Sustainable Development Foundation - Suppliers’ Disclosure of Conflict-of-Interest Template

Complant

The suppliers must disclose to the Foundation any situation of conflict of interest or suspected conflict of interest that may arise. He shall disclose to the Foundation whether any officer of the Foundation or contracted technical staff with the Foundation has an interest of any kind in the work done by the supplier or whether it has any economic ties with the supplier of whatsoever kind.

The conflict-of-interest disclosure form must be approved to complete the contract, and with this acknowledgment, the suppliers acknowledge what is shown below:

Suppliers’ information:

Commercial Name: ...........................................................

Suppliers Telephone Number: .........................................

Acknowledgement of Conflict of Interest:

In case of no conflict of interest: I hereby declare that there is no conflict of interest with any employee of the Sustainable Development Foundation.

In the event of a (conflict of interest) between employees, officers of the Sustainable Development Foundation, or their relatives with whom they have a relationship

With the supplier, it could lead to a conflict of interest. Please mention them below:

1.     Name: Kinship: ( )

2.     Name: Kinship: ( )

 

1.     The supplier acknowledges that there is no ownership interest or the possibility of obtaining a personal financial gain between any employee within the staff of the suppliers' company and any of the employees of the Sustainable Development Foundation.

2.     The supplier acknowledges that no employee of the Sustainable Development Foundation or former employee (for less than one year) has an ownership interest in the supplier’s company.

I declare that the given information is correct: -

The Person authorized to sign (supplier):

 

 

Name: Date: Signature: Stamp: