RFO_24C013001_Media_Services_Packet.pdf

REQUEST FOR OFFER

For the California Highway Patrol

RFO: #24C013001

For:

Revision and upgrade of iPhone “Start Smart” application; and Revision and upgrade of Android Version of “Start Smart” application

California Multiple Award Schedules (CMAS)

For: The CHP’s Office of Community Outreach and Media Relations

Date: October 14, 2024

You are invited to review and respond to this Request for Offer (RFO). To submit an offer for these goods and/or services, you must comply with the instructions contained in this document as well as the requirements stated in the State’s Scope of Work (SOW), Exhibit A and listed Attachments. By submitting an offer, your firm agrees to the terms and conditions stated in this RFO and your proposed CMAS contract.

Read the attached document carefully. The RFO due date is November 1, 2024.

Responses to this RFO and any required copies must be submitted by delivery or mail, clearly labeled to the department contact noted below.

Department Contact:

Matthew Macdonald Contract Services Unit

(916) 843-3611 matthew.macdonald@chp.ca.gov

Expedited UPS & Federal Express:

Matthew Macdonald California Highway Patrol BSS, Contract Services Unit 601 North Seventh Street Sacramento, CA 95811

U.S. Mail Address:

California Highway Patrol Business Services Section Contract Services Unit P.O. Box 942898 Sacramento, CA 94298-0001 mailto:Matthew.macdonald@chp.a.gov

CHP Office of Community Outreach and Marketing RFO #24C013001 Mobile Applications, Software Fixes, and IT Services Page 1 of 8

General Information

1. The Project

The CHP seeks a Contractor to update and maintain the CHP’s Start Smart mobile iPhone application (app), and Android version of the Start Smart app for the CHP’s Office of Community Outreach and Media Relations (COMR). The Contractor shall provide system analysis and project management, establish the specified maintenance and updates, work with the Apple Store and Google Play Store (Digital Distribution Platform or DDP) to ensure that the revisions meet the specifications of DDPs, aid the CHP in registering the revisions with DDPs, and transition the project prior to the Agreement’s end. The Contractor shall provide services as specified in the proposed Agreement’s Exhibit A, Scope of Work. The estimated maximum budget for this Agreement is fifteen thousand dollars ($15,000.00).

2. Contractor Qualifications

The Contractor must have a California Multiple Award Schedule (CMAS) contract awarded by the Department of General Services (DGS). Refer to point ten (10) for further information.

3. Consultant Qualifications

The consultant must have:

A. Three to five years of experience successfully revising, designing, and implementing iPhone and android applications;

B. Proficiency in writing, revising, and updating code, app features and project management of same.

C. Demonstrated experience in working with and meeting the requirements of Client Service Providers (CSP) such as Apple Store and Google Play Store.

4. Key Dates

It must be understood that time is always of the essence, both for the RFO submittal and contract completion. Offerors are advised of the key dates and times shown below and are expected to adhere to them.

Event Date RFO Release 10/14/2024 at 9:00 a.m.

RFO Questions Due 10/21/2024 at 9:00 a.m.

RFO Questions’ Response Due 10/25/2024 at 11:00 a.m.

RFO Response Submission Due Date 11/01/2024 at 11:00 a.m.

Mobile Applications, Software Fixes, and IT Services Page 2 of 8

5. 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 / Contractor must notify the State in writing if their solution or service includes, or makes available, any GenAI, including GenAI from third parties or subcontractors.

The State has developed a GenAI Reporting and Factsheet (STD 1000) to be completed by the Bidder / Offeror / Contractor.

Failure to submit the GenAI Reporting and Factsheet (STD 1000) will result in disqualification of the Bidder / Offeror / Contractor.

Failure to report GenAI to the State may void any resulting contract. The State reserves its right to seek any and all relief it may be entitled to as a result of such non-disclosure.

Upon receipt of a Bidder / Offeror / Contractor GenAI Reporting and Factsheet (STD 1000), the state reserves the right to incorporate GenAI Special Provisions into the final contract or reject bids/offers that present unacceptable level of risk to the state.

6. Worksite

The Contractor shall provide requested services as specified for COMR. Work tasks will be scheduled between the COMR and Contractor.

7. Agreement Term

The contract term is estimated to begin Upon Execution by CHP with an anticipated duration of approximately four (4) months, ending on 4/30/2025.

8. RFO Response Requirements

This RFO and the Offeror’s response documents to this RFO (Attachments A and B along with the Resumes of Offeror’s personnel) will be made part of the ordering department’s Purchasing Authority Purchase Order and procurement contract file.

The Offeror must fully complete and submit the documents specified in points 9 and 10 with their offer:

Responses must contain all required information and data and conform to the format described herein. It is the offeror’s responsibility to provide all necessary information for the State to consider the response, verify requested information and determine the offeror’s ability to perform the tasks and activities defined in the State’s Scope of Work (Exhibit A) and Cost Worksheet, (Attachment 8) provided as required below.

Mobile Applications, Software Fixes, and IT Services Page 3 of 8

Responses to this RFO and any required copies must be submitted by mail or expedited delivery, clearly labeled to the department contact noted on the coversheet. Mail or deliver one (1) original, one (1) copy and one (1) DVD-ROM of Offeror’s response, clearly labeled, to the CHP contact named on the cover sheet to this RFO. Responses must be received in the quantity of copies stated in the RFO and not later than due date and time specified in Section 5, “Key Dates.”

Please note that your RFO response must be delivered no later than 11:00 a.m. on the final filing date listed in Section 4 “Key Dates.”

9. RFO Response Content

Please sign applicable RFO attachments/forms in blue ink. The signatory must be a person authorized to bind the offering firm and must sign each form that requires a signature.

Signature stamps are not acceptable. Unsigned RFOs may be rejected.

Most of the information required to respond to this RFO is contained in the State’s Scope of Work, Exhibit A and Cost Worksheet, Attachment 8.

a) Response to State’s Scope of Work, Offeror’s Workplan “Attachment 7”:

This RFO and the Offeror’s response to this document will be made part of the CHP’s procurement file. The Offeror’s Workplan responds to the State’s Scope of Work and will be used to consider responsiveness to requirements. This Workplan response must map each task/deliverable item back to the Exhibits/Attachments. The response must include any additional information that the offeror deems necessary to explain how the Contractor intends to meet the State’s requirements. The Offeror’s Workplan needs to contain the following as appropriate:

i. Overview of the required tasks and outcomes, i.e. systems management, maintenance, repair, troubleshooting, validation and upgrading. etc.;

ii. Brief description of how the tasks will be performed;

iii. Work plan for each task, including sub-task description, including due date for each deliverable, i.e., quarterly backup and validation, etc.;

iv. Samples of work from other projects, or outlines of what deliverables are proposed for the required Tasks;

v. Resumes for the identified individual(s), detailing experience meeting the State’s requirements;

vi. Any other requirements shown in the State’s Scope of Work, Exhibit A.

If the Offeror proposes to utilize subcontractors, the Offeror’s Workplan must specify the firm name, address, contact person and proposed service.

b) Response to Attachment 8 Cost Worksheet

Mobile Applications, Software Fixes, and IT Services Page 4 of 8

This RFO and the offeror’s response to Attachment 8 will be made part of the CHP’s procurement file.

10. Offeror Qualifications and Submittal Requirements

The Offeror must have a CMAS contract issued by the Department of General Services with the category or Project Manager, System Development, or similar position and a maximum of up to five hundred thousand dollars ($500,000) per transaction dollar threshold.

The Offeror’s Offer must meet the minimum technical points requirement of seven hundred

(700) minimum technical points out of one thousand (1,000) maximum technical points, as considered by the CHP for this RFO.

The Offeror must submit the following documentations with their submittal;

A. Attachment 1 – Required Attachment Checklist;

B. Attachment 2 – Bidder Declaration (GSPD 05-105);

C. Attachment 3 – Contractor Certification Clauses-CCC 04/2017

D. Attachment 4 – Conflict of Interest And Confidentiality Statement – Vendor

E. Attachment 5 – Payee Data Record

F. Attachment 5-A – Payee Data Record Supplement (if applicable)

G. Attachment 6 – Darfur Contracting Act Certification

H. Attachment 7 – Offeror’s Workplan

I. Attachment 8 – Offeror’s Cost Worksheet

J. Attachment 9 – Client References

K. Attachment 10 – A copy of the Offeror’s entire CMAS Agreement with all addenda/revisions and a copy of the Offeror’s Pricing and Terms and Conditions segments of the Offeror’s General Service Administration (GSA) agreement.

L. Attachment 11 – Resumes of personnel who will be providing the services for this

Agreement (if not incorporated into Attachment 7).

M. Attachment 12 – Generative Artificial Intelligence (GenAI) Reporting and Factsheet

If a submittal is missing required documents or information, it may be deemed nonresponsive.

The successful Offeror and all personnel who are assigned to the Agreement may be subject to a driver’s license and fingerprint check through the California Criminal History Information System and Federal Bureau of Investigation before access to a CHP facility is

Mobile Applications, Software Fixes, and IT Services Page 5 of 8 authorized. Any adverse finding(s) under the fingerprint checks may, at the sole discretion of CHP, result in a requirement for personnel replacement, disqualification of the consultant and/or Offeror or cancellation of any subsequent Agreement.

Upon award of an offer, the CHP Business Services Section, Contract Services Unit, may initiate a “Letter of Intent to Award” to the prospective Contractor. Contractor will use the letter to report to the COMR within three (3) business days to initiate the security clearance process.

10. The CHP reserves the right to do any of the following up to offer submission deadline:

1) Modify any date or deadline appearing in this RFO or the RFO Time Schedule.

2) Issue clarification notices, addenda, alternate RFO instructions, forms, etc.

3) Waive any RFO requirement or instruction for all Offerors if CHP deems said requirement or instruction unnecessary, erroneous, or unreasonable.

4) Allow Offerors to submit questions about any RFO change, correction or addenda. If

CHP allows such questions, specific instructions will appear in the cover letter accompanying the document.

5) If applicable, the CHP will E-mail written clarification notices or addenda to all persons/firms receiving this RFO.

Exceptions may occur when CHP decides just before or on the offer due date, to extend the submission deadline. If this occurs, CHP may notify potential Offerors of the extension Email.

CHP will follow-up any verbal notice in writing by E-mail via Cal eProcure.

11. Conflict of Interest

Conflict of Interest: Offeror needs to be aware of the following provisions regarding current or former state employees. If Offeror has any questions on the status of any person rendering services or involved with the Agreement, the awarding agency must be contacted immediately for clarification.

a. Current State Employees (PCC 10410)

No officer or employee shall engage in any employment, activity, or enterprise from which the officer or employee receives compensation or has a financial interest, and which is sponsored or funded by any state agency, unless the employment, activity, or enterprise is required as a condition of regular state employment.

No officer or employee shall contract on his or her own behalf as an independent contractor with any state agency to provide goods or services.

b. Former State Employees (PCC 10411)

i. From the two-year period from the date he or she left state employment, no former state officer or employee may enter into a contract in which he or she engaged in any of the negotiations, transactions, planning, arrangements, or any part of the

Mobile Applications, Software Fixes, and IT Services Page 6 of 8 decision-making process relevant to the contract while employee in any capacity by any state agency.

ii. For the twelve-month period from the date he or she left state employment, no former state officer or employee may enter into a contract with any state agency if he or she was employed by that state agency in a policy-making position in the same general subject area as the proposed contract within the 12-month period prior to this or her leaving state service.

If the Offeror violates any provisions of the above paragraphs, such action by Offeror shall render any subsequent Agreement void (PCC 10420).

12. Follow-On Contracts

No person, firm, or subsidiary thereof who has been awarded a consulting services contract, or a contract which includes a consulting component, may be awarded a contract for the provision of services, delivery of goods or supplies, or any other contracts with a state agency to develop a feasibility study or provide formal recommendations for the acquisition of IT products or services is precluded from contracting for any work recommended in the feasibility study or the formal recommendation.

13. Insurance Requirements

The Offeror representing the selected finalist must provide a certificate of insurance for commercial general liability insurance, professional liability insurance, workers’ compensation insurance as well as the accompanying endorsements as specified in Exhibit E, “Insurance Requirements” upon notification and must retain said insurance throughout the term of any resulting contract.

Mobile Applications, Software Fixes, and IT Services Page 7 of 8

14. Contract Award

a. Review of Offers

Responses to this RFO will first be reviewed for responsiveness to all requirements of listed Attachments. If a response is missing information required in any attachment, it may be deemed nonresponsive. The Department will then conduct a preliminary assessment based on offeror submittals and may request that approximately three (3) to five (5) of the most qualified candidates be interviewed at no cost to the State or

CHP.

The Department may, at its sole discretion, waive candidate interviews entirely, or waive an individual candidate’s interview if the candidate responses do not meet the Department’s specifications. If the interview is waived, each RFO response will be considered based on offeror’s submittals, requirements, and relevancy of the response to the Scope of Work. The billing rate from Attachment 8, and the Resumes for the team member(s), shall be used in the contract.

Offers must meet the COMR’s minimum technical points for this Offer (established as seven hundred (700) minimum technical points out of one thousand (1,000) maximum possible technical points) in order to be deemed responsive. Responses will be considered for “effective value” as specified in Attachment 8, (Cost Worksheet).

b. Collecting Information from Offerors

1) If deemed necessary by CHP, CHP may request an offeror to submit additional documentation following the offer opening and/or consideration. CHP will advise the offerors orally, via E-mail, or in writing of the documentation that is required and the timeline for document submission. CHP will follow-up oral instructions with writing by E-mail or mail. Failure to submit the required documentation by the date and time indicated may cause CHP to deem an offer nonresponsive.

2) At its sole discretion, CHP reserves the right to collect, by mail, E-mail, fax, or other method, the following omitted and/or additional information:

i. Signed copies of any form submitted without a signature; Data or documentation omitted from any submitted RFO attachment/form;

ii. Information/material needed to clarify or confirm certifications or claims made by an offeror;

iii. Information/material or form(s) needed to correct or remedy an immaterial defect in an offer package.

c. Immaterial Defects in Offer

1) CHP may waive any immaterial defect in any RFO package and allow the Offeror to remedy those defects. CHP reserves the right to use its best judgment to determine what constitutes an immaterial deviation or defect.

Mobile Applications, Software Fixes, and IT Services Page 8 of 8

2) CHP’s waiver of an immaterial defect in an RFO package shall in no way modify this RFO or excuse an offeror from full compliance with all offer requirements.

d. Correction of clerical or mathematical errors

1) At its sole discretion, CHP reserves the right to overlook, correct or require an offeror to remedy any obvious clerical or mathematical errors on an offer form.

2) If the correction of an error results in an increase or decrease in the total price, CHP shall give the offeror the option to accept the corrected price or withdraw their offer.

3) Offerors may be required to initial corrections to costs and figures on Attachment B if the correction results in an alteration of the cost(s) offered.

4) If a mathematical error occurs in a total or extended price and a unit price is present, CHP will use the unit price to settle the discrepancy.

e. Right to Remedy Errors

CHP reserves the right to remedy errors caused by:

1) CHP office equipment malfunctions or negligence by agency staff;

2) Natural disasters (i.e., floods, fires, earthquakes, etc.);

f. No Agreement Award or RFO Cancellation;

The issuance of this RFO does not constitute a commitment by CHP to award an agreement. CHP reserves the right to reject all offers and to cancel this RFO if it is in the best interest of CHP to do so.

15. Award

Award of an Agreement resulting from this RFO will be based on effective value and will be considered as indicated in Attachment B.

16. Agreement Amendments After Award

The CHP reserves the right to amend the Agreement as specified in the RFO after CHP makes an agreement award.

17. Protests

This RFO is issued through the authority of PCC 10298 and, as such, is not subject to protest.

RFO #24C013001

Attachment 1, Page 1 of 2

Attachment 1, Page 1 of 2

Attachment 2, Page 1 of 1

Client References

List three (3) clients served in the past five (5) years for which your company provided similar services. List the most recent first. In addition to the references listed, CHP may check with CHP offices previously or currently serviced by your company.

REFERENCE 1

Name of Firm

Street address City State Zip Code

Contact Person Telephone number

Dates of service Value or cost of service

Brief description of service provided

REFERENCE 2

Name of Firm

Street address City State Zip Code

Contact Person Telephone number

Dates of service Value or cost of service

Brief description of service provided

REFERENCE 3

Name of Firm

Street address City State Zip Code

Contact Person Telephone number

Dates of service Value or cost of service

Brief description of service provided

If three references cannot be provided, explain why:

RFO # 24C013001

ATTACHMENT 3, Page 1 of 4

CCC 04/2017

CERTIFICATION

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to the clause(s) listed below. This certification is made under the laws of the State of California.

Contractor/Bidder Firm Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date Executed Executed in the County of

CONTRACTOR CERTIFICATION CLAUSES

1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with the nondiscrimination program requirements. (Gov. Code §12990 (a-f) and CCR, Title 2, Section 11102) (Not applicable to public entities.)

2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free workplace by taking the following actions:

a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations.

b. Establish a Drug-Free Awareness Program to inform employees about:

1) the dangers of drug abuse in the workplace;

2) the person's or organization's policy of maintaining a drug-free workplace;

3) any available counseling, rehabilitation and employee assistance programs; and,

4) penalties that may be imposed upon employees for drug abuse violations.

c. Every employee who works on the proposed Agreement will:

1) receive a copy of the company's drug-free workplace policy statement; and,

2) agree to abide by the terms of the company's statement as a condition of employment on the Agreement.

Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and Contractor may be ineligible for award of any future State agreements if the department determines that any of the following has occurred: the Contractor has made false certification, or violated the certification by failing to carry out the requirements as noted above. (Gov. Code §8350 et seq.)

ATTACHMENT 3, Page 2 of 4

3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor certifies that no more than one (1) final unappealable finding of contempt of court by a Federal court has been issued against Contractor within the immediately preceding two-year period because of Contractor's failure to comply with an order of a Federal court, which orders Contractor to comply with an order of the National Labor Relations Board. (Pub. Contract Code §10296) (Not applicable to public entities.)

4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO REQUIREMENT:

Contractor hereby certifies that Contractor will comply with the requirements of Section 6072 of the Business and Professions Code, effective January 1, 2003.

Contractor agrees to make a good faith effort to provide a minimum number of hours of pro bono legal services during each year of the contract equal to the lessor of 30 multiplied by the number of full time attorneys in the firm’s offices in the State, with the number of hours prorated on an actual day basis for any contract period of less than a full year or 10% of its contract with the State.

Failure to make a good faith effort may be cause for non-renewal of a state contract for legal services, and may be taken into account when determining the award of future contracts with the State for legal services.

5. EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not an expatriate corporation or subsidiary of an expatriate corporation within the meaning of Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the State of California.

6. SWEATFREE CODE OF CONDUCT:

a. All Contractors contracting for the procurement or laundering of apparel, garments or corresponding accessories, or the procurement of equipment, materials, or supplies, other than procurement related to a public works contract, declare under penalty of perjury that no apparel, garments or corresponding accessories, equipment, materials, or supplies furnished to the state pursuant to the contract have been laundered or produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor. The contractor further declares under penalty of perjury that they adhere to the Sweatfree Code of Conduct as set forth on the California Department of Industrial Relations website located at www.dir.ca.gov, and Public Contract Code Section 6108.

b. The contractor agrees to cooperate fully in providing reasonable access to the contractor’s records, documents, agents or employees, or premises if reasonably required by authorized officials of the contracting agency, the Department of Industrial Relations, or the Department of Justice to determine the contractor’s compliance with the requirements under paragraph (a).

7. DOMESTIC PARTNERS: For contracts of $100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.3.

8. GENDER IDENTITY: For contracts of $100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.35.

http://www.dir.ca.gov/

ATTACHMENT 3, Page 3 of 4

DOING BUSINESS WITH THE STATE OF CALIFORNIA

The following laws apply to persons or entities doing business with the State of California.

1. CONFLICT OF INTEREST: Contractor needs to be aware of the following provisions regarding current or former state employees. If Contractor has any questions on the status of any person rendering services or involved with the Agreement, the awarding agency must be contacted immediately for clarification.

Current State Employees (Pub. Contract Code §10410):

1). No officer or employee shall engage in any employment, activity or enterprise from which the officer or employee receives compensation or has a financial interest and which is sponsored or funded by any state agency, unless the employment, activity or enterprise is required as a condition of regular state employment.

2). No officer or employee shall contract on his or her own behalf as an independent contractor with any state agency to provide goods or services.

Former State Employees (Pub. Contract Code §10411):

1). For the two-year period from the date he or she left state employment, no former state officer or employee may enter into a contract in which he or she engaged in any of the negotiations, transactions, planning, arrangements or any part of the decision-making process relevant to the contract while employed in any capacity by any state agency.

2). For the twelve-month period from the date he or she left state employment, no former state officer or employee may enter into a contract with any state agency if he or she was employed by that state agency in a policy-making position in the same general subject area as the proposed contract within the 12-month period prior to his or her leaving state service.

If Contractor violates any provisions of above paragraphs, such action by Contractor shall render this Agreement void. (Pub. Contract Code §10420)

Members of boards and commissions are exempt from this section if they do not receive payment other than payment of each meeting of the board or commission, payment for preparatory time and payment for per diem. (Pub. Contract Code §10430 (e))

2. LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be aware of the provisions which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions, and Contractor affirms to comply with such provisions before commencing the performance of the work of this Agreement. (Labor Code Section 3700)

3. AMERICANS WITH DISABILITIES ACT: Contractor assures the State that it complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C.

12101 et seq.)

4. CONTRACTOR NAME CHANGE: An amendment is required to change the Contractor's name as listed on this Agreement. Upon receipt of legal documentation of the name change the State will process the amendment. Payment of invoices presented with a new name cannot be paid prior to approval of said amendment.

ATTACHMENT 3, Page 4 of 4

5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA:

a. When agreements are to be performed in the state by corporations, the contracting agencies will be verifying that the contractor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled.

b. "Doing business" is defined in R&TC Section 23101 as actively engaging in any transaction for the purpose of financial or pecuniary gain or profit. Although there are some statutory exceptions to taxation, rarely will a corporate contractor performing within the state not be subject to the franchise tax.

c. Both domestic and foreign corporations (those incorporated outside of California) must be in good standing in order to be qualified to do business in California. Agencies will determine whether a corporation is in good standing by calling the Office of the Secretary of State.

6. RESOLUTION: A county, city, district, or other local public body must provide the State with a copy of a resolution, order, motion, or ordinance of the local governing body which by law has authority to enter into an agreement, authorizing execution of the agreement.

7. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor shall not be:

(1) in violation of any order or resolution not subject to review promulgated by the State Air Resources Board or an air pollution control district; (2) subject to cease and desist order not subject to review issued pursuant to Section 13301 of the Water Code for violation of waste discharge requirements or discharge prohibitions; or (3) finally determined to be in violation of provisions of federal law relating to air or water pollution.

8. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other governmental entity.

Attachment 4, Page 1 of 1

STATE OF CALIFORNIA

DEPARTMENT OF CALIFORNIA HIGHWAY PATROL

It is a mandatory requirement for the contractor/vendor to complete and submit the Conflict of Interest and Confidentiality Statement prior to commencing contract services and/or delivering requested commodities. Failure to complete and submit the Conflict of Interest and Confidentiality Statement prior to commencement of work and/or delivery of requested commodities will be grounds for contract termination.

As an authorized representative and/or corporate officer of the company named below, I warrant my company and its employees have no personal or financial interest and no present or past employment or activity which would be incompatible with participating in any activity related to this contract. For the duration of this contract, I warrant my company and its employees will not accept any gift, benefit, gratuity or consideration, or begin a personal or financial interest in a party who is associated with this contract.

I warrant my company and its employees not to disclose any financial, statistical, personal, technical, media-related, and all other data and information made available to use by the state for the purpose of providing services to the California Highway Patrol (CHP) in conjunction with the contract identified above. I warrant that only those employees who are authorized and required to use such materials will have access to them. Authorization documentation must be provided to the CHP prior to the start of the contract.

I further warrant that all materials provided by the state will be returned promptly after use; all copies or derivations of the materials will be physically and/or electronically sanitized at a minimum in accordance with the Federal Information Security Management Act (FISMA), National Institute of Standard Technology (NIST), 43 NIST Special Publication 800-36. I will include, with the returned materials, a letter attesting to the complete return of materials and documenting the destruction of copies and derivations. Failure to so comply will subject my company to criminal and civil liabilities, including all damages to the state. I authorize the state to inspect and verify the destruction document(s) as described above.

I warrant that my company will not enter into any agreements or discussions with a third party concerning such materials prior to receiving written confirmation from the state that such third party has an agreement with the state similar in nature to this one. I agree to immediately advise the CHP contract coordinator of any person(s) who has access to project confidential information and intends to disclose that information in violation of this agreement.

NAME OF COMPANY

CONFLICT OF INTEREST AND CONFIDENTIALITY STATEMENT - VENDOR

CHP 78V (Rev. 4-11) OPI 076

OPI CONTRACT/REQUISITION NUMBER

NAME OF COMPANY REPRESENTATIVE TITLE

SIGNATURE OF COMPANY REPRESENTATIVE DATE

Safety, Service, and Security An Internationally Accredited Agency

Chp 78V_0416.pdf

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)

Attachment 5

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)

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

SOLE PROPRIETOR / INDIVIDUAL

SINGLE MEMBER LLC Disregarded Entity owned by an individual

PARTNERSHIP

ESTATE OR TRUST

CORPORATION (see instructions on page 2)

MEDICAL (e.g., dentistry, chiropractic, etc.)

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.

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

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.

OR

Federal Employer Identification Number

(FEIN)

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

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:

Print Form Reset Form

STATE AGENCY/DEPARTMENT OFFICE

Department of California Highway Patrol

UNIT/SECTION

Contract Services Unit

MAILING ADDRESS

601 N. 7th Street

FAX

916-322-3166

TELEPHONE (include area code) 916-843-3641

CITY

Sacramento

STATE

CA

ZIP CODE

95811

E-MAIL ADDRESS

Kristina.Crowe@chp.ca.gov

CITY, STATE, ZIP CODE E-MAIL ADDRESS

mailto:Kristina.Crowe@chp.ca.gov

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)

Attachment 5

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 signe e 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.

mailto:wscs.gen@ftb.ca.gov http://www.ftb.ca.gov/

STATE OF CALIFORNIA – STATE CONTROLLERS OFFICE

PAYEE DATA RECORD SUPPLEMENT

RFO #24C013001

Attachment 5

(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.) TAX ID NUMBER (Required) SSN, ITIN, or FEIN that matches Tax ID number provided on STD 204

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

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.

1 REMITTANCE ADDRESS (number, street, apt or suite no.)

CITY STATE ZIP CODE

2 REMITTANCE ADDRESS

3 REMITTANCE ADDRESS

4 REMITTANCE ADDRESS

5 REMITTANCE ADDRESS

Additional Contact Information Use the fields below to provide additional Authorized Representatives for the Payee if applicable.

1 CONTACT NAME

2 CONTACT NAME

3 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

TELEPHONE (Include area code) EMAIL

TELEPHONE EMAIL

STATE OF CALIFORNIA – STATE CONTROLLERS OFFICE

PAYEE DATA RECORD SUPPLEMENT

RFO #24C013001

Attachment 5

(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.

ATTACHMENT 6, Page 1 of 1

Attachment 7, Page 1 of 1

Offeror’s Workplan

Offeror is instructed to provide Offeror’s workplan to execute CHP’s Scope of Work, labeled as Attachment A.

Attachment 8, Page 1 of 2

Attachment 2

Offeror’s Cost Worksheet

Job Title or Classification

Task Hours Rate Per Hour

Extended Total

Name of Employee

Subtotal…