CITY OF RIA
LTO
REQUEST FOR
PROPOSAL
#
22 -
0 21
DISCLOSURES REQUIRED BY PER
SONS OR ENT
ITIES
CONTRACTING
WITH THE CI
TY OF RIALTO
Pursuant
to
City
of
Rialto
Code
of
Ordinances
Section
2.48.145,
all
persons
or
business
entities
supplying
any
goods
or
services
to
the
cit
y,
or
seeking
a
loan
or
grant
awarded
by
the
city,
whether
t
hrough
an
a
pplication
or
prop
o
sal,
shall
disclose
in
such
application
or
proposal
whether
any
city
officer,
employee,
or
consultant
may
have
a
financial
or
non
-
financial
interest
in
the
person
or
business
entity,
or
in
any
member,
employee,
owner,
or
offic
er
of
the
b
usiness
entity.
A
financial
i
nterest
shall
mean
any
interest
that
is
prohibited
under
state
law,
including
California
Government
Code
Sections
1090
and
87100,
and
California
Code
of
Re
gulation
Section
18700
et
seq
.
A
non
-
financial
interest
shal
l
mean
any
interest
that
is
p
r
ohibited
by
City
of
Rialto
Code
of
Ordinances
Section
2.48.140
(attached
here).
For
the
purpose
of
helping
the
City
understand
whether
City
personnel
might
have
a
co
nflict
of
interest
in
you
or
your
organization,
please
discl
ose
below
w
hether
you
or
any
o
f
your
memb
ers,
employees,
paid
or
unpaid
officers,
paid
or
unpaid
directors,
or
owners
are
(or
are
related
to)
a
City
elected
or
appointed
official,
a
City
officer,
or
a
City
employee
or
consultant.
Name
of
Your
Organization
’s
Affected
Member,
Employee,
Paid
or
Unp
aid
Officer,
Paid
or
Unpaid
Director,
or
Owner
Name
of
City
Elected
or
Appointed
Official,
City
Officer
,
a
City
Employee
or
Consultant
Relationship
Between
the
Two
By
submitting
[this
application/propo
sal],
or
su
pplying
any
goods
o
r
services
to
the
city,
the
[applicant/vendor/contractor/consultant]
hereby
attests
under
penalty
of
perjury,
personally
and/or
on
behalf
of
the
entity
[submitting
th
is
application/proposal
or
supplying
any
goods
or
services
t
o
the
city]
that
no
City
of
R
i
alto
electe
d
or
appointed
official,
employee
or
consultant
has
a
financial
or
non
-
financial
interest,
as
such
terms
are
defined
in
California
Government
Code
Sections
1090
and
87100
and
in
City
of
Rialto
Code
of
Ordinances
Sec
tion
2.48.1 45,
in
the
[applic
a
nt/vendor/c
ontractor/consultant],
except
as
specifically
disclosed
herein.
Person/Entity:
Title:
___________________________________________________
Signature
:
__________________________ Date:
_________________
F
orm
Date: 06/09
/2021