1-Form 1 Conflict of Interest Disclosure VOA UT.pdf
PDF 180 KB Posted
- Attached to
- Re-Issued Solicitation Electronic Rolling Security Gate and Fencing Installation (CDBG Funded)
- Solicitation number
- 2026-01-RFB-R1
- Issued by
- Salt Lake County, Salt Lake City, Utah
About this file
This is a Conflict of Interest Disclosure Form for Request for Bid No. 2026-01-RFB issued by Volunteers of America, Utah (VOA, UT). The form requires all bidders to disclose any actual or potential conflicts of interest related to the solicitation in accordance with 2 CFR 200.112 and 2 CFR 200.318(c)(1), as well as Community Development Block Grant (CDBG) requirements. Bidders must report conflicts involving any employee, officer, board member, or agent of VOA, UT, or their immediate family members, partners, or employing organizations that have financial interests in or receive tangible personal benefits from firms being considered for contract award. The form provides space for bidders to indicate whether a conflict exists and, if applicable, to provide detailed information about the conflicting individual, their position with VOA, UT, the bidder's company name, and the nature of the conflict or relationship.
Bidders are required to certify that all information provided is true, complete, and accurate to the best of their knowledge and to attest to compliance with all applicable federal, state, and local conflict of interest requirements. Bidders must notify VOA, UT immediately if an actual or potential conflict of interest arises during the solicitation or contract term. The form requires authorized certification with the company name, printed name and title of the authorized signatory, signature, and date. Failure to disclose a conflict of interest may result in bid disqualification, contract termination, or other remedies available to Volunteers of America, Utah.
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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:
File details come from the government source that posted it. Updated .