Conflict of Interest Form
|This form is to be completed when doing business with a company that is classified as a Conflict of Interest Company. Complete the form, then select the "Printable Form" button to get a page which is your Conflict of Interest Statement Form. Print the form, sign it, and send it to Procurement via mail at MS #1 or fax at (508) 457-2192. Please attach the appropriate supporting documentation.
Regarding this order, there is no conflict due to any financial or other personal beneficial interest and no individual internally within WHOI has unduly influenced this proposed procurement transaction.
Sole source (Complete Single/Sole Source Justification Form)
Low bid (Attach written Quotes)
Matching existing equipment (Describe Existing Equipment)
Other (see below)
Requisitioner's signature: ______________________________________ Date: _____/_____/_____