FORM 2 - Notice of Conflict of Interest.pdf
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- Solicitation number
- ITN-12132
- Issued by
- Clay County, Florida
About this file
This is a Form 2 Notice of Conflict of Interest document for the Florida Department of Corrections (FDC) Invitation to Negotiate (ITN) No. FDC-ITN-25-071, specifically relating to the Operation and Management of Contractor-Operated Correctional Facilities. The form is designed to comply with Chapter 112 of Florida Statutes and requires potential contractors to disclose any potential conflicts of interest, including corporate officers, directors, or agents who are current State of Florida employees or state employees who own a significant (5% or more) stake in the bidding company.
The document provides a standardized template for respondents to transparently report any potential conflicts that might arise during the solicitation process for correctional facility management services. By requiring this disclosure, the state aims to ensure ethical procurement practices and prevent potential improprieties in the contracting process. The form must be completed and signed by an authorized representative of the bidding company, with blank spaces provided for listing any relevant personnel or ownership interests that might constitute a conflict of interest.
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Text version
FORM 2 - NOTICE OF CONFLICT OF INTEREST
FDC-ITN-25-071
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
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