5-05-RRSegD-ChildSupport.pdf
PDF 1012 KB Posted
- Attached to
- 26IFB47 Ronald Reagan Blvd Widening - Segment D
- Solicitation number
- 26IFB47
- Issued by
- Williamson County, Texas
About this file
This is a State of Texas Child Support Business Ownership Form required for the Williamson County construction project Ronald Reagan Boulevard Widening - Segment D (Project Number 26IFB47). The form implements Section 231.006 of the Family Code, which mandates that any bid for a contract paid from state funds must include the names and social security numbers of all individuals owning 25 percent or more of the business entity submitting the bid. The project involves construction of new lanes and intersection improvements on Ronald Reagan Boulevard (Segments D1 and D2), including earthwork, grading, drainage structures, bridges, retaining walls, paving, illumination, signals, signing, striping, environmental work, and traffic control. Bidders must provide ownership information for up to four individuals or indicate that no individual owns 25 percent or more of the business entity.
The form certifies that vendors and applicants are not ineligible to receive the specified grant, loan, or payment under state law, with acknowledgment that contracts may be terminated and payment withheld if the certification is inaccurate. Social security numbers collected on this form are confidential and may be disclosed only for purposes of responding to requests from agencies operating under provisions of Part A and D of Title IV of the Federal Social Security Act. If the project involves a joint venture, all parties to the joint venture must submit a completed form. Information collected will be maintained by the local government entity and is subject to disclosure, review, and correction requests under the Texas Government Code.
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Other files
| File | Type | Posted |
|---|---|---|
| 13-13-RRSegD2-Final PavementReport.pdf | ||
| 12-11-RRSegD1-FinalGeotechandPavementReport.pdf | ||
| 9-08-RRSegD-FormCIQ.pdf | ||
| 10-09-RRSegD-DebarmentCert.pdf | ||
| 14-12-RRSegD2-FinalGeotechStructuralReport.pdf | ||
| 2-01-RRSegD-BidForm.xlsx | XLSX spreadsheet | |
| 3-02-RRSegD-PCM.pdf | ||
| 15-Pre-Bid Cancellation Notice 05.07.2026.docx | DOCX document | |
| 1-001 IFB HNTB Specifications Construction.docx | DOCX document | |
| 4-03-RRSegD-Plans.pdf | ||
| 6-04-RRSegD-BidderReference.pdf | ||
| 11-06-RRSegD-Bid Affidavit.pdf | ||
| 7-10-RRSegD-AntiBoycottStatement.pdf | ||
| 8-07-RRSegD-AddAcknowledge.pdf |
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Text version
State of Texas Child Support Business Ownership Form
County: ___________________________________
TxDOT CSJ: ______________________________
Project Name: _____________________________
LG Project Number: ________________________
Business Entity Submitting Bid:________________________________
Section 231.006, Family Code, requires a bid for a contract paid from state funds to include the names and social security number of individuals owning 25% or more of the business entity submitting the bid.
1. In the spaces below please provide the names and social security number of individuals owning 25% or more of the business.
Name Social Security Number
2. Please check the box below if no individual owns 25% or more of the business.
( ) No individual own 25% or more of the business.
Except as provided by Section 231.302(d), Family Code, a social security number is confidential and may be disclosed only for the purpose of responding to a request for information from an agency operating under the provisions of Part A and D to Title IV of the Federal Social Security Act (42 USC Section 601-617 and 651-699).
Under Section 231.006, Family Code, the vendor or applicant certifies that the individual or business entity named in this contract, bid, or application is not ineligible to receive the specified grant, loan, or payment and acknowledges that this contract may be terminated and payment may be withheld if this certification is inaccurate.
The information collected on this form will be maintained by ____________________________. With few exceptions, you are entitled on request to be informed about the information collected about you. Under Sections 552.021 and 552.023 of the Texas Government Code, you also are entitled to receive and review the information. Under Section 559.004 of the Government Code, you are also entitled to have information about you corrected that you believe is incorrect.
Signature Date
Printed Name
IF THIS PROJECT IS A JOINT VENTURE,
ALL PARTIES TO THE JOINT VENTURE MUST PROVIDE A COMPLETED FORM.
| County: Williamson |
| Project Name: Ronald Reagan Blvd Widening - Segment D |
| TxDOT CSJ: |
| LG Project Number: 26IFB47 |
| Business Entity Submitting Bid: |
| Social Security Number 1: |
| Social Security Number 2: |
| Social Security Number 3: |
| Social Security Number 4: |
| Date: |
| Printed Name: |
| None: Off |
| Name 1: |
| Name 2: |
| Name 3: |
| Name 4: |
| Local Government Name: Enter Local Government Name |
File details come from the government source that posted it. Updated .