11-IT Vendor Controls Cybersecurity Acknowledgment Form.pdf
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- Attached to
- RFP - Telepsychiatry Services for Harris County Community Supervision & Corrections Department
- Solicitation number
- 26/0006
- Issued by
- Harris County, Texas
About this file
This is an IT Vendor Controls and Cybersecurity Acknowledgment Form for a Telepsychiatry Services contract solicitation issued by Harris County Community Supervision & Corrections Department in Texas. The form requires authorized corporate officers, partners, or proprietors to certify their understanding of and commitment to comply with all IT vendor controls and cybersecurity requirements outlined in the solicitation. Signatories must attest to their authority to bind the company, confirm they have read and understand all solicitation documents in their entirety, and commit to providing required artifacts and documentation applicable to the goods and services being offered.
The acknowledgment form requires completion of standard vendor information fields including the project job number, project description, authorized representative names and signatures, company name and address, DUNS number, telephone, fax, and email contact information. The form must be signed in ink by an authorized company representative and submitted as part of the bidding process. This document serves as a contractual certification that the bidding vendor acknowledges and accepts the cybersecurity and IT control requirements stipulated in the Harris County solicitation for Telepsychiatry Services.
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Text version
12/15/23
INFORMATION TECHNOLOGY (IT) VENDOR CONTROLS AND CYBERSECURITY
ACKNOWLEGEMENT
This acknowledgment shall be signed, in ink, by a corporate officer, partner, or proprietor: I certify that I am authorized to sign this Acknowledgement and agree to abide by all conditions of this solicitation including but not limited to the IT Vendor Controls and Cybersecurity requirements and certify that I have read and understand the documents in their entirety. In signing this acknowledgement, I attest that under this solicitation I shall provide required artifacts/documents when applicable to the goods and/or services provided according to the published provisions of this solicitation. I certify that all statements made are true, complete and correct.
Project Job No.: ___________________________________________________
Project Description: ___________________________________________________
Authorized Representative Name (First & Last): _______________________________________________
Authorized Signature: _______________________________________________
Date: ____________________
Authorized Representative Name (First & Last): _______________________________________________
Company Name: Company Address: ___________________________________________________
Bidder DUNS Number: __________________
Telephone:________________________
Fax:____________________ e-mail:________________________
| Project Job No: |
| Project Description: |
| Authorized Representative Name First Last: |
| Authorized Representative Name First Last_2: |
| Company Name Company Address: |
| Bidder DUNS Number: |
| Telephone: |
| Fax: |
| email: |
| Date1_af_date: |
File details come from the government source that posted it. Updated .