1-Declaration of Compliance.pdf
PDF 108 KB Posted
- Solicitation number
- RFP 27-08
- Issued by
- Upton County, Texas
About this file
This is a Declaration of Compliance form for the Del Rio Consolidated Independent School District (CISD) in Texas related to the Freshman Cafeteria Dining Furniture Project. The document serves as a compliance certification that proposing vendors must complete and submit as part of their bid package. The form requires authorized company representatives to affirm that proposals were prepared independently without collusion, acknowledge various state and federal compliance requirements, and provide company contact information and addresses for ordering and remittance purposes.
The Declaration of Compliance addresses multiple statutory requirements under Texas law, including certifications regarding felony convictions of company owners or operators, suspension or debarment status from federal contracts exceeding $25,000 in aggregate annual expenditures, and compliance with boycott prohibitions related to Israel, energy companies, and the firearm industry. For companies with ten or more full-time employees and agreements valued at $100,000 or more, additional verifications are required confirming non-discrimination practices toward energy companies and firearm entities. The form requires the signature of the person responsible for the proposal, along with printed name, title, phone, fax, email, date, Federal ID or Social Security Number, and complete mailing addresses for the company, order location, and remittance destination.
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Text version
DECLARATION OF COMPLIANCE
A. The undersigned affirms that they are duly authorized to execute this contract, that this company, corporation, firm, partnership or individual has not prepared this proposal in collusion with any other proposer, and that the contents of this proposal as to prices, terms or conditions of said proposal have not been communicated by the undersigned nor by any employee or agent to any other person engaged in this type of business prior to the official B
B. Pursuant to the State of Texas Legislative Senate Bill No. 1, Section 44.043, Notification of Criminal History, the undersigned affirms this firm is /is not owned or operated by anyone who has been convicted of a felony. This statement is not required by a publicly-held corporation.
C. Pursuant to the Texas Education Agency Financial Accountability System Resource Guide, Item I.
Procurement and Suspension and Debarment Compliance requirements under Federal statutes, the undersigned affirms this firm is _____/is not_____suspended or debarred from participation in federal contracts when expenditures to the vendor are in excess of $25,000 in the aggregate over a twelve month period.
D. In accordance with Section 2270.002 of the Texas Government code, by signature hereon, Contractor certifies that it does not boycott Israel and will not boycott Israel during the term of this Contract.
E. In accordance with Senate Bill 13 Contracts with Companies that Boycott Energy Companies:
If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 22274, it does not boycott energy companies; and will not boycott energy companies during the term of the Agreement. This verification is not required for an agreement where a governmental entity, determines that these requirements are inconsistent with the governmental entity’s constitutional or statutory duties related to the issuance, incurrence, or management of debt obligation or the deposit, custody, management, borrowing, or investment of funds.
Contractor represents and warrants that 1) it does not, and will not for the duration of the contract, boycott energy companies, or 2) the verification required by Section 2274.022 of the Texas Government Code does not apply to the contract. Select 1_____Select 2)_____
F. In accordance with Senate Bill 19 Contracts with Companies that Discriminate Against Firearm Industry:
If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 2274, it does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and will not discriminate during term of the contract against a firearm entity or firearm trade association.
Contractor verifies that: 1) it does not, and will not for the duration of the contract, have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; or 2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract.
Select 1)_____Select 2)_____
COMPANY
SIGNATURE OF PERSON RESPONSIBLE FOR PROPOSAL NAME (PRINT OR TYPE) TITLE
PHONE FAX E-MAIL DATE
FEDERAL ID# OR SOCIAL SECURITY #:______________________________________________________________________
GENERAL E-MAIL ADDRESS FOR MAILING PURPOSES: _______________________________________________________
ORDER ADDRESS: REMITTANCE ADDRESS:
| Procurement and Suspension and Debarment Compliance requirements under Federal statutes the: |
| is not: |
| energy companies or 2 the verification required by Section 2274022 of the Texas Government Code does: |
| Select 2: |
| verification required by Section 2274002 of the Texas Government Code does not apply to the contract: |
| Select 2_2: |
| Select 1: |
| COMPANY: |
| FAX: |
| GENERAL EMAIL ADDRESS FOR MAILING PURPOSES: |
| ORDER ADDRESS 1: |
| ORDER ADDRESS 2: |
| ORDER ADDRESS 3: |
| REMITTANCE ADDRESS 1: |
| REMITTANCE ADDRESS 2: |
| REMITTANCE ADDRESS 3: |
| Text1: |
| Text2: |
| Text3: |
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