Public_Contract_Code_Disclosure.pdf

PDF 18 KB Posted

Attached to
Design-Build Services for a Hydrogen Fueling Station
Solicitation number
2026-RFP-0123
Issued by
Los Angeles County, California

About this file

Public Contract Code Disclosure Form

This is a Public Contract Code Disclosure form required by the State of California for the City of Pasadena's Design-Build Services for a Hydrogen Fueling Station project. The form comprises three separate statutory declarations that bidders must complete under penalty of perjury: a Public Contract Code Section 10285.1 statement regarding criminal convictions for fraud, bribery, collusion, conspiracy, or antitrust violations within the preceding three years; a Public Contract Code Section 10162 questionnaire addressing whether the bidder or its officers or employees with proprietary interest have been disqualified or prevented from bidding on or completing federal, state, or local government projects due to violations of law or safety regulations; and a Public Contract Code Section 10232 statement certifying that no more than one final unappealable finding of contempt of court has been issued against the contractor within the immediately preceding two years for failure to comply with a federal court order regarding National Labor Relations Board compliance. Each section requires the bidder to check "yes" or "no" boxes, provide signatures, and include dates. All three declarations are mandatory components of the bid submission and failure to complete them accurately or making false certifications may subject the certifier to criminal prosecution.

The disclosures apply to all bidders, including partners, members, officers, directors, responsible managing officers, and responsible managing employees. No exceptions or waivers are permitted under these statutory requirements. Bidders must acknowledge that these declarations carry significant legal consequences and represent binding certifications regarding their eligibility to participate in public works contracts with California public entities.

View the file

Other files

File Type Posted
Design-Build_Services_for_a_Hydrogen_Fueling_Station_(Addendum_#11_Revision).pdf PDF
Hydrogen_Fueling_Agreement_General_Conditions_Exhibits_and_Appendices.pdf PDF
Design-Build_Services_for_a_Hydrogen_Fueling_Station_(Addendum_#9_Revision).pdf PDF
Design-Build_Services_for_a_Hydrogen_Fueling_Station_(Addendum_#8_Revision).pdf PDF
AA_Price_Proposal.xlsx XLSX spreadsheet
Design-Build_Services_for_a_Hydrogen_Fueling_Station_(Addendum_#3_Revision).pdf PDF
Insurance_Requirements.pdf PDF
Design-Build_Services_for_a_Hydrogen_Fueling_Station.pdf PDF
[I]_-_Insurance_Requirements.pdf PDF
DESIGNATED_REPRESENTATIVESdocx.pdf PDF
Civil_Litigation_History_Certification_ver02.pdf PDF
Indemnity_Agreement_Form.pdf PDF
Price_Proposal.xlsx XLSX spreadsheet
Subcontractor_Listing.pdf PDF
Public_Contract_Code_Disclosure.pdf PDF
DB_Qualificiation_Statement_FINAL.docx DOCX document
Proof_of_Authority.pdf PDF
Declaration_of_Elibility_to_Contract_(not_debarred).pdf PDF
AFFIDAVIT_OF_JOINT_VENTURE.pdf PDF
Pasadena_Taxpayer_Protection_Amendment_Disclosure_(2).pdf PDF
DISQUALIFICATION_DISCLOSURE_(4).pdf PDF
REQUIRED_FORMS_-_AAs_-_SIG-LEGAL-STATUS_-_DECLARATION_OF_NONCOLUSION_08022024_v2.pdf PDF
CONFLICT_OF_INTEREST_(5).pdf PDF
Health_and_Safety_Plan.pdf PDF
City's_Standard_Form_(Traditional)_Design-Build_Agreement.pdf PDF
Soil_Management_Plan.pdf PDF
Geotechnical_Report.pdf PDF
Conceptual_Drawings.pdf PDF
Project_Manual.pdf PDF
Emergency_FEMA_TC.pdf PDF
AR_7_-_Alternative_Delivery_Method_Approval.pdf PDF
Unique_Entity_ID_(SAM).pdf PDF
Exclusive_Negotiation_Agreement__TEMPLATE.pdf PDF
Disclosure_of_Lobbying_Activities.pdf PDF
DoIT_Technical_Questionnaire.xlsx XLSX spreadsheet
Federal_Required_Certification_(4).pdf PDF
Show all 36

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

PUBLIC CONTRACT CODE DISCLOSURES

Public Contract Code Section 10285.1 Statement

Public Contract Code Section 10285.1 Statement In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has ___ , has not ___ been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1.

Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided.

The above Statement is part of the Bid. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution.

NAME AND TITLE SIGNATURE AND DATE

Public Contract Code Section 10162 Questionnaire

In conformance with Public Contract Code Section 10162, the Bidder shall complete, under penalty of perjury, the following questionnaire: Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest in the bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal, state, or local government project because of a violation of law or a safety regulation?

Yes _____ No _____ ________________________________________

SIGNATURE AND DATE

If the answer is yes, explain the circumstances in the following space.

Public Contract Code 10232 Statement

In conformance with Public Contract Code Section 10232, the Contractor, hereby states under penalty of perjury, that no more than one final unappealable finding of contempt of court by a federal court has been issued against the Contractor within the immediately preceding two year period because of the Contractor's failure to comply with an order of a federal court which orders the Contractor to comply with an order of the National Labor Relations Board.

Note: The above Statement and Questionnaire are part of the Bid. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution.

NAME AND TITLE SIGNATURE AND DATE

within the preceding three years of any offenses referred to in that section including any charge:
been convicted:
NAME AND TITLE:
Yes:
No:
If the answer is yes explain the circumstances in the following space:
NAME AND TITLE_2:

File details come from the government source that posted it. Updated .