Illinois Subcontractor Disclosure Form - Financial & Conflict Interest
This file is about financial interests and conflicts of interest disclosures required for subcontracts valued at $50,000 or more. Subcontractors must complete disclosure forms to meet the Illinois Procurement Code requirements. The file provides instructions on how to complete and submit these forms.
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How do I fill this out?
To fill out this form, you must provide financial information and potential conflict of interest details. Ensure you complete all required sections accurately. A person authorized to execute contracts must sign the form.
How to fill out the Illinois Subcontractor Disclosure Form - Financial & Conflict Interest?
1
Read the instructions carefully.
2
Complete Form A for financial information and potential conflicts of interest.
3
Complete Form B for other contracts and procurement-related information.
4
Attach any additional required documents.
5
Ensure an authorized person signs and dates the forms.
Who needs the Illinois Subcontractor Disclosure Form - Financial & Conflict Interest?
1
Subcontractors with contracts valued at $50,000 or more need this form to disclose financial interests.
2
Publicly traded companies must submit this form to meet Illinois Procurement Code requirements.
3
Privately held entities with over 400 shareholders need to provide ownership information.
4
Subcontractors with potential conflicts of interest need to disclose their relationships.
5
Entities seeking open-ended contracts must complete this form.
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What are the instructions for submitting this form?
Submit the completed form along with any required attachments to the designated procurement officer. Forms can be submitted via email to procurement@illinois.gov, via fax to (217) 555-1234, or by mail to Illinois Department of Transportation, Procurement Office, 123 Main Street, Springfield, IL 62701. Ensure that all forms are signed by an authorized representative.
What are the important dates for this form in 2024 and 2025?
Ensure you submit the form for all subcontracts valued at $50,000 or more on time. Deadlines vary depending on the specific bid or contract proposal.
What is the purpose of this form?
The purpose of this form is to collect essential financial information and potential conflicts of interest disclosures from subcontractors engaged in contracts with the state of Illinois. By gathering this information, the state aims to maintain transparency and compliance with the Illinois Procurement Code. Submitting this form is a requirement for all subcontracts valued at $50,000 or more and ensures that the subcontracting entity meets the necessary standards and regulations.
Tell me about this form and its components and fields line-by-line.
- 1. Subcontractor Name: The legal name of the subcontracting entity.
- 2. Legal Address: The official address of the subcontractor.
- 3. City: The city where the subcontractor's office is located.
- 4. State: The state where the subcontractor's office is situated.
- 5. Zip: The zip code for the subcontractor's address.
- 6. Telephone Number: The contact phone number for the subcontracting entity.
- 7. Email Address: The official email address for communication.
- 8. Fax Number: The fax number for the subcontractor, if available.
- 9. Disclosure of Financial Information: Details regarding ownership or distributive income share in the subcontracting entity.
- 10. Disclosure of Potential Conflicts of Interest: Information about any potential conflicts of interest related to state employment or other relationships.
What happens if I fail to submit this form?
Failure to submit this form can lead to serious consequences, including the voiding of the contract and potential suspension or debarment. Ensuring timely and accurate submission is crucial to maintain compliance.
- Contract Voiding: Failure to disclose required information may result in the cancellation of the subcontract.
- Suspension or Debarment: Non-compliance can lead to suspension or debarment from future procurement opportunities.
How do I know when to use this form?
- 1. State Contracts: For subcontracts valued at $50,000 or more with the state of Illinois.
- 2. Potential Conflicts: When there are potential conflicts of interest that need to be disclosed.
- 3. Financial Disclosure: To provide financial information required by the Illinois Procurement Code.
- 4. Open-Ended Contracts: For subcontractors seeking open-ended contracts with the state.
Frequently Asked Question
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Use PrintFriendly's PDF editor to enter your financial and conflict of interest information directly into the form fields.
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What sections do I need to fill out?
Complete Form A for financial information and potential conflicts of interest, and Form B for other contracts and procurement-related information.
Do I need to attach additional documents?
Yes, if required, attach any additional information or forms as specified in the instructions.
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How do I know if I need to fill out this form?
If you are a subcontractor with contracts valued at $50,000 or more with the state of Illinois, you need to fill out this form.
