5-General Grant Conflict of Interest Form 2026.docx
DOCX document 3 MB Posted
- Solicitation number
- 2026 DOSC Round 4 - General Grant
- Issued by
- Delaware
About this file
This is a General Grant Conflict of Interest Form associated with Delaware's 2026 Opioid Abatement Community Grant Program (DOSC Round 4), administered by the Commission. The General Grant category targets qualified organizations seeking funding awards of $30,000 or more to implement initiatives addressing opioid and substance use disorders over a performance period of up to two years. Eligible applicants must be formally registered, legally incorporated entities (nonprofit, for-profit, or governmental) operating within Delaware with a minimum of two years of consistent program delivery and documented operational stability. Organizations must demonstrate a proven track record executing similar initiatives, robust organizational management capabilities, and comprehensive financial and performance reporting readiness. The program prioritizes evidence-based programs that align with the state's objectives of expanding access to clinical care, implementing large-scale harm reduction and prevention strategies, and strengthening statewide recovery networks.
Applicants are required to complete the conflict of interest disclosure form as part of the application process, ensuring transparency regarding potential conflicts that could affect grant administration and program execution. Previous Commission grantees must demonstrate past performance, contract fidelity, and strict compliance with funding requirements. The form serves as a mandatory governance and compliance document designed to maintain institutional integrity and responsible resource allocation within Delaware's opioid abatement funding mechanisms. Organizations must be prepared to provide rigorous documentation of their organizational capacity, prior performance, and adherence to all programmatic and financial reporting standards throughout the grant period.
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Other files
| File | Type | Posted |
|---|---|---|
| 2-OARS Document.pdf | ||
| 4-General Grant Application Form 2026.docx | DOCX document | |
| 7-General Grant Budget Workbook Template.xlsx | XLSX spreadsheet | |
| 8-General Grant Supplanting Guidance 2026.docx | DOCX document | |
| 9-General Grant Program Description 2026.docx | DOCX document | |
| 3-General Grant Non-Collusion Statement 2026.docx | DOCX document | |
| 6-General Grant Confidential Information Form 2026.docx | DOCX document | |
| 1-Exhibit-E.pdf |
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GENERAL GRANT CONFLICT OF INTEREST FORM
Opioid Abatement Community Grant Program | Round 4 (2026)
Conflict of Interest Declaration:
Does your organization or any of its key personnel have any relationships, affiliations, or circumstances that could present an actual, potential, or perceived conflict of interest with DOSC, its staff, or its committee members?
☐ Yes ☐ No
Examples of potential conflicts of interest may include:
· Current or prior employment, consultancy, or advisory roles with DOSC.
· Personal relationships with DOSC staff or committee members.
· Financial interests or arrangements that may benefit the applicant organization directly.
If yes, please explain below:
Acknowledgment and Certification By signing below, I certify that:
· I have disclosed all known actual, potential, or perceived conflicts of interest.
· I will notify DOSC immediately if any new conflicts of interest arise during the grant period.
· I understand that failure to disclose conflicts of interest may result in disqualification or termination of the grant.
Name of Authorized Representative:
Title of Authorized Representative:
Signature of Authorized Representative:
Date:
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