No Conflict of Interest (49).pdf
PDF 77 KB Posted
- Solicitation number
- PE-64800-NONST-2026-000000079
- Issued by
- Douglas County, Georgia
About this file
This is a No Conflict of Interest certification form required by Douglas County, Georgia for bidders responding to the Douglas County Fleet Maintenance Generator Project. The certification requires the bidder to confirm that no members of the Douglas County Board of Commissioners, elected or appointed officials and employees of Douglas County or the State of Georgia, relatives of such persons, or members of Congress have any direct or indirect interest in the bidder's organization or in the proceeds of any contract resulting from the bid submission. The undersigned bidder representative must certify that they are legally authorized to make this representation and that the statement is true to the best of their knowledge without deliberate omission of relevant information.
The certification form must be completed with the bidder's signature, printed name, title, telephone number, email address, company name, and address, and must be submitted with the bid proposal. The form includes a section for bidders to identify and explain any exceptions to the conflict of interest certification. Bidders are cautioned that any false representation may result in disqualification from contract award and future work opportunities with Douglas County Board of Commissioners.
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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 .