STEP 1 SUPPORTING DOCUMENTATION SUBMITTAL (All vendors complete regardless of annual bid, offer, or contract value) (Subcontractors with subcontract annual value of more than $50,000 must complete) You must select one of the six options below and select the documentation you are submitting. You must provide the documentation that the applicable section requires with this form. Option 1 – Publicly Traded Entities 1.A. Complete Step 2, Option A for each qualifying individual or entity holding any ownership or distributive income share in excess of 5% or an amount greater than 60% ($106,447.20) of the annual salary of the Governor. OR 1.B. Attach a copy of the Federal 10-K or provide a web address of an electronic copy of the Federal 10-K, and skip to Step 3. Option 2 – Privately Held Entities with more than 100 Shareholders 2.A. Complete Step 2, Option A for each qualifying individual or entity holding any ownership or distributive income share in excess of 5% or an amount greater than 60% ($106,447.20) of the annual salary of the Governor. OR 2.B. Complete Step 2, Option A for each qualifying individual or entity holding any ownership share in excess of 5% and attach the information Federal 10-K reporting companies are required to report under 17 CFR 229.401. Option 3 – All other Privately Held Entities, not including Sole Proprietorships 3.A. Complete Step 2, Option A for each qualifying individual or entity holding any ownership or distributive income share in excess of 5% or an amount greater than 60% ($106,447.20) of the annual salary of the Governor. Option 4 – Foreign Entities 4.A. Complete Step 2, Option A for each qualifying individual or entity holding any ownership or distributive income share in excess of 5% or an amount greater than 60% ($106,447.20) of the annual salary of the Governor. OR 4.B. Attach a copy of the Securities Exchange Commission Form 20-F or 40-F and skip to Step 3. Option 5 – Not-for-Profit Entities Complete Step 2, Option B. Option 6 – Sole Proprietorships Skip to Step 3.
STEP 1 SUPPORTING DOCUMENTATION SUBMITTAL (All vendors complete regardless of annual bid, offer, or contract value) (Subcontractors with subcontract annual value of more than $50,000 must complete) You must select one of the six options below and select the documentation you are submitting. You must provide the documentation that the applicable section requires with this form. Option 1 – Publicly Traded Entities 1.A. Complete Step 2, Option A for each qualifying individual or entity holding any ownership or distributive income share in excess of 5% or an amount greater than 60% ($106,447.20) of the annual salary of the Governor. OR 1.B. Attach a copy of the Federal 10-K or provide a web address of an electronic copy of the Federal 10-K, and skip to Step 3. Option 2 – Privately Held Entities with more than 100 Shareholders 2.A. Complete Step 2, Option A for each qualifying individual or entity holding any ownership or distributive income share in excess of 5% or an amount greater than 60% ($106,447.20) of the annual salary of the Governor. OR 2.B. Complete Step 2, Option A for each qualifying individual or entity holding any ownership share in excess of 5% and attach the information Federal 10-K reporting companies are required to report under 17 CFR 229.401. Option 3 – All other Privately Held Entities, not including Sole Proprietorships 3.A. Complete Step 2, Option A for each qualifying individual or entity holding any ownership or distributive income share in excess of 5% or an amount greater than 60% ($106,447.20) of the annual salary of the Governor. Option 4 – Foreign Entities 4.A. Complete Step 2, Option A for each qualifying individual or entity holding any ownership or distributive income share in excess of 5% or an amount greater than 60% ($106,447.20) of the annual salary of the Governor. OR 4.B. Attach a copy of the Securities Exchange Commission Form 20-F or 40-F and skip to Step 3. Option 5 – Not-for-Profit Entities Complete Step 2, Option B. Option 6 – Sole Proprietorships Skip to Step 3.
Financial%20Disclosures%20and%20Conflicts%20of%20Interest%20V.15.2.docx