STANDARDS OF CONDUCTION DECLARATION-103D Standards of Conduct Declaration.pdf
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- Solicitation number
- Q27000351
- Issued by
- Honolulu County, Hawaii
About this file
This is a Standards of Conduct Declaration form (Form AG-010) required by the State of Hawaii's Judiciary for the fabrication, printing, and delivery of 120,000 sets of Notice of Entry of Judgment and/or Order forms used in Traffic Court. The contractor must declare under penalty of perjury that it is not a legislator or employee, nor a business with a controlling interest held by a legislator or employee. The contractor further certifies that it has not been personally represented or assisted by a former agency employee within the preceding two years who participated in the matter, has not engaged legislative or employee representation for compensation to obtain or perform the contract if those individuals were involved in contract development or award, and has not been represented on contract-related matters by individuals who were agency employees or legislators within the past twelve months. The District Court of the First Circuit requires the contractor to produce forms identical to provided samples except for specified wording changes, deliver the exact quantity with no overages or shortages, and cover all costs including labor, equipment, materials, transportation, and delivery to the designated location with forklift and floor stacking services included.
The contract is voidable by the State if entered into in violation of Hawaii Revised Statutes Chapter 84 (Code of Ethics), and any fees, compensation, gifts, or profits received as a result of violations may be recovered by the State. If the contractor declares itself to be a legislator or employee and the contract value exceeds $10,000, the contract must be awarded through competitive sealed bidding under Section 103D-302, HRS, or competitive sealed proposal under Section 103D-303, HRS; otherwise, the agency must post notice of intent to award and file a copy with the State Ethics Commission. Should additional quantities be needed prior to contract completion, the per-set price for additional forms shall be equal to or less than the quoted price.
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Text version
Form AG-010 Rev 11/15/2005
STANDARDS OF CONDUCT DECLARATION
For the purposes of this declaration:
"Employee" means any nominated, appointed, or elected officer or employee of the State, including members of boards, commissions, and committees, and employees under contract to the State or of a constitutional convention, but excluding legislators, delegates to the constitutional convention, justices and judges.
"Controlling interest" means an interest in a business or other undertaking which is sufficient in fact to control, whether the interest is greater or less than fifty per cent.
On behalf of ___________________________________________________________, CONTRACTOR, the undersigned does declare, under penalty of perjury, as follows:
1. CONTRACTOR is* is not a legislator or an employee or a business in which a legislator or an employee has a controlling interest. (Section 84-15(a), HRS).
2. CONTRACTOR has not been represented or assisted personally in the matter by an individual who has been an employee of the agency awarding this Contract within the preceding two (2) years and who participated while so employed in the matter with which the Contract is directly concerned. (Section 84-15(b), HRS).
3. CONTRACTOR has not been assisted or represented by a legislator or employee for a fee or other compensation to obtain this Contract and will not be assisted or represented by a legislator or employee for a fee or other compensation in the performance of this Contract, if the legislator or employee had been involved in the development or award of the Contract. (Section 84-14(d), HRS).
4. CONTRACTOR has not been represented on matters related to this Contract, for a fee or other consideration by an individual who, within the past twelve (12) months, has been an agency employee, or in the case of the Legislature, a legislator, and participated while an employee or legislator on matters related to this Contract. (Sections 84-18(b) and (c), HRS).
CONTRACTOR understands that the Contract to which this document is attached is voidable on behalf of the State if this Contract was entered into in violation of any provision of chapter 84, Hawaii Revised Statutes, commonly referred to as the Code of Ethics, including the provisions which are the source of the declarations above. Additionally, any fee, compensation, gift, or profit received by any person as a result of a violation of the Code of Ethics may be recovered by the State.
Form AG-010 Rev 11/15/2005
CONTRACTOR
By ____________________________________________ (Signature)
Print Name:_____________________________________
Print Title:______________________________________
Name of Contractor:______________________________
Date:__________________________________________
*Reminder to Agency: If "is" block is checked and the Contract involves goods or services or construction of a value in excess of $10,000, the Contract must be awarded by competitive sealed bidding under section 103D-302, HRS, or a competitive sealed proposal under section 103D-303, HRS. Otherwise, the Agency may not award the Contract unless it posts a notice of its intent to award it and files a copy of the notice with the State Ethics Commission. (Section 84-15(a), HRS).
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