IFB_RW2525001_Flip_Top_Table_Bases.pdf

State of California Department of Corrections and Rehabilitation

May 20, 2025

INVITATION FOR BID (IFB)

IFB # RW2525001

Notice to Prospective Contractors

The California Prison Industry Authority (CALPIA) invites you to review and respond to this Invitation for Bid (IFB), entitled RW2525001 for FLIP TABLE TOP BASES. In submitting your bid, you must comply with the instructions found herein. CALPIA does not accept alternate contract language from a prospective vendor. A bid with such language will be considered a counter proposal and will be rejected. CALPIA’s General Provisions (GP’s) are not negotiable.

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: RW2525001 IFB Name: FLIP TOP TABLE BASES Attention: Sadaqatullah Sahak 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: June 3, 2025 by 3:00 pm (PST) CALPIA Contact: Return Sealed Bid To:

Sadaqatullah Sahak Phone: (916) 358-1504

Email: Sadaqatullah.Sahak@calpia.ca.gov

California Prison Industry Authority Attention: Sadaqatullah Sahak

560 East Natoma Street Folsom, CA 95630

This IFB covers the estimated three (3) year requirement of FLIP TOP TABLE BASES for the California Prison Industry Authority (CALPIA) FURNITURE ENTERPRISE and MODULAR FURNITURE ENTERPRISE at Avenal State Prison (ASP) in Avenal, California.

Term: Any contract resulting from this solicitation will go into effect July 1, 2025 and will expire after three (3) 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 mailto:Sadaqatullah.Sahak@calpia.ca.gov

California Prison Industry Authority (CALPIA) IFB# RW2525001 Flip Top Table Bases Page 2 of 9

This IFB shall be awarded by line item; however, it is not necessary to bid on every item to be considered responsive. CALPIA reserves the right to award multiple contracts from this IFB.

Contract awards will be determined on the basis of best fit for CALPIA markets and manufacturing settings. That can include the life cycle cost of a product; product innovation, design, and durability; expressed warranties; Greenguard/LEED credits eligibility; and customer service commitments.

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 of 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 the best value is achieved. Any such factors must be reduced to written form and maintained in the contract file for the duration of the resulting contract.

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.

California Prison Industry Authority (CALPIA) IFB# RW2525001 Flip Top Table Bases Page 3 of 9

1.0 Purpose

The purpose of this IFB is to provide FLIP TOP TABLE BASES to the California Prison Industry Authority’s Furniture Enterprise and Modular Office System Enterprise. CALPIA will be manufacturing and installing the work surfaces onto these bases. Bidders are asked to provide on the Contract Price Sheet (Exhibit 1) the work surface dimensions that the table base will hold.

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.

2.0 Minimum Qualifications

CALPIA will only contract with manufacturers or representatives of the manufacturer who agree to work in the unique Correctional Industries setting. Only products offered by the manufacturer will be eligible. If the manufacturer declines to participate, the representatives will not be eligible to offer their product for sale to CALPIA. Bidders who are representatives of a manufacturer will provide a signed letter of agreement from the manufacturer with their bid package, stating that the manufacturer agrees to work with Correctional Industries and will provide CALPIA with any needed technical support.

The successful bidder shall have a minimum five (5) years of experience in manufacturing table bases or as a representative of said manufacturer. Bidders shall provide a company profile, including number of years in business and verifiable company references within the last five years (minimum two, maximum five references). Bidders who are representatives of a manufacturer shall provide a company profile for both the manufacturer as well as their own company.

3.0 Requirements, Certifications, and Specifications

3.1 Mandatory Requirements

3.1.1 Testing Standards

All items shall meet or exceed test and performance standard prescribed in ANSI/BIFMA applicable standards for flip top table bases and underbodies.

3.1.2 Workmanship

all items must display good quality workmanship. Details, finishes, colors, and material shall be consistent throughout the term of the contract.

3.1.2.1 Welding

3.1.2.1.1 Must be free from sharp edges or burrs and any other defects which compromise the use or operation or are harmful to persons or materials in contact with them.

3.1.2.1.2 All metal components shall be fabricated from top quality metal raw materials.

3.1.2.1.3 Surfaces shall be free from pits, scale, and other defects.

3.1.2.1.4 All welds shall be ground smooth, and all seams shall be flush.

California Prison Industry Authority (CALPIA) IFB# RW2525001 Flip Top Table Bases Page 4 of 9

3.1.2.2 Paint

Metal frame assembly and exposed metal surfaces shall have either a factory applied baked-on enamel or powder coat finish that is mar, fade, and chip resistant in either a chrome-like or black color. If bid is for CALPIA’s factory to apply finishing, items must be able to accept powder coat finish.

3.1.3 Compatibility

All flip top table bases must be compatible with CALPIA work surfaces. Current sizes for rectangular work surface are as follows: 60” width with 18”, 24”, or 30” depth, and 72” width with 24” or 30” depth. Current sizes for circular work surfaces are 48” and 60”.

3.2 Mandatory Certifications

CALPIA is interested in partnering with vendors who meet the same manufacturing requirements as CALPIA regarding sustainability and ISO certification. Provide documentation or certifications you have with your bid response.

3.2.1 BIFMA e3- 2019 Level 2 or Level 3 Certification

This certification is a multi-attribute, sustainability standard and third-party certification program. Provide a copy of your certificate.

3.2.2 ANSI/BIFMA M7.1 and X.7

This is a standard for volatile organic compounds emissions. Provide third party certification.

3.2.3 ISO 9001 (latest edition)

Provide a copy of your certification.

3.3 Specifications

All specifications for the flip top table bases ae a minimum unless otherwise mentioned.

3.3.1 Surfaces attached to the base must be able to flip to allow nesting.

3.3.2 Must be available in black and silver.

3.3.3 Mechanism that allows one person to fold flip top table with ease.

3.3.4 Separate bases to fit CALPIA rectangular and circular work surfaces.

3.3.5 Underbody cable management required as an option.

3.3.6 Modesty panel required as an option (list sizes available on Contract Price

Sheet).

3.3.7 Surface mounted power outlet as an option

3.3.8 Various foot options available (casters, glides) to be listed on Contract

Price Sheet.

4.0 Product Information

The following list of product information is required as part of a complete response. All literature must be in English. Information provided is for the sole purpose of evaluation by CALPIA and will remain confidential. If deemed necessary by CALPIA, information may be shared with an outside testing laboratory for evaluation only.

o Product Brochures/Profiles/Literature (English only) o Technical specifications (dimensions, ranges, mounting hardware, etc.)

o Assembly instructions with list of any special tool/jigs/fixtures required for assembly

California Prison Industry Authority (CALPIA) IFB# RW2525001 Flip Top Table Bases Page 5 of 9 o Product testing certifications (BIFMA e3, ANSI/BIFMA M7.1 and X.7, ISO) o Recycled/post-consumer and post-industrial content and recyclability of parts o Warranty information

5.0 Contract Dollar Value

Any contract resulting from this bid will expire three (3) years from its effective date unless extended. In the event the ordering agency’s requirements are curtailed because of reduced requirements, cancellation of State programs, lack of fiscal appropriations, etc., the State shall be excused from purchasing any outstanding balances.

6.0 Emergency Extension Option

In the event of an emergency, upon mutual agreement with the contractor(s), CALPIA may extend the contract for up to one (1) additional year beyond the stated term and any noted extensions. Extensions during this period may occur in various increments until the establishment of a new contract. The total of the Emergency Extension Option terms shall not exceed one (1) additional year. All original Terms and Conditions shall remain the same during the extensions. 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 circumstances that would otherwise cause an unanticipated disruption to CALPIA’s Furniture or Modular Furniture Enterprises.

7.0 Engineering Change Notifications (ECNs)

Vendor will notify CALPIA Contract Analyst in writing or via e-mail of any planned or intended ECNs for any component or material prior to shipments of any affected parts within 30 calendar days of proposed change. ECN shall include reason for change, drawings, assembly instructions/specifications or requirements, additional equipment requirements, ANSI-BIFMA test results, etc.

8.0 Warranty Parts Replacement Timeline/Procedures

The CALPIA warrants that products under the ensuing contract are free from defects in materials and workmanship found through normal usage for the specified warranty period of five (5) years. The CALPIA shall be provided warranty replacement parts for the duration of a minimum of the contract, including the vendors warranty period after the expiration of the contract with CALPIA.

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The vendor shall provide CALPIA replacement warranty parts ten (10) working days from point of factory contact to delivery of replacement parts. Vendor shall notify CALPIA of warranty parts status return with three (3) working days from point of factory contact.

Vendor shall assume freight charges for warranty parts.

9.0 Customer Support Services

In cases where the vendor’s product is defective and is still under the manufacturer's warranty, the Contractor shall provide field service technicians to any location in California within 48 hours of contact by CALPIA staff. The Contractor shall bear the cost of any service call required to repair or replace a defective product still under their warranty.

10.0 Quality Control

10.1 Quality Conformance

Failure of the product(s) to meet any requirement specified herein may, at the discretion of the State, be cause for refusal to accept further shipments of product until evidence has been provided by the manufacturer that corrective action has been taken to eliminate deficiencies.

The State may return or refuse to accept any delivery with obvious defects or that fails to meet any requirement contained in this IFB

10.2 Quality Assurance

The CALPIA would prefer that bidders are ISO certified. If not ISO certified, the supplier shall demonstrate that the manufacturer has a quality assurance program established that assures product continuity and consistency to specification, pattern, and color.

11.0 Freight On Board (F.O.B) Point

For the purposes of this contract, only F.O.B. Destination will be accepted. Proposals quoting other than F.O.B. Destination will be rejected.

12.0 Minimum Order

There is no minimum order requirement unless otherwise indicated on the Contract Prices Sheet (Exhibit 1) submitted with the vendor’s bid. Any minimum order requirement will be considered part of the award factor in the evaluation process. Orders for less than the stated quantity shall be considered non-contract and may be purchased from other sources.

13.0 Packaging

Table bases shall be packaged as kits rather than as bulk items. All pack materials used in shipment must maximize the use of recyclable material. Exterior packaging is to show the contents and the purchase order number. 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.

14.0 Delivery

14.1 Delivery Terms

The items are to be delivered when requested as determined by the vendor’s bid, Monday through Friday, 8:00 a.m. to 2:30 p.m. Weekend or holiday deliveries cannot be accepted

California Prison Industry Authority (CALPIA) IFB# RW2525001 Flip Top Table Bases Page 7 of 9 without prior approval in writing by ordering agency. Delivery terms will be considered part of the award factor in the evaluation process.

It shall be the Contractor's responsibility to notify CALPIA of any late deliveries (per purchase order/replacement due date) of complete kits, component parts, or replacement warranty parts immediately upon their knowledge.

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.

14.2 Delivery Addresses (Additional sites may be added as deemed necessary by

(CALPIA)

Avenal State Prison 1 Kings Way Avenal, CA 93204 Attn: CALPIA Furniture or General Fabrication Phone: (559) 386-6057 or (559) 386-6056

15.0 Pricing Provisions

The prices issued on a contract resulting from this IFB will be firm for the first year of the contract. After the first year, the prices may be adjusted upon mutual agreement of CALPIA and the Contractor. Any adjustments for price increase or decrease shall be based on documented changes to the Contractor’s costs of materials. The Contractor may request new pricing by submitting the proposed contract price changes up to 30 days prior to the anniversary month that the contract was issued for CALPIA’s review and approval.

CALPIA may also purchase any additional standard products not covered in the IFB at or below the lowest published price of the contractor.

16.0 Recycled Content

State agencies require that all suppliers certify the recycled content of all products offered or sold to the State. Copies of the recycled content certification form(s) and/or other certification documentation must be obtained and kept on file. The supplier must certify the minimum percentage of post-consumer material and post-industrial material in the product.

Note: Products that are refurbished, remanufactured, or reused are always considered recycled products, regardless of whether or not they meet the minimum content requirements.

Provide CALPIA with recycled content percentages by completing the CALPIA Supplier Material Declaration Form (Exhibit 5) included with this bid package for all products to be included on contract. any changes during the term of the contract must be in writing with content provided.

17.0 Samples: DO NOT SEND SAMPLES UNTIL REQUESTED

Samples may be required prior to the final award of proposal. CALPIA will send a request to qualified vendors for a sample of any product offered. If the samples do not meet specifications, the bid will be rejected. Samples will be returned at vendor’s expense.

Return authorization packing slip(s) will be required along with prepaid will call or return merchandise authorization packing slip(s).

California Prison Industry Authority (CALPIA) IFB# RW2525001 Flip Top Table Bases Page 8 of 9

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 into 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 with 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 must notify the State in writing if it: (1) intends to provide GenAI as a deliverable to the State; or (2), intends to utilize GenAI, including GenAI from third parties, to complete all or a portion of any deliverable that materially impacts: (i) functionality of a State system, (ii) risk to the State, or (iii) Contract performance. For avoidance of doubt, the term “materially impacts” shall have the meaning set forth in State Administrative Manual (SAM) § 4986.2 Definitions for GenAI.

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

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.

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CALIFORNIA PRISON INDUSTRY AUTHORITY

INVITATION FOR BID RW2525001

FLIP TOP TABLE BASES

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.

BIDDER’S 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 CALPIA Supplier Material Declaration Form

_____ Exhibit 6 Economic Sanctions Certification

_____ Exhibit 7 Payee Data Record (STD 204)

_____ Exhibit 8 Payee Data Record Supplement (STD 205) NOTE: For use only if additional remittance addresses or additional authorized representatives need to be identified

Required Documentation

_____ Product Brochure/Profile/Literature (English Only) _____ Manufacturer Agreement with Distributor (if applicable) _____ Company profile and references for manufacturer and distributor (if applicable) _____ Technical Specifications with dimensions, ranges, mounting hardware, etc.

_____ Assembly Instructions with list of special tools required for assembly _____ BIFMA e3 2019 level certification _____ ANSI/BIFMA M7.1 and X.7 certification _____ Product Warranty Information _____ Greenguard/LEED Credits if cited _____ ISO Certifications or other Quality Assurance documentation

IFB #RW2525001 Exhibit 1

CONTRACT PRICE SHEET

The costs provided are for flip top table bases only. Do not include the cost for any work surfaces in the price quotes. Bidders are asked to quote all sizes available for both rectangular and circular work surfaces. If additional space is needed, please use a separate page. The actual costs quoted by the bidder shall be binding for the term of the Agreement; however, CALPIA is not obligated to purchase any quantity of goods from the contractor.

If you offer a discounted price for a higher volume purchase, provide the minimum quantity required for the discount in the column below along with the discounted unit price available.

If you have more than one product line that meets the requirements of this IFB, submit multiple price sheets and label them as alternate proposals.

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.

FLIP TOP TABLE BASES

ITEM

NO. UNIT DESCRIPTION

RANGE OF

WORK

SURFACE

DIMENSIONS

UNIT PRICE

MINIMUM

QUANTITY

FOR A

VOLUME

DISCOUNT

DISCOUNT

UNIT PRICE

1 EA

Flip-Top Base for Rectangular Work Surface (list additional sizes if available) Model name/number: ______________________

60” x 18”

60” x 24”

60” x 30”

60” x 36”

48” x 18”

48” x 24”

48” x 30”

72” x 24”

$______/EA

72” x 30”

72” x 36”

84” x 24”

84” x 30”

84” x 36”

2 EA

Flip-Top Base for Circular Work Surface (list additional sizes if available) Model name/number: ______________________

48”

60”

3 EA Modesty Panel Option (list sizes available)

ITEM

NO. UNIT DESCRIPTION UNIT PRICE

MINIMUM

QUANTITY

FOR A

VOLUME

DISCOUNT

DISCOUNT

UNIT PRICE

4 EA Cable Management Option $______/EA ___________ $______/EA

5 EA Surface Mounted Power Outlet Option $______/EA ___________ $______/EA

6 SET

Foot options available:

Casters Glides Other: ________________________

$_______/ST

DELIVERY TERMS and MINIMUM ORDER REQUIREMENTS for BASES ONLY If additional space is needed than what is provided below to describe your delivery schedules or minimum order requirements, please use a separate page to describe in sufficient detail.

DELIVERY TERMS: (If none are provided, CALPIA will expect 30 days ARO)

MINIMUM ORDER REQUIREMENTS: (If none are provided, CALPIA will consider that there are no minimum order requirements)

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

Contact Name:

Street Address:

City, State, Zip:

Phone: Fax:

Email Address:

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 fulfil 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 be prepared to provide a written agreement between the manufacturer and your supplier. If there is no written agreement between these two parties, 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 the 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 the 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): ______________________________________________________

The 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 Page 2 of 2 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.

7 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 to check 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 be 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.

Exhibit 4

04/10/2025, Rev. F

BSS-F017

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 a) the prospective proposer/bidder named below is not a scrutinized company per Public Contract Code 10476; and

b) 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

By (Authorized Signature)

Printed Name and Title of Person Signing

Date Executed Executed in the County and State of

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

Exhibit 6 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

Exhibit 7

STATE OF CALIFORNIA – STATE CONTROLLERS OFFICE

PAYEE DATA RECORD SUPPLEMENT

(This form is optional. Form is used to provide remittance address information if different than the mailing address on the STD 204 – Payee Data Record.

Use this form to provide additional remittance addresses and additional Authorized Representatives of the Payee not identified on the STD 204.)

Payee Information (must match the STD 204) NAME (Required. Do not leave blank.)

BUSINESS NAME, DBA NAME or DISREGARDED SINGLE MEMBER LLC NAME (If different from above)

TAX ID NUMBER (Required)

SSN, ITIN, or FEIN that matches Tax ID number provided on STD 204

Additional Remittance Address Information Use the fields below to provide remittance addresses for payee if different from the mailing address on the STD 204.

The addresses provided below are for remittance purposes only. 1099 information returns will be sent to the mailing address specified on the STD 204.

REMITTANCE ADDRESS (number, street, apt or suite no.)

CITY STATE ZIP CODE

REMITTANCE ADDRESS

CITY STATE ZIP CODE

REMITTANCE ADDRESS

CITY STATE ZIP CODE

REMITTANCE ADDRESS

CITY STATE ZIP CODE

REMITTANCE ADDRESS

CITY STATE ZIP CODE

Additional Contact Information Use the fields below to provide additional Authorized Representatives for the Payee if applicable.

CONTACT NAME

TELEPHONE (Include area code) EMAIL

CONTACT NAME

TELEPHONE EMAIL

CONTACT NAME

TELEPHONE EMAIL

Certification I hereby certify under penalty of perjury that the information provided on this supplemental document is true and correct.

By signing this document, I authorize the State of California to remit payment to the addresses specified on this supplemental form (STD 205) and certify that all persons identified on this form are authorized representatives of this payee. Payments remitted to any of the listed addresses may be reported on 1099 information returns to the tax liable entity identified on the accompanying Payee Data Record - STD 204.

NAME OF AUTHORIZED PAYEE REPRESENTATIVE

(Print or Type name)

TITLE E-MAIL ADDRESS

SIGNATURE

X___________________________________________

DATE TELEPHONE (Include area code)

Print Form Reset Form Exhibit 8

STATE OF CALIFORNIA – STATE CONTROLLERS OFFICE

PAYEE DATA RECORD SUPPLEMENT

(This form is optional. Form is used to provide remittance address information if different than the mailing address on the STD 204 – Payee Data Record.

Use this form to provide additional remittance addresses and additional Authorized Representatives of the Payee not identified on the STD 204.)

GENERAL INSTRUCTIONS

Type or print the information on the Payee Data Record Supplement, STD 205. Sign, date, and return to the state agency/department with a completed STD 204. Prompt return of the fully completed forms will prevent delays when processing payments.

Purpose – Completion of this form (STD 205) is optional. Payees may use this form to provide remittance addresses or contact information in addition to the 1099 information return mailing address provided on the STD 204. This form shall only be used in conjunction with the STD 204, and will not be accepted without a STD 204.

Please note: The State of California Government will issue 1099 information returns to the mailing address provided on the most recently dated form STD 204 validated by the Payee. Addresses provided on this form (STD 205) will be used for remittance purposes only. If the payee would like to update the address for receiving 1099 information returns, please complete the STD 204.

Payee Information: The Payee’s Tax ID number (TIN) and Name (including any Business, DBA, or Disregarded LLC names) are required. This information is subject to TIN matching via the IRS database for validation. Payee Information provided in this section must clearly match the STD 204. Any discrepancies may result in delays of payment, up to and including denial of the request.

Name – Enter the name of the Payee. The name provided shall be the tax liable party and is subject to IRS TIN matching (when applicable).

Business Name – Enter the business name, DBA name, trade or fictitious name, or disregarded LLC name.

Tax ID Number-The State of California requires that all parties entering into business transactions that may lead to payment(s) from the state provide their Taxpayer Identification Number (TIN). The TIN is required by R&TC sections 18646 and 18661 to facilitate tax compliance enforcement activities and preparation of Form 1099 and other information returns as required by the IRC section 6109(a) and R&TC section 18662 and its regulations.

Additional Remittance Address Information - Enter the Payee’s additional remittance address(s) that are not listed on STD 204. Up to five (5) addresses may be provided on this form. The Payee may provide additional remittance addresses on a second STD 205 form if needed.

Additional Contact Information - Enter the Payee’s additional or updated contact information. Up to three contacts may be identified on this form. Payee may provide additional contacts on a second STD 205 if needed.

PRIVACY STATEMENT

Section 7(b) of the Privacy Act of 1974 (Public Law 93-579) requires that any federal, state, or local governmental agency, which requests an individual to disclose their social security account number, shall inform that individual whether that disclosure is mandatory or voluntary, by which statutory or other authority such number is solicited, and what uses will be made of it.

It is mandatory to furnish the information requested. Federal law requires that payment for which the requested information is not provided is subject to federal backup withholding and state law imposes noncompliance penalties of up to $20,000.

You have the right to access records containing your personal information, such as your SSN. To exercise that right, please contact the business services unit or the accounts payable unit of the state agency(ies) with which you transact that business.

All questions should be referred to the requesting state agency listed on the bottom front of the STD 204 form.