2-Conflict of Interest Declaration.pdf
PDF 224 KB Posted
- Solicitation number
- 26-003-30
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Conflict of Interest Disclosure form issued by Creighton Elementary School District #14 located at 2702 E Flower St, Phoenix, AZ 85016. The form implements Arizona School District Procurement Rules and Arizona Revised Statutes 38-503(C) to prevent conflicts of interest in the procurement of goods and services. The disclosure requirements apply to all purchases from district employees or their close relatives, regardless of dollar amount, and cover purchases using any district funds including extracurricular fees, tax credit contributions, and student activity monies. Employees with conflicts of interest are prohibited from entering requisitions, approving requisitions, supervising work, or approving payments for affected products or services.
The form requires vendors or bidders to affirm through initialed statements that agreements have been reached independently without collusion, that neither they nor close relatives (defined as spouse, children, grandchildren, parents, grandparents, siblings, and their spouses) are employed by Creighton Elementary School District No. 14, and that no conflicts exist under district policies or Arizona law. Vendors must disclose any existing family relationships with district employees, providing the employee's name, title, department or location, and the nature of the relationship. The form requires authorized signature and date upon completion and submission to the Purchasing Department, with instructions that any conflicts arising after initial disclosure must be reported immediately to the Purchasing Department.
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Text version
CREIGHTON ELEMENTARY SCHOOL DISTRICT #14
2702 E Flower St, Phoenix, AZ 85016
CONFLICT OF INTEREST DISCLOSURE
Districts are required to follow the School District Procurement Rules for all purchases of goods or services from district employees or close relatives of employees (spouse, child, grandchild, parent, grandparent, brother, sister and their spouses, and the parent, brother, sister, or child of a spouse) regardless of dollar amount. If an employee has a conflict they must not be involved in the purchasing/oversight process. They may not enter requisitions, approve the requisition, supervise the work being performed, or approve the payment for the respective product or service.
Arizona Revised Statutes §38-503(C) prohibits employees or relatives from providing their employers with any equipment, material, supplies, or services unless provided under an award or contract let after public competitive bidding. Districts must follow the School District Procurement Rules, regardless of the expenditure amount, when purchasing goods or services from district employees or relatives. This applies to any purchase using district monies, including extracurricular activities fees, tax credit contributions, and monies held in trust by the District, such as student activities monies. Following the guidelines for written quotes is not sufficient to comply with the requirements of A.R.S. §38-503(C).
By marking my initials below, I hereby indicate:
_____ I affirm, to the best of my knowledge, this Agreement has been arrived at independently, and is awarded without collusion with anyone to obtain information or gain any favoritism that would in any way limit competition or give an unfair advantage over other vendors in the award of this Agreement.
AND
_____ That neither I or a close relative (spouse, grandchild, parent, grandparent, brother, sister, and their spouses, and the parent, brother, sister, or child of a spouse) am presently an employee of the Creighton Elementary School District No. 14.
_____ That neither I, nor any close relative of mine, have a conflict per Creighton Elementary
School District policies or Arizona Revised Statutes.
_____ If a conflict of interest arises, it is my responsibility as an employee or a relative of the employee to complete a Conflict of Interest Disclosure Form with the Purchasing Department immediately.
OR
_____ That I or a close relative (spouse, child, grandchild, parent, grandparent, brother, sister, and their spouses, and the parent, brother, sister, or child of a spouse) am presently an employee of the Creighton Elementary School District No. 14.
Continued on the next page
CREIGHTON ELEMENTARY SCHOOL DISTRICT #14
2702 E Flower St, Phoenix, AZ 85016
CONFLICT OF INTEREST DISCLOSURE (Attachment 10)
Please identify the conflict interest Name, Title, Department/Location, and Relationship below:
By signing this document, you agree that you have disclosed any necessary affiliations with a Creighton
Elementary School District employee.
Company Name: ____________________________________________________________________
Printed Name and Title: _______________________________________________________________
Date: _____________________ Authorized Signature: ______________________________________
File details come from the government source that posted it. Updated .