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
This document is a Notice of Conflict of Interest form (Form 02) for the MyFloridaNetwork-3 procurement issued by the State of Florida's Department of Management Services (DMS), with the Invitation to Negotiate (ITN) number 24/25-260. The form is designed to ensure transparency and compliance with Chapter 112 of Florida Statutes by requiring potential vendors to disclose any conflicts of interest that might exist between their corporate officers, directors, agents, and current State of Florida employees.
The form requires bidding companies to declare if any of their corporate representatives are currently employed by the State of Florida or its agencies, and to disclose any State of Florida employees who own a 5% or more interest in their company. By completing this form, potential vendors must transparently report any relationships or ownership stakes that could potentially create a conflict of interest in the solicitation and contracting process, thereby maintaining ethical standards in government procurement.
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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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