ESBD_564376_1790883445275_Attachment D- 1295 Certificate of Interested Parties Form.pdf
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- Attached to
- Managed Services – College and Career Advising
- Solicitation number
- RFO-781-6-CB-20
- Issued by
- Texas
About this file
Summary
This is a Certificate of Interested Parties Form (Attachment D) associated with a Managed Services – College and Career Advising contract opportunity in Texas. The form is a disclosure document required as part of the bidding process for this state contract opportunity. The certificate serves as an attachment to the proposal submission materials and is used to identify all parties with a financial interest in the proposed contract, including the bidder and any subcontractors, partners, or affiliated entities involved in delivering the college and career advising services.
The form requires bidders to disclose interested parties in accordance with Texas procurement regulations and ethical business practices. This disclosure mechanism ensures transparency in the contracting process by documenting all entities that will benefit financially from the contract award. Completion and submission of this certificate is a mandatory requirement for bid consideration, and incomplete or inaccurate disclosure may result in proposal rejection or contract termination.
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Text version
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 5/14/2025
Attachment D - CERTIFICATE OF INTERESTED PARTIES FORM 1295
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 .
Mus t fi le on lin e a t h ttp s:/ /pr d.t ec prd .et hic se file .co m/File
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