FACTS
This purpose of this document is to provide assurance that each and every business providing services to the Monterey Peninsula Water Management District (Water Management District) shall take any and all steps to avoid any actual or apparent conflict of interest that may arise with respect to the performance of contract duties. This is vital due to the incredibly high environmental and economic value of the water resource that may be in conflict and the Water Management District’s responsibility to manage the resource as uniquely empowered by the state legislature. In the event an actual or apparent conflict of interest arises, the business shall make a written report of circumstances under which the conflict arose as soon as the business becomes aware of that actual or apparent conflict of interest.
The Water Management District is a public entity and special district holding authority pursuant to California Statutes of 1977, Chapter 527, as amended (found at West’s Water Code – Appendix, Chapter 118, et seq.). As a public agency, the Water Management District and its officials are required to comply with conflict of interest requirements imposed by the Political Reform Act, Government Code, section 81000, et seq., and self-contracting limitations imposed by Government Code, section 1090. The Water Management District is also required by law to comply with the Ralph M. Brown Act, the Public Records Act, and the Public Contract Code.
Each contractor and sub-contractor dealing with the Water Management District is also subject to conflict of interest requirements, self-contracting limitations, and other disclosure obligations.
DECLARATION
1. The undersigned agrees to identify whether this contracting relationship is entered into as a sole proprietorship, partnership, joint venture, corporation or other business entity. The name of each principal (any individual who owns five percent (5%) or more of the firm’s ownership) shall be provided to the Water Management District with this form, and further, notice of any change to the composition of this business entity shall be promptly provided to the District.
2. The undersigned discloses that for the preceding two years, the business has worked on projects within the boundaries of the Water Management District as shown on the list attached to this form by the undersigned.
3. For the duration of this contract, the business agrees to make a written report to the General Manager of any project in which the business is engaged within the boundaries of the Water Management District.
4. For the duration of this contract, the business agrees to make a written report to the General Manager of any litigation within the County of Monterey in which the work of the business is a material issue.
5. With respect to the performance of any contract duties, the business agrees to make a written report as soon as the undersigned or its principals become aware of that circumstance, (a) any actual or apparent conflict of interest, and (b) any circumstance that has the appearance of a conflict of interest.
6. The undersigned certifies to the best of his/her knowledge and belief, that the principals of the business have not been convicted of or had a civil judgment rendered against them or a fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public function, transaction or contract; commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property.
7. The undersigned certifies to the best of his/her knowledge and belief, that the principals of the business are not presently debarred, suspended, or declared ineligible from practice before any federal or state public entity or professional regulatory body.
8. The undersigned certifies to the best of his/her knowledge and belief, that the business and its principals have not had a public transaction or contract terminated for cause or default.
9. The undersigned is authorized to execute this document on behalf of all principals of this business entity.
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Business Name
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Name (Print)
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Title
__________________________________________ ________________________
Signature Date
Approved 12/10/02
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