No Conflict of Interest (15).pdf
PDF 77 KB Posted
- Attached to
- I-20 Landscape Maintenance Bid
- Solicitation number
- PE-64800-NONST-2025-000000048
- Issued by
- Douglas County, Georgia
About this file
This document is a No Conflict of Interest certification form for a Douglas County, Georgia contract opportunity. The form requires bidders to certify that no county commissioners, state officials, employees, relatives, or congressional delegates have any direct or indirect financial interest in the bidder's organization or potential contract proceeds. The certification mandates that the bidder disclose any exceptions and confirms that the signatory is legally authorized to make representations about potential conflicts of interest.
The form emphasizes that any false representations may result in disqualification from the current contract and potential future work with the Douglas County Board of Commissioners. Bidders must sign and submit this certification with their bid, providing their contact information including name, title, telephone number, email, company name, and address. The document provides space for noting any specific exceptions to the conflict of interest declaration, though no exceptions are filled in on this particular form.
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Text version
NO CONFLICT OF INTEREST
Except as may be identified and explained below, the undersigned hereby certifies that: (a) no member of the Board of Commissioners, elected, appointed, and employee of the Douglas County;
(b) no elected, appointed, and employed official or employee of the State of Georgia and of a governing body, instrumentality, or political subdivision; (c) no relative of any persons described above; (d) no member of and delegate to the Congress of the United States has an interest whatsoever (regardless of how indirect and how remote that interest may be) in bidder’s organization and in the proceeds of a Contract and agreement which might be made between bidder and the Douglas County Board of Commissioners as a result of the, quote, or qualification statement accompanied by this certification.
The undersigned certifies that he/she is legally authorized by the bidder to make the above representation, and that the representation is true to the best of his/her knowledge and belief and without deliberate omission of any inquiry which would to the best of his/her belief tend to change the above representation. The undersigned understands that any representation made knowing it to be false may disqualify the bidder from being awarded the Contract and future work by Douglas County Board of Commissioners.
NOTE: THIS CERTIFICATION MUST BE SIGNED AND SUBMITTED WITH THIS BID.
EXCEPTIONS: (Please explain)
Signature:
Print Name:
Title: Telephone #:
Email:
Name of Company:
Address:
File details come from the government source that posted it. Updated .