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 Form 02 - Notice of Conflict of Interest for the MyFloridaNetwork-3 ITN (Invitation to Negotiate) No. 24/25-260, issued by the State of Florida's Department of Management Services. The form is designed to identify and disclose potential conflicts of interest for companies participating in the solicitation process, in compliance with Chapter 112 of Florida Statutes.
The form requires companies to declare any conflicts of interest, specifically focusing on two key areas: (1) corporate officers, directors, or agents who are currently employees of the State of Florida or its agencies, and (2) current State of Florida employees who own a five percent (5%) or more interest in the company. By completing this form, respondents must transparently report any such potential conflicts, with the option to write "N/A" if no conflicts exist. The document provides blank spaces for listing names and details related to these potential conflicts of interest.
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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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