IFB_-_S16012534_-_Milk_Testing_Services.pdf

State of California Department of Corrections and Rehabilitation

October 7, 2025

INVITATION FOR BID (IFB)

IFB No. S16012534

MILK TESTING SERVICES

Notice to Prospective Contractors

The California Prison Industry Authority (CALPIA) invites you to review and respond to this Invitation for Bid (IFB), entitled MILK TESTING SERVICES, IFB NO. S16012534. In submitting your bid, you must comply with the instructions found herein and the Bidders Instructions REV-524 located on the CALPIA website (www.calpia.ca.gov), select About tab and then Doing Business with CALPIA).

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: October 21, 2025 by 3:00 PM CALPIA Contact SUBMIT BID TO:

Rommel Disuanco, Contract Analyst Phone: (916) 358-1433

Email: Rommel.Disuanco@calpia.ca.gov

California Prison Industry Authority Attention: Rommel Disuanco, Contract Analyst

560 East Natoma Street Folsom, CA 95630

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.

Term: The CALPIA anticipates that the proposed contract term will be for a period of two (2) years with the option to extend for an additional one (1) year.

The contract award will be made on the basis of BEST VALUE as determined by CALPIA alone, under statutory authority (Penal Code 2808) considering the following criteria:

1. Cost: Fair, reasonable, and competitive price, and customer service commitments for goods and or services.

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

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

http://www.calpia.ca.gov/ mailto:Rommel.Disuanco@calpia.ca.gov

California Prison Industry Authority (CALPIA) IFB No. S16012534 Milk Testing Services

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

In the interest of achieving best value, CALPIA does not grant Small Business, Disabled Veteran Business Enterprise (DVBE), Target Area Contract Preference Act (TACPA), Local Agency Military Base Recovery Act (LAMBRA), or Enterprise Zone Act (EZA) preferences in evaluating bids.

Employment of ex-offenders by the bidder is encouraged by CALPIA as part of our ongoing mission to change lives through opportunities.

Any agreement resulting from this solicitation shall be of no force or effect until it is signed by both parties and approved by CALPIA. The Contractor is not to begin work until a contract has been made, all approvals have been obtained, and the contract has been fully executed. Should work begin before all approvals are obtained, services shall be considered voluntary.

California Prison Industry Authority (CALPIA) IFB No. S16012534

TABLE OF CONTENTS

SECTION

PAGE

A. Purpose and Description of Service 4 B. Bid Information 4 C. Bidder’s Submittal Requirements 5 D. Bid Evaluation 6 E. Licenses and Permits 6 F. Standard Language 6 G. Bid Attachments 6

Attachment 1: Bid Document Submittal Check List 7 Attachment 2: Sample Standard Agreement (STD 213), Statement of

Work and Payment Provisions 9

Attachment 3: Cost Sheet 15 Attachment 4A: Payee Data Record (STD 204) 18 Attachment 4B: Payee Data Record Supplement (STD 205) 20 Attachment 5: Darfur Certification 22 Attachment 6: Appropriate Attire Policy 23 Attachment 7: Experience/Past Performance (References) 25 Attachment 8: Contractor Certification Clauses (CCC’s) 26 Attachment 9: PREA Volunteer/Contractor Information Sheet 30 Attachment 10: Economic Sanctions Certification 33 Attachment 11: California Civil Rights Laws Certification 34

Bid Submittal Documents:

Attachment 1: Bid Document Submittal Check List 1 page Attachment 3: Cost Sheet 3 page Attachment 4A: Payee Data Record (STD 204) 2 pages Attachment 4B: Payee Data Record Supplement (STD 205) 2 pages Attachment 5: Darfur Certification 1 page Attachment 7: Experience/Past Performance (References) 1 page Attachment 8: Contractor Certification Clauses (CCC’s) 4 pages Attachment 9: PREA Volunteer/Contractor Information Sheet 3 pages Attachment 10: Economic Sanctions Certification 1 page

Attachment 11: California Civil Rights Laws Certification 1 page

Bidder Instructions and Contract Provisions:

Bidders Instructions REV-524* 10 pages General Provisions REV-0524* 21 pages Security Provisions REV-0325* 5 pages

NOTE: Items shown with an Asterisk (*), are hereby incorporated by reference and are located on our website at the following link http://www.calpia.ca.gov select About tab, then select Doing Business with CALPIA.

California Prison Industry Authority (CALPIA) IFB No. S16012534

A. Purpose and Description of Service

The California Prison Industry Authority (CALPIA) requires State Certified Food Product Testing (lab testing) services for raw and finished milk products produced at the CALPIA Milk Processing Enterprise at California State Prison, Corcoran (COR) located in Corcoran, California.

Milk product samples may consist of any of the following: 1% milk, 2% milk, whole milk, non-fat milk, and chocolate milk.

Refer to the Sample STD 213, Statement of Work and Payment Provisions, attached to this IFB as Attachment 2.

CALPIA reserves the right, before the conclusion of the contract term to extend the contract for an additional one-year period. A written and approved amendment will be required to extend the contract prior to contract expiration.

B. Bid Information

1. Time Schedule

It is recognized that time is of the essence. All bidders are hereby advised of the following schedule and will be expected to adhere to the required dates and times. All times are Pacific Standard Time (PST)/Pacific Daylight Time (PDT).

*estimated timeframes

2. Bid Submittal

Bids must be received via U.S. Mail, common carrier, or hand delivered; no other method of response will be accepted. Bids not submitted under sealed cover may be rejected. Submit one (1) copy of the bid to the address and Contract Analyst on page 1 of this document. The interior sealed envelope 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:

EVENT DATE

TIME

(Pacific STD /Daylight Time)

IFB available to prospective bidders October 7, 2025 Final Date for Bid Submission/Bid Opening 10/21/2025 By 3:00 PM Successful Bidder Letter and Posting of Intent to Award* 10/22/25 5:00 PM Last Day to Appeal Intent to Award* 10/28/25 5:00 PM Proposed Start Date of Agreement* November 4, 2025

Company Name Company Address

IFB Number: S16012534 IFB Name: Milk Testing Services Attention: Rommel Disuanco

BID SUBMITTAL – DO NOT OPEN

California Prison Industry Authority (CALPIA) IFB No. S16012534

C. Bidder’s Submittal Requirements

Experience: Contractor must provide proof of five (5) years of experience with services similar in nature to the services identified in the attached Scope of Work. Experience will be determined by documentation submitted by the Contractor and further information provided by the references submitted under the Past Performance requirement below. Experience is defined as the kind and amount of work a Contractor has done relevant to the work contemplated by this procurement.

Past Performance: Contractor will be evaluated on prior performance through Contractor’s references (Attachment 7), on three (3) projects similar in nature within the last three (3) years.

Past performance is defined as the Contractor’s record of conforming to standards of good workmanship; Contractor’s record of forecasting and controlling costs; Contractor’s adherence to contract schedules, including the administrative aspects of performance; Contractor’s history of reasonable and cooperative behavior and commitment to customer satisfaction; and the Contractor’s business-like concern for the interest of the customer.

Licenses/Permits: The Contractor shall provide copies of all required license(s) and permit(s) as required by the city, county, or both as determined by bidder’s place of business.

Executive Order N-6-22 – Russia Sanctions:

CALPIA requires Bidders to include a completed Economic Sanctions Certification form (BSS- F069) as required by Executive Order N-6-22 in order to be eligible to conduct business with the State of California.

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 (CALPIA) IFB No. S16012534

D. Bid Evaluation

Award of a contract resulting from this IFB will be based on the contractor providing the best value. The Contractor must meet or exceed the minimum requirements of the following criteria:

Category – Description Cost Past Performance Experience

E. Licenses and Permits

During the term of the contract, the Contractor must maintain all required licenses and/or permits in full force and effect. If and when the State learns that the Contractor has failed to do so, the State may, in addition to any other remedy it may have, immediately terminate this contract without any cost or liability to the State. If, after bid submission, the Contractor replaces or renews a required license or permit or obtains a newly-applicable license or permit, the Contractor shall provide the State with a copy of the renewed or replaced or newly-obtained license or permit within 20 days following the Contractor's receipt of same.

F. Standard Language

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.

G. Bid Attachments

Refer to the following pages for additional required attachments that are a part of this IFB.

ATTACHMENT 1

BID DOCUMENT SUBMITTAL CHECK LIST

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

Complete this checklist to confirm the items listed below have been included in 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 be returned with your bid package.

NAME OF BIDDER:

COMPANY NAME:

Attachment Name/Description

_____ Attachment 1: Bid Document Submittal Check List _____ Attachment 3: Cost Sheet

_____ Attachment 4A: Payee Data Record (STD 204) NOTE: If company is incorporated, Payee’s Legal business name on the STD 204 must match the name registered with the Secretary of State of California.

_____ Attachment 4B: Payee Data Record Supplement (STD 205) NOTE: For use if additional remittance addresses are needed or if additional authorized representatives need to be identified.

_____ Attachment 5: Darfur Certification _____ Attachment 7: Experience/Past Performance (References) _____ Attachment 8: Contractor’s Certification Clauses _____ Attachment 9: PREA Volunteer/Contractor Information Sheet _____ Attachment 10: Economic Sanctions Certification _____ Attachment 11: California Civil Rights Laws Certification

Additional Items Description

_____ Copy of Business License(s) and permits as required by the state, city, and/or county (Outlined on Page 5 in Section C)

_____ Accredited Laboratory Certification(s); Biological, Chemical, etc., as applicable (Outlined on Page 5 in Section C)

_____ Scopes of accreditation which accompany the laboratory certifications mentioned above (Chemical Scope of Accreditation, Biological Scope of Accreditation, etc.), as applicable (Outlined on Page 5 in Section)

STATE OF CALIFORNIA

STANDARD AGREEMENT

STD 213 (Rev 6/21/06) AGREEMENT NUMBER

IFB No. S16012534

REGISTRATION NUMBER

MILK TESTING SERVICES

1. This Agreement is entered into between the State Agency and the Contractor named below:

STATE AGENCY'S NAME

CALIFORNIA PRISON INDUSTRY AUTHORITY

CONTRACTOR'S NAME

2. The term of this XXXX XX, 2025 or upon approval, whichever is the later, through XXXX XX, 2027 Agreement is:

3. The maximum amount $ of this Agreement is: Dollars and No Cents

4. The parties agree to comply with the terms and conditions of the following exhibits that by this reference made a part of the Agreement.

Attachment 2 - Scope of Work and Payment Provisions 5 pages

Attachment 3 - Cost Sheet 3 pages

General Provisions REV-0524* 21 pages

Security Provisions REV-0325* 5 pages NOTE: Items shown with an Asterisk (*), are hereby incorporated by reference and made part of this agreement as if attached

These documents can be viewed at http://www.calpia.ca.gov, (select About tab, then select Doing Business with CALPIA).

IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.

CONTRACTOR

CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.)

BY (Authorized Signature)

DATE SIGNED(Do not type)

PRINTED NAME AND TITLE OF PERSON SIGNING

ADDRESS

STATE OF CALIFORNIA

AGENCY NAME

California Prison Industry Authority BY (Authorized Signature)

DATE SIGNED(Do not type)

PRINTED NAME AND TITLE OF PERSON SIGNING

ADDRESS

560 East Natoma Street Folsom, CA 95630

SAMPLE

SCOPE OF WORK AND PAYMENT PROVISIONS

I. SCOPE OF WORK

1. Contractor agrees to provide the California Prison Industry Authority (CALPIA) with State certified food product testing (lab testing) services for raw and finished milk products produced at the CALPIA Dairy - Milk Processing Enterprise located at the California State Prison, Corcoran (COR) in Corcoran, California.

A. The Contractor shall furnish all labor, including travel and per diem, materials, non-consumable supplies, parking fees and bridge tolls, insurance, transportation, equipment and every other item of expense necessary to perform services.

2. The services shall be performed at the Contractor’s place of business; however, the Contractor will be expected to pick-up milk samples from the CALPIA Dairy - Milk Processing Enterprise located at:

A. California State Prison, Corcoran (COR) 4001 King Avenue Corcoran, CA 93212

3. The services shall be provided during regular business hours, 6:00 AM to 6:00 PM, Sunday through Saturday, except State holidays, or as otherwise directed by the CALPIA Project Representative, or designee.

4. Service shall be available not later than the express date set by CALPIA and the Contractor, after all approvals have been obtained, the agreement is fully executed, and an ERPLX Tracking Number is issued. Should the Contractor fail to commence work at the agreed upon time, the CALPIA, upon five (5) days written notice to the Contractor, reserves the right to terminate the agreement effective immediately. In addition, the Contractor shall be liable to the CALPIA for the difference between Contractor's bid price and the actual cost of performing work by another best value contractor.

5. The Project Representatives during the term of this agreement will be:

State Agency: CALPIA Contractor:

Section/Unit: COR/Dairy (Milk Processing) Section/Unit:

Attention: Attention:

Address: 4001 King Avenue

Corcoran, CA 93212 Address:

Phone: Phone:

Email: Email:

Note: No formal amendment of this agreement is needed to change the contact information. Changes will be made by written or electronic notification.

6. Contractor shall furnish to the CALPIA a certificate of insurance, stating that there is Commercial General Liability, Worker’s Compensation, and Automotive Liability. The certificate of insurance shall include the following three (3) provisions in their entirety:

A. The insurer will not cancel the insured’s coverage without 30 days prior written notice to the State and will provide the State with a written 10-day notice for Contractor’s non-payment of premiums.

B. Under Contractor’s General Liability and Automobile Liability insurance CALPIA and the State of California, its officers, agents, employees, and servants are included as additional insured, but only insofar as the operations under this contract are concerned.

C. The State will not be responsible for any premiums or assessment of the policy.

7. Contractor shall provide the following:

A. The Contractor will test milk product samples at a licensed lab recognized and approved by each of the following agencies: the California Department of Food & Agriculture (CDFA), the California Department of Public Health (CDPH), the United States Department of Agriculture (USDA), and the United States Food & Drug Administration (USFDA or FDA).

i. The Contractor must have, and maintain for the term of the agreement, current accreditations, licenses, and/or permits as required by the above-mentioned control agencies.

B. The Contractor shall pick-up the milk product samples from the CALPIA Dairy - Milk

Processing Enterprise located at COR once a week on Thursday.

i. Milk product samples may consist of any of the following: 1% milk, 2% milk, whole milk, non-fat milk, and chocolate milk.

C. The Contractor will test CALPIA milk samples once per week unless otherwise directed by the CALPIA Project Representative, or designee.

i. Lab testing and additional services shall include those identified on the Cost Sheet, Attachment 3.

a. CALPIA may request additional tests as needed.

ii. Test results shall be emailed to the CALPIA Project Representative, or designee, the following Monday and an original copy of the test results shall follow in the mail.

a. Mailed test results should be addressed to the attention of the CALPIA Project

Representative, or designee, at the address listed in Section 2, Part A above.

8. 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 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.

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

GenAI Technology Use & Reporting

During the term of the contract, Contractor must notify the State in writing if their services or any work under this contract includes, or makes available, any previously unreported GenAI technology, including GenAI from third parties or subcontractors. At the direction of the State, Contractor shall discontinue the use of any new or previously undisclosed GenAI technology that materially impacts functionality, risk or contract performance, until use of such GenAI technology has been approved by the State.

The State reserves the right to amend the contract, without additional cost, to incorporate GenAI Special Provisions into the contract at its sole discretion and/or terminate any contract that presents an unacceptable level of risk to the State.

10. CALPIA reserves the right to amend the agreement, prior to expiration, in writing on the STD 213A. CALPIA may adjust the terms of the agreement including but not limited to the following:

A. Term extension up to one (1) year.

B. Decreasing the amount of the contract’s original value.

C. Increasing the contract amount by up to 30% of the original value.

II. PAYMENT PROVISIONS

1. Invoicing and Payment

A. For services satisfactorily rendered, and upon receipt and approval of the invoices, the CALPIA agrees to compensate the Contractor in accordance with the amount specified in the Cost Sheet , Attachment 3, which is attached hereto and made part of this agreement.

B. Invoices shall be itemized and include the time period covered by the invoice, work completed for the period (detailed statement of services) and number of hours worked (if applicable). Invoices shall include the six-digit Purchase Order (Sage X3) Number and the Agreement Number referenced in the executed contract cover letter. Invoices shall be submitted in triplicate not more frequently than once every 30 days in arrears to:

CALPIA - COR

Attention: TBD

4001 King Avenue Corcoran, CA 93212

C. All invoice packages must contain original documents and be legible. Failure to provide original, legible documents will delay payment at Contractor’s expense.

D. Accurate/correct invoice packages must be submitted for review and payment in a timely manner subject to the following:

i. All invoices, including revised/amended/corrected invoices, must be received by

CALPIA within 60 days from the date services were rendered.

ii. Invoices received by CALPIA more than 60 days after the date services were rendered will be denied, deemed a forfeiture of payment by Contractor, and no payment will be issued.

a. It is Contractor’s responsibility to ensure invoices are received by CALPIA by the deadline. No exceptions will be allowed for invoice packages lost in transit unless supported by documentation that they should have arrived on time (i.e., proof of overnight delivery).

b. If a revision/amendment/correction of a timely submitted invoice is requested by

CALPIA, payment will not be forfeited if the requested invoice is received more than 60 days after the date services were rendered.

iii. All invoices received shall be deemed accurate/correct unless Contractor provides

CALPIA with written notice of any error(s) within 60 days from the date services were rendered. Written notice must include a written explanation of the change, a revised/amended/corrected invoice, and supporting documentation.

iv. Invoices received by CALPIA on the 60th day from the date services were rendered cannot be revised/amended/corrected by Contractor except at the request of CALPIA.

E. Contractors unable to provide accurate/correct invoice packages in a timely manner may receive a vendor performance report for failure to meet contract needs. Patterns related to failed vendor performance may result in termination of contract at any time.

F. Contractor is to provide a monthly report showing billed, paid, and outstanding invoices.

2. Availability of Funds

All financial obligations of CALPIA for the fiscal year(s) encompassed by the term of this agreement are subject to the availability and approval of funding by the Prison Industry Board and/or the presence of sufficient funds to cover those obligations in the fund from which those obligations are to be paid. If such obligations are, or become contingent, on funding by and/or through the CALPIA budget or on the availability of federal funds or on the action of any Legislative body, said obligations are contingent on the appropriation and availability of funds for the purpose of meeting those obligations. If insufficient funds are approved or appropriated or otherwise available in order to meet CALPIA’s obligations under this agreement, CALPIA may immediately terminate this agreement.

3. Prompt Payment Clause

Payment will be made in accordance with, and within the time specified in, Government Code Chapter 4.5, commencing with Section 927. Unless expressly exempted by statute, the Act requires State agencies to pay properly submitted, undisputed invoices not more than 45 days after (a) the date of acceptance of goods or performance of services or (b) receipt of an undisputed invoice, whichever is later.

4. Cash Discounts

CALPIA has a history of taking cash discounts and intends to take advantage of cash discounts offered when they are in the best interest of the CALPIA.

ATTACHMENT 3

COST SHEET

The estimated quantities indicated below were used solely for computing the cost to determine the best value bidder and is not binding upon the contracting agency. However, the actual costs quoted by the bidder shall be binding for the term of the Agreement. CALPIA is not obligated to purchase any quantity of services from the contractor.

Under no circumstances will the contractor be allowed to use a subcontractor for more than 50% of the contract dollar amount. For all services where a subcontractor is used, the contractor will be required to provide a minimum of 50% of the staffing for the project including project contact person.

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.

IMPORTANT NOTE: During a 12-month period, the estimated quantity for each test is based on 52 weeks for each of the dairy products produced by the CALPIA Dairy and Milk Processing Enterprise located at the CSP-COR. Products include 1% milk, 2% milk, whole milk, non-fat milk, and chocolate milk. CALPIA may request additional tests as needed.

Item No. Description of Test and/or Service Quoted Cost

1 SPC (Milk) $ /Test

2 Pseudomonas $ /Test

3 Fat, MOJ (Fluid Milk) $ /Test

4 Somatic Cell $ /Test

5 Raw Milk (Coliform) $ /Test

6 Water Samples (Coli/Pseudo) $ /Test

7 IRMA % BF $ /Test

8 Flavor/Color/Odor $ /Test

Coliform (Milk)

$ /Test

Phosphatase

Keeping Quality

TS/Moist (Fluid Milk, Powder)

IRMA % SNF

Vitamin A & D

Lab Pasteurize Count

Total Acidity (Cream)

PH Test (Cream)

Listeria Species

Environmental Swabbing on the Micro

Salmonella AOAC Method

E. coli

Swabs

AOAC Listeria Method

24 Additional Test (As needed)

$ /Test

Listeria Product $ /Test

Salmonella $ /Test

25 Certification & Calibration of Thermometers $ /Each

26 Pipette Calibration $ /Each

27 Sample Pick-up Charge (Weekly pick-up of samples from CSP-COR)

$ /Each (On a per trip basis)

NOTE: The bid amount includes all charges for travel to and/from the CSP-COR.

___ __% Cash discount for payment within ________ days of receipt.

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: __________ Expiration Date: __________

b. Disabled Veteran Business Enterprise Yes No

If yes, enter your service code: __________

NAME OF BIDDER:

COMPANY NAME

ADDRESS:

PHONE: FAX:

EMAIL:

AUTHORIZED

NAME: PLEASE PRINT

AUTHORIZED

SIGNATURE DATE:

TITLE:

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

ATTACHMENT 4A

California Prison Industry Authority (CALPIA) Milk Testing Services

STATE OF CALIFORNIA – DEPARTMENT OF FINANCE

IFB No. S16012534

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. The name provided in Section 1 must match to the TIN provided in section 3. Enter any DBA, trade, or fictitious business names under Business Name.

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

Mailing Address – The mailing address is the address where the payee will receive information returns. Use form STD 205, Payee Data Record Supplement to provide a remittance address if different from the mailing address for information returns, or make subsequent changes to the remittance address.

Section 2 – Entity Type If the Payee in Section 1 is a(n)… THEN Select the Box for…

Grantor (Revocable Living) Trust disregarded for federal tax purposes Sole Proprietor/Individual Limited Liability Company (LLC) owned by an individual and is disregarded for federal tax purposes Single Member LLC-owned by an individual Partnerships Limited Liability Partnerships (LLP) and, LLC treated as a Partnership Partnerships Estate Trust (other than disregarded Grantor Trust) Estate or Trust Corporation that is medical in nature (e.g., medical and healthcare services, physician care, nursery care, dentistry, etc. LLC that is to be taxed like a Corporation and is medical in nature

Corporation-Medical

Corporation that is legal in nature (e.g., services of attorneys, arbitrators, notary publics involving legal or law related matters, etc.) LLC that is to be taxed like a Corporation and is legal in nature

Corporation-Legal

Corporation that qualifies for an Exempt status, including 501(c) 3 and domestic non-profit corporations. Corporation-Exempt Corporation that does not meet the qualifications of any of the other corporation types listed above LLC that is to be taxed as a Corporation and does not meet any of the other corporation types listed above

Corporation-All Other

Section 3 – Tax Identification 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.

Section 4 – Payee Residency Status Are you a California resident or nonresident?

A corporation will be defined as a "resident" if it has a permanent place of business in California or is qualified through the Secretary of State to do business in California.

A partnership is considered a resident partnership if it has a permanent place of business in California.

An estate is a resident if the decedent was a California resident at time of death.

A trust is a resident if at least one trustee is a California resident.

o For individuals and sole proprietors, the term "resident" includes every individual who is in California for other than a temporary or transitory purpose and any individual domiciled in California who is absent for a temporary or transitory purpose. Generally, an individual who comes to California for a purpose that will extend over a long or indefinite period will be considered a resident. However, an individual who comes to perform a particular contract of short duration will be considered a nonresident.

For information on Nonresident Withholding, contact the Franchise Tax Board at the numbers listed below:

Withholding Services and Compliance Section: 1-888-792-4900 E-mail address: wscs.gen@ftb.ca.gov For hearing impaired with TDD, call: 1-800-822-6268 Website: www.ftb.ca.gov

Section 5 – Certification Provide the name, title, email address, signature, and telephone number of individual completing this form and date completed. In the event that a SSN or ITIN is provided, the individual identified as the tax liable party must certify the form. Note: the signee may differ from the tax liable party in this situation if the signee can provide a power of attorney documented for the individual.

Section 6 – Paying State Agency This section must be completed by the state agency/department requesting the STD 204.

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 this form.

A

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

ATTACHMENT 4B

California Prison Industry Authority (CALPIA)

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.

California Prison Industry Authority (CALPIA) Milk Testing Services

ATTACHMENT 5

DARFUR CONTRACTING ACT CERTIFICATION

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

OPTION #1 – DOMESTIC ONLY

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

OPTION #2 - CERTIFICATION

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

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

Company/Vendor Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date Executed Executed in the County and State of

OPTION #3 – WRITTEN PERMISSION FROM DGS

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

We are a scrutinized company as defined in Public Contract Code section 10476, but we have received written permission from the Department of General Services to submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission from DGS is included with our bid or proposal.

Company/Vendor Name (Printed) Federal ID Number

Initials of Submitter

Printed Name and Title of Person Initialing

California Prison Industry Authority (CALPIA) Milk Testing Services

ATTACHMENT 6

APPROPRIATE ATTIRE POLICY

Employees that are not required to wear a state approved uniform shall wear clothing that is conservative, professional and commensurate with their work environment, and does not pose potential injury while in the performance of their duties. All employees including, but not limited to contract employees, registry employees, volunteers, and off duty custody staff are expected to be in appropriate attire while on Institution grounds. Supervisors are responsible for monitoring their areas daily to ensure that employees comply with this directive. Appropriate, progressive discipline may be taken for violations.

The following guidelines are to be applied:

1. Dresses and skirts must reach at the knee or below when standing and worn in a professional and conservative manner.

2. Capri pants must reach below the knee.

3. Sleeveless garments (i.e., dresses and/or shirts) worn in a conservative and professional manner are permitted. However, these garments must be completely covered when worn in the presence of the inmate population (i.e. corridors, medical areas, housing units, etc.).

4. Spaghetti strapped garments (i.e., dresses, tops) are not permitted.

5. Leggings or any other footless style tights (spandex or cotton) worn under a dress, tunic or skirt are not permitted.

6. Any clothing containing emblems, quotes, lettering, or pictures pertaining to and/or depicting sex, politics, profanity, drugs, alcohol, violence, or illegal behavior are not permitted.

7. Shorts, skorts, tube tops, halter tops, pajama pants and/or lounging pants of any style are not permitted.

8. Sweat suits, jogging suits, nylon suits and/or velour suits are not permitted.

9. Any clothing similar to state clothing colors worn by inmates, (blue chambray, blue denim or orange/white worn as a two-piece) is not permitted.

10. Camouflage clothing of any color is not permitted.

11. Clothing that exposes any part of the midriff is not permitted.

12. All white blouses/shirts must be worn with the appropriate camisole or t-shirt underneath. In addition, the appropriate camisole or t-shirt shall be worn to avoid the perception of a plunging neckline.

13. Visible body piercings other than the ear lobes are not permitted (i.e., eyebrow, cheeks, nose, lip, tongue, etc.). Gauge earrings are not permitted.

California Prison Industry Authority (CALPIA) Milk Testing Services

14. Excluded Footwear Styles: strapless or any open-toe style shoe, boot or sandal that exposes more than two (2) toes is not permitted.

15. Acceptable Footwear Styles: closed toe or peep-toe style shoes, boot or sandal that exposes less…