RFQ_25CL010.pdf

STATE OF CALIFORNIA — DEPARTMENT OF STATE HOSPITALS GAVIN NEWSOM, Governor

DEPARTMENT OF STATE HOSPITALS

Solicitation Number:

DSH 2010 - Revised 10/26/20

Please see the Competitive Solicitation language at:

DVBE Waiver Notification:

The DVBE Program requirement is either not applicable or is waived for this solicitation and resulting contract.

Tie Breaking Ties between bidders will be resolved in accordance with GC 14838 and CCR, Title 2,

1896.6. If a tie remains, a witnessed coin toss will determine the winner.

Post-Award Protests In accordance with PCC 10306, the following are the key action dates related to Post- Award Protests. All dates are Close of Business (COB).

DVBE Incentive An incentive will be given to bidders who provide DVBE participation either as DVBEs or through subcontracting. The following percentages will apply:

DVBE Participation Incentive

4/17/2018 to submit a protest to the awarding department/buyer concerning the proposed contract award

4/27/2018 to file a full and complete written statement specifying in detail the ground of the protest and the facts in support thereof

5% 4% to 4.99% inclusive 4% 3% to 3.99% inclusive 3%

5% or Over

Small-Business Subcontractor Pref.:

www.documents.dgs.ca.gov/pd/SAM/Chapter8.21.pdf

4/10/2018 to submit a written request to have notice of proposed award publicly posted

DEPT. OF STATE HOSPITALS - ATASCADERO

Procurement 10333 El Camino Real

Atascadero, CA 93422

Carolynn LaRue

Bidder Declaration Form Requirements:

Bidder Instructions: https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf

Classification: Non-Information Technology (Non-IT)

Recycled Products Requirement

Recycled products shall be offered and/or used to the maximum extent economically feasible

December 22, 2025

The Department of State Hospitals (DSH) would like to request a quote from your company, which will be awarded to the lowest cost vendor. If your company/firm is interested in bidding, please note that the following provisions and instructions are in force for this solicitation. Bidders are advised to read each document.

Solicitation Method: Competitive (<$25,000)

General Provisions: NonITGeneralProvisions11192021.pdf

25CL010

10333 El Camino Real Atascadero, CA 93422

805-468-2887 ASHprocurement@dsh.ca.gov https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-106.pdf

DEPT. OF STATE HOSPITALS - ATASCADERO

Written questions about the solicitation must be submitted to ASHprocurement@dsh.ca.gov. by:

Cert. #:

1.

2.

3.

4.

X

DVBE Participation %:Date Bid ExpiresApproximate Lead Time: Product Warranty Period:

Printed Name and Title of Signatory:

Date Executed:Signature:

That I have understood and shall comply with the terms, conditions, and requirements as outlined in this solicitation and its attachments, including but not limited to, the General Provisions and Bidder's Instructions as referenced herein.

BIDDER'S REPRESENTATIVE

Phone Number: Fax Number:Designated Contact Person:

BIDDER'S CERTIFICATIONS

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY, and under the laws of the State of California, the following:

That I am duly authorized to legally bind the prospective Contractor to the specifications, clauses, and requirements of this solicitation and its attachments;

That the information provided is accurate to the best of my knowledge;

That the products I have identified in Attachment B meet the specifications as they are written in this solicitation and its attachments; AND

Seller's Permit / Cert. of Registration #:

Cert. #:Certified DVBE?

City, State, and Zip:Firm's Address:

Bidder's FEIN Number: Claiming SB/MB or Non-SB Pref.?

Firm's Legal Name:

REQUEST FOR QUOTATION

SOLICITATION SPECIFICS:

Solicitation Number: Solicitation Evaluation Date: Evaluation Method:Solicitation Due Date/Time:

Delivery Location:

Receiving Dock: 10333 El Camino Real, Atascadero, CA 93422

BIDDER'S INFORMATION

Specific Delivery Instructions/Requirements (if any):

ATTACHMENT A - BIDDER'S INFORMATION AND CERTIFICATIONS

Receiving Dock Hours: Monday through Friday, 7:00am - 3:00pm, excluding holidays.

01/14/26 Low Cost Determination25CL010 Inquiries/Questions:

1/7/2026

1/14/26 2:00 PM

YES NO YES NO

DEPT. OF STATE HOSPITALS - ATASCADERO

DEPT. OF STATE HOSPITALS - ATASCADERO

# DESCRIPTION OF GOODS / SERVICES MODEL # QTY UOM UNIT PRICE EXTENSION

Flight-Type Warewash machine (Reference:

Stero Model #STPC-ER3T) (See attached specifications, Quote must include installation and one year warranty.)

Reference:

STPC-ER3T

1 EA

SUBTOTAL:

OTHER, NON-SHIPPING

TOTAL:

Do NOT include tax in your pricing. Tax will be added later.

QUOTATION AWARD: This solicitation shall be awarded by line item OR by all or none total for all the line items, whichever is deemed to be in the best interest of the State.

NOTE: For the purpose of this solicitation, if applicable, shipping F.O.B. Destination - Freight Prepaid is preferred by the State.

Substitutions will be considered based on comparability to the model specified.

REQUEST FOR QUOTATION

ATTACHMENT B - GOODS AND SERVICES PRICING PAGE

Email / Fax Response Information:

FAX RESPONSE DISCLAIMER: Bidders are hereby made aware that, for solicitations originating from the office listed above, facsimile machine bids will be considered only if they are sent to the fax number indicated above. Bids sent to any other fax number(s) will not be considered. To be considered, all pages of the faxed bid that are received prior to the bid opening time specified in the bid will be considered "the complete bid". Please be advised that there is a heavy demand placed on the fax machine receiving bids and the State assumes no responsibility if a supplier cannot transmit their bid via fax, if the entire bid is not received prior to the bid opening time.

Return Fax Number:

(805) 468-3451

Vendor Name:

ASHprocurement@dsh.ca.gov

Return Email Address: Soliciting Office:

DSH-A Procurement

Solicitation # 25CL010

DEPT. OF STATE HOSPITALS - ATASCADERO

Form Name Form #: Form Description

Darfur Certification Form Darfur Public Contract Code section 10475, et. seq. prohibits state agencies from doing business with vendors which have certain business dealings with the Sudan. This form documents that the bidder has no such relationships and is therefore eligible to bid.

Payee Data Record Std. 204 This form provides the awarding department the bidder's legal name and address, corporate status, and tax identification number.

Bidders Declaration Form GSPD-05-105 This form is used to capture subcontractor information and is used to determine whether a bidder is performing a commercially useful function, as required by statute.

DVBE Declarations Form Std. 843 This form documents the ownership and broker-status of a disabled veteran business enterprise.

Recycled Content Certification Form

CIWMB 74 This form is required to document the amount of post-consumer content, if any, contained in each item in the solicitation.

Confidentiality Statement N/A This form is required to ensure that all bidders for IT solicitation adhere to strict confidentiality related to the solicitation process

Attachments N/A The attachments are hereby incorporated into this solicitation. By signing this solicitation, the bidder represents that they have read and agree to the contents of each attachment.

The Department of State Hospitals shall make available to each bidder the forms checked below. However, failure on the part of the DSH to provide each form does not excuse the bidder from their responsibility to submit the required forms with their bids. Bidders are hereby advised that they may locate copies of each of the forms below at the Department of General Services' website, at www.pd.dgs.ca.gov. Bidders may also contact the Buyer for this solicitation and request a copy of some or all of these forms prior to the due date for the solicitation.

Required Forms Disclaimer:

If a box is checked below, the corresponding form must be submitted with a bidder's bid before the bid due date.

Other forms not check may be required after the close of the solicitation and prior to award. Failure on the part of the bidder to submit those forms may be grounds for disqualification.

REQUEST FOR QUOTATION

ATTACHMENT C - REQUIRED FORMS

Provision of Required Forms Disclaimer:

Vendor Name:

Solicitation #: 25CL010