INTEREST:

Contractor needs to be aware of the following provisions regarding current or former state employees. If Contractor has any questions on the status of any person rendering services or involved with the Agreement, the awarding agency must be contacted immediately for clarification.

a) Current State Employees (PCC 10410):

1. No officer or employee will engage in any employment, activity or enterprise from which the officer or employee receives compensation or has a financial interest, and which is sponsored or funded by any state agency, unless the employment, activity or enterprise is required as a condition of regular state employment.

2. No officer or employee will contract on his or her own behalf as an independent contractor with any state agency to provide goods or services.

b) Former State Employees (PCC 10411):

1. For the two-year period from the date, he or she left state employment, no former state officer or employee may enter into a contract in which he or she engaged in any of the negotiations, transactions, planning, arrangements or any part of the decision-making process relevant to the contract while employed in any capacity by any state agency.

2. For the twelve-month period from the date, he or she left state employment, no former state officer or employee may enter into a contract with any state agency if he or she was employed by that state agency in a policy-making position in the same general subject area as the proposed contract within the 12-month period prior to his or her leaving state service.

If Contractor violates any provisions of above paragraphs, such action by Contractor will render this Agreement void. (PCC 10420)

Members of boards and commissions are exempt from this section if they do not receive payment other than payment of each meeting of the board or commission, payment for preparatory time and payment for per diem. (PCC 10430 (e))

LABOR CODE/WORKERS' COMPENSATION:

Contractor needs to be aware of the provisions which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions, and Contractor affirms to comply with such provisions before commencing the performance of the work of this Agreement. (Labor Code Section 3700) https://10295.35/

AMERICANS WITH DISABILITIES ACT:

Contractor assures the State that it complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.)

CONTRACTOR NAME CHANGE:

An amendment is required to change the Contractor's name as listed on this Agreement. Upon receipt of legal documentation of the name change the State will process the amendment.

Payment of invoices presented with a new name cannot be paid prior to approval of said amendment.

CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA:

a) When agreements are to be performed in the state by corporations, the contracting agencies will be verifying that the contractor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled.

b) "Doing business" is defined in R&TC Section 23101 as actively engaging in any transaction for the purpose of financial or pecuniary gain or profit. Although there are some statutory exceptions to taxation, rarely will a corporate contractor performing within the state not be subject to the franchise tax.

c) Both domestic and foreign corporations (those incorporated outside of California) must be in good standing in order to be qualified to do business in California. Agencies will determine whether a corporation is in good standing by calling the Office of the Secretary of State.

RESOLUTION:

A county, city, district, or other local public body must provide the State with a copy of a resolution, order, motion, or ordinance of the local governing body which by law has authority to enter into an agreement, authorizing execution of the agreement.

AIR OR WATER POLLUTION VIOLATION:

Under the State laws, the Contractor will not be: (1) in violation of any order or resolution not subject to review promulgated by the State Air Resources Board or an air pollution control district; (2) subject to cease and desist order not subject to review issued pursuant to Section 13301 of the Water Code for violation of waste discharge requirements or discharge prohibitions;

or (3) finally determined to be in violation of provisions of federal law relating to air or water pollution.

PAYEE DATA RECORD FORM STD. 204:

This form must be completed by all contractors that are not another state agency or other government entity.

ATTACHMENT 6

Darfur Contracting Act Certification

Pursuant to Public Contract Code section 10478, if a bidder or proposer currently or within the previous three years has had business activities or other operations outside of the United States, it must certify that it is not a “scrutinized” company as defined in Public Contract Code section 10476.

Therefore, to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete only one of the following three paragraphs (via initials for Paragraph # 1 or Paragraph # 2, or via initials and certification for Paragraph # 3):

Company/Vendor Name (Printed) Federal ID Number

Printed Name and Title of Person Initialing (for Options 1 or 2)

1. We do not currently have, and have not had within the previous

Initials three years, business activities or other operations outside of the United States.

OR

2. We are a scrutinized company as defined in Public Contract Code Initials section 10476, but we have received written permission from the Department of General

Services (DGS) to submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission from DGS is included with our bid or proposal.

OR

3. We currently have, or we have had within the previous three years, Initials business activities or other operations outside of the United States, + certification but we certify below that we are not a scrutinized company below as defined in Public Contract Code section 10476.

CERTIFICATION For # 3

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective proposer/bidder to the clause listed above in # 3. This certification is made under the laws of the State of California.

By (Authorized Signature)

Date Executed Executed in the County and State of

ATTACHMENT 7

IFB 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 the State. For your bid to be responsive, all required attachments must be returned. This checklist must also be returned with your bid package.

X Attachment Attachment Name/Description

Bidder’s Cost Sheet – Contract Years 1 – 3

Bidder’s Cost Sheet – Contract Years 1 – 3 (REQUIRED - Attachment included in this IFB)

Attachment 1 Bid/Bidder Certification Sheet (REQUIRED - Attachment included in this IFB.)

Attachment 2 Bidder References (REQUIRED - Attachment included in this IFB.)

Attachment 3 Bidder Declaration See Internet Web Site: Bidders Declaration (REQUIRED - Submit with Bid Package)

Attachment 4 Payee Data Record (STD. 204) See Internet Web Site: Payee Data Record (REQUIRED - Submit with Bid Package)

Attachment 5

Contractor Certification Clauses (CCC 04/2017) See Internet Web Site: Contractor Certification Clause (REQUIRED - Submit with Bid Package)

Attachment 6

Darfur Contracting Act Certification Form See Internet Web Site: Darfur Contracting Act Certification (REQUIRED - Submit with Bid Package)

Attachment 7 IFB Checklist (REQUIRED - Attachment included in this IFB.)

If the following are not applicable, place “N/A” next to each item not being submitted with the bid package

Attachment 8 Small Business Preference (OPTIONAL - Submit if applicable.)

Attachment 9 California Civil Rights Laws Certification (REQUIRED – Submit if bid is over $100,000.00)

Attachment 10 Target Area Contract Preference Act (TACPA) See Internet Website: TACPA (OPTIONAL - Submit if applicable.)

https://inside.dca.ca.gov/documents/gspd_05_106.pdf http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf https://inside.dca.ca.gov/documents/ccc307_contractor.pdf https://inside.dca.ca.gov/documents/ccc307_contractor.pdf https://inside.dca.ca.gov/documents/darfur.pdf https://inside.dca.ca.gov/documents/darfur.pdf https://www.documents.dgs.ca.gov/DGS/FMC/PDF/std830.pdf

ATTACHMENT 8

Small Business (SB) Preference Sheet

NOTICE TO ALL BIDDERS:

Small Business and Non-Small Business Subcontractor Preferences

a. Small businesses will be granted the five percent (5%) small business preference on a bid evaluation by an awarding department when a responsible non-small business has submitted the lowest-priced, responsive bid or a bid that has been ranked as the highest scored bid pursuant to a solicitation evaluation method described in Section 1896.8, and when the small business:

1. Has included in its bid a notification to the awarding department that it is a small business or that it has submitted to the Department a complete application pursuant to Section

1896.14 no later than 5:00 p.m. on the bid due date, and is subsequently certified by the Department as a small business; and

2. Has submitted a timely, responsive bid; and

3. Is determined to be a responsible bidder.

b. Non-small business bidders will be granted a five percent (5%) non-small business subcontractor preference on a bid evaluation by an awarding department when a responsible non-small business has submitted the lowest-priced responsive bid or a bid that has been ranked as the highest scored bid pursuant to a solicitation evaluation method described in Section1896.8, and when the non-small business bidder:

1. Has included 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 small business(es); and

2. Has submitted a timely, responsive bid; and

3. Is determined to be a responsible bidder; and

4. Submits a list of the small business(es) it commits to subcontract with for a commercially useful function in the performance of the contract. The list of subcontractors will include their name, address, phone number, a description of the work to be performed, and the dollar amount or percentage (as specified in the solicitation) per subcontractor.

Are you a California certified small business? YES NO

Are you a non-SB subcontracting at least 25% to a California certified SB? YES NO

Company Name:

Signature: ___________________________________________ Date:

A copy of the SB certification letter from OSDS or any proof of certification from the State of California, including an e-mail or a Web site print out must be included.

If you have applied and not yet been formally certified, include the date of application.

Date applied (if not yet certified):

ATTACHMENT 9

CALIFORNIA CIVIL RIGHTS CERTIFICATION

Pursuant to Public Contract Code section 2010, if a bidder or proposer executes or renews a contract over $100,000.00 on or after January 1, 2017, the bidder or proposer hereby certifies compliance with the following:

1. CALIFORNIA CIVIL RIGHTS LAWS:

For contracts over $100,000.00 executed or renewed after January 1, 2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of the Civil Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code); and

2. EMPLOYER DISCRIMINATORY POLICIES:

For contracts over $100,000.00 executed or renewed after January 1, 2017, if a Contractor has an internal policy against a sovereign nation or peoples recognized by the United States…