2-Form 6 - Litigation Disclosure.pdf
PDF 172 KB Posted
- Attached to
- Mowing Services for Vacant Lot
- Solicitation number
- 135-26-HLH-RFP
- Issued by
- Cameron County, Texas
About this file
This is a Litigation Disclosure Form (Form 6) required by the City of Brownsville, Texas Procurement Department for respondents bidding on mowing services for vacant lot properties. The form mandates that each respondent disclose any litigation, arbitration, or claims pending, settled, or closed within the past five years involving the respondent, its officers, or principals that relate to performance of public contracts or professional services similar to those solicited by the City. Respondents must indicate whether they have been involved in such matters and, if applicable, provide detailed information including case title and parties, case number and venue, brief description of the dispute, and status or outcome with resolution date. The form includes space for up to six separate case disclosures with additional pages available if necessary.
Respondents must certify under penalty of perjury that the information provided is complete and accurate to the best of their knowledge and that no other litigation, arbitration, or claims exist except as disclosed. The form explicitly acknowledges that submission of false, incomplete, or misleading information may result in disqualification, termination of contract, or prosecution under Texas Penal Code Section 37.10 (Tampering with a Governmental Record). The form requires the respondent's signature, printed name, title, date, company name, and phone number to complete the certification process.
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Text version
FY26 – Version 2 Procurement Department October 2025
Form 6 – Litigation Disclosure
Purpose
This form requires each Respondent to disclose any litigation, arbitration, or claims—pending, settled, or closed—within the past five (5) years involving the Respondent, its officers, or principals that relate to performance of public contracts or services similar to those solicited by the City of Brownsville.
Disclosure Statement
☐ The Respondent has NOT been involved in any litigation, arbitration, or claim within the past five (5) years related to public contracting or professional services.
☐ The Respondent HAS been involved in one or more litigation, arbitration, or claim matters within the past five (5) years as described below:
Case Title / Parties Case No. / Court / Venue Brief Description of Dispute
Status / Outcome / Date Resolved
Attach additional pages if necessary.
Certification
By signing below, the undersigned Respondent certifies that the information provided herein is complete and accurate to the best of their knowledge and that no other litigation, arbitration, or claims exist except as disclosed above. The Respondent acknowledges that submission of false, incomplete, or misleading information may result in disqualification, termination of contract, or prosecution under Texas Penal Code § 37.10 (Tampering with a Governmental Record).
Signature: ____________________________________________
Printed Name: _________________________________________
Title: ________________________________________________
Date: ______________________
Company Name: ________________________________________
Phone: ______________________
| The Respondent has NOT been involved in any litigation arbitration or claim within the past five 5 years: Off |
| The Respondent HAS been involved in one or more litigation arbitration or claim matters within the past: Off |
| Case Title PartiesRow1: |
| Case No Court VenueRow1: |
| Brief Description of DisputeRow1: |
| Status Outcome Date ResolvedRow1: |
| Case Title PartiesRow2: |
| Case No Court VenueRow2: |
| Brief Description of DisputeRow2: |
| Status Outcome Date ResolvedRow2: |
| Case Title PartiesRow3: |
| Case No Court VenueRow3: |
| Brief Description of DisputeRow3: |
| Status Outcome Date ResolvedRow3: |
| Case Title PartiesRow4: |
| Case No Court VenueRow4: |
| Brief Description of DisputeRow4: |
| Status Outcome Date ResolvedRow4: |
| Case Title PartiesRow5: |
| Case No Court VenueRow5: |
| Brief Description of DisputeRow5: |
| Status Outcome Date ResolvedRow5: |
| Case Title PartiesRow6: |
| Case No Court VenueRow6: |
| Brief Description of DisputeRow6: |
| Status Outcome Date ResolvedRow6: |
| Printed Name_6: |
| Title_7: |
| Date_6: |
| Company Name_6: |
| Phone_6: |
| Signature6_es_:signer:signature: |
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