7-1002HVAC Anti-Terrorism Certification.pdf
PDF 58 KB Posted
- Attached to
- CNS Disposal Serive State and local contract opportunity
- Solicitation number
- 1074CNDS
- Issued by
- Van Zandt County, Texas
About this file
This document is an Anti-Terrorism Certification form for Lyford CISD (Consolidated Independent School District) in Texas, requiring potential contractors to certify they are not on state-maintained lists of scrutinized companies. The certification is based on Texas Government Code Chapter 2252, specifically Sections 2270.0201, 807.051, and 2252.153, which relate to companies potentially doing business with terrorist-affiliated entities.
The form requires a company representative to declare under penalty of perjury that their company is not identified on specified government lists and commits to immediately notifying the Lyford CISD Business Office if the company's status changes. The document is a blank template designed to be completed by a company representative, including fields for the company name, representative's date of birth, county, state, and date of execution.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 1-1002HVAC Bid Sheet.pdf | ||
| 15-1003INSU Specifications.pdf | ||
| 5-1002HVAC Form CIQ.pdf | ||
| 8-1002HVAC Tex Govt Code 2270 Verification.pdf | ||
| 10-1002HVAC Vendor Debarment Statement.pdf | ||
| 14-1003INSU Addendum 1.pdf | ||
| 3-1002HVAC Non-Collusive Certificate.pdf | ||
| 4-1002HVAC Felony Conviction Notification.pdf | ||
| 6-1002HVAC Form 1295.pdf | ||
| 9-1002HVAC Lobbying Certification.pdf | ||
| 11-1002HVAC Certificate of Residency.pdf | ||
| 12-1002HVAC HUB or Minority Owned Business.pdf | ||
| 13-1002HVAC W-9 Form.pdf | ||
| 16-1003INSU Questionnaire 2022.pdf | ||
| 2-1002HVAC Deviations Form.pdf |
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Text version
Attachment f.
ANTI-TERRORISM CERTIFICATION
I, _______________________________________, the undersigned representative of ______________________________ (the “Company”), my date of birth being ________________________, pursuant to Texas Government Code Chapter 2252, certifies that the above-named Company is not identified on the list prepared and maintained under Texas Government Code Section 2270.0201 (formerly 806.051) as a scrutinized company, Section 807.051, or Section 2252.153. I further certify that should the above-named Company become listed in accordance with any of the foregoing Sections (or as the Sections may be amended or supplemented) or enter into a contract with a company that is on said listings, I will immediately notify Lyford CISD Business Office.
I declare under penalty of perjury that the foregoing is true and correct.
Executed in ___________________ County, State of __________________, on the ___________ day of ________________________ 20____.
File details come from the government source that posted it. Updated .