[A]_Attachment_A_-_Conflict_of_Interest_Disclosure.pdf

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Attached to
Bulk Fuel Delivery
Solicitation number
2023-RFP-013
Issued by
Los Angeles County, California

About this file

This document is a Conflict of Interest Disclosure form for the Pasadena Fire & Police Retirement System, related to an auditing services contract opportunity. The form requires proposers to disclose any financial or business relationships with the City of Pasadena, its agencies, the Fire & Police Retirement System, or Board Members over the past five years that might constitute a potential conflict of interest. Proposers must also list current clients who may have a financial interest in the contract outcome and certify compliance with the General Accounting Office's Government Auditing Standards independence requirements.

The disclosure form is part of a broader solicitation for auditing services, where the Retirement Board seeks a certified public accounting firm to perform financial statement audits for three years with two potential option years, totaling a five-year contract term beginning April 1, 2023. The selected auditor will be responsible for performing fiscal year 2023 audits, coordinating with the System's actuary and legal counsel on funding issues, and providing consultation on reporting changes and regulatory requirements. The form ensures transparency and helps prevent potential conflicts of interest in the procurement process by requiring detailed disclosure from proposing firms.

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ATTACHMENT A

Pasadena Fire & Police Retirement System

CONFLICT OF INTEREST DISCLOSURE

All proposers are required to complete and sign this Attachment and include it with the proposal submission. If additional pages are needed, each page must be signed in the format below.

1. A list and description of any financial or other business relationship (currently and for the past five years) with the City of Pasadena or any of its component units/agencies, Fire & Police Retirement System, or Board Members of the Fire & Police Retirement System, together with a statement explaining why such relationships do not constitute a conflict of interest relative to performing the financial audit. If there are none, a statement to that effect must be provided.

2. A list and description of the proposer’s current clients who may have a financial interest in the outcome of the contract, together with a statement explaining why such relationships do not constitute a conflict of interest relative to performing the financial audit. If there are none, a statement to that effect must be provided.

3. I certify that we conform to the independence standard promulgated in the General Accounting Office’s Government Auditing Standards and that we will continue to conform throughout the audit engagement.

Name of Firm

Authorized Signature Date

Printed Name Title

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