IFB_RW2411014_Flour.pdf

IFB #RW2411014 Page 1 of 6 Bulk Wheat Flour

October 21, 2024

INVITATION FOR BID (IFB)

IFB # RW2411014

Notice to Prospective Contractors

The California Prison Industry Authority (CALPIA) invites you to review and respond to this Invitation for Bid (IFB), entitled RW 2411014 for BULK WHEAT FLOUR. In submitting your bid, you must comply with the instructions found herein.

Mail or deliver your bid package for the IFB to the address below. Faxed or electronically forwarded bids will not be accepted. Bids not submitted under sealed cover will be rejected. The sealed cover must be plainly marked with the IFB number and title, must show your firm name and address, and must be marked with “DO NOT OPEN”, as shown in the following example:

IFB Number: RW2411014 IFB Name: BULK WHEAT FLOUR Attention: MARIE MOYER Bid Submittal: Do Not Open

In the opinion of CALPIA, this IFB is complete and without need of explanation. However, should you have questions, or need clarifying information, please contact the Contract Analyst indicated below.

Due Date/Time: November 12, 2024 by 3:00 pm

CALPIA Contact Return Bid To:

Marie Moyer Phone: (916) 358-1109

Email: Marie.Moyer@calpia.ca.gov

California Prison Industry Authority Attention: Marie Moyer 560 East Natoma Street

Folsom, CA 95630

This IFB covers the estimated annual requirement of BULK WHEAT FLOUR for the California Prison Industry Authority (CALPIA) BAKERY ENTERPRISE at R.J. Donovan Correctional Facility in San Diego, California.

Term: Any contract resulting from this solicitation will be effective January 1, 2025 or upon approval, expire after two (2) years, regardless of the amount purchased, unless extended or terminated. The contract resulting from this solicitation may be extended by mutual agreement of CALPIA and the contractor for one (1) additional one (1) year period or portion thereof. The terms, conditions, and prices for the contract extension option shall be by mutual agreement between the contractor and CALPIA.

mailto:Marie.Moyer@calpia.ca.gov

Method of Award:

The contract award will be made on the basis of BEST VALUE as determined by CALPIA alone, under statutory authority considering the following criteria:

1. Cost: Fair, reasonable, and competitive price, expressed warranties, life cycle of product, and customer service commitments for goods and or services.

2. Performance: Past performance, including but not limited to the quality and/or reliability for the product or service as well as efficient billing practices; certification by the International Organization for Standardization (ISO).

3. Experience: Length of time and/or number of instances the bidder has offered or produced the requested type of product and/or service.

CALPIA may consider other factors deemed necessary to ensure that best value is achieved.

In the interest of achieving best value, CALPIA does not grant Small Business, Disabled Veteran Business Enterprise (DVBE), Target Area Contract Preference Act (TACPA), Local Agency Military Base Recovery Act (LAMBRA), or Enterprise Zone Act (EZA) preferences in evaluating bids. Employment of ex-offenders by the bidder is encouraged by CALPIA as part of our ongoing mission to change lives through opportunities.

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

Specifications:

This bid covers whole wheat flour per the CALPIA Commodity Standard for Flour dated March 2014 included as Attachment A. The flour is needed for the California Prison Industry Authority (CALPIA) Bakery Enterprise at R.J. Donovan Facility in San Diego, California. Documents substantiating these standards are required to be sent in with the bid documents.

Non-Compliant Product:

Any product received by CALPIA that is deemed non-compliant will be returned to the vendor at the vendor’s expense and replaced with compliant product.

Corrective Action Plan (CAP):

Should there be any issue with quality, food safety and/or damage to the final product, CALPIA can request a written Correction Action Plan (CAP). A CAP will be provided to CALPIA from the vendor no later than 3 business days from time that the incident is reported to the vendor contact. The CAP will contain the nature of the reported issue, what immediate actions are taking place to correct the problem, and how the problem is going to be prevented from happening again. The CAP can also contain any other relevant information that the vendor feels is necessary to explain the situation. CALPIA may issue a vendor performance report based on the circumstances.

Contract Modifications:

This contract may be amended at any time by mutual agreement of contracting parties, in writing. Change orders amending, modifying, or terminating the contract, including any modification of the compensation payable, may be issued only by the CALPIA Procurement Officer.

Contract Dollar Value:

Any contract resulting from this bid will expire one year from its effective date unless extended or terminated early. However, in the event the ordering agency’s requirements are curtailed because of reducing requirements, cancellation of State programs, lack of fiscal appropriations, etc., the State shall be excused from purchasing any outstanding balances.

Quantity shown on the cost sheet is the estimated anticipated contract purchase requirement.

The State will not be obligated to purchase the contractor’s excess inventory of any line item if actual purchases vary from the anticipated purchase pattern. The State reserves the right to order more or less of any line item provided the total monetary amount of the contract is not exceeded.

Please Note:

Only bids quoted on the State’s own Cost Sheet will be considered. Bids submitted referencing supplier attachments, which include legal terms and conditions that conflict with the State’s general bid provisions shall be considered non-responsive and such bids shall be rejected. On the Cost Sheet if there is a discrepancy between the unit price and the extension price, the unit price shall prevail.

Cost to Cover:

Any failure to perform its obligations under the contract by the contractor shall, in addition to any other remedies available to CALPIA, entitle CALPIA to recover from the contractor the difference between the contractor’s price and an alternate supplier’s higher price in the event that CALPIA chooses to pay an alternate supplier a higher price for goods or services that the contractor fails to provide in a timely fashion.

Emergency Extension Option:

In the event of an emergency, CALPIA, upon mutual agreement with the contractor, may extend the contract in various increments until the establishment of a new contract. The total term of the emergency extension shall not exceed one (1) additional year. The Emergency Extension Option may be exercised in the event that a replacement contract cannot be established due to the protest of Intent to Award, loss of key CALPIA procurement staff, or other circumstance that would otherwise cause an unanticipated disruption to production processes at the CALPIA Bakery Enterprise.

Minimum Order:

The minimum order of bulk whole wheat shall consist of one full trailer load (approximately 47,000 to 48,500 pounds). Orders are expected to be delivered every other week unless otherwise requested. Any order for less than this quantity shall be considered non-contract and may be purchased from other sources.

Emergency/Expedited Orders If there is an emergency order, the contractor will have the right to accept shorter delivery times, which will be subject to Less-Than-Truckload freight rates. The contractor will notify CALPIA by phone upon receipt of the order that such higher freight rates are forthcoming and confirm in writing within 24 hours.

Order Cancellation There may be instances when the bakery is unexpectedly closed due to equipment failures, lockdowns, etc., and they are not able to empty the silo before the next scheduled delivery. In such cases, CALPIA may have to cancel one or two deliveries until they are ready to receive more flour.

Freight on Board (F.O.B.) Point For the purpose of this bid, only bids quoting F.O.B. Destination will be accepted. Bids quoting other than F.O.B. Destination will be rejected.

Packaging:

All packaging shall conform to the applicable freight classifications, I.C.C. and/or postal regulations, and is to be of a quality to assure final delivery without damage to the contents.

Bulk whole wheat flour must have a Guarantee of Analysis included with each shipment.

A packing slip shall accompany each shipment and show the contract and order numbers, contents, and the quantity shipped.

Delivery:

Flour is to be delivered when and as requested according to the delivery schedule submitted with the purchase order from the CALPIA Bakery Superintendent. Typical delivery schedule is a minimum of three (3) truckloads per month. All orders phoned in to the contractor will be followed up with a written purchase order within one week. Delivery must be made between the hours of 7:00 A.M. to 12:00 noon Monday through Friday. Weekend or holiday deliveries cannot be accepted, and rail spurs are not available.

Delivered flour will be subject to inspection and acceptance by the CALPIA bakery staff. Bulk flour must be delivered to on-site silo. Any failure to deliver in a timely manner will be a material breach of this contract by the contractor.

It shall be the contractor’s responsibility to obtain proper clearance for delivery drivers prior to any and all deliveries. Contact the institution listed for the driver clearance procedure.

Delivery Address: Delivery sites may be added as deemed necessary by CALPIA.

California Prison Industry Authority R.J. Donovan Correctional Facility 480 Alta Road San Diego, CA 92179-0001 Attn: Roman Castillo, Supervisor

(619) 661-6500 Ext. 5831

Samples:

Prior to award, bidders may be requested to provide six (6) 100 lb. bags for trial run tests. These samples must be provided within ten calendar days of notification to the R.J. Donovan Correctional facility. Bidder will be required to submit farinographs for any samples requested for testing. If the samples do not meet specifications, the bid will be rejected. The bidder will not be allowed to re-submit corrected samples. If awarded the contract, the contractor must provide the same product submitted under the sample provision for the duration of the contract.

Executive Order N-6-22 – Russia Sanctions

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia and Russian entities and individuals. “Economic Sanctions” refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine, as well as any sanctions imposed under state law. The EO directs state agencies to terminate contracts with, and to refrain from entering any new contracts with, individuals or entities that are determined to be a target of Economic Sanctions. Accordingly, should the State determine Contractor is a target of Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or entities, that shall be grounds for termination of this agreement. The State shall provide Contractor advance written notice of such termination, allowing Contractor at least 30 calendar days to provide a written response. Termination shall be at the sole discretion of the State.

Executive Order N-12-23 – Generative Artificial Intelligence (GenAI)

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 / Contractor must notify the State in writing if their solution or service includes, or makes available, any GenAI technology, including GenAI from third parties or subcontractors.

The State has developed a GenAI Disclosure & Factsheet (STD 1000) to be completed by the Bidder / Offeror / Contractor. Failure to submit the GenAI Reporting and Factsheet (STD 1000) will result in disqualification of the Bidder / Offeror / Contractor.

Failure to report GenAI to the State may void any resulting contract. The State reserves its right to seek any and all relief it may be entitled to as a result of such non-disclosure.

Upon receipt of a Bidder / Offeror / Contractor GenAI Reporting and Factsheet (STD 1000), 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.

Payment:

Payment terms for this contract are net 45 days. Payment will be made in accordance with the provisions of the California Prompt Payment Act, Government Code Section 927 etc. seq.

Unless expressly exempted by statute, the Act requires State agencies to pay properly submitted, undisputed invoices not more than 45 days after (a) the date of acceptance of goods or performance of services or (b) receipt of an undisputed invoice, whichever is later. Under no circumstances will CALPIA be subject to late payment fees or interest charges.

Attachment A

REV March 2014 Page 1 of 1

CALIFORNIA PRISON INDUSTRY AUTHORITY

COMMODITY STANDARD

FLOUR

SCOPE:

This Commodity Standard establishes requirements for whole wheat flour for use by California Prison Industry Authority’s bakery at R.J. Donovan Correctional Facility in San Diego, California.

REQUIREMENTS:

Material: Flour shall be milled from clean, sound, and scoured grain that is essentially free from smut, ergot, weed seeds and other foreign material. Whole wheat flour shall have a range of 13.4% to 14.0% protein levels. This document requires the following types of flour:

Whole Wheat Flour (Coarse or Fine): 100% whole wheat. No reconstitution or addition of milling product in the final flour.

Wheat flour shall be milled from wheat of the following classes and shall be U.S.

No. 2 grade or better. Un-classed wheat and mixed wheat are excluded.

Whole Wheat Flour Hard Red Winter, Dark Northern Spring

Wheat. (White also acceptable)

Finished Product:

The finished product shall have a good characteristic color; shall have a natural flour flavor and odor; and shall be free from rancid, bitter, musty and all other undesirable flavors and odors. The flour shall be free flowing and free of lumps.

Enrichment Requirement:

Enrichment shall be in accordance with the requirements of the definitions and standards for flour of the Federal Food and Drug Administration.

Quality Assurance Provisions:

Testing of Finished Product: Test methods approved by the Association of Official Analytical Chemist (AOAC) and the American Association of Cereal Chemist (AACC) shall be used. Conformance to the referenced characteristics shall be ascertained by examination of mill laboratory analysis.

Presence of foreign material (e.g., metal, filth, wood, glass, paint, insects, etc.)

shall be cause of rejection of the lot. A lot is defined as all flour of the same type delivered to a receiving agency at one time. This commodity will be sampled and inspected for compliance to this specification as deemed necessary. When verification of characteristics is required, the industry established test methods would be used. Any product that fails to meet the standards will be picked up and replaced with compliant product at the expense of the contract vendor.

CALIFORNIA PRISON INDUSTRY AUTHORITY

Invitation for Bid RW2411014

BULK WHEAT FLOUR

REQUIRED ATTACHMENT CHECK LIST

A complete bid or bid package will consist of the items identified below.

Complete this checklist to confirm that the items listed below have been included with your bid.

Place a check mark or “X” next to each item that you are submitting. For your bid to be responsive, all required attachments must be returned. This checklist should also be returned with your bid package.

COMPANY NAME:

Attachments Attachment Name/Description

_____ Exhibit 1 Contract Price Sheet

_____ Exhibit 2 Bidder/Supplier Responsibility Information

_____ Exhibit 3 Bid/Bidder Certification Sheet

_____ Exhibit 4 Darfur Certificate

_____ Exhibit 5 Economic Sanctions Certification

_____ STD 204 Payee Data Record

_____ STD 205 Payee Data Record Supplement NOTE: For use only if additional remittance addresses or additional authorized representatives need to be identified

_____ STD 1000 GenAI Reporting & Factsheet Form

_____ Documents substantiating Commodity Standard for Flour as on Attachment A

IFB #RW2411014 Exhibit 1 Bulk Wheat Flour Page 1 of 1

CONTRACT PRICE SHEET

The estimated annual quantity indicated below is not binding upon the contracting agency.

However, the actual costs quoted by the bidder shall be binding for the term of the Agreement.

The Extension Price is calculated by multiplying the Estimated Annual Quantity by the Unit Price. In case of discrepancy between the Unit Price and the total set forth for the Extension Price, the Unit Price shall prevail.

NOTE: 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.

ITEM

NO.

ESTIMATED

ANNUAL

QUANTITY

UNIT DESCRIPTION

UNIT

PRICE

EXTENSION

PRICE

1 1,400,000 LB

FLOUR, WHOLE WHEAT, BULK

Whole Wheat Patent Unbleached Flour, Fine Per the attached specifications Bulk delivery into silo

CALPIA #0027.439

Brand Offered: _______________ Mill: ________________________

$_____/LB $____________

Bidder to complete: Name and Address to which orders are to be sent:

Name:

Street Address:

City/State/Zip:

Email Address:

Phone: Fax:

Supplier Contact:

Contractor shall have, preferably in California, a contact person available during the hours of 8:00 A.M. to 5:00 P.M. on weekdays to answer questions regarding product, orders, or other areas in relation to the contract and the State’s needs.

All questions shall be answered within twenty-four (24) hours (except on weekends or holidays).

Contact person:

Phone Number: Fax number:

Email Address:

Exhibit 2

Bidder/Supplier – Materials, Responsibility Information

The intent of these questions is to establish that the bidder has secured the necessary production, distribution, and financial resources to perform the contract being proposed.

Except in cases when CALPIA concludes that a specified brand name is the only one that will meet the needs of CALPIA, all commodities shall be entered into with the best value bidder meeting all specifications. Responsibility in this context relates to the bidder’s qualifications and capability to successfully fulfill the requirements of the Invitation for Bid (IFB). A bidder is deemed not responsible when they have demonstrated a lack of reliability in complying with and completing previously awarded State/Private contracts. Prior to awarding the contract related to this IFB, CALPIA’s Authorized Representative will determine whether the proposed awardee is responsible. In order to obtain information necessary to establish a bidder’s responsibility, each bidder shall complete the information requested below.

Failure to complete these questions may cause your offer to be rejected as non-responsive. Incomplete, vague or misleading responses could cause your offer to be rejected as non-responsible. Use additional sheets as necessary to provide all the requested information.

Bidders who are manufacturers should be able to directly respond to the questions. Non-manufacturers may need to consult with their supply chain to properly complete each question. The burden of proof lies with the bidder to prove, to CALPIA’s satisfaction, that the bidder has adequate knowledge and control of the supply chain being utilized.

1. (A) If you are not the manufacturer, please list your role in the supply chain and list all points of business interaction(s) between the manufacturer and your firm. (Manufacturer/Producer, wholesaler/broker, warehousing/distribution)

Please be prepared to provide a written agreement between your firm and your supplier upon request. If your supplier is not the manufacturer, please also be prepared to provide a written agreement between the manufacturer and your supplier. If there is no written agreement between these two parties, to provide upon request supporting documents showing that they have worked together in the past.

1. (B) Name and address of the manufacturer and any other key parties utilized:

Exhibit 2

2.) How long has your firm been part of this supply chain? If less than 2 years, then please provide names of all the suppliers relative to this solicitation with whom you have worked in the past 2 years:

3.) How much business have you successfully completed as part of the supply chain described above? (Total dollar values, length of contract, product types, and geographic areas supplied.

4.) Names(s) of packaging and shipping firms(s) to be utilized for this contract.

5.) Have you ever had a contract terminated prior to its designated end date/term? If yes, please explain circumstances for each such contract termination.

6.) Using the format below, list contracts that you were awarded within the last five years with a value of at least 50% of the value of the contract to be awarded herein, which demonstrate your ability to meet the requirements of the proposed contract.

Contract Number: ____________________________________________________________________________________________ Description of product/services: _________________________________________________________________________________ Contract Value ($):____________________________________________________________________________________________ Contract Award Date: _________________________________________________________________________________________ Required Delivery or Completion Date: ___________________________________________________________________________ Actual Delivery or Completion Date: _____________________________________________________________________________ Customer Contact Information (Name, phone number and email): ______________________________________________________

Business Services Section will review your past performance. A history of late or non-compliant deliveries on past or present contracts may cause your bid to be rejected.

Exhibit 3

BID/BIDDER CERTIFICATION SHEET

This Bid/Bidder Certification Sheet must be signed and returned along with other bid/quote documents as an entire package with original signatures

A. _____% Cash discount for payment within __________ days of receipt. (See Bidders Instructions Item 26 for complete instructions on offering Cash Discounts.)

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

C. The signature affixed hereon and dated is authorized to bind the bidding firm contractually and 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.a Telephone Number 2.b. 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/SSN)

8. California Corporation No.

9. Indicate applicable license and/or certification information:

Contractor’s State Licensing Board Number:

10. PUC License Number CAL- T:

11. Other Licenses:

12. Bidder’s Name (Print) 13. Title

14. Signature 15. Date

16. For accounting reporting purposes, please provide the following information: Are you certified with the California Department of General Services, Office of Small Business Certification and Resources (OSBCR) as:

a. California Small Business Micro Business

Yes No Yes No If yes, enter certification number below: Expiration Date:

b. Disabled Veteran Business Enterprise Yes No

If yes, enter your service code below:

Qualifying Experience:

Exhibit 3

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, 2a, 2b, 3 Must be completed. 1. Enter your name if sole proprietor or independent contractor. All other 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.

5 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.

6 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.

Enter your federal employee tax identification number.

8 If you are a corporation: 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.

9 Complete if your firm holds a California contractor’s license. This information will used to verify possession of a contractor’s license for public works agreements.

10 Complete if your firm holds a PUC license. This information will be used to verify possession of a PUC license for public works agreements.

11 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.

12, 13, 14, 15 Must be completed. These items are self-explanatory.

This information is requested by CALPIA Accounting. If certified as a Small Business Enterprise/Micro 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.

11/16, Rev. E BSS-F017 Page 1 of 1

DARFUR CONTRACTING ACT CERTIFICATION

Public Contract Code Sections 10475 - 10481 applies to any company that currently or within the previous three years has had business activities or other operations outside of the United States. For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company that has been granted permission by the Department of General Services to submit a proposal.

OPTION #1 – DOMESTIC ONLY

If your company has not, within the previous three years, had any business activities or other operations outside of the United States, initial here and submit with your bid package. (Initial ______)

OPTION #2 - CERTIFICATION

If your company, within the previous three years, has had business activities or other operations outside of the United States, in order to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete the certification below.

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that the prospective proposer/bidder named below is not a scrutinized company per Public Contract Code 10476; and I am duly authorized to legally bind the prospective proposer/bidder named below. This certification is made under the laws of the State of California.

Company/Vendor Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date Executed Executed in the County and State of

OPTION #3 – WRITTEN PERMISSION FROM DGS

Pursuant to Public Contract Code section 10477(b), the Director of the Department of General Services may permit a scrutinized company, on a case-by-case basis, to bid on or submit a proposal for a contract with a state agency for goods or services, if it is in the best interests of the state. If you are a scrutinized company that has obtained written permission from the DGS to submit a bid or proposal, complete the information below.

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

Company/Vendor Name (Printed) Federal ID Number

Initials of Submitter

Printed Name and Title of Person Initialing

5/5/2022, Rev. B BSS-F069 Page 1 of 1

ECONOMIC SANCTIONS CERTIFICATION

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (EO) regarding sanctions against Russia and Russian entities and individuals. The EO is located at https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf.

As a potential vendor, contractor, or grantee, compliance with the economic sanctions imposed in response to Russia’s actions in Ukraine is required, including with respect to, but not limited to, the federal executive orders identified in the EO and the sanctions identified on the U.S. Department of the Treasury websites (https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions and https://home.treasury.gov/news/press-releases/jy0608). Failure to comply may result in the termination of purchase orders, contracts, or grants, as applicable.

In order to be eligible to submit a bid, proposal, or conduct business with CALPIA, please complete the following certification and return with your bid documents or as otherwise requested.

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that the prospective proposer/bidder named below is in compliance with the economic sanctions imposed by the U.S.

government in response to Russia’s actions in Ukraine, as well as sanctions imposed under state law, if any, and I am duly authorized to legally bind the prospective proposer/bidder named below.

This certification is made under the laws of the State of California.

Company/Vendor Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date Executed Executed in the County and State of https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions https://home.treasury.gov/news/press-releases/jy0608