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TRCAPLEA000282.2024 City of Redwood City | FORMS <br />ROOSEVELT AVENUE PERMANENT TRAFFIC CALMING PROJECT ENGINEERING DESIGN <br />RFP #ENG24-12 <br />Local Assistance Procedures Manual EXHIBIT 10-T <br />Conflict of Interest & Confidentiality Statement <br />Date: __________________ Signed: ________________________________________ <br />Name: ________________________________________ <br />Title: _________________________________________ <br />Dept./Local Agency: _____________________________ <br />Employer: ___________________________________ <br />CONTRACT ADMINISTRATOR’S REVIEW <br />I have reviewed the foregoing “Conflict of Interest and Confidentiality Statement” and have <br />determined, according to the information provided, that this individual: <br />□does not have a conflict of interest and can participate in the “Selection <br />Panel” <br />□does have a conflict of interest and cannot participate in the “Selection Panel” <br />Signed: ________________________________________ Date: __________________ <br />Name: ________________________________________ <br />Title: _________________________________________ <br />Dept./Local Agency: _____________________________ <br />Employer: _____________________________________ <br />Distribution: Original – Local Agency Consultant File <br />LPP 18-01 Page 3 of 3 <br />January 2019 <br />N/A <br />Kimley-Horn and Associates, Inc. <br />Michael S. Mowery, PE <br />Senior Vice President <br />ATTY/AGR.2024.181/KImley-Horn (Roosevelt Ave Permanent Traffic Calming Project De (Page 39 of 42) <br />6.B. - Page 43 of 46 <br />68