Mer board member or employee (whose last day of duty was within the past two years) has any ownership or control, or who is an employee. Additionally, the HHSC adopted standards for contracting with contractors associated with current or former employees and board members, and their relatives. Completion of this form is necessary to help HHSC determine compliance with those rules. All potential nongovernmental contractors for any type of contract must complete this certification. An application.
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How to fill out the Nongovernmental Contractor Certification online
Completing the Nongovernmental Contractor Certification is essential for organizations seeking to contract with the Texas Health and Human Services Commission (HHSC). This guide will help you navigate the form step-by-step, ensuring a smooth submission process.
Follow the steps to complete the certification form accurately
- Click ‘Get Form’ button to obtain the Nongovernmental Contractor Certification and open it in your preferred editor.
- Begin filling out the required information. Ensure you provide the name of the potential nongovernmental contractor as it appears in legal documents.
- Answer the series of questions regarding the involvement of current or former HHSC employees and their relations. Respond ‘Yes’ or ‘No’ to each question accurately.
- If you answered ‘Yes’ to any of the questions in step 3, you must complete and attach Form 4732-A to this certification.
- In the certification section, sign the form as the authorized representative. Enter the Taxpayer Identification Number and National Provider Identifier (NPI).
- Review the completed form for accuracy, ensuring all required fields are filled out correctly.
- After verifying the information, save changes, download the form, or print it for submission.
Complete the Nongovernmental Contractor Certification online to ensure compliance with HHSC requirements.
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