ESBD_383080_1731698259405_EXHIBIT I - Form 1295 Certificate of Interested Parties.pdf
PDF 493 KB Posted
- Attached to
- Employee Assistance Program Benefits
- Solicitation number
- 2510-003
- Issued by
- Travis County, Texas
About this file
This document is a Form 1295 Certificate of Interested Parties required by the Texas Ethics Commission. It is to be filed in relation to a contract between a business entity and a governmental entity or state agency. The form requires the disclosure of any interested parties, including their name, nature of interest, and location. The form must be completed for contracts where there are interested parties, or a statement that there are no interested parties. The governmental entity or state agency that is a party to the contract, as well as a description of the services, goods, or other property to be provided under the contract, must also be included.
The document does not provide any additional details about the specific contract opportunity beyond the requirements for completing the Form 1295. It does not contain information about the products or services requested, project overviews, item quantities, response dates, due dates, site visits, bidder's meetings and conferences, award dates, the term of the contract, or any renewal options. There is also no information provided about pricing terms, set asides, incumbents, the current environment, funding requirements and sources, or any other salient details.
View the file
Other files
Show 40 more
Latest 50 of 62 listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 12/22/2017
FORM 1295CERTIFICATE OF INTERESTED PARTIES
OFFICE USE ONLOFFICE USE ONLOFFICE USE ONLOFFICE USE ONLOFFICE USE ONLYYYYY
6 UNSWORN DECLARATION
My name is _______________________________________________________, and my date of birth is _______________________________.
My address is ________________________________________________, ___________________, _______, __________, ______________.
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in ___________________ County, State of ______________ , on the _______ day of _______________, 20______.
(month) (year)
Signature of authorized agent of contracting business entity (Declarant)
ADD ADDITIONAL PAGES AS NECESSARY
Name of Interested Party Nature of Interest (check applicable)City, State, Country
(place of business) Controlling Intermediary
Name of governmental entity or state agency that is a party to the contract for which the form is being filed.
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract.
Complete Nos. 1 - 4 and 6 if there are interested parties.
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.
1 Name of business entity filing form, and the city, state and country of the business entity's place of business.
Check only if there is NO Interested Party.
Mus t fi le on lin e a t w ww.et hic s.s tat e.t x.u s/F ile
File details come from the government source that posted it. Updated .