No Conflict of Interest (51).pdf
PDF 77 KB Posted
- Attached to
- I-20 LANDSCAPE MAINTENANCE BID
- Solicitation number
- PE-64800-NONST-2026-000000081
- Issued by
- Douglas County, Georgia
About this file
This is a No Conflict of Interest certification form required by the Douglas County Board of Commissioners in Georgia for the I-20 Landscape Maintenance Bid. The certification requires the bidder to declare that no member of the Douglas County Board of Commissioners, state officials, employees, relatives of such persons, or members of Congress have any direct or indirect interest in the bidding organization or the potential contract proceeds. The form must be signed by an individual legally authorized to represent the bidder and submitted with the bid submission. Any false representation in the certification may result in disqualification from contract award and future work with Douglas County.
The certification allows for exceptions to be noted and explained by the bidder if conflicts of interest exist. Required information on the form includes the signatory's signature, printed name, title, telephone number, email address, company name, and address. This standard conflict of interest declaration is a compliance requirement for participation in the landscape maintenance project covering four I-20 interchanges in Douglas County, where contractors must provide all materials, labor, and equipment while adhering to GDOT's Standard Specifications.
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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 .