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 Conflict of Interest Disclosure Form (Form 02) for the MyFloridaNetwork-3 project (ITN No. 24/25-260) issued by the Florida Department of Management Services. The form is designed to comply with Chapter 112 of Florida Statutes and requires companies participating in the solicitation process to disclose any potential 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 participating company.
The form provides blank spaces for respondents to list any such conflicts, with instructions to write "N/A" if no conflicts exist. It requires the company name, signature of an authorized representative, printed name, and date to be completed. The document is part of the procurement process for MyFloridaNet-3 Core Services, ensuring transparency and preventing potential ethical issues in state contract bidding. The form is a standard mechanism for maintaining integrity in the government procurement process by requiring proactive disclosure of 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
File details come from the government source that posted it. Updated .