5-Attachment 8 - Conflict of Interest.pdf
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- Solicitation number
- RFP-2026-004
- Issued by
- Milwaukee County, Mattoon Village, Wisconsin
About this file
This is a Conflict of Interest Stipulation attachment for a Request for Proposal issued by Milwaukee County, Wisconsin, to procure Basic Life Insurance and Optional Life Insurance program services. The RFP seeks qualified and experienced firms to provide insurance coverage and full administrative services for the County's life insurance programs. The County intends to award a contract for an initial three-year term with renewal options to the selected Respondent. Willis Towers Watson Midwest, Inc. serves as Milwaukee County's Broker of Record for this procurement.
The Conflict of Interest Stipulation requires all Respondents to disclose whether any Milwaukee County employee, agent, or representative, or an immediate family member of such individuals, holds an ownership, officer, employee, agent, or representative position in the business submitting the proposal. Respondents must answer either "YES" or "NO" to this disclosure question. If the answer is "YES," Respondents must identify the individual's name, position with Milwaukee County, and their relationship to the business. The appropriate and authorized corporate representative must sign, date, and certify the completed stipulation, including the Respondent's company name, printed name, signature, title, and date of execution.
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Text version
ATTACHMENT 8
CONFLICT OF INTEREST
STIPULATION
For purposes of determining a possible conflict of interest, all Respondents submitting a proposal in response to this RFP must disclose if any Milwaukee County employee, agent or representative or an immediate family member of any Milwaukee County employee, agent or representative is also an owner, officer, employee, agent or representative of the business submitting the proposal.
Please answer below either YES or NO to the question of whether any Milwaukee
County employee, agent or representative or immediate family member is also an owner, officer, employee, agent or representative of your business:
YES ___________
NO ___________
If the answer to the question above is YES, then identify the name of the individual, the individual’s position with Milwaukee County, and the individual’s relationship to your business:
Name _______________________________________________________________________
County Position________________________________________________________________
Business Relationship ___________________________________________________________
The appropriate and authorized corporate representative must sign and date this Conflict of
Interest Stipulation below:
Respondent's Company Name: _________________________________________________
Printed Name __________________________________________________________________
Authorized Signature ___________________________________________________________
Title __________________________________________________________________________
Date __________________________________________________________________________
File details come from the government source that posted it. Updated .