ESBD_383182_1732987087837_HB 1295 Form Example Revised 11.1.24.pdf
PDF 195 KB Posted
- Solicitation number
- 2412-100-378
- Issued by
- Bastrop County, Texas
About this file
This document outlines Texas House Bill 1295 requirements for vendors awarded contracts by Belton ISD's Board of Trustees. The file includes both explanatory text and a sample Certificate of Interested Parties Form 1295. Vendors must complete this form through the Texas Ethics Commission's website before conducting business with the district. After completing the electronic form, vendors must print, sign, and return it to the Purchasing Department. The district's Purchasing Department has 30 days to complete the electronic acknowledgment process after board approval.
The form requires vendors to provide business entity information, identify the governmental entity (Belton ISD), include contract identification numbers and descriptions, and list any interested parties with controlling or intermediary interests. The document includes a sample form showing required fields and notarization requirements. Failure to comply with HB 1295 requirements will prevent vendors from conducting business with the district. Technical support is available through the Texas Ethics Commission at 512-463-5800, and vendors can access additional information and required forms at www.ethics.state.tx.us.
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Text version
TEXAS HB 1295
House Bill 1295 requires all vendors awarded district solicitations by the Board of Trustees to complete a Certificate of Interested Parties form. Vendors are required to complete an online form through the Texas Ethics Commission in order for the district to process a contract or purchase order for products or services from awarded vendors. The link below provides additional information on how this process will take place. This must be done before doing business with the vendor.
www.ethics.state.tx.us
It is recommended that vendors watch the video related to submitting a Form 1295 at this website. After the vendor completes the electronic form, they will be prompted to print the form and return it to the Purchasing Department, by mail or via the electronic method assigned and will be filed with the contract.
The Purchasing Department will complete the required electronic acknowledgement of the vendor’s 1295 form.
It is critical that these steps are followed in a timely manner. The District’s Purchasing Department has only 30 days to complete the process with the Texas Ethics Commission after the approval of the board. It is critical that these steps are followed in a timely manner.
PLEASE NOTE:
The Form 1295 must be completed for every contract entered into with Belton ISD that will be awarded by the board.
Failure to comply with HB 1295 will prevent the District from conducting business with the vendor.
If you have questions, please contact Tammy Shannon, the Director of Purchasing.
The Texas Ethics Commission can be reached at 512-463-5800 to assist vendors with specific questions and technical support.
http://www.ethics.state.tx.us/
EXAMPLE
CERTIFICATE OF INTERESTED PARTIES FORM 1295
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.
OFFICE USE ONLY
Certificate Number:
Date Filed:
Date Acknowledged:
1 Name of business entity filing form, and the city, state and country of the business entity's place of business.
THE NAME OF YOUR BUSINESS CITY, STATE
2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed.
BELTON ISD USE THIS FOR OTHER GOVT AGENCY
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.
XXXX-XXX-XXX, TYPE OF BID/RFP/RCSP # PROVIDED BY BISD & DESCRIPTION OF
GOODS/SERVICES GOODS/SERVICES PROVIDED TO DISTRICT
Name of Interested Party
City, State, Country (place of business)
Nature of Interest (check applicable)
Controlling Intermediary
5 Check only if there is NO Interested Party.
6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
NOTARY SEAL SIGNATURE OF FORM SIGNER
Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said , this the day of , 20 , to certify which, witness my hand and seal of office.
TO BE COMPLETED BY NOTARY PUBLIC
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
ADD ADDITIONAL PAGES AS NECESSARY
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 4/8/2016 http://www.ethics.state.tx.us/
File details come from the government source that posted it. Updated .