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HomeMy WebLinkAboutEvaluation Committee Signed Non-Conflict & ProceduresI .1P L) HOME OF PELICAN ISLAND EVALUATION COMMITTEE MEMBER CONFLICT OF INTEREST DISCLOSURE FORM RFP #24-01 STRATEGIC PLANNING SERVICES "Conflict of Interest" or "Interest" is defined as a situation in which a Committee Member has, or appears to have, a financial relationship with a responding proposer, or has a family relationship with any responding proposer. "Financial Relationship," includes involvement of the evaluator and the proposer in a current partnership, joint venture, company, or corporation, and any other relationship that could make it appear that the evaluator would obtain a monetary benefit if a favorable evaluation was given. "Immediate Family" is defined as spouse, father, mother, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece, grandfather, grandmother, grandson, granddaughter, father-in-law, mother-in-law, Bon- in -law, daughter-in-law, brother-in-law, sister-in-law, step -mother, step -father, step -son, step -daughter, step- brother, step -sister, half-brother or half-sister, or domestic partner 1. 1 certify that I do not have a conflict of interest as a result of any financial relationship or other interest on my part to that of any member of my immediate family. 2. 1 certify that I am not employed by nor do I have any arrangement for future employment with any responding proposers under consideration. 3. 1 certify that I will not solicit or accept gratuities, favors, or anything of monetary value from any proposers under consideration. 4. 1 certify to the best of my knowledge that I have not had discussions, conversations, offers, agreements or arrangements for future employment with any proposers under consideration. 5. 1 certify to the best of my knowledge that I have no financial relationship of any kind with any proposers under consideration, which might appear to create a conflict of interest. 6. 1 certify to evaluate/score proposals independently and not be unfairly prejudiced. �, j�ire.�^ �..,� � C� � I bt•..�,c! j�ldalao� � Signature Print Name/Title Date Jh 61 HOME OF PELICAN KLANb EVALUATION COMMITTEE POLICIES AND PROCEDURES Thank you for participating on the Evaluation Committee for the City of Sebastian. To protect the integrity of this solicitation and the evaluation process, it is essential that each participant understands and abides by the following code of conduct. Adherences to these requirements help to assure the effectiveness of the evaluation team as a whole and protect the overall interests of the City of Sebastian in the award of this solicitation. Cone of Silence. A Cone of Silence is in effect during this solicitation process. Evaluation Committee Members must independently evaluate the proposals, and must refrain from discussing the project outside of scheduled evaluation meetings. Evaluation Committee Members are not permitted to have any form of communication with any Proposers, other vendors and vendor representatives regarding the solicitation. Any questions or clarifications should be addressed to the Procurement/Contracts Manager. 2. Sunshine Law. The State of Florida has established a Sunshine Law which establishes a basic right of access to most meetings of boards, councils and committees of state and local governmental agencies or authorities and it also prohibits communication between individuals comprising these boards, councils and committees outside a publicly accessible meeting. Evaluation Committee Members should not discuss with each other the formal solicitations or proposals outside the evaluation or other publicly advertised meetings. 3. Fairness and Integrity. It is the responsibility of every Committee Member to collectively ensure that the evaluation is conducted in an impartial, objective and professional manner, and that the same level of effort and consideration is extended to the evaluation of all of the proposals received. 4. Conflicts of Interest. An individual may not participate as a Committee Member if he or she, or a family member, has a personal interest in any company that may submit a proposal. A family member is defined as, but not limited to, a spouse, child, grandchild, brother, sister, half-brother or half-sister, brother- and sister-in-law, child of a spouse, and child of a brother, sister, half-brother, or half-sister. An individual must agree that if he or she currently has, or later discovers, a conflict of interest which meets these criteria, he or she will declare the circumstances immediately to the Procurement Division and remove himself or herself from the committee. I have read this document and understand my obligations as explained herein. I further understand that I must advise the Procurement Division if a conflict currently exists or arises during my term of service as an Evaluation Committee Member. I further understand that I must sign and deliver this statement to the Procurement Division prior to participating in the evaluation process. 13rJ A MAL 4% Print Name/Title Signature Date .Ih Of SEBAS-TIAN HOME OF P€WAN ISLAND EVALUATION COMMITTEE POLICIES AND PROCEDURES Thank you for participating on the Evaluation Committee for the City of Sebastian. To protect the integrity of this solicitation and the evaluation process, it is essential that each participant understands and abides by the following code of conduct. Adherences to these requirements help to assure the effectiveness of the evaluation team as a whole and protect the overall interests of the City of Sebastian in the award of this solicitation. Cone of Silence. A Cone of Silence is in effect during this solicitation process. Evaluation Committee Members must independently evaluate the proposals, and must refrain from discussing the project outside of scheduled evaluation meetings. Evaluation Committee Members are not permitted to have any form of communication with any Proposers, other vendors and vendor representatives regarding the solicitation. Any questions or clarifications should be addressed to the Procurement/Contracts Manager. 2. Sunshine Law. The State of Florida has established a Sunshine Law which establishes a basic right of access to most meetings of boards, councils and committees of state and local governmental agencies or authorities and it also prohibits communication between individuals comprising these boards, councils and committees outside a publicly accessible meeting. Evaluation Committee Members should not discuss with each other the formal solicitations or proposals outside the evaluation or other publicly advertised meetings. 3. Fairness and Integrity. It is the responsibility of every Committee Member to collectively ensure that the evaluation is conducted in an impartial, objective and professional manner, and that the same level of effort and consideration is extended to the evaluation of all of the proposals received. 4. Conflicts of Interest. An individual may not participate as a Committee Member if he or she, or a family member, has a personal interest in any company that may submit a proposal. A family member is defined as, but not limited to, a spouse, child, grandchild, brother, sister, half-brother or half-sister, brother- and sister-in-law, child of a spouse, and child of a brother, sister, half-brother, or half-sister. An individual must agree that if he or she currently has, or later discovers, a conflict of interest which meets these criteria, he or she will declare the circumstances immediately to the Procurement Division and remove himself or herself from the committee. I have read this document and understand my obligations as explained herein. I further understand that I must advise the Procurement Division if a conflict currently exists or arises during my term of service as an Evaluation Committee Member. I further understand that I must sign and deliver this statement to the Procurement Division prior to participating in the evaluation process. � _r) a � � / i���� P b c.�- ) l ' 7 f �J 13 r Print Name/Title Signature - Date .m �r HOME OF PELIC M &LAND EVALUATION COMMITTEE MEMBER CONFLICT OF INTEREST DISCLOSURE FORM RFP #24-01 STRATEGIC PLANNING SERVICES "Conflict of Interest" or "Interest" is defined as a situation in which a Committee Member has, or appears to have, a financial relationship with a responding proposer, or has a family relationship with any responding proposer. "Financial Relationship" includes involvement of the evaluator and the proposer in a current partnership, joint venture, company, or corporation, and any other relationship that could make it appear that the evaluator would obtain a monetary benefit if a favorable evaluation was given. "Immediate Family" is defined as spouse, father, mother, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece, grandfather, grandmother, grandson, granddaughter, father-in-law, mother-in-law, son- in-law, daughter-in-law, brother-in-law, sister-in-law, step -mother, step -father, step -son, step -daughter, step- brother, step -sister, half-brother or half-sister, or domestic partner 1. 1 certify that I do not have a conflict of interest as a result of any financial relationship or other interest on my part to that of any member of my immediate family. 2. 1 certify that I am not employed by nor do I have any arrangement for future employment with any responding proposers under consideration. 3. 1 certify that I will not solicit or accept gratuities, favors, or anything of monetary value from any proposers under consideration. 4. 1 certify to the best of my knowledge that I have not had discussions, conversations, offers, agreements or arrangements for future employment with any proposers under consideration. 5. 1 certify to the best of my knowledge that I have no financial relationship of any kind with any proposers under consideration, which might appear to create a conflict of interest. 6. 1 certify to evaluate/score proposals independently and not be unfairly prejudiced. G.-J �� K,,.4-_, CYT 1k�Aq laao3 Signature Print Name/Title Date HOME: of PFIK AN ISLAND EVALUATION COMMITTEE POLICIES AND PROCEDURES Thank you for participating on the Evaluation Committee for the City of Sebastian. To protect the integrity of this solicitation and the evaluation process, it is essential that each participant understands and abides by the following code of conduct. Adherences to these requirements help to assure the effectiveness of the evaluation team as a whole and protect the overall interests of the City of Sebastian in the award of this solicitation. Cone of Silence. A Cone of Silence is in effect during this solicitation process. Evaluation Committee Members must independently evaluate the proposals, and must refrain from discussing the project outside of scheduled evaluation meetings. Evaluation Committee Members are not permitted to have any form of communication with any Proposers, other vendors and vendor representatives regarding the solicitation. Any questions or clarifications should be addressed to the Procurement/Contracts Manager. 2. Sunshine Law. The State of Florida has established a Sunshine Law which establishes a basic right of access to most meetings of boards, councils and committees of state and local governmental agencies or authorities and it also prohibits communication between individuals comprising these boards, councils and committees outside a publicly accessible meeting. Evaluation Committee Members should not discuss with each other the formal solicitations or proposals outside the evaluation or other publicly advertised meetings. 3. Fairness and Integrity. It is the responsibility of every Committee Member to collectively ensure that the evaluation is conducted in an impartial, objective and professional manner, and that the same level of effort and consideration is extended to the evaluation of all of the proposals received. 4. Conflicts of Interest. An individual may not participate as a Committee Member if he or she, or a family member, has a personal interest in any company that may submit a proposal. A family member Is defined as, but not limited to, a spouse, child, grandchild, brother, sister, half-brother or half-sister, brother- and sister-in-law, child of a spouse, and child of a brother, sister, half-brother, or half-sister. An individual must agree that if he or she currently has, or later discovers, a conflict of interest which meets these criteria, he or she will declare the circumstances immediately to the Procurement Division and remove himself or herself from the committee. I have read this document and understand my obligations as explained herein. I further understand that I must advise the Procurement Division if a conflict currently exists or arises during my term of service as an Evaluation Committee Member. I further understand that I must sign and deliver this statement to the Procurement Division prior to participating in the evaluation process. - �I q) z3 JPA)V, . Print Name/Title Signature Date MO SE� HOME OF PELICAN ISLAND EVALUATION COMMITTEE MEMBER CONFLICT OF INTEREST DISCLOSURE FORM RFP #24-01 STRATEGIC PLANNING SERVICES "Conflict of Interest" or "Interest" is defined as a situation in which a Committee Member has, or appears to have, a financial relationship with a responding proposer, or has a family relationship with any responding proposer. "Financial Relationship" includes involvement of the evaluator and the proposer in a current partnership, joint venture, company, or corporation, and any other relationship that could make it appear that the evaluator would obtain a monetary benefit if a favorable evaluation was given. "Immediate Family" is defined as spouse, father, mother, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece, grandfather, grandmother, grandson, granddaughter, father-in-law, mother-in-law, Bon- in -law, daughter-in-law, brother-in-law, sister-in-law, step -mother, step -father, step -son, step -daughter, step- brother, step -sister, half-brother or half-sister, or domestic partner 1. 1 certify that I do not have a conflict of interest as a result of any financial relationship or other interest on my part to that of any member of my immediate family. 2. 1 certify that I am not employed by nor do I have any arrangement for future employment with any responding proposers under consideration. 3. 1 certify that I will not solicit or accept gratuities, favors, or anything of monetary value from any proposers under consideration. 4. 1 certify to the best of my knowledge that I have not had discussions, conversations, offers, agreements or arrangements for future employment with any proposers under consideration. 5. 1 certify to the best of my knowledge that I have no financial relationship of any kind with any proposers under consideration, which might appear to create a conflict of interest. 6. 1 certify to evaluate/score proposals independently and not be unfairly prejudiced. Signature Print Name/Title '�Gi Date