IFB_Package.pdf

I have read the information above and understand my responsibility to immediately report any information that indicates an offender is being, or has been, the victim of sexual violence, staff sexual misconduct, or sexual harassment.

STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION

OBS 1510 (01/17)

CALIFORNIA CIVIL RIGHTS LAWS CERTIFICATION

Pursuant to Public Contract Code section 2010, if a bidder or proposer executes or renews a contract over $100,000 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 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 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 government, the Contractor certifies that such policies are not used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing Act (Section 12960 of the Government Code).

CERTIFICATION

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

Proposer/Bidder Firm Name (Printed)

Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date Executed Executed in the County and State of

ACORD CERTIFICATE OF INSURANCE

ISSUE DATE (MM/DD/YY)

PRODUCER:

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO

RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND

OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.

COMPANIES AFFORDING COVERAGE

COMPANY

LETTER A

LETTER B

INSURED: COMPANY

LETTER C

LETTER D

LETTER E

COVERAGES

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTHWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

CO

LTR

TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE

DATE (MM/DD/YY)

POLICY EXPIRATION

DATE (MM/DD/YY)

LIMITS

GENERAL LIABILITY GENERAL AGGREGATE $

COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $

CLAIMS MADE OCCUR. PERSONAL & ADV. INJURIES $

OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $

FIRE DAMAGE (Any One person) $

MED. EXPENSE (Any One person) $

AUTOMOBILE LIABILITY

COMBINED SINGLE $

ANY AUTO LIMIT

ALL OWNED AUTOS

BODILY INJURY $

SCHEDULED AUTOS (Per Person)

HIRED AUTOS

BODILY INJURY $

NON-OWNED AUTOS (Per Person)

GARAGE LIABILITY

PROPERTY DAMAGE $

EXCESS LIABILITY EACH OCCURRENCE $

UMBRELLA FORM AGGREGATE $

OTHER THAN UMBRELLA FORM

WORKER'S COMPENSATION STATUTORY LIMITS

AND EACH ACCIDENT $

EMPLOYERS' LIABILITY DISEASE-POLICY LIMIT $

DISEASE-EACH EMPLOYEE $

OTHER

DESCRIPTION OF OPERATIONS/LOCATION/VEHICLES/SPECIAL ITEMS Re: All operations

The State of California, its officers, agents, employees and servants are hereby named as additional insured but only with respect to work performed for the State of California.

CERTIFICATE HOLDER CANCELLATION

California Department of Corrections and Rehabilitation Office of Business Services 9838 Old Placerville Rd, Suite B-2 Sacramento, CA 95827

Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions:

Name of Bidding Firm / Prime Contractor CDCR IFB or RFP Number:

Total Dollar Value of Subcontractor Use CDCR Bid Number:

This document confirms and acknowledges that the firm named below agreed to be identified by a bidding firm as a proposed small business or microbusiness (SB/MB) subcontractor or supplier for a CDCR agreement.

Subcontractor acknowledgements:

A. The subcontracting firm named herein has committed to perform or provide services/labor or supplies equal to a percentage of the total bid/cost proposal price submitted by the bidding firm named above.

B. The subcontracting firm named herein acknowledges the total dollar value of claimed participation identified above.

C. The subcontracting firm named herein agrees to provide the following subcontracted services/labor or supplies under the resulting contract if the bidding firm named above receives the contract award:

Provide a brief description in the box below of the commercially useful function(s) that the subcontractor/supplier identified herein will provide or supply. Attach additional page(s) if necessary.

The subcontracting firm named herein understands it is its sole responsibility to contact the bidding firm named above to learn if the Proposer was awarded the contract pursuant to the referenced bid number and to confirm its subcontract agreement. If the bidding firm named above receives an award based in part on non-small business subcontractor preference, the bidding firm/contractor is obligated to use each SB/MB subcontractor or supplier identified in its proposal unless a subcontractor substitution is requested after contract execution pursuant to Public Contract Code Section 4107 and Title 2 California Code of Regulations Section 1896.10.

The person signing below certifies the information supplied on this form is true and accurate to the best of their knowledge and agrees to allow the State to confirm this information, if deemed necessary.

SB/MB Certification #:

SB/MB Certification Expiration Date:

Name of Proposed Subcontractor/Supplier:

Date Signed:

Street Address:

City:

State:

Zip Code:

Telephone Number:

SB/MB E-mail Address (if applicable):

SB/MB Federal Employer ID (FEIN) #:

Printed/Typed Name:

Title:

Information Verified by:

Date:

STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION

OBS 554

DVBE Bid Incentive Request and Acknowledgement

Name of Prime Contractor: CDCR IFB or RFP Number:

Completion of this document confirms DVBE BID Incentive request and acknowledges that the firm named below agreed to be identified by a bidding firm as a proposed DVBE subcontractor or supplier for a CDCR agreement. Unless otherwise stated, the DVBE incentive shall be equal to a bidder’s DVBE participation level. Unless otherwise stated, the DVBE Bid Incentive is subject to a minimum of 3 percent and a maximum of 5 percent during the bid evaluation process. Each named DVBE must have an application on file with the Department of General Services, Office of Small Business and Disabled Veteran Business Enterprise Certification Services (OSDS) by 5:00 p.m. on the day bids are due. If the DVBE is a subcontractor, then they must acknowledge their participation as claimed herein via the DVBE Subcontractor/Supplier Acknowledgement below:

Subcontractor/Supplier Acknowledgement Subcontractor acknowledgements:

A. The subcontracting firm named herein has committed to perform or provide services/labor or supplies equal to a percentage of the total bid/cost proposal price submitted by the bidding firm named above.

B. The subcontracting firm named herein acknowledges the total dollar value of claimed participation identified above.

C. The subcontracting firm named herein agrees to provide the following subcontracted services/labor or supplies under the resulting contract if the bidding firm named above receives the contract award:

Provide a brief description in the box below of the commercially useful function(s) that the subcontractor/supplier identified herein will provide or supply. Attach additional page(s) if necessary.

l

The subcontracting firm named herein understands it is its sole responsibility to contact the bidding firm named above to learn if the Proposer was awarded the contract pursuant to the referenced bid number and to confirm its subcontract agreement. If the bidding firm named above receives an award based in part on the DVBE incentive, the bidding firm/contractor is obligated to use each DVBE subcontractor or supplier identified in its proposal unless a subcontractor substitution is requested after contract execution pursuant to Public Contract Code Section 4107 and Title 2 California Code of Regulations Section 1896.10.

The person signing below certifies the information supplied on this form is true and accurate to the best of their knowledge and agrees to allow the State to confirm this information, if deemed necessary.

Total Dollar Value of DVBE Subcontractor Use:

Total DVBE Percentage:

DVBE Certification #: DVBE Certification Expiration Date:

Name of Proposed DVBE Subcontractor/Supplier: Date Signed:

Street Address: City: State: Zip Code:

Telephone Number:

DVBE E-mail Address (if applicable): DVBE Federal Employer ID (FEIN) #:

Printed/Typed Name: Title: Signature of Subcontractor/Supplier Representative:

For State Use Only Information Verified by:

Date:

Subscribed and sworn to before me on

NOTE: The above information may not encompass all of the requirements or may be incomplete. Contractor is responsible for verifying and applying all of the California Labor Code, including Sections 1770-1781 and 1810-1815.

STATE OF CALIFORNIA

DEPARTMENT OF CORRECTIONS AND REHABILITATION

KNOW ALL MEN BY THESE PRESENTS:

That we, __________________________________________________________________________________________________ ____________________________________________________________________________________________as Principal, and as Surety, are held and firmly bound unto the State of California, hereinafter called the State, in the penal sum of ten percent (10%) of the total amount of the bid of the Principal above named, submitted by said Principal to the State of California, Department of Corrections and Rehabilitation, for the work described below, for the payment of which sum in lawful money of the United States, well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by these presents.

THE CONDITION of this obligation is such that:

WHEREAS, the Principal has submitted the above-mentioned bid to the State of California, Department of Corrections and Rehabilitation for certain construction specifically described as follows, for which bids are to be opened at ___________________ ___________________________________________________________________________on____________________________

(Place where bids will be opened) (Date of bid opening) for ______________________________________________________________________________________________________

(Copy here the exact description of work, including location as appears on the Proposal)

NOW, THEREFORE, if the aforesaid Principal is awarded the contract and within the time and manner required under the specifications, after the prescribed forms are presented to him for signature entered into a written contract, in the prescribed form, in accordance with the bid, and files the two bonds with the Department, one to guarantee faithful performance and the other to guarantee payment for labor and materials, as required by law, then this obligation shall be null and void; otherwise, it shall be and remain in full force and virtue.

In the event suit is brought upon this board by the Obligee and judgment is recovered, the Surety shall pay all costs incurred by the Obligee in su

IN WITNESS WHEREOF, we have hereunto set our hands and seals on this _____ day of _________20____.

_________________________________________________(SEAL)

_________________________________________________(SEAL)

_________________________________________________(SEAL)

Principal

_________________________________________________(SEAL)

_________________________________________________(SEAL)

_________________________________________________(SEAL)

Surety

NOTE: Signatures of those executing for the Surety must be properly acknowledged.

CERTIFICATE OF ACKNOWLEDGEMENT

State of California County of _____________________________

On this ________ day of ______________________in the year on 20_____ before me, a Notary Public in and for the County and State aforesaid, personally appeared, ____________________________________________________________________________ known to me to be the person whose name is subscribed to the within instrument and known to me to be the attorney-in-fact of ___ ____________________________________________________________________________and acknowledged to me that he subscribed the name of the said company there to as surety, and his own name as attorney-in-fact.

Notary Public

(SEAL)