Page 1 of 2
Rev Aug. 2019
CONFLICTOFINTERESTNONCOMPETE
STATEMENT
ActinginthebestinterestoftheUniversity,theBuyermayrequirethisformtobeusedin
documentingtheacquisitionofgoodsand/orserviceswhenacompetitivesolicitationisnot
used.Examplesofnon‐competitivegoodsandservicesmaybeclassifiedasProfessionalor
ConsultingServices,InformationTechnology,Repair,Exempt,Sole‐Source,orEmergency.
Fordetailedinformation,seeIdahoCode18‐1356,18‐5701,18‐5702,18‐5703,59‐1026,
SBOEPolicySection1SubsectionG,ISUPurchasingPolicies2560and2560A.Thisdocument
becomesapartofthePurchasingfileandmustbecompletedpriortocreatingaPurchase
Order.
CONFLICTOFINTERESTANDETHICALCONSIDERATIONS
Aconflictofinterestortheappearanceofaconflictofinterestmayoccurifyouaredirectlyor
indirectlyinvolvedwithanorganizationorindividualthatisrecommendedtoprovidegoods
orservicesidentifiedabove.Priortoproposinganindividualorentity,youmustinform
PurchasingServicesofanypotentialconflictsofinterestortheappearancethereof.A
potentialprovidermaynotbeacceptedifthereexistsanaffiliationorrelationshipthatmay
createtheappearanceofbiasorunfairadvantageoveranycompetitiveprovider. Examplesof
potentiallybiasingaffiliationsorrelationshipsarelistedbelow:
1.
Yoursolicitation,acceptance,oragreementtoacceptfromanyoneanybenefit,pecuniary
orotherwise,asconsiderationforyourrecommendationasaproposedorsuggested
provider.
2.
Youraffiliationwithanindividualorentity.Forexample,aconflictmayexistwhenyou:
(a)
areemployedbyorarebeingconsideredforemploymentwiththe
individualorentityrecommended,orholdaconsulting,advisory,orother
similarpositionwithsaidindividualorentity;
(b)
holdanycurrentmembershiponacommittee,board,orsimilarposition
withtheindividualorentity;
(c)
holdownershipoftheentity,securities,orotherevidencesofdebt;
(d)
haveanyrelationshipinthepastwiththeindividualorentitysuchasthat
ofaformeremployee,co‐worker,associate,owner,orpartner.
2. Yourrelationshipwithsomeonewhohasapersonalinterestintheacquisitionofthegoodsor
services. This includes any affiliation or relationship by marriage or through any family
membership,anybusinessorprofessionalpartnership,closepersonalfriendship,oranyother
relationshipthatyouthinkmighttendtoaffectyourobjectivityorjudgmentormaygivean
appearanceofimproprietytosomeoneviewingitfromoutsidetherelationship.
Page 2 of 2
Rev Aug.2019
CONFLICTOFINTERESTNONCOMPETE
Ihavereadthisdocumentandunderstandmyobligationsasexplainedherein. Iunderstand
thatImustadvisePurchasingServicesifaconflictexists. IfurtherunderstandthatImust
signanddeliverthisdocumenttoPurchasingServicesaspartoftheRequisitionprocess.
Date: Req#:
Name:
Signature:
Title:
PROPOSEDINDIVIDUALORENTITY:
Name:
Address:
Contact:
Phone:
Email:
click to sign
signature
click to edit