HomeMy WebLinkAboutAgreement A-16-604 with Parks & Recreation Division.pdfEXHIBIT E
SUGGESTED LANGUAGE FOR RECYLING CERTIFICATION
State law requires that state contracts sha ll have Recycling Certification in writing under penalty of
perjury , the minimum , if not exact, percentage of recycled content , both post consumer
waste and secondary waste as defined in the Public Contract Code , Sections 12161 and 12200 , in
materials , goods , or supplies offered or products used in the performance of this Agreement, regardless
of whether the product meets the required recycled product percentage as defined in the Public
Contract Code , Sections 12161 and 12200. Contractor may certify that the product contains zero
recycled content. (PCC 10233 , 10308 .5 , 10354)
RECYCLED CONTENT CERTIFICATION
I, the official named below , CERTIFY UNDER PENAL TV 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 .
Name and Title of Person Signing Date Executed
Ernest Buddy Mendes , Chairman Ddo~'f" \\ ) d.O \ lo
Authorized Signature Executed in the County of
~Ll Fresno
LJ ~
t?
Title Telephone Number
Chairman
Legal Business Name Federal ID Number
Fresno County Sheriffs Office 94-6000512
The Contractor hereby certifies under penalty of perjury , that zero
percent of the materials , goods, supplies offered, or products used in the performance of this contract
meets the or exceeds the minimum percentage of recycled material as defined in Sections
12161 and 12200 of the Public Contract Code . The Contractor may certify that the product contains
zero recycled content.
ATTEST:
BERNICE E . SEIDEL , Clerk
Board of Supervisors
Contract# C16L0606, Fresno County Sheriffs Office, Boating Safety and Enforcement Equipment Grant-FY 2016/17, Date: 06/03/2016 Page : 68 of 83
EXHIBIT E (Cont.)
CCC-307
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
Fresno County Sheriff's Office 94-6000512
By (Authorized Signature)
~ _51t/J. 13. I .A ~
Printed Name and Title of Person £(ning
Ernest Buddy Mendes , Chairman
'
Date Executed Executed in the County of
D~o"-cex \ \) d-J)\lo Fresno
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 8103) (Not applicab le 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 .)
Contract# C16L0606. Fresno County Sheriffs Office . Boating Safety and Enforcement Equipment Grant -FY 2016 /17 , Date : 08/03/2016 Page : 69 of 83
Exhibit F
DARFUR CONTRACTING ACT
Pursuant to Public Contract Code section 10478 , if a bidder or proposer currently or within the
previous three years has had business activities or other operations outside of the United States , it
must certify that it is not a "scrutinized " company as defined in Pub li c Contract Code section 10476.
Therefore , to be eligible to submit a bid or proposal , please comp lete only one of the following three
paragraphs (via initials for Paragraph # 1 or Paragraph # 2, or via initia ls and certification for
Paragraph # 3):
~·/JR A-1. ~ We do not currently have , or we have not had within the previous three years , business
activities or other operations outside of the United States.
OR
2 .~ We are a scrutinized company as defined in Public Contract Code section 10476 , but we
have received written permission from the Department of General Services (DGS) to submit
a bid or proposal pursuant to Pub lic Contract Code section 10477(b). A copy of the written
permission from DGS is included with our bid or proposal.
3 .
OR
We currently have , or we have had within the previous three years , business activities or
other operations outside of the United States , but we certify below that we are not a
scrutinized company as defined in Public Contract Code section 104 76 .
CERTIFICATION For# 3.
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to
legally bind the prospective proposer/bidder to the clause listed above in # 3 . This certification is
made under the laws of the State of California .
Grantee Agency Name (Printed) Federa l ID Number
Fresno County Sheriff's Office 94-6000512
By (Authorized Signature)
Printed Name and Title of Person Signing
'
Date Executed Executed in the County of
Fresno
YOUR BID OR PROPOSAL WILL BE DISQUALIFIED UNLESS YOUR BID OR PROPOSAL
INCLUDES THIS FORM WITH EITHER PARAGRAPH #1 OR #2 INITIALED OR PARAGRAPH #3
INITIALED AND CERTIFIED
Contract# C16L0606, Fresno County Sheriffs Office, Boating Safety and Enforcement Equipment Grant-FY 2016/17, Date : 08/03/2016 Page : 74 of 83
1 Boating and Waterways Equipment Grant ($100,000) (Fiscal Year 2016-17)
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REVIEWED & RECOMMENDED
FOR APPROVAL
A-ks<J<~Q
MAR ARET MIMS , Shenff-Coroner
APPROVEDASTOLEGALFORM :
9 Daniel C . Cederberg , County Counsel
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By
12 De
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APPROVED AS TO ACCOUNTING FORM :
ATTEST:
BERNICE E. SEIDEL , Clerk
Board of Supervisors
16 VICKI CROW, Auditor-Controlle rrrreasurer-Tax Collector
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1a sy Q.12v-e~e.d rf
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20 Fund
Subclass
21 ORG
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Account
0001
10000
31113210
4375
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