3-Form 6 - Litigation Disclosure.pdf

PDF 172 KB Posted

Attached to
Traffic Signal Improvements at the Intersection of Paredes Line RD at Coffee Road
Solicitation number
164-26-EPW-IFB
Issued by
Cameron County, Texas

About this file

This is a Litigation Disclosure Form (Form 6) submitted by a bidder or contractor for the City of Brownsville, Texas in connection with the Traffic Signal Improvements at the Intersection of Paredes Line Road at Coffee Road project. The form serves as a declaration of any pending or threatened litigation involving the submitting entity that could impact its ability to perform contract obligations or affect the City's interests.

The disclosure document requires the bidder to identify all litigation matters, including lawsuits, claims, and legal proceedings that are either currently active or reasonably anticipated. This form is a standard requirement in competitive bidding processes to ensure transparency and allow the City to assess potential risks associated with contractor selection. Any disclosed litigation would be evaluated as part of the City's overall determination of bidder responsibility and capability to successfully complete the traffic signal modernization and replacement project in compliance with applicable federal, state, and local standards.

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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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