Appendix_B-Conf_of_Int.pdf

PDF 85 KB Posted

Attached to
Fire Alarm System Inspection Testing Certification, Term Contract State and local contract opportunity
Solicitation number
030-MJ-0225
Issued by
Polk County, Florida

About this file

This document is an Appendix B Conflict of Interest Statement form for the School Board of Polk County, Florida. The form requires proposers to disclose any contractual, business, or personal relationships existing between the proposer, its principals, affiliates, or subcontractors and the School Board of Polk County, Florida, or any other entities involved in the project from 2020 to the present. The form emphasizes that while not every relationship constitutes a conflict of interest, all relationships must be disclosed, and failure to do so may result in proposal disqualification.

The form provides a blank space for detailed disclosure and includes a checkbox option for respondents to indicate no relationships exist. The document stresses that the District will make the final determination regarding potential conflicts of interest. Proposers are instructed to provide specific details about any relationships rather than simply stating no conflict exists, with the understanding that the School Board will evaluate the disclosed information to determine if an actual conflict of interest is present.

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Text version

Appendix B Conflict of Interest Statement

In the space provided below, please disclose any contractual relationship that exists or has existed during any part of the period of time from year 2020 through the present between the proposer, or a predecessor organization of the proposer, or a subcontractor included in the proposer’s response to this RFP, and the School Board of Polk County, Florida.

Also, in the space provided please disclose any existing business or personal relationship between the proposer, its principals, or any affiliate or subcontractor, and the District, or any other entity or person involved in the project that is the subject of this solicitation.

If no relationships as described above exist or have existed, please indicate this by placing a check mark in the box provided below.

Not every prior or existing relationship will constitute a conflict of interest. However, each such relationship must be disclosed. Proposer should not merely state the conclusion that no conflict of interest exists. Failure to disclose any such prior or existing contractual or personal relationship as described in this section may result in disqualification of the proposal. The District will make the final determination regarding the existence of a conflict of interest.

Disclosure Statement:

No relationships exist/have existed.

Name of Firm/Respondent (Typed)

Authorized Representa�ve’s Signature Date

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