Conflict of Interest Statement

2014 Volunteer Fire Grant Fund

WHEREAS, the members of the Name of Department, a Volunteer Fire Department of Name of County County and its Board of Directors or governing body shall seek only the furtherance of the Department’s mission and are expected to act in the best interest of the Department, and where volunteer and career members and directors have a varied range of interest and backgrounds, and

WHEREAS, such backgrounds and interests may result in situations where a dual interest may be interpreted as a conflict of interest and where members and directors shall avoid conflict of interests and any conduct which may suggest the appearance of impropriety when exercising their responsibility with regards to disbursement of the Volunteer Fire Grant Funds, and

WHEREAS, officers, employees, volunteers, and governing directors shall not participate in the selection, award, or administration of the grant monies to a vendor or contractor where to his knowledge he, his business partner or immediate family, has a financial interest in that purchase or contract or has arrangement concerning prospective employment with the vendor or contractor, and

WHEREAS, an officer, employee, volunteer, or governing director which may have a conflict of interest shall disclose in writing, to the department’s Board and withdraw from any participation or personal influence on such selection of vendors or contractors, and

WHEREAS, no officer, employee, volunteer, or governing director shall accept, directly or indirectly, gifts, favors, or anything of monetary value from individuals or organizations which are current or potential providers of goods or services in conjunction with grant monies, unless such gifts are in conjunction with official duties such as travel for inspection of equipment, and where such gifts shall be fully disclosed, in writing, at the time of the selection of vendors or contractors,

BE IT RESOLVED, that Legal Name of Department Volunteer Fire Organization has made all of its officers, employees, volunteers, and governing directors aware of this policy and by the signature below by the chief officer signifies that Legal Name of Department Volunteer Fire Organization is in compliance with this conflict of interest policy prior to the receipt of any Volunteer Fire Organization Funds.

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Chief Officer Date

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Witness Date

This form has been verified as true and correct by the department official and witness.