Certification Of No Conflict

Certification of No Conflict

I ___________________________, serving as the _________________ at the _____________________ organization while also serving as the _______________________ at the _____________________ organization, hereby certify the following:

• That although I serve in positions for both organizations, I do not draw a paycheck from {Organization}.
• That I have received acknowledgment and permission from both organizations to continue my duties in both capacities.
• None of my duties for {Organization 1} are done during work hours or on company property for {Organization 2}.
• None of my duties for {Organization 1} are done during work hours or on company property for {Organization 1}.
• My involvement with {Organization 1} has no conflict of interest with {Organization 2}.
• My involvement with {Organization 2} has no conflict of interest with {Organization 1}.

I understand that if circumstances should change and my activities become in conflict between the two organizations, I shall submit a waiver of conflict of interest and refrain from activities that are in conflict until such time that a waiver is granted.

____________________________________

Signature & date

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