Corporate Board of Directors Resolution
THE FOLLOWING FORM IS FOR CORPORATIONS ONLY,
AS INDICATED ON THE DISCLOSURE OF OWNERSHIP, QUESTION III (D).
State Of __________________________________
County Of _________________________________
On The ____________________ Day Of __________________________________________________, 20________, at a meeting of
The Board Of Directors Of __________________________________________________, A Corporation, held in the city of
____________________________________, in________________________________ county.
With A Quorum Of The Directors Present, The Following Business Was Conducted:
It was duly moved and seconded that the following resolution be adopted:
Be it resolved that the board of directors of the above corporation do hereby authorize
________________________________________________________________________________
and his/her successors in office to negotiate, on terms and conditions that he/she may deem
advisable, a contract or contracts with the Texas Health and Human Services Commission, and to
execute said contract or contracts on behalf of the corporation, and further we do hereby give him/
her the power and authority to do all things necessary to implement, maintain, amend, or renew
said contract.
The above resolution was passed by a majority of those present and voting in accordance with the
by–laws and Articles of Incorporation.
I certify that the above constitutes a true and correct copy of a part of the minutes
of a meeting of the board of directors of
________________________________________________________________________________,
held on the ________________ day of _____________________________________, 20_______.
________________________________
Signature of Secretary
Subscribed and Sworn Before Me, ____________________________________________________, a Notary Public for the County of
__________________________, on the _________ day of __________________, 20____.
Notary Stamp/Seal
Notary Public, County of
___________________________________
State of
_________________________________________________
Signature
________________________________________________
MESSAGE TO NOTARY:
COMPLETE ALL OF THE BLANKS IN THIS
NOTARY STATEMENT.
Page A-2
Appendix A: Additional Forms
Rev. XXXIV
Revised 08/01/2016 | Effective 10/01/2016