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25G - PRISON TO EMPLOYMENT
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25G - PRISON TO EMPLOYMENT
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Last modified
12/12/2019 3:59:34 PM
Creation date
12/12/2019 3:41:43 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Community Development
Item #
25G
Date
12/17/2019
Destruction Year
2024
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EXHIBIT 1 <br />State of ealifenia—Department of General Services Procurement Division Solicltatlon Number 84049 <br />GSPD-05-105(REV09l09) <br />BIDDER DECLARATION <br />1. Prime bidder information (Review attached Bidder Declaration Instructions prior to completion of this form): <br />a. Identify current California certification(s)(MB,SB,NVSA,DVBE): or None-Z,. (If"None-gotoltem92) <br />b. Will subcontractors be used for this contract? Yes 21 No ❑ (if yes, indicate the distinct element of work y9ur firm will perform In this contract <br />e.g., list the proposed products produced by your firm, state if your firm owns the transportation vehicles that will deliver the products to the State, <br />identify which solicited services your firm will perform, etc.). Use additional sheets, as necessary. <br />Grant overeia r <br />and support services. <br />c. If you area California certifiedDVBE: (1) Are you a broker or agent? Yes 0NoO. <br />12) If the contract includes equipment rental, does nr co any oM�u1,at least 5 l%of the equipment <br />provided in this contract(quantityandvalue)?Yesj_jNo NIA Le/ <br />2. If no subcontractors will be used, skip to certification below. Otherwise, list all subcontractors for this contract. (Attach additional pages if necessary): <br />Subcontractor Name, Contact Person, <br />Subcontractor Address <br />CA Certification (ME,SB, <br />Work performed or goods provided <br />Corresponding <br />Good <br />5i% <br />Phone Number &Fax Number <br />&Email Address <br />NVSA, DVBE or None) <br />for this contract <br />%of bid price <br />Standing? <br />Rental? <br />City of Anaheim <br />Luz Flores <br />201 S. Anaheim Blvd <br />None <br />Coordination of Services - Case <br />25% <br />714-765-4341 <br />Suite 1001 <br />Management, Assessment, <br />Fax 714-765-4356 <br />Anaheim CA 92805 <br />Training, OJT and support <br />- <br />Iflores@anaheim.net <br />services <br />County of Orange <br />Caroms Lacy <br />1300 S. Grand Ave <br />Bldg. B, 3rd Ed. <br />None <br />Coordination of services - Case <br />Management, Assessment <br />20% <br />❑ <br />714-480-6420 <br />Santa Ana CA 92705 <br />Training, OJT, and support <br />Fax 714-834-7132 <br />carrna.lacy@occr.ocgov.com <br />sewlces <br />O <br />Working Wardrobes <br />Jam Rosen <br />1851 Kettering St <br />Irvine, CA 92614 <br />None <br />Case Management, workforce <br />readiness training, soft skills, job <br />15 <br />❑ <br />714-210-2460 <br />jerri@workingwardrobes.org <br />development and placement, <br />Fax 714434-2870 <br />intewlewhe ork wardrobe <br />CERTIFICATION: By signing the bid response, I certify under penalty of perjury that the information provided Is true and correct. <br />Page 1_of 2 <br />25G-40 <br />
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