Exhibit F_Proposer_Disclosure_Statement.doc
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- Solicitation number
- PE-50300-RFP-2024-000000061
- Issued by
- Fulton County, Georgia
About this file
This document is a Proposer's Disclosure Statement required for a contract opportunity with the Georgia Institute of Technology, which is a unit of a public agency. The purpose of this disclosure statement is for proposers to describe any business transactions, gifts, hospitality, or benefits provided to the Georgia Institute of Technology, the Board of Regents of the University System of Georgia (the Owner), or the ultimate end-user of the proposed project within the prior one or two-year period. Proposers must also disclose any conflicts of interest or potential conflicts of interest with these entities.
The disclosure statement must be dated and signed by an authorized signatory for the proposer and submitted with the proposer's submittal as a deliverable. This disclosure is required to ensure transparency and avoid any appearance of impropriety in the selection process and contract performance.
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Text version
Exhibit F Proposer’s Disclosure Statement
All proposers should be aware that the Owner’s Representative (Georgia Institute of Technology) is a unit of a public agency. Therefore, at the direction of the Owner and in accordance with all applicable laws, including any laws, rules and Executive Orders of the State of Georgia, Owner’s Representative shall make every effort to avoid even the appearance of a conflict of interest or any impropriety in both the selection process for this project and the negotiation and performance of any resulting contract. As part of any submittal you intend to make for this project, you must include a Disclosure Statement with your submittal which answers the following specific questions:
1. Describe any business transactions occurring within the prior two years between your firm and the Georgia Institute of Technology (User), the Board of Regents of the University System of Georgia (BOR, Owner) or the ultimate end-user of the proposed project.
Insert Response Here
2. Describe any gift, hospitality, or benefit of any sort that your firm has provided to Georgia Institute of Technology, BOR, Owner, or the end-user of the proposed project within the prior one-year period.
Insert Response Here
3. A conflict of interest or potential conflict of interest is defined as any action, decision, or recommendation by a person acting in a capacity as a public official, the effect of which is or could be to the private monetary or financial benefit or detriment of the person, the person’s relative, or any business with which the person or a relative of the person is associated. The potential conflict of interest is viewed from the perspective of a reasonable person who has knowledge of the relevant facts. Based upon this definition, describe any conflict of interest or potential conflict of interest that your firm has with Georgia Institute of Technology, BOR, Owner, or the end-user of this project.
Insert Response Here This Disclosure Statement should be dated and signed by an authorized signatory for the Proposer and submitted with the Proposer’s Submittal as a deliverable.
Name of Firm
Authorized Signature
Date
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