Exhibit G.docx
DOCX document 16 KB Posted
- Solicitation number
- PE-50300-RFP-2025-000000136
- Issued by
- Fulton County, Georgia
About this file
This document is a Proposer's Disclosure Statement for a design-build services contract opportunity issued by Georgia Tech Facilities, Inc. (GTFI), an affiliate of the Georgia Institute of Technology (GIT), which is part of the Board of Regents of the University System (BOR). The proposed project is for the replacement of Chillers 1 & 2 at the 10th Street Chiller Plant on the Georgia Tech campus in Atlanta, Georgia. Respondents submitting proposals for this project must include this Disclosure Statement, which requires them to describe any prior business transactions, gifts or benefits provided, and any conflicts of interest or potential conflicts of interest with GTFI, BOR, the Using Agency, or the end-user of the project.
The related State and Local Contract Opportunity is for Design-Build Services for the 10th Street Chiller Plant Replacement of Chillers 1 & 2 project, with a bid/contract number of 2001-25, project number of 0527-2024, and BOR project number of BR-J431. The solicitation is for Statements of Qualifications (Step 1 RFQ) from interested firms, and qualified respondents may be shortlisted for interviews and proposal submissions (Step 2 RFP). The project is located in the jurisdictions of Fulton County and the City of Atlanta, Georgia.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit F Project Cost Matrix.xlsx | XLSX spreadsheet | |
| Exhibit D Precon Cost Expense Breakdown.xlsx | XLSX spreadsheet | |
| Exhibit C.docx | DOCX document | |
| 2001_25 DB RFQP_Final.pdf | ||
| J_431 Shortlist Announcement.pdf | ||
| Exhibit B.docx | DOCX document | |
| Addendum _1 Dated 08_13_2024.pdf | ||
| Exhibit E General Conditions Breakdown.xlsx | XLSX spreadsheet | |
| Exhibit A.docx | DOCX document |
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Text version
Exhibit G
“Insert Project Name/Description” Georgia Institute of Technology
Proposer’s Disclosure Statement
All proposers should be aware that the project you are submitting a proposal on is a project on which the Owner, Georgia Tech Facilities, Inc. (GTFI), is an affiliate of a public agency; specifically Georgia Institute of Technology (GIT), a unit of the Board of Regents of the University System (BOR), which is the ultimate end user of the proposed project. Pursuant to the laws, rules and Executive Orders of the State of Georgia, 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 GTFI, 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 GTFI, 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 GTFI, 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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