7-04 - Form 1295 Certificate of Interested Parties.pdf

This is a House Bill 1295 Certificate of Interested Parties form related to a Texas state contract opportunity for Ancillary Insurance Benefits. The contract encompasses Life, Disability, Employee Assistance Program (EAP), Health Savings Account (HSA)/Flexible Spending Accounts (FSA)/Health Reimbursement Arrangement (HRA), COBRA administration, and voluntary worksite products. The form serves as a disclosure document requiring interested parties to provide information about their ownership and control structure prior to contract award.

The Certificate of Interested Parties is a statutory requirement under House Bill 1295 that mandates disclosure of all parties with ownership or control interest in the entity submitting a bid or proposal. This form must be completed and submitted as part of the contracting process for state and local opportunities in Texas. The document establishes transparency requirements and ensures that the state has accurate information regarding the individuals and entities with financial or operational interest in awarded contracts.