5-Prohibited Contracts Form.pdf
PDF 117 KB Posted
- Attached to
- Lake Nasworthy Boat Ramp Construction Phase 1
- Solicitation number
- OP-01-26
- Issued by
- Travis County, Texas
About this file
This is a Verification Related to Prohibited Contracts Form from the City of San Angelo, Texas Purchasing Division. The form serves as a certification document required from contractors bidding on the Lake Nasworthy Boat Ramp Construction Phase 1 project. Contractors must declare compliance with five specific prohibitions: (1) the contracting company does not have contracts with or provide supplies or services to foreign terroristic organizations as identified by the Texas Comptroller; (2) the company does not boycott Israel and will not do so during the contract term; (3) the company does not boycott energy companies and will not do so for the duration of the contract; (4) the company does not have practices, policies, or directives that discriminate against firearm entities or firearm trade associations; and (5) the contractor must promptly notify the City of San Angelo if circumstances relevant to these provisions change during contract performance. The declarant must provide personal identifying information including name, date of birth, address, and position within the contracting company, and execute the certification under penalty of perjury.
This verification form reflects Texas state statutory requirements enacted through Senate Bills 13 and 19 of the 87th Legislature and various sections of the Texas Government Code. The form requires the declarant's signature, execution county, and date to be completed before submission. Failure to comply with any of these prohibitions or providing false certification could result in contract termination and potential legal penalties. This certification must be submitted as part of the bid package for the Lake Nasworthy Boat Ramp Construction Phase 1 project, which involves replacement of three boat ramps and three boat docks at three City-owned facilities with an estimated 180-day project duration beginning May 2026.
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Text version
CITY OF SAN ANGELO, TEXAS
PURCHASING DIVISION
72 West College Avenue, San Angelo, Texas 76903
325.657.4219 • sapurch@cosatx.us
Verification Related to Prohibited Contracts
CITY OF SAN ANGELO, TEXAS
My name is “Declarant”;
FIRST MIDDLE LAST
My date of birth is ; and, BIRTHDAY
My address is , .
STREET CITY STATE
, and .
ZIP CODE COUNTRY
My position with , contracting company, is .
CONTRACTING COMPANY OFFICE HELD
(1) The foregoing named contracting Company does not now and will not during the term of this contract, have contracts with or provide supplies or services to, an entity or company known to have contracts with or to provide supplies or services to a foreign terroristic organization or with an entity or company identified as providing such on a list prepared and maintained by the Texas Comptroller pursuant to Subchapter “F”, Sections 2252.151 et. seq., Chapter 2252 “Contracts with Governmental Entity” of the Texas Government Code; neither is contracting Company identified as an entity providing such supplies or services on said list.
(2) The foregoing named contracting Company does not boycott Israel; and will not boycott Israel during the term of the contract with the City of San Angelo.
(3) Entities that Boycott Energy Companies. In accordance with Senate Bill 13, Acts 2021, 87th Leg., R.S., pursuant to Section 2274.002 of the Texas Government Code (relating to prohibition on contracts with companies boycotting certain energy companies), the foregoing named contracting Company represents and warrants that it does not, and will not for the duration of the Contract, boycott energy companies.
(4) Entities that Discriminate Against Firearm and Ammunition Industries. In accordance with Senate Bill 19, Acts 2021, 87th Leg., R.S., pursuant to Section 2274.002 of the Texas Government Code (relating to prohibition on contracts with companies that discriminate against firearm and ammunition industries), The foregoing named contracting Company verifies that it does not, and will not for the duration of the Contract, have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association.
(5) If circumstances relevant to this provision change during the course of the Contract the City of San Angelo shall be promptly notified.
I declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of , on the
COUNTY OFFICE HELD
day of , 20
DAY MONTH YEAR
Declarant Signature mailto:sapurch@cosatx.us
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