STATE OF CALIFORNIA — DEPARTMENT OF STATE HOSPITALS Gavin Newsom, Governor

DEPARTMENT OF STATE HOSPITALS

Solicitation Number:

DSH 2010 - Revised 08/22/23

Except as outlined in PCC 12156 (b), it is unlawful to prohibit a printer or duplication cartridge that is sold to the State from being remanufactured or recycled.

General Provisions: DGS.ca.gov - General Provisions

DEPT. OF STATE HOSPITALS - ATASCADERO

10333 El Camino Real Atascadero, CA 93422

Isaiah RodriguezOctober 20, 2025

Bidder Declaration Form Requirements:

DGS.ca.gov - Bidder Declaration Use and Evaluation Procedure

Bidder Instructions: DGS.ca.gov - Bidder Instructions

10333 El Camino Real Atascadero, CA 93422

805-468-2591 isaiah.rodriguez@dsh.ca.gov

#25IR021

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.

Classification: Non-Information Technology (Non-IT)

Recycled Products Requirement

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

Solicitation Method: Competitive (Advertised) to submit a protest to the awarding department/buyer concerning the proposed contract award

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.

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

GENAI Disclosure & Factsheet

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. Bidders/Offerors must notify the State in writing if their solution or service includes, or makes available, any GenAI technology, including GenAI from third parties or subcontractors. The State has developed a GenAI Disclosure & Factsheet to be completed by the Bidder/Offeror. Failure to disclose GenAI to the State and submit the GenAI Disclosure & Factsheet will result in disqualification of the Bidder/Offeror and 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 GenAI Disclosure & Factsheet the state reserves the right to incorporate GenAI Special Provisions into the final contract or reject bids/offers that present an unacceptable level of risk to the state.

11/7/2025 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 Pref.: DGS.ca.gov - Small Business Preference

10/21/2025 to submit a written request to have notice of proposed award publicly posted

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).

10/28/2025 https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/Required-Language-for-Solicitations-and-Contracts https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/Required-Language-for-Solicitations-and-Contracts https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/Required-Language-for-Solicitations-and-Contracts https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/Required-Language-for-Solicitations-and-Contracts https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/Required-Language-for-Solicitations-and-Contracts https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/Required-Language-for-Solicitations-and-Contracts https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/Required-Language-for-Solicitations-and-Contracts https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/Required-Language-for-Solicitations-and-Contracts https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04 https://www.dgs.ca.gov/PD/Resources/Page-Content/Procurement-Division-Resources-List-Folder/Required-Language-for-Solicitations-and-Contracts https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiN0_6s5_CAAxXGJ0QIHWnwBUAQFnoECBIQAQ&url=https%3A%2F%2Fwww.dgs.ca.gov%2F-%2Fmedia%2F79E7700ECE0F47EB95525FDEA2ABBEB8.ashx&usg=AOvVaw3pfibKAopkeq11D3vTa1Gg&opi=89978449 https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/DGSPD%20451.pdf https://www.dgs.ca.gov/PD/Resources/SCM/TOC/12/12-04

DEPT. OF STATE HOSPITALS - ATASCADERO

Cert. #:

1.

2.

3.

4.

X

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

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.

Printed Name and Title of Signatory:

Signature: Date Executed:

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

BIDDER'S REPRESENTATIVE

Designated Contact Person: Phone Number: E-Mail:

BIDDER'S CERTIFICATIONS

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

Approximate Lead Time: Product Warranty Period: Date Quote Expires DVBE Participation %:

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

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

#25IR021 11/3/2025 by 3:00 PM PST 11/04/25 Low Cost Determination Delivery Location:

10333 El Camino Real, Atascadero, CA 93422-5808 United States Specific Instructions/Requirements (if any):

Delivery to Department of State Hospitals - Atascadero Receiving Dock Monday-Friday, 7:00 AM-3:00 PM PST.

Submission for questions due by 10/27/2025 by 3:00 PM PST. (Isaiah.Rodriguez@dsh.ca.gov)

BIDDER'S INFORMATION

Firm's Legal Name: Seller's Permit / Cert. of Registration #:

REQUEST FOR QUOTATION

ATTACHMENT A - BIDDER'S INFORMATION AND CERTIFICATIONS

SOLICITATION SPECIFICS:

Solicitation Number: Solicitation Due Date: Solicitation Eval Date: Evaluation Method:

YES NO YES NO

DEPT. OF STATE HOSPITALS - ATASCADERO

Solicitation #: #25IR021 Vendor Name:

Quotation Award

# DESCRIPTION OF GOODS / SERVICES QTY UOM UNIT PRICE EXTENSION

1 Cranberry Juice Cocktail 300 CS $ - 2 Pineapple Juice 200 CS $ - 3 Vegetable/Tomato Juice 200 CS $ - 4 $ -

BID SPECIFICATIONS: All Fruit Juices (Juice Cocktail), Pineapple, Vegetable (or Tomato) Fruit Juices must be 100% Fruit Juice without added sugar or sweeteners (execept cranberry juice cocktail). Cranberry Juice Coctail at least 10% Fruit Juice.

Vegetable (or Tomato Juice). All Containers must be 12 Count/46

oz. Each. No plastic containers or metal cans. Must be shelf stable, requiring no refridgeration. Products must have minimum of six months post-delivery shelf life.

6 $ -

Contract Period: (1/1/26-6/30/26) Must provide nutritional info/ingredients for each product submitted. Allow for increase/decrease of 15% in quantity for each item. Pallets of juice must have a tier/layer of 6 or less. Delivery Schedule will be provided once the bid is awarded to vendor (when estimated time of start for the contract is better established). Deliveries monthly.

When delivered, pallet must be configured with a tier/layer count of or less.

SHIPPING OPTIONS Initial Date

1 No shipping Fee is associated with this quote

2 ADD Shipping (Non Taxable)

3 ADD Shipping and Handling (Taxable)

SUBTOTAL:

OTHER, NON-SHIPPING * CHARGES:

*: Do NOT include tax in your pricing. Tax will be added later. TOTAL: -$

REQUEST FOR QUOTATION

ATTACHMENT B - GOODS AND SERVICES PRICING PAGE

Response Disclaimer:

Solicitations sent to any other email will not be considered. To be considered, all pages of the emailed solicitation that are received prior to the bid solicitation deadline specified in the solicitation will be considered "the complete solicitation". Supplier shall carefully review all documents referenced and made a part of this solicitation to ensure that all information required to properly respond to the solicitation has been received or made available and all requirements are priced in the solicitation. Failure to examine any document, drawing, specification, or instruction will be at the supplier's sole risk.

Soliciting Office: Return E-Mail Address:

Amount

DEPT. OF STATE HOSPITALS - ATASCADERO

Solicitation #: #25IR021 Vendor Name:

Form Name Form Form Description Darfur Contracting Act Certification 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 STD204 This form provides the awarding department the bidder's legal name and address, corporate status, and tax identification number.

Bidders Declaration Form GSPD-05-106 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 STD843 This form documents the ownership and broker-status of a disabled veteran business enterprise.

Recycled Content Certification Form CalRecycle074 Effective 1/1/23 PCC 12201.c.2. During bid evaluation, DSH reserves the right to award to the vendor who meets recycled products content in lieu of lowest bid. Not in excess of 10% greater total cost than nonrecycled products.

Voluntary Statistical Data Sheet VSDS Utilized to track reporting data.

The Department of State Hospitals shall make available to each bidder the forms checked below by double clicking the form name under the "Form" header. 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, and if the forms were not provided with the solicitation itself.

Required Forms Disclaimer:

If a box is checked below, the corresponding form must be submitted with a bidder's bid before the solicitation 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: