6-0056 7-7 child-support-biz-ownership.pdf
PDF 959 KB Posted
- Attached to
- PW Meandering Road City Project No. 100873
- Solicitation number
- 26-0147
- Issued by
- Tarrant County, Texas
About this file
This is a State of Texas Child Support Business Ownership Form required for bids submitted on state-funded contracts, specifically for the PW Meandering Road City Project No. 100873 in Texas. The form mandates disclosure of ownership information for all business entities submitting bids, with particular focus on individuals owning 25% or more of the submitting entity. Bidders must provide the names and social security numbers of all owners meeting this threshold, or certify that no individual owns 25% or more of the business. The project involves reconstruction of Meandering Road from four to three lanes, realignment of the intersection at Roberts Cut Off, construction of intersection improvements at Yale Street and LTJG Barnett, and addition of sidewalks, sidepaths, and bike lanes within the specified project limits.
Under Section 231.006 of the Texas Family Code, vendors and applicants must certify that the named business entity is not ineligible to receive the contract payment, with acknowledgment that failure to provide accurate information may result in contract termination and payment withholding. Social security numbers collected are confidential and may only be disclosed for purposes of responding to requests from agencies operating under Parts A and D of Title IV of the Federal Social Security Act. For joint ventures, all parties to the venture must submit a completed form. The information collected will be maintained by the designated local government entity, with requesters entitled to review, receive, and request corrections to their information under applicable sections of the Texas Government Code.
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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: |
| Project Name: |
| TxDOT CSJ: |
| LG Project Number: |
| 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 .