1-Conflict of Interest Statement Form.pdf

This is a Conflict of Interest Statement Form required by Florida Statute 112.313 for respondents bidding on Marion County procurement opportunities. The form is designed to identify any prohibited relationships between bidders and Marion County employees, public officers, or advisory board members that could create conflicts of interest in the contracting process. Respondents must disclose if they are county employees or officers, related to county personnel by marriage or kinship, have material interests exceeding five percent in entities with county connections, employ county officials, or are former county employees with less than one year of inactive service. The form also addresses whether bidders will request advisory board member waivers under Florida Statute 112.313(12). The document requires the respondent company name, printed name, signature, and contact information for authorized representatives completing the disclosure.

Marion County uses this conflict of interest certification as a mandatory compliance document in its procurement process to ensure vendor eligibility and maintain ethical standards in government contracting. Any vendor relationships identified as prohibited under the Florida Ethics Code will result in disqualification unless the county grants a specific waiver or exemption. The form serves as a prerequisite step in Marion County's bidding process, requiring completion and submission as part of proposal packages for solicitations such as the recycling container rental, collection, and processing services opportunity referenced in the associated contract documentation.