FORM 02-NOTICE OF CONFLICT OF INTEREST.pdf
PDF 132 KB Posted
- Attached to
- MyFloridaNet-3 Core Services - ITN
- Solicitation number
- ITN-12980
- Issued by
- Clay County, Leon County, Polk County, Florida
About this file
The document is a Form 02 - Notice of Conflict of Interest for the MyFloridaNetwork-3 project, issued by the State of Florida's Department of Management Services (DMS) under Invitation to Negotiate (ITN) No. 24/25-260. The form is designed to ensure transparency and compliance with Chapter 112 of Florida Statutes by requiring potential bidders to disclose any conflicts of interest that may exist during the solicitation process for the MyFloridaNet-3 Core Services contract.
The form requires companies to declare if any of their corporate officers, directors, or agents are currently employees of the State of Florida or its agencies, and if any current State of Florida employees own a 5% or more interest in the company. This disclosure is a critical step in maintaining ethical standards and preventing potential conflicts that could compromise the integrity of the procurement process. The document provides space for companies to list such individuals or to write "N/A" if no conflicts exist, with the expectation that the authorized representative will sign and date the form, affirming the accuracy of the information provided.
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Text version
ITN No.: DMS-24/25-260 Page 1 of 2 MyFloridaNet-3 Core Services
FORM 02 – NOTICE OF CONFLICT OF INTEREST
4050 Esplanade Way Tallahassee, FL 32399-0950
850-488-2786
Ron DeSantis, Governor Pedro Allende, Secretary
FOR
MyFloridaNetwork-3
ITN NO: 24/25-260
THE STATE OF FLORIDA
DEPARTMENT OF MANAGEMENT SERVICES
ITN No.: DMS-24/25-260 Page 2 of 2 MyFloridaNet-3 Core Services
FORM 02 - NOTICE OF CONFLICT OF INTEREST
Company Name
For the purpose of participating in the solicitation process and complying with the provisions of Chapter 112, Florida Statutes, the company states the following conflict(s) of interest exists as noted below (if none, write N/A in the applicable section(s) below):
The persons listed below are corporate officers, directors, or agents and are currently employees of the State of Florida or one of its agencies:
The persons listed below are current State of Florida employees who own an interest of f ive percent (5%) or more in the company named above:
Name of Respondent’s Organization Signature of Authorized Representative and Date
Print Name
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