By clicking Approve on the online routing screen within the COI System, the individual to whom the Unity ID and password is connected is making the following relevant certifications. Delegation of COI approval authority is not allowed other than where pre-approved by the Office of Research Administration.
Employees making false representations or providing false information in this application and its supporting documents constitutes a violation of their employment responsibilities which can result in disciplinary action, potential personal liability, and may be a criminal offense (U. S. Code, Title 18, Section 1001).
Note: If you object to or refuse to make any of these representations and certifications by making a note in any of the comments fields within the COI System, any noted objections become null and void once you click “approve”. Should you have any questions or concerns about these representations and certifications, contact Richard Best (Director of Research Compliance) by phone at (919) 515-0158 or email at email@example.com.
Certifications and Representations for Employees:
- I have read and understand the Conflicts of Interest and Conflicts of Commitment regulation outlined in PRR 01.25.01 posted on this page, and I will comply fully with the objectives of that regulation.
- I certify that this conflict of interest form is complete, and that to the extent a conflict exists, it accurately portrays all potential conflicts of interest as required by the aforementioned regulation.
- Where applicable, I certify that the management plan I have outlined in the online COI System was discussed with appropriate leadership to whom I report, and it satisfactorily ensures my objectivity in conducting my duties as an employee of North Carolina State University.
- To the extent circumstances change wherein a potential conflict arises and exists in the future, I will promptly (within 30 days of discovery) complete a modified conflict of interest disclosure via the COI System.
- By clicking “approve” on the approval screen within COI System, I hereby personally certify, warrant, and represent that the statements made on my COI form are true and accurate, and I can attest to and make the above certifications.
Certifications and Representations for Department Heads, Center Directors, Vice Chancellors, and Deans:
- I have reviewed this conflict of interest form for completeness and find that it has been satisfactorily completed.
- I represent that the form is accurate to the best of my knowledge, which is based on what the completing employee has disclosed herein.
- Where applicable, I certify that I discussed and collaborated in developing the management plan filed by the disclosing employee in the online COI System, and that I will ensure compliance with that management plan to the best of my abilities.
- By clicking “approve” on the approval screen within the COI System, I hereby personally certify and warrant the above statements and representations.