ESBD_521436_1780090851200_04. Texas Family Code Schedule.docx

DOCX document 38 KB Posted

Attached to
Wavetronix SmartSensor Matrix, Advance Detection Systems and Accessories
Solicitation number
601330000046273
Issued by
Brazoria County, Amarillo City, Texas

About this file

This is a Texas Family Code Schedule form required for Solicitation No. 601330000046273, administered by the State of Texas. The schedule serves as a certification document that respondents must complete, sign, and return with their bid submissions to confirm eligibility to receive state grants, loans, or contract payments under Texas Family Code Section 231.006, which relates to child support obligations. Respondents and any other individuals or business entities named in the solicitation must acknowledge that the contract may be terminated and payment withheld if the certification is inaccurate. Any response submitted must include the names and Social Security numbers of all persons or entities holding at least a twenty-five percent ownership interest in the business entity submitting the response. Failure to sign and return this completed schedule with the response may result in the bid being considered non-responsive.

Respondents meeting the ownership criteria must provide the required identifying information for all qualifying owners on the form. Alternatively, respondents who do not meet the ownership criteria under Texas Family Code Section 231.006 may check the applicable box and submit the schedule without listing ownership information. The Social Security numbers collected are used solely to identify individuals who may owe child support obligations and will be kept confidential to the fullest extent permitted by Texas Family Code Section 231.302(e). This schedule is a mandatory compliance document that must accompany all bid submissions.

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TEXAS FAMILY CODE SCHEDULE

SOLICITATION NO. 601330000046273

Ineligibility to Receive State Grants or Loans or Receive Payment on State Contracts Respondent shall fill out the appropriate information, sign and return the schedule.

Under Family Code §231.006, relating to child support obligations, Respondent and any other individual or business entity named in this solicitation are eligible to receive the specified payment and acknowledge that this contract may be terminated and payment withheld if this certification is inaccurate. Any response submitted under this solicitation shall contain the names and social security numbers of person or entity holding at least a twenty-five percent ownership interest in the business entity submitting the response. Respondents meeting the ownership must complete the following:

Click or tap here to enter text.XXX-XX-Click or tap here to enter text.
NameSocial Security Number
Click or tap here to enter text.XXX-XX-Click or tap here to enter text.
NameSocial Security Number
Click or tap here to enter text.XXX-XX-Click or tap here to enter text.
NameSocial Security Number

If the respondent does not meet the ownership criteria under Texas Family code - Section 231.006, check the box below, sign and return the schedule.

☐ This Schedule is not applicable FEDERAL PRIVACY ACT NOTICE: This notice is given pursuant to the Federal Privacy Act. Disclosure of your Social Security (SSN) is required under Section 231.006(c) and Section 231.302(c)(2) of the Texas Family Code. The SSN will be used to identify persons that may owe child support. The SSN will be kept confidential to the fullest extent allowed under Section 231.302(e), Texas Family Code.

Signature Name Click or tap here to enter text.

Title Click or tap to enter a date.

THIS PAGE MUST BE RETURNED WITH THE RESPONSE. FAILURE TO SIGN AND RETURN THIS PAGE MAY RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE.

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