HomeMy WebLinkAboutC2025-110 - 6/17/2025 - Approved (2) CERTIFICATE OF INTERESTED PARTIES FORM 1295
Complete Nos. 1-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos. 1, 2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2025-1316649
Infor, US LLC
Alpharetta, GA United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 05/29/2025
being filed.
City of Corpus Christi, Texas Date Acknowledged:
16/30/2025
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 underthe contract.
25-0970
Infor software
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check appiicabie)
Controlling7 Intermediary
5 Check only if there is NO Interested Party.
X
6 UNSWORN DECLARATION
rIly name is �1v�6 y � • 1 � ���J� and my datc of girth 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 ,, 1 '•(-1('Y)i County, State of —on the day of INI" 20 Z_�,.
(month (year)
Signat46 of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.tls Version V4.1.0.e02d6221