Exhibit F _ Proposer_s Disclosure Statement.doc
DOC document 31 KB Posted
- Attached to
- GSOU J-460-PM School of Optometry
- Solicitation number
- PE-47200-RFQ-2026-000000126
- Issued by
- Brooks County, Georgia
About this file
Exhibit F is a Proposer's Disclosure Statement for the Georgia Southern University School of Optometry Program Management Services project (Project No. J-460-PM) in Statesboro, Georgia, administered by the Board of Regents (BOR) as the contracting public agency. The document requires all proposers to complete a mandatory disclosure statement as part of their proposal submittal to ensure compliance with Georgia state laws, rules, and Executive Orders regarding conflict of interest prevention and procurement integrity.
The disclosure statement requires proposers to provide written responses to three specific questions: (1) description of any business transactions between the proposer's firm and BOR, the Using Agency, or the project's end-user occurring within the prior two years; (2) description of any gifts, hospitality, or benefits provided by the proposer's firm to BOR, the Using Agency, or end-user within the prior one-year period; and (3) disclosure of any actual or potential conflicts of interest as defined by Georgia law, evaluated from the perspective of a reasonable person with knowledge of relevant facts. The completed disclosure statement must be dated and signed by an authorized signatory of the proposing firm and submitted as a required deliverable with the proposal submittal.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit D _ PM Fee Proposal Form.xlsx | XLSX spreadsheet | |
| Exhibit E _ Contractor Affidavit.docx | DOCX document | |
| Exhibit A _ RFQ Certification Form.docx | DOCX document | |
| Egnyte Upload Instructions.pdf | ||
| Exhibit B _ Certificate of Minority Form.docx | DOCX document | |
| J_460 GSOU School of Optometry PM RFQ_RFP_djh.pdf | ||
| Exhibit C _ Project Team Composition Form.docx | DOCX document |
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Text version
Exhibit “F” Proposer’s Disclosure Statement All proposers should be aware that the project you are submitting a proposal on is a public project, and the Owner (BOR) is a public agency. Pursuant to the laws, rules and Executive Orders of the State of Georgia, BOR 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 BOR, the Using Agency, 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 BOR, the Using Agency, 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 BOR, the Using Agency, or the end-user of this project.
Insert Response Here This Disclosure Statement should be dated and signed by an authorized signator for the Proposer and submitted with the Proposer’s Submittal as a deliverable.
Name of Firm
Authorized Signature
Date
File details come from the government source that posted it. Updated .