FORM 2 - Notice of Conflict of Interest.pdf

This is a Notice of Conflict of Interest form (Form 2) required for participation in solicitation FDC-ITN-27-022, issued by the Florida Department of Corrections for the operation and management of contractor-operated correctional facilities, specifically the Blackwater River Correctional Facility. The form is designed to ensure compliance with Chapter 112, Florida Statutes, and requires respondents to disclose any conflicts of interest prior to submitting proposals. Interested vendors must submit responses through the MyFloridaMarketPlace Sourcing Event via the SAP Business Network, with all communications directed to Procurement Officer Sharita Newman at the Florida Department of Corrections.

The form contains designated sections for disclosure of conflicts, requiring respondents to identify any corporate officers, directors, or agents who are currently employed by the State of Florida or its agencies, and to list any current State of Florida employees who own an interest of five percent (5%) or more in the company. If no conflicts exist, respondents must indicate this by marking "N/A" in the applicable sections. The form requires the authorized representative's signature, printed name, title, and date, establishing a formal certification of the company's conflict of interest status as a prerequisite to solicitation participation.