4-Conflict of Interest Declaration.pdf

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Attached to
Locally Raised Beef for use in National School Lunch Program
Solicitation number
26-002-30
Issued by
Arizona

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This document is a Conflict of Interest Disclosure form from Creighton Elementary School District #14, located in Phoenix, Arizona. The form outlines the district's procurement rules and legal requirements regarding potential conflicts of interest when purchasing goods or services from district employees or their close relatives. The document details specific restrictions under Arizona Revised Statutes §38-503(C), which prohibit employees or their relatives from providing equipment, materials, supplies, or services to their employer without going through a public competitive bidding process.

The form requires vendors or potential contractors to disclose any affiliations with Creighton Elementary School District employees, including close relatives such as spouses, children, grandchildren, parents, grandparents, siblings, and their respective spouses. Signatories must affirm that they have arrived at the agreement independently, without collusion, and disclose any potential conflicts of interest. If a conflict exists, the individual is responsible for completing a Conflict of Interest Disclosure Form with the Purchasing Department immediately. The document serves as a preventative measure to ensure transparency, fair competition, and ethical procurement practices within the school district.

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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 .