Exhibit F_ Proposers Disclosure Statement.doc

DOC document 31 KB Posted

Attached to
SGSC, J-476-DP Library Renovation
Solicitation number
PE-47200-RFQ-2027-000000157
Issued by
Columbia County, Georgia

About this file

This is a Proposer's Disclosure Statement for Project J-476-DP, Library Renovation at South Georgia State College in Douglas, Georgia, issued by the Board of Regents (BOR) of the State of Georgia. The document establishes disclosure requirements for all firms submitting proposals for this design professional services project. Proposers must complete and submit the disclosure statement as part of their proposal package, signed by an authorized representative of the firm. The statement requires responses to three specific questions addressing business transactions, gifts or benefits, and potential conflicts of interest occurring within defined timeframes prior to proposal submission.

The disclosure requirements are designed to ensure transparency and prevent conflicts of interest in both the selection process and contract performance. Firms must disclose any business transactions with BOR, the Using Agency, or the end-user occurring within the prior two years; any gifts, hospitality, or benefits provided within the prior one-year period; and any actual or potential conflicts of interest that could affect the public officials involved or their relatives. The disclosure is evaluated from the perspective of a reasonable person with knowledge of relevant facts. This compliance document is mandatory for all proposers and must be included as a deliverable in the proposal submittal to satisfy Georgia state laws, rules, and Executive Orders governing public projects.

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Text version

Exhibit F J-476 – Library Renovation South Georgia State College, Douglas, Georgia

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

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