FORM 2 - Notice of Conflict of Interest.pdf
PDF 98 KB Posted
- Solicitation number
- ITN-17169
- Issued by
- Palm Beach County, Florida
About this file
This is a Notice of Conflict of Interest Form (Form 2) required for participation in ITN FDC-ITN-27-023, issued by the Florida Department of Corrections for the operation and management of contractor-operated correctional facilities, specifically the South Bay Correctional Facility. The form serves as a compliance document under Chapter 112, Florida Statutes, requiring respondents to disclose any conflicts of interest prior to participating in the solicitation process. Respondents must identify corporate officers, directors, or agents who are currently employed by the State of Florida or its agencies, as well as any current State of Florida employees who own five percent or more interest in the responding company. The form requires completion by an authorized representative with signature and date.
Responses to the solicitation must be submitted through the MyFloridaMarketPlace Sourcing Event via the SAP Business Network. Interested vendors should direct inquiries to Sharita Newman, Procurement Officer, at the Florida Department of Corrections, with all emails containing the solicitation number FDC-ITN-27-023 in the subject line. The form itself contains no pricing terms, set-asides, or contract duration information, serving solely as a conflict of interest disclosure document required as part of the response submission process.
View the file
Other files
Show all 25
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
FORM 2 - NOTICE OF CONFLICT OF INTEREST
FDC-ITN-27-023
Operation and Management of Contractor-Operated Correctional Facilities
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 five percent (5%) or more in the company named above:
Respondent’s Name Signature of Authorized Representative
Date Print Name/Title
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
File details come from the government source that posted it. Updated .