Res 2009-143 - Laserfiche WebLink

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and to bind the company under any contract which may result from the submission of this Proposal. 12. By signature hereon, Applicant represents and warrants that if a Texas address is shown as the address of the Applicant, Applicant qualifies as a Texas Bidder as defined by 34 Texas Administrative Code §20.32(68). 13. Check below if preference claimed under 34 Texas Administrative Code §20.38: • Goods produced or offered by a Texas bidder that is owned by a Texas resident service-disabled veteran • Goods produced in Texas or offered by a Texas bidder that is not owned by a Texas resident service- disabled veteran • Agricultural products grown in Texas • Agricultural products offered by a Texas bidder • Services offered by a Texas bidder that is owned by a Texas resident service-disabled veteran • Services offered by a Texas bidder that is not owned by a Texas resident service disabled veteran • Texas Vegetation Native to the Region • USA produced supplies, materials or equipment • Products of persons with mental or physical disabilities • Products made of recycled, remanufactured, or environmentally sensitive materials including recycled steel • Energy Efficient Products • Rubberized asphalt paving material • Recycled motor oil and lubricants • Products produced at facilities located on formerly contaminated property • Products and services from economically depressed or blighted areas • Vendors that meet or exceed air quality standards • Recycled or Reused Computer Equipment of Other Manufacturers • Foods of Higher Nutritional Value 14. By signature hereon, under Section 231.006, Texas Family Code, regarding child support, Applicant certifies that the individual or business named in the Proposal is not ineligible to receive the specified payment and acknowledges that the contract may be terminated and payment may be withheld if this certification is inaccurate. Furthermore, any Applicant subject to Section 231.006, Texas Family Code, must include names and Social Security numbers of each person with at least 25% ownership of the business entity submitting the Proposal. This information must be provided prior to award. Enter the Name and Social Security Number for each person below: Name: SSN: Name: SSN: Name: SSN: FEDERAL PRIVACY ACT NOTICE: This notice is given pursuant to the Federal Privacy Act. Disclosure of your Social Security Number (SSN) is required under Section 231.006(c) and Section 231.302(c)(2), 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. 15. By signature hereon, Applicant represents and warrants that no relationship, whether by relative, business associate, capital funding contract or by any other such kinship exist between Applicant and an employee of any Comptroller component, and Applicant has not been an employee of any Comptroller component within the immediate twelve (12) months prior to Applicant's Proposal. By signature hereon, Applicant certifies that it is in compliance with Section 669.003, Texas Government Code, relating to contracting with executive head of a state agency. All such disclosures will be subject to administrative review and approval prior to Comptroller entering into any contract with Applicant. Applicant acknowledges that any contract resulting from this RFA may be terminated at any time, and payments withheld, if this information is false.