Section III.D.3. Purchasing of Architecture and Engineering Services
Procedures Page 7 of 8
Variance Request (Form III.D.3.)
Please complete this form to request a one-time member reduction
in the Submission Review Committee (SRC) or Interview Review
Committee (IRC) because of a vacancy or approved leave.
Submit to the Chancellor’s Office once complete.
Requestor: ______________________________________
RFQ Number: ___________________________________
Review Committee: The Review Committee presently consists of
________ members. The mandatory number of Review Committee
members is seven (7) for the Submission Review Committee (SRC)
and five (5) for the Interview Review Committee (IRC).
Request: Explain the reason the SRC or IRC is requesting a Variance (e.g., a vacancy
exists at the Project Director level):
Not Approved
Stephen C. Head, Ph.D. Date
To protect the integrity, propriety, and fair play of procurement processes of Lone Star College (“College”)
and to obtain the best value for the College—
I, ______________________ , the undersigned, a member of the Evaluation Committee for the
competitive solicitation referenced above (“Solicitation”), certify to the College that the following statements
are true and correct and that I understand and agree to be bound by the commitments contained herein.
I am not currently employed by, nor am I receiving any compensation from any proposer, offeror, bidder, or
vendor involved with this Solicitation (each, a “Proposer”), with any disclosed or identified subcontractor or
supplier to any Proposer (each, a “Subcontractor”), with any parent entity, subsidiary, or other affiliate of any
Proposer or Subcontractor (each, a “Affiliate”), or with any agent, broker, officer, director, shareholder,
manager, member, partner, executive, owner, or other person or entity acting in conjunction with a
Proposer, Subcontractor, or Affiliate (each, a “Proposer Party”). I have not received nor been promised any
present or future economic opportunity, employment, gift, loan, trip, favor, special discount, special
treatment, special service, or any other gratuity or benefit in return for favorable consideration of any
proposal, response, or bid of any Proposer in connection with this Solicitation (each, a “Proposal”). I am
not closely related by blood or marriage to any Proposer, Subcontractor, Affiliate, or Proposer Party.
Until the Solicitation endsthrough an executed contract or the College’s decision not to procure the solicited
goods or services—I agree to keep confidential, and to not to disclose or otherwise divulge, any information
or materials pertaining to the contents, cost or price information, or status or ranking of any Proposal to
anyone except the Evaluation Committee leader, other Evaluation Committee members, the Director of
Purchasing, any College-retained consultant for this Solicitation, or College legal counsel, unless otherwise
directed by the Board of Trustees as a whole, the Chancellor, the Director of Purchasing, or College legal
counsel. I ag
ree to comply with all present and future non-disclosure agreements applying to the College.
I understand that loss, misplacement, or mishandling of any portion of a Proposal provided to me as an
Evaluation Committee member may fall within the phrase “disclose or otherwise divulge”.
I agree to comply with all applicable laws and College policies and procedures on conflicts of interest in
connection with this Solicitation. I understand that violating applicable laws, policies, or procedures may be a
breach of ethical standards under Board Policy Manual Section IV.D.3.01., which may subject violator(s) to
immediate employment termination under Board Policy Manual Section IV.F.13.03.
I agree to immediately and fully inform the Director of Purchasing if I witness or learn of any communication
or conduct relating to this Solicitation by any Proposer, Subcontractor, Affiliate, Proposer Party, College
employee, or third party that reasonably appears to violate this Non-Disclosure Statement, applicable laws,
policies, procedures, or any non-contact provision under the Solicitation, even if the communication or
conduct only creates an appearance of impropriety. I agree that this duty remains in effect during the
Solicitation and for up to four years after the contract is awarded or until I am no longer employed by the
College, whichever comes first.
I have no preconceived position on any Proposal’s relative merits. I agree to evaluate all Proposals without
bias, to the best of my ability, and with the College’s best interests paramount in all decisions.
Signature Date
Section III.D.3. Purchasing of Architecture and Engineering Services Procedures
Page 8 of 8
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