1-Form 1 Conflict of Interest Disclosure VOA UT.pdf
PDF 180 KB Posted
- Solicitation number
- 2026-01-RFB
- Issued by
- Salt Lake County, Salt Lake City, Utah
About this file
This Conflict of Interest Disclosure Form is required by Volunteers of America, Utah (VOA, UT) for submission with bids in response to Request for Bid No. 2026-01-RFB for an electronic rolling security gate and fencing installation project. The form mandates that all bidders disclose any actual or potential conflicts of interest involving VOA, UT employees, officers, board members, agents, or their immediate family members in relation to the bidding company. Bidders must certify whether conflicts exist and, if so, provide detailed information including the name and position of the VOA, UT individual involved, the bidder or company name, and the nature of the conflict or relationship. A mandatory site visit is scheduled for March 17, 2026, and attendance is required for bid responsiveness.
The project involves furnishing and installing a complete, code-compliant electronic rolling security gate system with access control pedestal and perimeter fencing for the staff parking lot at Volunteers of America, Utah's Youth Resource Center in Salt Lake City. The contract is funded entirely by Community Development Block Grant (CDBG) funds and requires mandatory compliance with Davis-Bacon and Related Acts (DBRA) prevailing wage requirements. All pricing must be firm and fixed for the contract duration, and the award will be made to the lowest cost responsive and responsible bidder. Bidders must certify the accuracy of all information provided and agree to notify VOA, UT immediately of any conflicts that arise during the solicitation or contract term. Failure to disclose conflicts may result in bid disqualification, contract termination, or other available remedies.
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Text version
Form 1 – Conflict of Interest Disclosure REQUEST FOR BID NO. 2026-01-RFB
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Form 1 – Conflict of Interest Disclosure
Volunteers of America, Utah (VOA, UT)
This form must be completed and submitted with the Bid.
In accordance with applicable federal regulations, including 2 CFR §200.112 (Conflict of
Interest) and 2 CFR §200.318(c)(1), as well as Community Development Block Grant
(CDBG) requirements, Bidders must disclose any actual or potential conflicts of interest related to this solicitation.
A conflict of interest exists when any employee, officer, board member, or agent of
Volunteers of America, Utah, or any member of their immediate family, partner, or organization employing or about to employ any of the parties listed herein, has a financial or other interest in, or receives a tangible personal benefit from, a firm considered for a contract award.
Please indicate below:
☐ YES – A conflict of interest exists ☐ NO – No conflict of interest exists
If YES, provide the following information (attach additional pages if necessary):
Name of VOA, UT Individual:
Position / Role with VOA, UT:
Name of Bidder / Company:
Nature of Conflict or Relationship:
Form 1 – Conflict of Interest Disclosure
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The Bidder certifies that the information provided above is true, complete, and accurate to the best of its knowledge. The Bidder further certifies compliance with all applicable federal, state, and local conflict of interest requirements. The Bidder agrees to notify
Volunteers of America, Utah immediately if an actual or potential conflict of interest arises during the solicitation or contract term.
Failure to disclose a conflict of interest may result in disqualification of the bid, termination of any resulting contract, or other remedies available to Volunteers of
America, Utah.
Authorized Certification
Company Name:
Printed Name & Title:
Signature:
Date:
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