3-1295 Example 1.pdf
PDF 570 KB Posted
- Solicitation number
- RFP - 26-002
- Issued by
- Upton County, Texas
About this file
This document is a declaration of controlling and intermediary interest form template related to an RFP for Cold Storage Services, used in conjunction with the Laredo Independent School District's procurement for Police & Security Officer Uniforms, Tactical Gear & Specialized Equipment in Texas. The form requires bidders to identify their company or business entity and declare any controlling or intermediary interests held by individuals associated with the organization. Controlling interest is defined as ownership exceeding 10 percent, membership on a governing board of ten or fewer members, or officer status in entities with four or fewer officers or among the four most highly compensated officers in larger entities. The form includes spaces for the declarant's signature, date of birth, address information, and the date and location of the declaration.
The form does not contain substantive information regarding contract scope, pricing, deliverables, timelines, or award terms for the underlying procurement opportunity. Instead, it serves as a compliance and disclosure document requiring bidders to certify their organizational structure and financial interests prior to bid submission. This type of form is typically used to ensure transparency and prevent conflicts of interest in government contracting processes.
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Example Only
) check applicable (
Your Company/Business Entity Name, City, State, Country
Example RFP 25‐001 Cold Storage Services
`Person who has controlling interest in a business entity Controlling Interest‐ has an ownership interest or participating interest in a business entity by virtue of units, percentage, shares, stock, or otherwise that exceeds 10 percent;
is a member of the board of directors or other governing body of a business entity of which the board or other governing body is composed of not more than 10 members; or serves as an officer of a business entity that has four or fewer officers, or serves as one of the four officers most highly compensated by a business entity that has more than four officers.
Subsection (c) of this section does not apply to an officer of a publicly held business entity or its wholly owned subsidiaries.
Intermediary Interest:
receives compensation from the business entity for the person's participation;
communicates directly with the governmental entity or state agency on behalf of the business entity regarding the contract; and is not an employee of the business entity or of an entity with a controlling interest in the business entity.
and my date of birth is _______________________.
( street ) ( state ) ( zip code ) ( country )
( year ) ( month )
State of ________________, on the _____day of ___________, 20_____.
( city )
( Declarant )
File details come from the government source that posted it. Updated .