Employer Conflict Of Interest Disclosure Form


Employer Conflict Of Interest Disclosure Form

To avoid a conflict of interest, all Employers who have any financial and/or family/relative relationship(s) as defined in Section 112.3143, F.S. with any CareerSource Palm Beach County (CareerSource) employee or CareerSource Board of Director must clearly disclose such a relationship by completing and submitting this form when submitting an application to obtain Onthe-Job-Training (OJT) funding from CareerSource.

Financial or family relationships with Employers will disqualify a CareerSource staff member or CareerSource Board member from participating in the discussion and voting to approve the Employer’s application for OJT funding. Contracts with an Employer or individual represented on the CareerSource Board of Directors must be approved by a two-thirds vote of the board when a quorum has been established and the CareerSource Board member who could benefit financially from the transaction must abstain from all discussion and voting on the contract. If Employer’s OJT requires prior approval of the CareerSource Board of Directors and impacts CareerSource’s ability to perform its duties/tasks in a timely manner, the OJT submitted by the Employer who has a conflict of interest relationship will not be considered by CareerSource. Contracts equal to or greater than $25,000 with a CareerSource Board member or other person or entity who could benefit financially from the contract as defined in paragraph Section 112.312(2), F.S. must be reviewed by the Department of Economic Opportunity and approved by CareerSource Florida, Inc. Contracts under $25,000 must be reported to CareerSource Florida, Inc.

In the space provided below, please identify any such relationships as defined in Section 112.3143, F.S. or verify that none exist at this time.

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