ATTACHMENT 03 Conflict of Interest Disclosure and Attestation.pdf

This is a Conflict of Interest Disclosure and Attestation form for the Hawaii state government related to a Marketing and Communication Services contract opportunity for 2026-2027 with the Hawaii Retirement Savings Program (HRSP). The form serves as a required submission document for vendors bidding on HRSP's end-to-end marketing and communications services, which will support the public launch, community awareness, and employer/employee participation initiatives.

The disclosure form contains three primary sections: Section 1 requires bidders to disclose any potential conflicts of interest across six categories including relationships with financial services providers, existing Hawaii state contracts, employer-facing interactions, restrictions affecting independence, access to non-public information, and other potential conflicts, with written explanations required for affirmative responses; Section 2 requires attestations regarding duty of impartiality, appropriate use of information, independence in procurement, accuracy of proposal information, compliance with state requirements, and financial independence; and Section 3 provides certification space for contractor/organization identification, authorized signature, date, printed name and title, and notation of attached pages. Prospective vendors must complete and submit this form as part of their proposal package to ensure compliance with Hawaii's procurement standards and conflict of interest requirements.