ATTACHMENT D - NON-CONFLICT OF INTEREST CERTIFICATION.pdf

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Attached to
RFP 24-USDA-1 Broadline Groceries and the Storage and Distribution of USDA Food Products and Supplie
Solicitation number
S-X03101-00011019
Issued by
Hood River County, Oregon

About this file

The document is an Attachment D - Non-Conflict of Interest Certification issued by the Oregon Child Development Coalition Inc. for a Request for Proposal (RFP 24-USDA-1) seeking a year-round distributor to provide broad-line grocery supplies for the production of meals in the organization's Head Start Centers throughout the State of Oregon. The certification requires the proposer to confirm that no conflict of interest exists that would preclude an impartial bid/proposal submission.

The RFP is for retaining a distributor to provide broad-line grocery supplies and the storage and distribution of USDA food products and supplies for the Oregon Child Development Coalition's Head Start Centers across the state. No additional details are provided regarding item quantities, response dates, award dates, or contract term and renewal options.

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ATTACHMENT D

NON-CONFLICT OF INTEREST CERTIFICATION

Issuing Agency: Oregon Child Development Coali�on Inc.

hereby cer�fy I have read the statement defining conflict of interest as quoted below; that I understand the statement;

that no conflict of interest exists as therein defined, which precludes an impar�al Bid/Proposal to be submited by myself or the en�ty/company for which the Bid/Proposal is submited, and that if such a conflict should arise, I will immediately no�fy the Oregon Child Development Coali�on Inc and disqualify my Bid/Proposal.

"NO OFFICER, BOARD MEMBER, EMPLOYEE, OR AGENT OF OREGON CHILD DEVELOPMENT COALITION, DIRECTLY OR INDIRECTLY, BENEFITS FROM ANY SIGNIFICANT PERSONAL MATERIAL OR MONTEARY GAIN AS A RESULT OF HIS/HER ASSOCIATION WITH THE PROPOSER OR HAVE A MATERIAL FINANCIAL INTEREST IN

ANY CONTRACT OR SUBCONTRACT BETWEEN THE PROPOSER AND OREGON CHILD DEVELOPMENT

COALITION”

Proposer Name (signature)

Proposer Name (printed)

Proposer Title (printed)

Entity/Company Name (printed)

Date

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