10-G3. REQUIRED CONFLICT OF INTEREST DISCLOSURE.pdf

This is a Conflict of Interest Disclosure form mandated by the Pasco County Board of County Commissioners in Florida for the Ranch Road Sidewalk construction project from US 19 to Ponderosa Avenue. The document requires all bidders to disclose any officers, directors, or agents who are also employees of Pasco County, as well as the names of any Pasco County employees who own, directly or indirectly, an interest of ten percent or more in the bidder's firm or any of its branches. The disclosure is made under penalty of perjury and certifies that the bid proposal is submitted without prior understanding, agreement, or connection with any other corporation, firm, or person submitting a bid for the same work, materials, supplies, or equipment, and that the bid is fair and without collusion or fraud.

The form requires the bidder to provide their legal name, the name and title of the authorized representative submitting the proposal, and the date of submission. Bidders must declare any conflicts of interest related to Pasco County employment or ownership stakes and may attach additional sheets if necessary to fully disclose all required information. This mandatory disclosure is governed by Chapter 112, Florida Statutes, and failure to comply or providing false information may result in bid disqualification or legal consequences.