FORM 2 - Notice of Conflict of Interest.pdf

This is a Form 2 - Notice of Conflict of Interest document from the Florida Department of Corrections (FDC) for Invitation to Negotiate (ITN) number FDC-ITN-25-070, specifically related 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 currently state employees, or state employees who own a 5% or greater interest in the company.

The document is a blank template requiring respondents to list any individuals who might present a conflict of interest, with designated spaces for the respondent's name, signature of an authorized representative, date, and printed name/title. No specific conflicts are pre-populated on this form, indicating that each potential contractor must independently evaluate and disclose any relevant relationships or ownership interests that could constitute a conflict when bidding on this correctional facility management contract.