8-Verification V5 08052024 Israel Energy Firearms Chld Sup China.pdf
PDF 90 KB Posted
- Solicitation number
- 2025-306
- Issued by
- Jefferson County, Texas
About this file
This document is an Anti-Boycott, Anti-Discrimination, Child Support Arrearage, and China Tech Prohibition Verification form for Johnson County, Texas. The form is designed for for-profit organizations with at least 10 full-time employees seeking to enter into a contract valued at $100,000 or more with a Texas governmental entity.
The verification requires companies to certify that they: (1) are not on the Texas Comptroller's list of companies with contracts with foreign terrorist organizations, (2) do not boycott Israel, (3) do not boycott energy companies, and (4) do not discriminate against firearm entities or trade associations. Additionally, companies must comply with National Defense Authorization Act sections regarding China Tech Prohibitions and certify they are not ineligible to receive state or federal funds due to child support arrearages. The document provides space for a company's authorized representative to sign, print their name, list their title, and date the certification, with a notary verification section included for formal documentation.
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Text version
Anti-Boycott, Anti-Discrimination, Child Support Arrearage, and China Tech Prohibition Verifications
Chapter 2270 of the Texas Government Code, Chapter 2252 of the Texas Government Code, Chapter 809 of the
Texas Government Code, and Chapter 2274 of the Texas Government Code are statutes that prohibit certain vendors from contracting with governmental entities if they boycott Israel, are listed as a company that conducts business with terrorist organizations by the Texas Comptroller, boycott energy companies, or discriminate against firearm or ammunition entities or trade organizations, respectively. Such state laws require written verification (per the statement below) by a for-profit organization that is not a sole proprietor, has at least 10 full-time employees, and the contract with the governmental entity has a value of at least $100,000 before a Texas governmental entity may enter into a contract with the company for goods or services involving the expenditure of public funds.
STATEMENT:
Company hereby certifies that:
1. It is not a company identified on the Texas Comptroller’s list of companies (https://comptroller.texas.gov) known to have contracts with, or provide supplies or services to, a foreign organization designated as a Foreign Terrorist Organization by the U.S. Secretary of State;
2. Neither Company, nor any affiliate, subsidiary, or parent company of Contractor, if any (the
“Contractor Companies”), boycotts Israel;
3. Neither Company, nor any affiliate, subsidiary, or parent Companies boycotts energy companies; and
4. It does not discriminate against a firearm entity or firearm trade association.
Company agrees that Company and affiliate, subsidiary, or parent Companies will not engage in the activities listed above during the term of this Agreement. For purposes of the Agreement, the term “boycott” shall have the meaning set forth in Chapter 2271 and Chapter 809 of the Government Code, as applicable.
Company certifies by signature of its authorized representative on this document that it does and will so long as any Agreement is in effect with Johnson County, Texas comply fully with Section 889 of the National Defense Authorization Act for Fiscal Year 2019 (NDAA FY19) and Section 5949 of the National Defense Authorization Act for Fiscal Year 2023 (NDAA FY23) that by their terms are applicable to the Company in its capacity s an information technology services provider providing services to Johnson County, Texas, and with any additional existing and future “China Tech Prohibitions” promulgated or enacted by the Unites States Government.
Company certifies that pursuant to Section 231.006 of the Texas Family Code that the individual or business entity named below is not ineligible to receive the specified payment(s) and acknowledges that any contract may be terminated and payment may be withheld if this certification is inaccurate. Company states that it is not ineligible to receive State or Federal funds due to child support arrearages.
Company Name: ________________________________________________________________
Signature of Company’s Authorized Official: ________________________________________
Print Name: _________________________________________________
Title: ______________________________ Date: __________________________
VERIFICATION
STATE OF _______________ COUNTY OF _______________
BEFORE ME the undersigned authority, _________________________________________ appeared on behalf of ________________________________ (company), who did verify that the above Statement is true.
Notary Public, State of __________________________
| Company Name: |
| Signature of Companys Authorized Official: |
| Print Name: |
| Title: |
| Date: |
| STATE OF: |
| COUNTY OF: |
| BEFORE ME the undersigned authority: |
| of: |
| Textfield: |
| Notary Public State of: |
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