1-Tax Residence Certification.pdf

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Attached to
ITB – Hydro-Insensitive High Density Polyurethane Foam Material, Installation and Related Items for Harris County Precinct 4
Solicitation number
25/0358
Issued by
Harris County, Texas

About this file

This document is a Tax Form/Debt/Residence Certification form for advertised projects issued by Harris County, Texas. The form is designed to collect information from bidders or proposers regarding their business status, property ownership, county debt, and residency certification. The form requires companies to provide their Taxpayer Identification Number (T.I.N.), confirm their business registration in Texas, and disclose any taxable properties in Harris County.

The certification section of the form specifically addresses Texas Government Code §2252.001, which defines "resident" and "nonresident" bidders based on their principal place of business. Companies must check a box certifying whether they are a resident or nonresident bidder, with resident bidders defined as those whose principal place of business or majority owner is located in Texas. The form also includes a section for bidders to disclose any outstanding debts to Harris County, including taxes, tickets, fines, tolls, or court judgments, with instructions to attach an explanation if applicable.

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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 .