8-09 Child Support Business Ownership Form.pdf
PDF 136 KB Posted
- Solicitation number
- Bid #35-02-26
- Issued by
- Bell County, Texas
About this file
This is a Child Support Business Ownership Form required by the State of Texas for bid submissions on the Georgetown Railroad Trail, Phase 1 project in Bell County, which is funded by TxDOT and administered by the City of Temple. The form pertains to a construction project involving the installation of approximately 7,400 linear feet of 10-foot ADA-compliant hike and bike trail along the Georgetown Railroad from South 31st Street to South 5th Street. The project scope includes landscaping elements, an irrigation system, pedestrian lighting, electrical components, and a pedestrian HAWK signal at the intersection of South 31st Street and the Georgetown Railroad. The selected contractor must complete all work within 210 consecutive calendar days from the Notice to Proceed, and the contract will be structured as a unit price agreement under TxDOT Standard Specifications.
The engineer's estimate of probable cost for this project is $3,780,000. Section 231.006 of the Texas Family Code 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. Bidders must either provide complete ownership information for all individuals meeting this threshold or certify that no individual owns 25 percent or more of the business. The vendor certifies that it is not ineligible to receive the grant or payment and acknowledges that the contract may be terminated and payment withheld if this certification is inaccurate. For joint ventures, all parties must submit a completed form. The information collected will be maintained by the City of Temple and is subject to confidentiality protections under Texas Family Code Section 231.302(d).
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Text version
STATE OF TEXAS CHILD SUPPORT BUSINESS OWNERSHIP FORM
County: Bell Project Name: Georgetown Railroad Trail, Phase 1 TxDOT CSJ: 0909-36-173 LG Project Number: Bid #95-02-26
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 the City of Temple. 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.
File details come from the government source that posted it. Updated .