1-Tax Residence Certification.pdf

PDF 24 KB Posted

Attached to
CSP - Renovation of the Radiographic Room at the Aldine Health Center for Harris Health (Estimated Budget $300, 000)
Solicitation number
25/0287
Issued by
Harris County, Texas

About this file

Written by GovTribe AI ·

This document is a Tax Form/Debt/Residence Certification form for advertised projects issued by Harris County, Texas. The form requires potential bidders to provide details about their business status, property ownership, and residency for government contract purposes. It includes three main sections: (1) listing taxable property in Harris County, (2) disclosing any outstanding debts to Harris County, and (3) certifying the bidder's residency status under Texas Government Code §2252.001.

The form is designed to capture critical information for government contract eligibility, specifically defining bidders as either "Resident" or "Nonresident" based on their principal place of business. Bidders must disclose their Taxpayer Identification Number (T.I.N.), business registration status in Texas, and any partnership or assumed business names. The document also requires bidders to list any taxable property in Harris County and declare whether they owe any debts to the county. By completing this form, businesses certify their compliance with local government contracting regulations and provide transparency about their business operations and financial standing.

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TAX FORM/DEBT/ RESIDENCE CERTIFICATION

(for Advertised Projects)

Taxpayer Identification Number (T.I.N.):

Company Name submitting Bid/Proposal:

Mailing Address:

Are you registered to do business in the State of Texas? Yes No

If you are an individual, list the names and addresses of any partnership of which you are a general partner or any assumed name(s) under which you operate your business

I. Property: List all taxable property in Harris County owned by you or above partnerships as well as any d/b/a names. (Use a second sheet of paper if necessary.)

Harris County Tax Acct. No.* Property address or location**

* This is the property account identification number assigned by the Harris County Appraisal District.

** For real property, specify the property address or legal description. For business personal property, specify the address where the property is located. For example, office equipment will normally be at your office, but inventory may be stored at a warehouse or other location.

II. Harris County Debt - Do you owe any debts to Harris County (taxes on properties listed in I above, tickets, fines, tolls, court judgments, etc.)?

Yes No If yes, attach a separate page explaining the debt.

III. Residence Certification - Pursuant to Texas Government Code §2252.001 et seq., as amended, Harris County requests Residence Certification. §2252.001 et seq. of the Government Code provides some restrictions on the awarding of governmental contracts; pertinent provisions of §2252.001 are stated below:

(3) "Nonresident bidder" refers to a person who is not a resident.

(4) "Resident bidder" refers to a person whose principal place of business is in this state, including a contractor whose ultimate parent company or majority owner has its principal place of business in this state.

I certify that is a Resident Bidder of Texas as defined in Government Code

[Company Name]

§2252.001.

I certify that is a Nonresident Bidder as defined in Government Code

[Company Name]

§2252.001 and our principal place of business is .

[City and State] Revised 11/09

for Advertised Projects:
undefined:
Company Name submitting BidProposal:
Are you registered to do business in the State of Texas: Off
assumed names under which you operate your business 1:
assumed names under which you operate your business 2:
Harris County Tax Acct No 1:
Harris County Tax Acct No 2:
Harris County Tax Acct No 3:
Harris County Tax Acct No 4:
Property address or location 1:
Property address or location 2:
Property address or location 3:
Property address or location 4:
fines tolls court judgments etc: Off
I certify that:
is a Resident Bidder of Texas as defined in Government Code:
I certify that_2:
Company Name:
is a Nonresident Bidder as defined in Government Code:

File details come from the government source that posted it. Updated .