_J_Contractor's_Declaration_Form_Painting.pdf
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- Solicitation number
- 2026-RFP-00103
- Issued by
- San Mateo County, California
About this file
This is a Contractor's Declaration Form for the San Mateo County Department of Public Works' Job Order Contracts (JOC 2617 and 2618) for painting services at various county-owned facilities. Contractors bidding on this procurement must complete and submit this form with their proposal by the December 10, 2025, deadline at 2:00 pm. The form requires contractors to provide standard company information including name, contact person, phone, and fax number. A mandatory pre-proposal conference is scheduled for November 5, 2025, at 10:00 am in Redwood City, with questions due by November 12, 2025. The contract award is anticipated for January 27, 2026, with a one-year term for each Job Order Contract and a maximum aggregate fiscal obligation of $1,000,000 per agreement.
The declaration form requires contractors to certify compliance with multiple San Mateo County ordinances and federal employment regulations. Contractors with contracts exceeding $5,000 must comply with the Equal Benefits Ordinance by either offering equal benefits to employees with spouses and domestic partners or providing cash equivalent payments. Contractors must declare whether any 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, with required explanation of outcomes if applicable. For contracts exceeding $100,000, contractors must certify compliance with the Employee Jury Service Ordinance, which requires a written policy providing San Mateo County resident employees up to five days of regular pay for actual jury service. The form must be signed under penalty of perjury by an authorized representative, and all required certifications and compliance documentation are essential components of a responsive bid submission.
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CONTRACTOR’S DECLARATION FORM
THIS FORM MUST BE COMPLETED IN FULL AND SUBMITTED WITH THE BID
Project: Job Order Contract for Painting at various County of San Mateo owned facilities for Project No. JOC 2617 and 2618
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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