3-Attachment C - Tax Residence Certification.pdf
PDF 69 KB Posted
- Solicitation number
- KJ02242026
- Issued by
- Harris County, Texas
About this file
This is a Tax Residence Certification form required by Harris County, Texas for bidders on advertised projects, specifically for the RFO regarding Primary Care Services for HIV/AIDS Geriatric Patients through Harris Health. The form serves as a compliance document to establish bidder eligibility under Texas Government Code 2252.001 et seq., which contains restrictions on governmental contract awards based on residency status. Bidders must complete all required sections, including their Taxpayer Identification Number, company name, mailing address, business registration status in Texas, and disclosure of any partnerships or assumed business names under which they operate.
The certification requires bidders to list all taxable property owned in Harris County, including property account numbers and addresses, and to disclose any outstanding debts owed to Harris County such as property taxes, tickets, fines, tolls, or court judgments. Most critically, bidders must certify whether they qualify as a Resident Bidder (with principal place of business in Texas, including contractors whose ultimate parent company or majority owner is based in Texas) or as a Nonresident Bidder (with principal place of business outside Texas). This certification is mandatory for contract consideration and must be submitted with the bid proposal. The form is designed to ensure compliance with Texas state law regarding preferential treatment for in-state vendors on government contracts.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
TAX FORM/DEBT/ RESIDENCE CERTIFICATION
(for Advertised Projects)
Taxpayer Identification Number (T.I.N.):
Company Name submitting Offer:
Mailing Address:
Are you registered to do business in the State of Texas? Yes No
If you are an individual, list the names and addresses of any partnership of which you are a general partner or any assumed name(s) under which you operate your business
I. Property: List all taxable property in Harris County owned by you or above partnerships as well as any d/b/a names. (Use a second sheet of paper if necessary.)
Harris County Tax Acct. No.* Property address or location**
* This is the property account identification number assigned by the Harris County Appraisal District.
** For real property, specify the property address or legal description. For business personal property, specify the address where the property is located. For example, office equipment will normally be at your office, but inventory may be stored at a warehouse or other location.
II. Harris County Debt - Do you owe any debts to Harris County (taxes on properties listed in I above, tickets, fines, tolls, court judgments, etc.)?
Yes No If yes, attach a separate page explaining the debt.
III. Residence Certification - Pursuant to Texas Government Code §2252.001 et seq., as amended, Harris County requests Residence Certification. §2252.001 et seq. of the Government Code provides some restrictions on the awarding of governmental contracts; pertinent provisions of §2252.001 are stated below:
(3) "Nonresident bidder" refers to a person who is not a resident.
(4) "Resident bidder" refers to a person whose principal place of business is in this state, including a contractor whose ultimate parent company or majority owner has its principal place of business in this state.
I certify that is a Resident Bidder of Texas as defined in Government Code
[Company Name]
§2252.001.
I certify that is a Nonresident Bidder as defined in Government Code
[Company Name]
§2252.001 and our principal place of business is .
[City and State] Revised 11/09
| for Advertised Projects: |
| undefined: |
| Company Name submitting BidProposal: |
| Are you registered to do business in the State of Texas: Off |
| assumed names under which you operate your business 1: |
| assumed names under which you operate your business 2: |
| Harris County Tax Acct No 1: |
| Harris County Tax Acct No 2: |
| Harris County Tax Acct No 3: |
| Harris County Tax Acct No 4: |
| Property address or location 1: |
| Property address or location 2: |
| Property address or location 3: |
| Property address or location 4: |
| fines tolls court judgments etc: Off |
| I certify that: |
| is a Resident Bidder of Texas as defined in Government Code: |
| I certify that_2: |
| Company Name: |
| is a Nonresident Bidder as defined in Government Code: |
File details come from the government source that posted it. Updated .