10-Prohibited Contracts Form.pdf
PDF 117 KB Posted
- Attached to
- Equipment Financing State and local contract opportunity
- Solicitation number
- FS-03-26
- Issued by
- Tyler County, Texas
About this file
This is a Prohibited Contracts Verification Form issued by the City of San Angelo, Texas Purchasing Division in connection with an Equipment Financing contract opportunity. The form requires the contracting company's declarant to certify compliance with multiple Texas statutory prohibitions and restrictions on state and local contracts. The Equipment Financing proposal seeks financing for approximately $4-5 million in construction and street repair equipment that will be procured through a separate Request for Bids (RFB) and/or purchasing cooperatives. The City of San Angelo Fleet Services Division is issuing this solicitation for interested financing providers.
The declarant must verify under penalty of perjury that the contracting company does not and will not maintain contracts with entities known to have relationships with foreign terrorist organizations as listed by the Texas Comptroller, does not boycott Israel, does not boycott energy companies as prohibited under Senate Bill 13 of the 87th Texas Legislature, and does not discriminate against firearm and ammunition industries as prohibited under Senate Bill 19 of the 87th Texas Legislature. The declarant must also commit to promptly notify the City of San Angelo if circumstances relevant to these provisions change during the contract term. The form requires completion with the declarant's personal information, company affiliation, signature, and execution date in order to establish compliance eligibility for this contracting opportunity.
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Text version
CITY OF SAN ANGELO, TEXAS
PURCHASING DIVISION
72 West College Avenue, San Angelo, Texas 76903
325.657.4219 • sapurch@cosatx.us
Verification Related to Prohibited Contracts
CITY OF SAN ANGELO, TEXAS
My name is “Declarant”;
FIRST MIDDLE LAST
My date of birth is ; and, BIRTHDAY
My address is , .
STREET CITY STATE
, and .
ZIP CODE COUNTRY
My position with , contracting company, is .
CONTRACTING COMPANY OFFICE HELD
(1) The foregoing named contracting Company does not now and will not during the term of this contract, have contracts with or provide supplies or services to, an entity or company known to have contracts with or to provide supplies or services to a foreign terroristic organization or with an entity or company identified as providing such on a list prepared and maintained by the Texas Comptroller pursuant to Subchapter “F”, Sections 2252.151 et. seq., Chapter 2252 “Contracts with Governmental Entity” of the Texas Government Code; neither is contracting Company identified as an entity providing such supplies or services on said list.
(2) The foregoing named contracting Company does not boycott Israel; and will not boycott Israel during the term of the contract with the City of San Angelo.
(3) Entities that Boycott Energy Companies. In accordance with Senate Bill 13, Acts 2021, 87th Leg., R.S., pursuant to Section 2274.002 of the Texas Government Code (relating to prohibition on contracts with companies boycotting certain energy companies), the foregoing named contracting Company represents and warrants that it does not, and will not for the duration of the Contract, boycott energy companies.
(4) Entities that Discriminate Against Firearm and Ammunition Industries. In accordance with Senate Bill 19, Acts 2021, 87th Leg., R.S., pursuant to Section 2274.002 of the Texas Government Code (relating to prohibition on contracts with companies that discriminate against firearm and ammunition industries), The foregoing named contracting Company verifies that 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.
(5) If circumstances relevant to this provision change during the course of the Contract the City of San Angelo shall be promptly notified.
I declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of , on the
COUNTY OFFICE HELD
day of , 20
DAY MONTH YEAR
Declarant Signature mailto:sapurch@cosatx.us
File details come from the government source that posted it. Updated .