Conflict_of_Interest_Statement.pdf
PDF 127 KB Posted
- Attached to
- ERCES Inspections State and local contract opportunity
- Solicitation number
- 033-TD-0426
- Issued by
- Florida
About this file
This is a Conflict of Interest Statement form required for the ERCES Inspections contract opportunity with the School Board of Polk County, Florida. The statement requires proposers to disclose any contractual relationships that have existed between the proposer, predecessor organizations, or subcontractors and the School Board of Polk County from 2020 through the present. Additionally, proposers must disclose any existing business or personal relationships between the proposer, its principals, affiliates, subcontractors, and the District or any other entity or person involved in the project. The form emphasizes that all such relationships must be disclosed even if they do not constitute a conflict of interest, as the District will make the final determination regarding conflict of interest status. Failure to disclose any prior or existing contractual or personal relationship may result in proposal disqualification.
The form provides space for proposers to complete a disclosure statement and requires the name of the firm or respondent, the authorized representative's signature, and the date. Proposers may indicate that no relationships exist by placing a check mark in the designated box, though the document stresses that proposers should not merely state a conclusion of no conflict without providing detailed disclosure of any relationships that do exist.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Addendum_Acknowledgment_Form.pdf | ||
| Coercion_affidavit_10.16.25.pdf | ||
| Reference_Request.docx | DOCX document | |
| Contact_Information_Form.pdf | ||
| Foreign_Countries_affidavit_9.23.25.pdf | ||
| 033-TD-0426_ERCES_Inspections_final.pdf | ||
| PCSB_Form_Contract_Addendum_7.17.25.pdf | ||
| Drug_Free_Workplace_Certification_Form.pdf |
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Text version
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 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 solicitation, and the School Board of Polk County.
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 Representative’s Signature Date
Conflict of Interest Statement
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