224-22 Exhibit B-RFQ Licensed Tree Expert for Township Tree Inventory.pdf

TOWNSHIP OF WEST ORANGE Page | 19 NON-CONFLICT OF INTEREST CERTIFICATION REQUEST FOR QUALIFICATIONS FOR _____________________________________ (Title of RFQ) The undersigned certifies to the Township of West Orange, County of Essex, State of New Jersey that in performing services to the Township he/she is aware of no circumstance that would constitute a conflict of interest, financial or otherwise, between him/her (or his/her firm) and the interests of the Township. The undersigned certifies that he/she has made a search of his/her firm’s client base and has executed this certification subsequent to such search. The undersigned acknowledges this a continuing certification, and shall remain in effect for the term of the services contained in the solicited request for qualifications. I certify that the foregoing statements made by me are true and accurate to my personal knowledge; I am making this certification in good faith. I am aware that if any of the foregoing statements made by me are false, the Board is free to terminate any professional service agreement entered into with the undersigned and/or his or her firm. Certifying Official: PRINT NAME: _________________________________________________ SIGNED BY: ___________________________________________________ TITLE: ________________________________________________________ DATE: _________________________________________________________