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HOUSE BILL 89 VERIFICATION <br />I, (person's name), the undersigned <br />representative (hereafter referred to as "Representative") of <br />(company or business name, hereafter referred to as "Business Entity"), being an adult over the <br />age of eighteen (18) years of age, after being duly sworn by the undersigned notary, do hereby <br />depose and affirm the following: <br />1. That Representative is authorized to execute this verification on behalf of Business <br />Entity; <br />2. That Business Entity does not boycott Israel and will not boycott Israel during the <br />term of any contract that will be entered into between Business Entity and the <br />(name of public entity); and <br />3. That Representative understand that the term "boycott Israel" is defined by Texas <br />government Code Section 2270.001 to mean refusing to deal with, terminating <br />business activities with, or otherwise taking any action that is intended to penalize, <br />inflict economic harm on, or limit commercial relations specifically with Israel, or <br />with a person or entity doing business in Israel or in any Israeli -controlled territory, <br />but does not include an action made for ordinary business purposes. <br />SIGNATURE OF REPRESENTATIVE <br />SUBSCRIBED AND SWORN TO BEFORE ME, the undersigned authority, on this <br />day of ... 20_. <br />Notary Public <br />16 <br />