8-Conflict of Interest Statement Form.pdf

This is a Conflict of Interest Statement Form required under Florida Statute 112.313 for vendors responding to the Belleview Heights Estates Unit 8 (SE 44th Avenue) project in Florida. The form is designed to identify any conflicts of interest that may exist between respondents and Marion County government employees, public officers, or advisory board members. The project involves the new construction of 0.11 miles of 20-foot-wide paved roadway with roadside swales, including clearing and grubbing of the right of way, stabilized subgrade and limerock base, excavation and grading of drainage swales, installation of swaled concrete driveway aprons, thermoplastic striping, and stabilization of all disturbed areas.

The conflict of interest statement requires respondents to disclose various relationships that could be prohibited under Florida's ethics code, including direct employment or advisory board status with the County, family relationships to County employees or officials, ownership interests exceeding five percent in the respondent entity held by County officials or their families, employment of County officials by the respondent, or prior employment with Marion County Board of County Commissioners within one year. Respondents must indicate whether none of these conflicts apply or select the applicable conflict category. Additionally, respondents must specify whether they will request an advisory board member waiver under Florida Statute 112.313(12). The County reserves the right to review all disclosed relationships and will disqualify any vendor whose conflicts are not waived or deemed exempt under applicable law.