Attachment_J-2_Conflict_of_Interest_Declaration_Matrix-Final-05-19-2016.xls

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Transit Safety Outreach and Oversight (Bus Safety and SSO) program
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DTFT6016R00004
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Attachment 2 - Conflict of Interest Declaration Matrix

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Sheet: Sheet1 Sheet: Sheet2 Sheet: Sheet3 Offeror Name:

Please indicate with an X if you have any conflicts working with State Government Transit Oversight agencies, Transit Grant Agencies, or Transit Agencies in the following jurisdictions. Please specify Offices or Agencies below. Attach additional sheets State or State-level Jurisdiction State Government Rail Safety Oversight Agency State Government Transit Grant Agency Tranisit agency within this Jurisdiction 1.0 Alabama 2.0 Alaska 3.0 Arizona 4.0 Arkansas 5.0 California 6.0 Colorado 7.0 Connecticut 8.0 Delaware 9.0 Florida 10.0 Georgia 11.0 Hawaii 12.0 Idaho 13.0 Illinois 14.0 Indiana 15.0 Iowa 16.0 Kansas 17.0 Kentucky 18.0 Louisiana 19.0 Maine 20.0 Maryland 21.0 Massachussetts 22.0 Michigan 23.0 Minnesota 24.0 Mississippi 25.0 Missouri 26.0 Montana 27.0 Nebraska 28.0 Nevada 29.0 New Hampshire 30.0 New Jersey 31.0 New Mexico 32.0 New York 33.0 North Carolina 34.0 North Dakota 35.0 Ohio 36.0 Oklahoma 37.0 Oregon 38.0 Pennsylvania 39.0 Puerto Rico 40.0 Rhode Island 41.0 South Carolina 42.0 South Dakota 43.0 Tennessee 44.0 Texas 45.0 Tri-State Oversight Committee (TOC) 46.0 Utah 47.0 Vermont 48.0 Virginia 49.0 Washington, DC 50.0 Washington (State) 51.0 West Virginia 52.0 Wisconsin 53.0 Wyoming By signing this form I affirm that the information contained is correct to the best of my knowledge.

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