Non-Conflict of Interest Certificate
I, ___________________________________, of _________________________
hereby represent and certify as follows in relation to my interest in the share capital of
__________________________(the “Company”):
1. Other than in my role as:
a. __________________________________ in_____________________
from_______________ to ______________,
b. __________________________________ in_____________________
from_______________ to ______________,
I do not and have not acted as Public Official in any other capacity. For purposes
of this certificate, the term “Public Official” means an elected or appointed official,
employee or agent of any national, regional or local government/state or
department, agency or instrumentality of any such government/state or any
enterprise in which such a government/state owns, directly or indirectly, a majority
or controlling interest; an official of a political party; a candidate for public office;
and any official, employee or agent of any public international organization.
2. I own _________% of the share capital of _____________________________.
None of my ownership interests in the Company have been or are pledged to or
otherwise subject to any encumbrance in favor of any person, and no dividends
or other income arising from such interests, nor any rights to such dividends or
income, have been assigned, paid, promised, offered, or obligated to any
individual or entity other than myself, or are subject to claims by any person other
than myself, nor are there any oral or written agreement or understandings in
place or contemplated that render, or would render, the foregoing representations
inaccurate or incomplete.
3. I obtained my beneficial ownership interest in the Company through lawful
means, in compliance with all applicable laws and my continuing to hold these
ownership interests in the Company complies with all applicable laws referred to
in paragraph 7 below.
4. I receive only such remuneration for my beneficial interest in the Company as is
paid proportionally to all investors in the Company and receive no special
treatment or benefit as compared with all other investors in the Company.
5. I have not and will not use any authority, power, or responsibility I may possess in
relation to my previous or current position or office, directly or indirectly, to grant,
deny, or otherwise affect or influence the award of business to, or confer any
undue advantage upon the Company.
6. Except for myself, and _____________________________, who is my
____________________, no close relative of mine (spouse or partner, child,
siblings or parents; the spouse or partner of my children or siblings; or any
household member) holds any position as a Public Official, with authority, power,
or responsibility, directly or indirectly, to grant, deny or otherwise influence or
affect the award of business to or confer any undue advantage upon the
Company.
7. I am familiar and have fully complied with the principles articulated in Nigerian
Laws on bribery and anti-corruption such as The Criminal Code, the Penal Code,
Economic and Financial Crimes Act, Independent Corrupt Practices and Other
Related Offences Act etc and the Convention on Combating Bribery of Foreign
Public Officials in International Business Transactions, signed in Paris on
December 17, 1997, which entered into force on February 15, 1999, and such
Convention’s Commentaries, US Foreign Corrupt Practices Act 1977 (as
amended) and the UK Bribery Act 2010.
8. Neither I nor to my knowledge anyone on my behalf, has made or offered nor will
make or offer any payment, gift or promise or give any advantage, whether
directly or indirectly through an intermediary, to or for the benefit of any Public
Official, where such payment, gift promise or advantage would be for purposes of:
(i) influencing any act or decision of such Public Official; (ii) inducing such Public
Official to do or omit to do any act in violation of his or her lawful duties; (iii)
securing any improper advantage; or (iv) inducing such Public Official to use his
or her influence to affect any act or decision of any department, agency or
instrumentality of any government or public enterprise.
9. I understand that the recipients of this certificate will be relying on the information
set forth herein in doing business with the Company. Should there be a change in
circumstances such that any representation or warranty in this certificate is no
longer complete and accurate, I will promptly provide written notice of such
change to the recipients of this certificate.
I declare that the foregoing statements are true and correct.
Name: ___________________________ Signature & Date ______________________
WITNESS:
Name:_______________________________________
Address: _____________________________________
Signature & Date ______________________________
