STATE OF CALIFORNIA WORKFORCE DEVELOPMENT

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State of Callfornla,Deparlmeat of General Services, Procurement Divlslon GSPD-0S-105(REV WAS) Instructions BIDDER DECLARATION Instructions All prime bidders (the firm submitting the bid)must complete the Bidder Declaration. 1 2.(continued)Colum r Labels I.e. Identify all current certifications Issued by the State of(alifornia. If the prime bidder has no California - certifiation(s), check the line labeled"None"and proceed to Item a If the prime bidder possesses one or more of the following certifications, enter the appl [able certification(s) on the line: Mhrobusiness(MD) Small Business (SB) NonprofilVeteran Service Agency (NVSA) • Disabled Veteran Business Enterprise (DVBE) t.b. Mark either'Wor"No"to Identify whether subcontractors will be used for the contract. If the response is Wprdceed to Item dl.c. If'Yes"enter on the line the distinct element of work Contained in the Contact to be performed or the goods to be provided by the prime bidder. Do not include goods or services to be provided by subcontractors. Bidders certified as MB,50,NVSA,andfor DVBE in u st provide a commercially useful function as defined In Military and Veterans Code 5ectlon 999 for DOEsand Government Code Section 1 4837(d) (4) (A) forsmalg microbusinesses. Bids nous( prepose that certified bidders provide Comm eacially useful function far the resulting Contactor the bid will be deemed non -responsive and rejected by the State. for quonions regard Ingthe solicitation, contact the procurement official identified In the Sol Idtatlom Note:A sub contractor Is any person, firm, Gorpomtfon,or organisation Contracting to perfome part of the prime's contract. 1.c. This item lsonlytobe completed by businesses certified by California as a. DVBE. (1) Declare whether the prime bidder 1s a broker or agent by marking either"Yes,Wile. The Military and Veterans Code Section 999.2 (b) defines"brwkerbr"agent"asa certified DVBE contractor orsubcon- tra ctor that does not have fitle, possession, control, and risk of loss of materials, supplies, services, or equipment provided to an awarding department, unless one or more of the disabled veteran owners has at least5l-percent ownership ofthe quantity and nine of the materials, supplies,seMces,andof each piece of equipment provided underthe Contract, (2) Nbidding rental equipment, mark efther"Yes"or"No"to identify If the prime bidder owns at least 51% of the equipment provided (quantity and value). If not bidding rental equipment,mark"N/A"for"not applicable." 2. If no subcontractors are proposeddo not complete the table. Read the certification atthe bottom of the f erm an lcomplete"Page_of_"onthe form. IfSubcontactorsWill be used complete Durable listing all subcontractors Aneoessary,attachadditional pages and complete the"Page-„_of_"acmrdingiy. SubcontractorNnme,ContactPerson,Phone hurvalWaNumber—Listeach element for all subcontractors. SubmntracmrAddress&EmadfAddress—Enterthe address and ifavailabie,an Email address. CA CerNBcatfon (MD, SD, NVSA, DPDE orlh owl-1 f the subcontractor Possesses a coal State of Califomlacertifiatidn(s),vecffyonihiswebsite(wwwemwmreaddosaaa 1. WorkperformedorgoodspraddedkrDrtsmntiaer—Identifythe distinct element ofworkcontained in the contract to be performed orthe goodsto be provided by each subcontractor. Confided subcontractors must provide a commercially useful function for the Contract. (Seeparagmph 1.b abonforcade ckations regarding the definition of commercially useful function.) If a Coupled subcontractor isfurther subcontract- ing a greater portion of the work or goods provided for the resulting contract than would be expected by normal industry practices, attach a separate sheet of paper explaining the situation. Carmixondyng %ofbidprire—Emerthe corresponding percentage of the total bid price for the goods and/or Services to be provided by each subcontractor. Do not enter a dollaramoure. Good Standing?—Providea response foreach submmmctorlisted. Finer either"Yes"or"Neto indicate that the prime bidder has verified that the subcontmdor(s) is in good standing for all of the following: • Possesses valid license(s)frranyRemelt) of permits required by the solicitation or bylaw • Aaorporalion,theCompany Is qualified to do business in California and designated by the Sate of Cal Noma Secretary of State to be in good standing • Possesses valid State of California ertificatlon(s)ifclaiming MB, Sit, NVSA,and/or AIDE status 51%Aentcolt—Ittspertains to the applicability of rental equipment. Based on the following parameters, enter either°N/A°(not appllable),"Yes"or"No"foreach subcontractor listed. EnterWA°lfthe, Subcontractor Is NOT DVBE (regardless of whether or not rental equipment is provided by the Subcontractor) or • Subcontractor is NOT providing rental equipment(regardless ofwhether ornot subcontractor isa OVSEI. Enter Wes"if the su bon tractm Is a California Certified DVBE pmviding renal equipment and the subcontractor owns at last 51%oftherental equipment (quantity and value) (twill beproviding for the contract. Enter"No"if the subcontractor Isa Cdlif nnia certified DVBE providing rental equipment but the sub- contractor does NOT own at least51% ofthe rental equipment (quantity and value) It wall be providing Read the certification atthe bottom wither page and complete the"Page _of_,,.°accordingty.