IFB__RW2525005_Sit-To-Stand_Desktop_Converters.pdf

State of California Department of Corrections and Rehabilitation

August 6, 2025

INVITATION FOR BID (IFB)

IFB # RW2525005

Notice to Prospective Contractors

The California Prison Industry Authority (CALPIA) invites you to review and respond to this Invitation for Bid (IFB), entitled RW2525005 for SIT-TO-STAND DESKTOP CONVERTER. 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: RW2525005 IFB Name: SIT-TO-STAND DESKTOP CONVERTER 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 August 27, 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 annual three (3) requirement of Sit-to-Stand Desktop Converter for the California Prison Industry Authority (CALPIA) General Fabrication Enterprise, located at Avenal State Prison in Avenal, California.

Term: Any contract resulting from this solicitation 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 RW2525005 Sit-To-Stand Desktop Converter Page 2 of 5

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; 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.

CALPIA does not accept alternate contract language from a prospective Contractor. A bid with such language will be considered a counter proposal and will be rejected. CALPIA’s General Provisions (GP’s) are not negotiable.

Sit-To-Stand Desktop Converter

1.0 Purpose

The purpose of this IFB is to include sit-to-stand desktop converters in CALPIA’s General Fabrication product line. The desktop converter sits on top of desks or work surfaces, enabling the user to adjust the computer/keyboard up and down and allowing the user to easily change from a sitting to standing position (also referred to as desktop sit stand workstation).

CALPIA will be purchasing fully assembled desktop converters initially, but it would like the option to purchase unassembled kits as well. This will allow the incarcerated workforce to assemble the units and package for shipping.

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.

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 in this evaluation, the representatives of a manufacturer 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 of five (5) years of experience in manufacturing desktop converters or as a representative of said manufacturer. Due to significant challenges of working inside a correctional facility compared to a normal retail setting, the successful bidder shall also provide a document that they a minimum of three (3) years of experience working in a correctional industry setting as a manufacturer or 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. Bidders shall provide documented quality control procedures that include receiving inspection standards.

3.0 Mandatory Requirements, Certifications, and Specifications

3.1 Mandatory Requirements

3.1.1 Workmanship

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

3.1.2 Welding

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

3.1.2.2 All metal components shall be fabricated from top quality metal raw materials

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

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

3.2 Certifications

3.2.1 BIFMA e3- 2019 Level Certification

This certification is multi-attribute, sustainability standard, and third party certification program. Bidders are required to provide a copy of their e3- 2019 Level certificate.

3.3 Specifications (All specifications are a minimum unless otherwise stated.)

• Pneumatic height adjustment

• Scissor or X lift-style mechanism

• Weight adjustable counterbalance pneumatic lift with built-in tension adjustment

• 35 lb. platform weight capacity

• Height adjustment range minimum of 16.0” o Retracted height: 6.0” o Extended height: 22.0”

• Top platform size approximately 35” w x 21”d

• Keyboard platform size approximately 26.5” w x 10.5”d

• Minimum of 1.0” keyboard platform depth adjustment range upon installation

• Unit weight less than 41lbs

• Integrated cable management

• Fluid, one-handed operation, stopping at any point up or down o Must be straight vertical travel up/down o Worksurface and keyboard platforms must move simultaneously

• Weight tension pre-set to lift 22 lb.

• Ratchet wrench included for easy weight tension adjustment

• Black only

4.0 Product Information

The following list of product information is required as part of a complete response. (All literature must be in English)

• Product Brochures/Profiles/Literature

• Technical specifications (dimensions, ranges, hardware, etc.)

• Product testing certifications (ANSI/BIFMA Standards and those listed in Section 3.2)

• Recycled/post-consumer and post-industrial content and recyclability of parts and products

• Warranty information

• List of any value-added operations available for CALPIA workforce to perform

• Design for Environment (DFE) statement or documentation answering the question “How was the environment considered in the design?” (needed to support CALPIA’s BIFMA Level 2 certification)

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.

5.0 Contract Dollar Value

Any contract resulting from this bid will expire three (3) years from its effective date; unless extended. 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.

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.

CALPIA has the right to reject ECNs that may result in institution security issues and retains the right to terminate use of affected product on the contract.

CALPIA Contract Analyst should be notified of any ECN affecting any current product in inventory that may be affected by a safety issue (i.e., product safety recall). If ECN affects current inventory (i.e., creates obsolete parts), vendor will pick-up and credit CALPIA for any obsolete inventory.

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.

The vendor shall provide CALPIA replacement warranty parts 10 working days from point of factory contact to delivery of replacement parts. Vendor shall notify CALPIA of warranty part status return within 3 working days from point of the 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

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 purpose of this bid, only bids quoting F.O.B. Destination (freight prepaid by the vendor to the ordering facility’s receiving point) will be accepted. Bids quoting other than F.O.B.

Destination will be rejected.

12.0 Minimum Order

The minimum order will be the quantity indicated on the Contract Price Sheet submitted with the vendor’s proposal. These minimums will be considered part of the award factor in the evaluation process. Orders for less than this quantity shall be considered non-contract and may be purchased from other sources.

13.0 Packaging

Each desktop converter shall be packaged either as a fully assembled unit or unassembled kit, one per box, not as bulk items. All packaging 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.

A packing slip must accompany each delivery showing the contract number and Purchase Order number and give an accurate description of the item, weight, quantities, etc.

14.0 Delivery

14.1 Delivery Terms

The items are to be delivered when requested as determined by the vendor’s proposal, Monday through Friday, 8:00 a.m. to 2:30 p.m. Weekend or holiday deliveries cannot be accepted without prior approval in writing by the ordering agency. Delivery terms will be considered part of the award in the evaluation process. Any single 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 notify CALPIA of any late deliveries (per purchase order/replacement due date) 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 Address: Additional sites may be added as deemed necessary by

CALPIA.

Avenal State Prison 1 Kings Way Avenal, CA 93204 Attn: CALPIA General Fabrication Phone: (55) 386-6057 or (559) 386-6056

14.3 Direct Delivery Option

CALPIA may request direct shipping of completely assembled desktop converter(s) from the manufacturer to a customer location. In such cases, CALPIA will allow additional charges for actual shipping costs in accordance with the State’s Transportation codes.

Copy of the freight bill will be required for reimbursement.

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 adjustment 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 from the Contractor any additional standard sit-to-stand desktop converters 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 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 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 package slip(s) will be required along with prepaid will call or return merchandise authorization packing slip(s).

18.0 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.

19.0 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.

CALIFORNIA PRISON INDUSTRY AUTHORITY

INVITATION FOR BID RW2525005

SIT-TO-STAND DESKTOP CONVERTERS

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

_____ 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

Required Documentation for each Product Line Item Offred

_____ Product Brochure/Profile Information _____ Technical Specifications with dimensions, ranges, hardware, etc.

_____ Product Warranty Information _____ BIFMA e3 2019 Level certification _____ Design for Environment statement or documentation _____ Greenguard/LEED Credits if cited _____ ISO Certifications or other Quality Assurance documentation _____ List of value-added operations available for CALPIA workforce to perform _____ Manufacturer Agreement with Distributor (if applicable)

Exhibit 1

CONTRACT PRICE SHEET

The costs quoted by the bidder shall be binding for the first year of the Agreement unless otherwise agreed upon. CALPIA is not obligated to purchase any quantity of goods from the Contractor.

Extended prices is calculated by multiplying the estimated 3-year quantity by the unit amount. In case of discrepancy between the unit price and the calculated total set forth, the unit price shall prevail. Bidders are asked to provide minimum quantity eligible for discount pricing, if available, as well as the discounted unit price. Bidders are also asked to provide price for a desktop converter without any platforms attached. CALPIA’s workforce will build the necessary platforms and assemble at its location.

If you have more than one product line that meets the requirements of this IFB, you may submit multiple copies of this price sheet 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.

1. Straight 36” wide Desktop Converter

MODEL NAME/NO.: ________________________________________________________

Item No.

Estimate d 3-Year Quantity

UOM Description Unit Price Extended Price

Discount Quantity

Discounted Unit Price

Unassembl ed Kit Price

1 5,000 EA

Scissors Lift Desktop Converter for Rectangular Worksurface 36” Wide, Black Finish Fully Assembled

$_________/EA

_______EA

$_______EA

$_______EA

*Kit to be assembled by CALPIA workforce

Delivery Terms a Minimum Order Requirements: (If none are provided, CALPIA will expect 30 days ARO)

MINIMUM ORDER REQUIREMENTS:

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

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

Company Name:

Street Address:

City/State/Zip:

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 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.

04/10/2025, Rev. F 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 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

Exhibit 5

STATE OF CALIFORNIA

California Integrated Waste Management Board

To be completed by the State agency

CIWMB 74 (Revised 4/07 for State Agencies) State Agency:

Purchasing Agent: PO #: Postconsumer-Content Certification Phone: E-mail:

The State Agency Buy Recycled Campaign (SABRC) is a state mandated program that requires the reporting of all purchases made within 11 specified product categories. All state agencies are required to verify the recycled-content of all products purchased within each of these categories.

All businesses shall certify in writing to the contracting officer or his or her representative the minimum percentage, if not exact percentage, of postconsumer recycled-content (PCRC) material in the products, materials, goods, or supplies offered or sold to the State regardless of whether the product meets the minimum content requirements specified in law (see reverse side). The certification shall be furnished under penalty of perjury. The certification shall be provided regardless of content, even if the product contains no recycled material. A State agency may waive the certification requirement if the percentage of postconsumer material in the products, materials, goods, or supplies can be verified in a written advertisement, including, but not limited to, a product label, a catalog, or a manufacturer or vendor Internet website.

Contractor/Company Name_________________________________________________________________________________

Address_____________________________________________________________________Phone_____________________

Purchase Order #

RFQ #

RFP #

IFB #

Cal Card Order #

Item #

Product or Services Description 1Percent

Postconsumer Recycled- Content Material

2SABRC

Product Category Code

M eets SA

B R

C

Public Contract Code sections 12205 (a) (1), (2), (3) and (b) (1), (2), and (3)

Pursuant to Public Contract Code 12205(a)(1), I certify under penalty of perjury under the laws of the State of California that the above information is true and correct.

Print Name Signature Title Date

(See footnotes on the back of this page.)

EXHIBIT 5

FOOTNOTES:

1. “Postconsumer recycled-content material” is defined as products that were bought, used, and recycled by consumers. For example, a newspaper that has been purchased, recycled, and used to make another product would be considered postconsumer material.

2. “Product category” refers to one of the categories listed below, into which the reportable purchase is best placed.

3. If the product does not belong in any of the product categories, enter “N/A.” Common “N/A” products include wood products, natural textiles, aggregate, concrete, and electronics such as computers, TV, software on a disk or CD, and telephones.

4. Reused or refurbished products, there is no minimum content requirement. (PCC 12209 (l))

Code Product Categories Product Examples Minimum Postconsumer Content Requirement

Examples are inclusive but are not limited to the individual product.

1 Paper Products Paper janitorial supplies, cartons, wrapping, packaging, file folders, and hanging files, building insulation and panels, corrugated boxes, tissue, and toweling.

30 percent by fiber weight postconsumer fiber.

2 Printing and Writing Papers

Copy, xerographic, watermark, cotton fiber, offset, forms, computer printout paper, white wove envelopes, manila envelopes, book paper, note pads, writing tablets, newsprint, and other uncoated writing papers, posters, index cards, calendars, brochures, reports, magazines, and publications.

30 percent by fiber weight postconsumer fiber.

3 Mulch, Compost, and Co-compost Products

Soil amendments, erosion controls, soil toppings, ground covers, weed suppressants, and organic materials used for water conservation; yard trimmings and wood byproducts that are separated from the municipal solid waste stream or other source of organic materials such as biosolids or other comparable substitutes such as livestock, horse, or other animal manure, food residues or fish processing byproducts; mechanical breakdown of materials.

80 percent recovered material that would otherwise be normally disposed of in a landfill.

4 Glass Products Windows, test tubes, beakers, laboratory or hospital supplies, fiberglass (insulation), reflective beads, tiles, construction blocks, desktop accessories, flat glass sheets, loose-grain abrasives, deburring media, liquid filter media, and containers.

10 percent postconsumer, by weight.

5 Lubricating Oils Intended for use in a crankcase, transmission, engine, power steering, gearbox, differential chainsaw, transformer dielectric, fluid, cutting, hydraulic, industrial, or automobile, bus, truck, vessel, plane, train, heavy equipment, or machinery powered by an internal combustion engine.

70 percent re-refined base oil.

6a Plastic Products Printer or duplication cartridges, diskette, carpet, office products, plastic lumber, buckets, wastebaskets, containers, benches, tables, fencing, clothing, mats, packaging, signs, posts, binders, sheet, buckets, building products, garden hose, and trays.

10 percent postconsumer, by weight.

6b Printer or Duplication Cartridges

a. Have 10 percent postconsumer material, or

b. Are purchased as remanufactured, or

c. Are backed by a vendor-offered program that will take back the printer cartridge after their useful life and ensure that the cartridge is recycled and comply with the definition of recycled as set forth in section Public Contract Code 12156.

7 Paint Water-based paint, graffiti abatement, interior and exterior, and maintenance. 50 percent postconsumer paint (exceptions when 50 percent postconsumer content is not available or is restricted by a local air quality management district, then 10 percent postconsumer content may be substituted).

8 Antifreeze Recycled antifreeze, and antifreeze containing a bittering agent or made from polypropylene or other similar non-toxic substance.

70 percent postconsumer material.

9 Tires Truck and bus tires, and those used on fleet vehicles and passenger cars. Retreaded: Must use an existing casing that has undergone retreading or recapping process in accordance with Public Resource Code (commencing with section 42400).

10 Tire- Derived Products Flooring, mats, wheelchair ramps, playground cover, parking bumpers, bullet traps, hoses, bumpers, truck bedliners, pads, walkways, tree ties, road surfacing, wheel chocks, rollers, traffic control products, mudflaps, and posts.

50 percent recycled used tires.

11 Metal Staplers, paper clips, steel furniture, desks, pedestals, scissors, jacks, rebar, pipe, plumbing fixtures, chairs, ladders, file cabinets, shelving, containers, lockers, sheet metal, girders, building and construction products, bridges, braces, nails, and screws.

10 percent postconsumer material, by weight.

For additional information, please visit www.ciwmb.ca.gov/BuyRecycled/StateAgency/

EXHIBIT 5

http://www.ciwmb.ca.gov/BuyRecycled/StateAgency/

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

STATE OF CALIFORNIA – DEPARTMENT OF FINANCE

PAYEE DATA RECORD

(Required when receiving payment from the State of California in lieu of IRS W-9 or W-7) STD 204 (Rev. 03/2021)

Section 1 – Payee Information NAME (This is required. Do not leave this line blank. Must match the payee’s federal tax return)

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

MAILING ADDRESS (number, street, apt. or suite no.) (See instructions on Page 2)

CITY, STATE, ZIP CODE E-MAIL ADDRESS

Section 2 – Entity Type Check one (1) box only that matches the entity type of the Payee listed in Section 1 above. (See instructions on page 2)

CORPORATION (see instructions on page 2)SOLE PROPRIETOR / INDIVIDUAL MEDICAL (e.g., dentistry, chiropractic, etc.)SINGLE MEMBER LLC Disregarded Entity owned by an individual

PARTNERSHIP

ESTATE OR TRUST

LEGAL (e.g., attorney services)

EXEMPT (e.g., nonprofit)

ALL OTHERS

Section 3 – Tax Identification Number Enter your Tax Identification Number (TIN) in the appropriate box. The TIN must match the name given in Section 1 of this form. Do not provide more than one (1) TIN.

The TIN is a 9-digit number. Note: Payment will not be processed without a TIN.

For Individuals, enter SSN.

If you are a Resident Alien, and you do not have and are not eligible to get an SSN, enter your ITIN.

Grantor Trusts (such as a Revocable Living Trust while the grantors are alive) may not have a separate FEIN. Those trusts must enter the individual grantor’s SSN.

For Sole Proprietor or Single Member LLC (disregarded entity), in which the sole member is an individual, enter SSN (ITIN if applicable) or FEIN (FTB prefers SSN).

For Single Member LLC (disregarded entity), in which the sole member is a business entity, enter the owner entity’s FEIN. Do not use the disregarded entity’s FEIN.

For all other entities including LLC that is taxed as a corporation or partnership, estates/trusts (with FEINs), enter the entity’s FEIN.

Social Security Number (SSN) or Individual Tax Identification Number (ITIN)

OR

Federal Employer Identification Number

(FEIN)

Section 4 – Payee Residency Status (See instructions)

CALIFORNIA RESIDENT – Qualified to do business in California or maintains a permanent place of business in California.

CALIFORNIA NONRESIDENT – Payments to nonresidents for services may be subject to state income tax withholding.

No services performed in California

Copy of Franchise Tax Board waiver of state withholding is attached.

Section 5 – Certification I hereby certify under penalty of perjury that the information provided on this document is true and correct.

Should my residency status change, I will promptly notify the state agency below.

NAME OF AUTHORIZED PAYEE REPRESENTATIVE TITLE E-MAIL ADDRESS

SIGNATURE DATE TELEPHONE (include area code)

Section 6 – Paying State Agency Please return completed form to:

STATE AGENCY/DEPARTMENT OFFICE UNIT/SECTION

MAILING ADDRESS FAX TELEPHONE (include area code)

CITY STATE ZIP CODE E-MAIL ADDRESS

California Prison Industry Authority (CALPIA) Business Services Section (BSS)

560 East Natoma Street (916) 358-1811 (916) 358-2755

Folsom CA 95630 bsshelpdesk@calpia.ca.gov

Print Form Reset Form

STATE OF CALIFORNIA – DEPARTMENT OF FINANCE

PAYEE DATA RECORD

(Required when receiving payment from the State of California in lieu of IRS W-9 or W-7) STD 204 (Rev. 03/2021)

GENERAL INSTRUCTIONS

Type or print the information on the Payee Data Record, STD 204 form. Sign, date, and return to the state agency/department office address shown in Section 6.

Prompt return of this fully completed form will prevent delays when processing payments.

Information provided in this form will be used by California state agencies/departments to prepare Information Returns (Form1099).

NOTE: Completion of this form is optional for Government entities, i.e. federal, state, local, and special districts.

A completed Payee Data Record, STD 204 form, is required for all payees (non-governmental entities or individuals) entering into a transaction that may lead to a payment from the state. Each state agency requires a completed, signed, and dated STD 204 on file; therefore, it is possible for you to receive this form from multiple state agencies with which you do business.

Payees who do not wish to complete the STD 204 may elect not to do business with the state. If the payee does not complete the STD 204 and the required payee data is not otherwise provided, payment may be reduced for federal and state backup withholding. Amounts reported on Information Returns (Form 1099) are in accordance with the Internal Revenue Code (IRC) and the California Revenue and Taxation Code (R&TC).

Section 1 – Payee Information Name – Enter the name that appears on the payee's federal tax return. The name provided shall be the tax liable party and is subject to IRS TIN matching (when applicable).

Sole Proprietor/Individual/Revocable Trusts – enter the name shown on your federal tax return.

Single Member Limited Liability Companies (LLCs) that is disregarded as an entity separate from its owner for federal tax purposes - enter the name of the individual or business entity that is tax liable for the business in section 1. Enter the DBA, LLC name, trade, or fictitious name under Business Name.

Note: for the State of California tax purposes, a Single Member LLC is not disregarded from its owner, even if they may be disregarded at the Federal level.

Partnerships, Estates/Trusts, or Corporations – enter the entity name as shown on the entity’s federal tax return.