_J_Contractor's_Declaration_Form_Hazardous_Materials.pdf
PDF 91 KB Posted
- Attached to
- Job Order Contract for Asbestos Abatement w/ Hazardous Materials (JOC 2619 and JOC 2621)
- Solicitation number
- 2026-RFP-00104
- Issued by
- San Mateo County, California
About this file
This is a Contractor's Declaration Form submitted by bidders responding to the County of San Mateo Department of Public Works' Job Order Contract solicitation for asbestos abatement and hazardous materials management services at county-owned facilities (JOC 2619, 2620, and 2621). The form requires contractors to complete and submit declarations regarding compliance with county ordinances and non-discrimination policies as part of their bid submission. The related solicitation seeks up to three contractors to perform comprehensive hazardous materials remediation services across multiple facility types, with proposals due December 10, 2025, at 2:00 pm via the eProcurement system and bid opening scheduled for 2:15 pm via Microsoft Teams. A mandatory pre-proposal meeting is scheduled for November 5, 2025, at 10:00 am, with proposal questions due by November 12, 2025, at 2:00 pm. Each contract carries a maximum fiscal obligation of $3,000,000 with a one-year term, and the apparent lowest, responsive, and responsible bidder for each JOC will be excluded from consideration for successive contracts to ensure competitive rotation.
The declaration form requires bidders to certify compliance with the County's Equal Benefits Ordinance, Employee Jury Service Ordinance, and non-discrimination policies. Contractors with contracts exceeding $5,000 must demonstrate equal benefits compliance for spouses and domestic partners or provide cash equivalents, while those with contracts over $100,000 must maintain written policies providing up to five days regular pay for jury service to San Mateo County employees. Bidders must also declare whether discrimination findings have been issued against them within the past year by the Equal Employment Opportunity Commission, Fair Employment and Housing Commission, or other investigative entities. Additional procurement requirements include prevailing wage compliance, registration with the Department of Industrial Relations, California Class C-21 licensing, minimum five-year continuous experience in comparable municipal projects, a staffed office within San Mateo County or within 55 miles of the County Center, and comprehensive insurance coverage. Each bid requires a $25,000 bid bond, with successful bidders obligated to provide $250,000 Performance and Payment Bonds (increasing to $3,000,000 if aggregate Job Orders exceed $1,000,000), and contractors must pay a 1% JOC System License Fee on all Job Orders.
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Text version
CONTRACTOR’S DECLARATION FORM
THIS FORM MUST BE COMPLETED IN FULL AND SUBMITTED WITH THE BID
Project: Job Order Contract for Hazardous Materials at various County of San Mateo owned facilities for Project No. JOC 2619, 2620 and 2621
I CONTRACTOR INFORMATION
Contractor Name: Phone:
Contact Person: Fax:
II EQUAL BENEFITS (check one or more boxes) Contractors with contracts in excess of $5,000 must treat spouses and domestic partners equally as to employee benefits.
Contractor complies with the County’s Equal Benefits Ordinance by:
offering equal benefits to employees with spouses and employees with domestic partners.
offering a cash equivalent payment to eligible employees in lieu of equal benefits.
Contractor does not comply with the County’s Equal Benefits Ordinance.
Contractor is exempt from this requirement because:
Contractor has no employees, does not provide benefits to employees’ spouses, or the contract is for $5,000 or less.
Contractor is a party to a collective bargaining agreement that began on (date) and expires on (date), and intends to offer equal benefits when said agreement expires.
III NON-DISCRIMINATION (check appropriate box)
Finding(s) of discrimination have been issued against the Contractor within the past year by the Equal Employment Opportunity Commission, Fair Employment and Housing Commission, or other investigative entity. Please see attached sheet of paper explaining the outcome(s) or remedy for the discrimination.
No finding of discrimination has been issued in the past year against the Contractor by the Equal Employment Opportunity Commission, Fair Employment and Housing Commission, or any other entity.
IV EMPLOYEE JURY SERVICE (check one or more boxes) Contractors with original or amended contracts in excess of $100,000 must have and adhere to a written policy that provides its employees living in San Mateo County up to five days regular pay for actual jury service in the County.
Contractor complies with the County’s Employee Jury Service Ordinance.
Contractor does not comply with the County’s Employee Jury Service Ordinance.
Contractor is exempt from this requirement because:
the contract is for $100,000 or less.
Contractor is a party to a collective bargaining agreement that began on (date) and expires on (date), and intends to comply when said agreement expires.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually.
Signature Name
Date Title
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