19-Conflict of Interest Form.docx

This is a Conflict of Interest Form for a Construction Engineering and Inspection (CEI) Services solicitation issued by Hillsborough County Capital Programs Department in Florida. The form requires bidding firms to declare whether they have any conflicts of interest concerning this solicitation, as required under 2 CFR 200.112 (Additional Applicable Federal Contract Provisions, Section 2.7.2.5). Firms must provide their name, address, email, and phone number on the form and indicate either "Yes" or "No" regarding conflicts of interest. If conflicts exist, firms must provide a detailed explanation. The form requires signature and date authorization from an authorized agent of the firm.

The related solicitation seeks proposals from experienced and qualified professionals to provide comprehensive CEI services, including materials testing and contract administration for various Capital Improvement Program (CIP) and Work Order projects. The contract has an estimated performance period of three years with a total value of $5,000,000.00. Questions and requests for interpretation must be submitted no later than 14 calendar days after the solicitation issuance date, site visit, or pre-bid conference, whichever occurs later, as stated in the Contract Terms and Conditions Document.