ESBD_547785_1786368580904_HB 1295 Form Example.pdf
PDF 704 KB Posted
- Attached to
- Kitchen Repairs and Services
- Solicitation number
- 2608-675-428
- Issued by
- Texas
About this file
This file is a procedural guidance document and form example from the Belton Independent School District (ISD) in Texas regarding compliance with Texas House Bill 1295. The document outlines the Certificate of Interested Parties form requirement that all vendors awarded district solicitations must complete before conducting business with Belton ISD. Vendors are required to submit the form electronically through the Texas Ethics Commission website, print the completed form, and return it to the district's Purchasing Department by mail or electronic method. The district's Purchasing Department has 30 days from board approval to complete the acknowledgement process with the Texas Ethics Commission. Failure to comply with this requirement will prevent the district from processing contracts or purchase orders with the vendor.
The Certificate of Interested Parties form requires vendors to disclose the controlling name of interested parties, the nature of interest, and the place of business for each interested party. Vendors must provide their business entity name, address, and the BELTON ISD solicitation or contract number. An authorized agent of the contracting business entity must sign the form under penalty of perjury, and notarization is no longer required. Contact information for the Texas Ethics Commission is provided at 512-463-5800 for vendor assistance. Questions regarding the process should be directed to Tammy Shannon, Director of Purchasing for Belton ISD. This procedural requirement applies to every contract entered into with Belton ISD that is awarded by the Board of Trustees.
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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.
Texas Ethics Commission
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 HB 1295 Form must be completed for every contract entered into with Belton ISD that will be awarded by the board.
Failure to comply 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.
https://www.ethics.state.tx.us/filinginfo/1295/
Controlling Name of Interested Party
Nature of interest
City, State, Country (place of business) Intermediary
(check applicable)
CERTIFICATE OF INTERESTED PARTIES 1295FORM
OFFICE USE ONLY
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.
Name of business entity filing form, and the city, state and country of the business entity's place of business.
Name of governmental entity or state agency that is a party to the contract for which the form is being filed.
BELTON ISD
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.
BELTON ISD Solicititation RFP or Contract # < insert number here >
Certificate Number:
Date Filed:
Date Acknowledged:
CERTIFICATION OF FILING
Signature of authorized agent of contracting business entity
My name is _______________________________________________________________, UNSWORN DECLARATION
Check only if there is NO Interested Party.5
My address is _______________________________________________, _______________________, and my date of birth is _______________________.
Executed in ________________________________________County, I declare under penalty of perjury that the foregoing is true and correct.
(street) (state) (zip code) (country)
(year)(month)
State of ________________, on the _____day of ___________, 20_____.
(city)
(Declarant)
Version V1.0.3337www.ethics.state.tx.usForms provided by Texas Ethics Commission
Vendor or contract business name
If no interested parties, check this box.
Notarization is no longer required.
SAMPLE ONLY!
Vendor must complete form electronically on Texas Ethics Commission’s website:
https://www.ethics.state.tx.us/filinginfo/1295/ http://www.ethics.state.tx.us
| HB 1295 Form Example.pdf |
| HB 1295 Form Example.pdf |
| Binder3.pdf |
| Texas-Ethics-Commission-Conflict-of-Interest.pdf |
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