No Conflict of Interest (9).pdf
PDF 77 KB Posted
- Attached to
- Mowing & Litter Removal
- Solicitation number
- PE-64800-NONST-2025-000000043
- 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. The document requires bidders to certify that no Board of Commissioners members, elected/appointed officials, employees of Douglas County or the State of Georgia, their relatives, or members/delegates of the U.S. Congress have any interest in the bidder's organization or potential contract proceeds. The certification must be signed and submitted with the bid.
The form includes spaces for noting any exceptions to the certification, along with fields for the authorized signatory's information including signature, printed name, title, telephone number, email, company name, and address. The document emphasizes that making false representations may disqualify the bidder from being awarded the contract and future work 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 .