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How do I fill this out?

Follow these steps to fill out the Conflict of Interest Disclosure and Compliance Certification. Ensure that all required information is provided accurately. If there is any potential conflict of interest, make sure to disclose it completely.

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How to fill out the Conflict of Interest Disclosure and Compliance Certification?

  1. 1

    Collect all necessary information about your organization.

  2. 2

    Affirm that no City Elected Official or associated person has an interest in your organization.

  3. 3

    Provide detailed information if there is any potential conflict of interest.

  4. 4

    Fill in the required fields with accurate details about your organization.

  5. 5

    Sign and notarize the certification before submission.

Who needs the Conflict of Interest Disclosure and Compliance Certification?

  1. 1

    Vendors looking to enter into a contract with NYC need this file for compliance.

  2. 2

    Organizations seeking funding from NYC need this file to disclose any conflicts of interest.

  3. 3

    Consultants working with NYC must complete this file to certify their compliance.

  4. 4

    Non-profit organizations receiving NYC funds are required to submit this file.

  5. 5

    Any entity engaging in business with NYC must fill out this form to ensure transparency.

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    Use the PDF editor to fill out required fields.

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    Make necessary changes and additions to the content.

  4. 4

    Review the edited file to ensure accuracy.

  5. 5

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What are the instructions for submitting this form?

Submit this form along with your contract or funding application. Mail the completed and notarized form to NYC Mayor's Office of Contract Services, 253 Broadway - 9th Floor, New York, NY 10007. Alternatively, you might use online submission forms if provided in your contract or funding guidelines. It is crucial to ensure all information is accurate and complete before submission.

What are the important dates for this form in 2024 and 2025?

Submission deadlines for this form typically align with contract or funding application dates. Check specific deadlines provided in your contract or application guidelines.

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What is the purpose of this form?

The purpose of the Conflict of Interest Disclosure and Compliance Certification form is to ensure transparency and compliance in the contracting process with the NYC Mayor's Office of Contract Services. By filling out this form, vendors, consultants, non-profits, and other entities disclose any potential conflicts of interest involving City Elected Officials or their associates. This certification is crucial to maintaining integrity and trust in the procurement process, safeguarding public interest, and ensuring fair competition. The form helps to identify and address any potential conflicts before they affect the contracting or funding process, promoting ethical standards and accountability.

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Tell me about this form and its components and fields line-by-line.

This form contains several fields to collect relevant information about the vendor and any potential conflicts of interest. Each field is designed to gather specific details essential for the certification process.
fields
  • 1. Vendor Information: Includes the name, address, and EIN of the vendor, and the signature of an authorized official.
  • 2. Conflict of Interest Disclosure: Affirmation and detailed disclosure of any potential conflicts of interest involving City Elected Officials or their associates.
  • 3. Corporate Status: Information about the vendor's incorporation under NYS Not-for-Profit Corp. Law and compliance with applicable legal requirements.

What happens if I fail to submit this form?

Failing to submit this form may result in penalties, including ineligibility for contract awards and potential criminal charges.

  • Non-Responsibility: The vendor may be deemed non-responsible for the purpose of contract award.
  • Criminal Charges: Making a materially false statement may subject the person to criminal charges.

How do I know when to use this form?

Use this form when engaging in contracts or seeking funding with the NYC Mayor's Office of Contract Services. It ensures disclosure of any potential conflicts of interest.
fields
  • 1. Contracting with NYC: Submit this form when entering into a contract with NYC to certify compliance and transparency.
  • 2. Seeking Funding: Use this form when applying for funding from NYC to disclose any potential conflicts of interest.

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