For the purpose of protecting both the integrity and objectivity of its
employees in the performance of their University obligations it is the policy of
the University that conflicts of interest should be avoided where possible or
otherwise disclosed and managed. It is the responsibility of all employees to
disclose anything that is, or may appear to be, a conflict of interest.
This includes contracting with the employee or persons with whom the employee
has a Family Relationship, or contracting with any entity with which the
employee has a Family Relationship, Financial Relationship or
Personal Relationship.
- Family Relationship - means
- Employee's spouse/partner
- Employee's children, grandchildren, parents, grandparents, brothers and
sisters (including half brothers and sisters)
- The spouses of any of the persons listed in the above bullet
- The spouse's/partner's parents, brothers, sisters and children
- Any firm in which the employee or any of the above persons is a partner or
sole proprietor or any corporation in which the employee or any of those persons
holds 5% or more stock either directly or indirectly, or any other individual
living in the same household
- Financial Relationship - means a partnership or other commercial relationship
involving a joint venture between the employee and another person or entity.
Examples are: research grants, consultancies, honoraria and travel, self-managed
equity interest in a company, employment of an immediate family member in a company
and/or other benefits or substantial gifts from a company
- Personal Relationship - means a relationship with a person or entity sufficiently
close that a reasonable person would believe that it would be difficult for the
SFA employee to deal with the person as he or she would deal with a stranger
- Financial Relationship - means a partnership or other commercial relationship
involving a joint venture between the employee and another person or entity.
Examples are: research grants, consultancies, honoraria and travel, self-managed
equity interest in a company, employment of an immediate family member in a company
and/or other benefits or substantial gifts from a company
- Personal Relationship - means a relationship with a person or entity sufficiently
close that a reasonable person would believe that it would be difficult for the
SFA employee to deal with the person as he or she would deal with a stranger
Name of Employee:
Department:
Have you read and do you understand the
Purchases From Employees Policy C-27?
YES NO
Have you read and do you understand the
Purchasing Ethics and Confidentiality Policy C-33?
YES NO
Are you aware of any relationships involving you or a related individual that might give rise to an actual or appearance of a conflict of interest?
YES (complete the below information) NO
Identify all entities that have or could potentially have a business relationship
with the University and with which you have a Family, Financial or Personal Relationship:
I have read and understand the
Purchases From Employees Policy C-27
and the Purchasing Ethics and Confidentiality Policy C-33.
I certify that this disclosure includes all entities with whom I have a Family,
Financial or Personal Relationship that may give rise to a conflict of interest
situation. In addition, I understand that I may not participate in any part of
the procurement process for an independent contract with any person with whom I
have a Family Relationship. I understand that I am obligated to immediately update
this disclosure statement should I, at any time in the future, become involved in
an activity and/or relationship which could be construed as a conflict of interest.
I certify that the foregoing is information is true and complete to the best of
my knowledge and understand that any false statements on this form and/or the
withholding of information will be sufficient grounds for disciplinary action,
up to and including dismissal.