1-05 - Offeror Acknowledgment.pdf
PDF 124 KB Posted
- Attached to
- Ancillary Insurance Benefits
- Solicitation number
- RFP 2026-018
- Issued by
- Johnson County, Texas
About this file
This is an Offeror Acknowledgment form for the State of Texas's Ancillary Insurance Benefits contract opportunity. The document serves as confirmation that potential vendors have received and reviewed all pertinent bidding documents, including the Request for Proposal (RFP), any addenda, exhibits, and supporting materials related to the procurement. The acknowledgment form requires offerors to confirm receipt of specific documents and amendments, ensuring all bidders are working from the same current specifications and terms. By signing and submitting this form, vendors acknowledge their understanding of the contract requirements for Life, Disability, Employee Assistance Program (EAP), Health Savings Account (HSA)/Flexible Spending Account (FSA)/Health Reimbursement Arrangement (HRA), COBRA administration, and voluntary worksite products offerings.
The Offeror Acknowledgment form is a critical procedural requirement that must be completed and submitted as part of the proposal package. This document protects both the state and bidders by creating an auditable record that all parties have access to identical information and any issued addenda or amendments. Submission of a completed acknowledgment form is typically mandatory for proposal acceptance, and failure to include it may result in disqualification of an offer. The form ensures transparency in the competitive bidding process and establishes a baseline for equitable evaluation of all submitted proposals.
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Text version
Offeror Acknowledgment
Compliance with HB 89: Proposer agrees per HB 89 vendor shall not boycott Israel at any time while providing products or services to the City of Burleson.
Yes, we agree No, we do not agree
Compliance with SB 252: Proposer agrees per SB 252 vendor shall not do business with Iran, Sudan or a foreign terrorist organization while providing products or services to the City of Burleson.
Yes, we agree No, we do not agree
Compliance with SB 13: Proposer agrees per SB 13 vendor does not boycott energy companies as those terms are defined in the Texas Government Code § 809.001, and will not boycott energy companies during the term of any contract with the City of Burleson.
Yes, we agree No, we do not agree
Compliance with SB 19: Proposer agrees per SB 19 vendor does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association as those terms are defined in the Texas Government Code § 2274.001, and that vendor will not so discriminate during the term of any contract with the City of Burleson.
Yes, we agree No, we do not agree
Compliance with SB 2116: Proposer agrees per SB 2116 it is not owned by or the majority of its stock or other ownership interest is held or controlled by i) individuals who are citizens of China, Iran, North
Korea, Russia, or a designated country as defined by Texas Government Code § 2275.0101; or ii) a company or other entity, including a governmental entity, that is owned or controlled by citizens of or is directly controlled by the government of China, Iran, North Korea, Russia, or a designated country; nor is it headquartered in China, Iran, North Korea, Russia, or a designated country
Yes, we agree No, we do not agree
I acknowledge that my signature affixed hereto verifies that I have read and understood the contents of this document, and I affirm the accuracy and truthfulness of the information provided therein
Vendor:
By:
Name:
Title:
Date:
File details come from the government source that posted it. Updated .