11-HCC Ownership Disclosure Requirement.pdf
PDF 100 KB Posted
- Solicitation number
- RFSQ 25-43
- Issued by
- Harris County, Texas
About this file
This document is an Ownership Interest Disclosure List form, which is Exhibit 1 to Attachment No. 2 of a contract solicitation. The form requires respondents to disclose detailed information about company members, including contractors, individuals with 10% or more ownership interest, and subcontractors listed on the Contractor and Subcontractor Participation Form.
The form provides a structured table with columns for Name, Title, and Company Name, allowing for comprehensive transparency about the organizational structure and ownership of the responding company. At the bottom of the form, space is provided for the company name, an authorized representative's details, signature, and date. There is also a checkbox option to indicate if no ownership interest disclosures are being made. The document appears to be part of a larger solicitation package, with this specific exhibit focused on ensuring full disclosure of ownership and organizational relationships.
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Text version
EXHIBIT 1 TO ATTACHMENT NO. 2
OWNERSHIP INTEREST DISCLOSURE LIST
Instruction: Using the following table, please fill in the names of any member of the Respondent’s company who is a “Contractor” (as defined in Section 5 above); any person with an ownership interest of 10% or more; and any Subcontractor listed on the “Contractor and Subcontractor Participation Form.”
Name Title Company Name
Company Name: _____________________________________________________________________
Authorized Company Representative: ___________________________________________________
Authorized Representative’s Title: _______________________________________________________
Authorized Representative’s Signature: ___________________________________________________
Date: ____________________________________________________________________________
If NO Ownership Interest Discloser has been stated above, check
BALANCE OF PAGE INTENTIONALLY LEFT BLANK.
File details come from the government source that posted it. Updated .