Annual Certification of Compliance with the Code of Conduct

For reference, please see LIPA’s Code of Ethics and Conduct here.

Annual Certification of Compliance with the Code of Conduct

Each year, LIPA employees are required to certify that they will act in compliance with LIPA’s code of conduct.

Annual Certification of Compliance with the Code of Conduct Form

Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Title(Required)

Email(Required)

Review and check only one (provide any comments or explanations as necessary below):(Required)

I have read and understand the Code of Ethics and Conduct of the Long Island Power Authority and hereby certify that I am in compliance with all of the policies and standards and principles of conduct stated therein and I have no direct or indirect Financial Interests or Other Interests which may create or appear to create a conflict with my official job duties and responsibilities. I further certify that I have inquired as to my spouse and dependent children* and based upon such inquiry none of the above has any direct or indirect Financial Interests or Other Interests which may create or appear to create a conflict with my official job duties and responsibilities.

I have read and understand the Code of Ethics and Conduct of the Long Island Power Authority and acknowledge my responsibility to fully disclose any and all Financial Interests or Other Interests which may create or appear to create a conflict with my official job duties and responsibilities and these interests are described below. I also understand that as a result of any conflict of interest, additional action will need to be taken to relieve the conflict. I further certify that I have inquired as to my spouse and dependent children* and based upon such inquiry none of the above has any direct or indirect Financial Interests or Other Interests which may create or appear to create a conflict with my official job duties and responsibilities except as described below.

Message

Please certify your understanding of the following LIPA policy:(Required)

I understand that all business relating to the Long Island Power Authority (“LIPA”) must be conducted through a LIPA email address. I understand that failure to comply will subject personal email accounts and text messages to search by LIPA or LIPA’s outside counsel for items including, but not limited to, Freedom of Information Law (“FOIL”) requests and litigation matters.

Review and check if applicable

Within the last year, I, as a former private sector employee with less than two years of employment at the Authority, have not (1) approved any invoices for payment rendered by my former private sector employer; (2) assigned work to my former private sector employer; or (3) participated in any RFP in which my former private sector employer submitted a proposal.

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Annual Certification of Compliance with the Code of Conduct

Annual Certification of Compliance with the Code of Conduct

Annual Certification of Compliance with the Code of Conduct Form