7-Appendix C Acknowledgement of Personnel Relationships-LPT-7NJV654.pdf

PDF 114 KB Posted

Attached to
Itineris Early College High School- Food Service Management
Solicitation number
RA27-13
Issued by
Salt Lake County, Utah

About this file

Written by GovTribe AI ·

This is an Acknowledgement of Personnel Relationships form for a Food Service Management Contract (FSMC) with Itineris Early College High School in Utah. The document serves as a certification mechanism to address potential conflicts of interest when the School Food Authority (SFA) and the FSMC employ the same individuals. The form requires both the SFA and FSMC authorized representatives to acknowledge and certify that any shared employees do not have real or apparent conflicts of interest and will be restricted from participating in critical contract functions. Specifically, shared employees must not participate in contract selection, award, or administration; access or control food service financial accounts; establish meal pricing for reimbursable or non-reimbursable meals, à la carte items, adult meals, catering, or vending; access student information or foodservice software systems; or be involved in the completion, distribution, collection, or verification of free and reduced-price meal applications and eligibility determinations. The form provides space for up to ten employee entries, with columns for employee name, SFA position title and job duties, and FSMC position title and job duties, followed by signature lines for authorized representatives from both the SFA and FSMC.

The document contains no pricing information, set-asides, or funding details, as it functions solely as a compliance and conflict-of-interest disclosure form. The related procurement opportunity for Food Service Management at Itineris Early College High School, located in West Jordan, Utah, has a proposal submission deadline of August 24, 2026, at 9:00 AM, with a questions cutoff date of August 6, 2026, at 5:00 PM MDT. Proposals should be submitted to Amanda Luong at amanda.luong@iechs.org or to the school's physical address at 8714 Roy Del Circle, West Jordan, UT 84088.

View the file

Other files

File Type Posted
1-2026-2027 - Fixed Price RFP and Contract 072926 final.docx DOCX document
9-Menu (1).xlsx XLSX spreadsheet
8-Appendix F Independent Price Determination Certificate (1).pdf PDF
5-Bid Protest Procedures (1).pdf PDF
4-Appendix D Certification-Regarding-Lobbying.pdf PDF
10-Accepted Changes - Att.-A-Agency-Terms-and-Conditions-GS for 2026 DPS Banquet 7.29.26.pdf PDF
2-Appendix B FSMC Certification of Acknowledgement (3).pdf PDF
6-KL26-34 Documents for Signature completed.pdf PDF
11-FSMC RFP.pdf PDF
3-Appendix A SFA Certification of Acknowledgement (2) (1).pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Appendix C Acknowledgement of Personnel Relationships

Yes No (choose one), the SFA employs the same person/people that is/are employee(s) of the FSMC.

If Yes, we the undersigned certify that the employee(s):

• Does not have a real or apparent conflict of interest.

• Will not participate in the selection, award, or administration of the contract.

• Will not have access to or control of the food service financial account.

• Will not be involved in the establishment of the selling prices for all reimbursable and non-reimbursable meals, a la carte items, adult meals, catering, or vending items.

• Will not have access to SFA’s Student information software system or foodservice software system

• Will not be involved in the completion, distribution or collection of the parent letters and household applications for free and reduced-price meals.

• Will not be involved in the determination or verification of eligibility for free and reduced-price meals.

Employee Name SFA Position Title and Job Duties FSMC Position Title and Job Duties

SFA FSMC

SFA Authorized Representative Signature FSMC Authorized Representative Signature

Printed Name of SFA Authorized Representative Printed Name of FSMC Authorized Representative

SFA Authorized Representative Title FSMC Authorized Representative Title

Yes: Off
No choose one the SFA employs the same personpeople that isare employees of the FSMC: Off
Employee NameRow1:
SFA Position Title and Job DutiesRow1:
FSMC Position Title and Job DutiesRow1:
Employee NameRow2:
SFA Position Title and Job DutiesRow2:
FSMC Position Title and Job DutiesRow2:
Employee NameRow3:
SFA Position Title and Job DutiesRow3:
FSMC Position Title and Job DutiesRow3:
Employee NameRow4:
SFA Position Title and Job DutiesRow4:
FSMC Position Title and Job DutiesRow4:
Employee NameRow5:
SFA Position Title and Job DutiesRow5:
FSMC Position Title and Job DutiesRow5:
Employee NameRow6:
SFA Position Title and Job DutiesRow6:
FSMC Position Title and Job DutiesRow6:
Employee NameRow7:
SFA Position Title and Job DutiesRow7:
FSMC Position Title and Job DutiesRow7:
Employee NameRow8:
SFA Position Title and Job DutiesRow8:
FSMC Position Title and Job DutiesRow8:
Employee NameRow9:
SFA Position Title and Job DutiesRow9:
FSMC Position Title and Job DutiesRow9:
Employee NameRow10:
SFA Position Title and Job DutiesRow10:
SFA:
Printed Name of SFA Authorized Representative:
SFA Authorized Representative Title:
FSMC Position Title and Job DutiesRow10:
FSMC:
Printed Name of FSMC Authorized Representative:
FSMC Authorized Representative Title:

File details come from the government source that posted it. Updated .