Conflict of Interest Statement


For any member of 10bitworks hackerspace:

No member of 10bitworks hackerspace, or any of its Committees, shall derive any personal profit or gain, directly or indirectly, by reason of his or her participation with the 10bitworks hackerspace. Each individual shall disclose to 10bitworks hackerspace any personal interest which he or she may have in any matter pending before 10bitworks hackerspace and shall refrain from participation in any decision on such matter.

At this time, I am a Board member, a committee member, or an employee of the following organizations:

1) _______________
2) _______________
3) _______________

Now this is to certify that I, except as described below, am not now nor at any time during the past year have been:

1) A participant, directly or indirectly, in any arrangement, agreement, investment, or other activity with any vendor, supplier, or other party doing business with 10bitworks hackerspace which has resulted or could result in personal benefit to me.

2) A recipient, directly or indirectly, of any salary payments or loans or gifts of any kind or any free service or discounts or other fees from or on behalf of any person or organization engaged in any transaction with 10bitworks hackerspace.

Any exceptions to 1 or 2 above are stated below with a full description of the transactions and of the interest, whether direct or indirect, which I have (or have had during the past year) in the persons or organizations having transactions with 10bitworks hackerspace.

1) _______________
2) _______________
3) _______________
4) _______________

Date: ____

Signature: _______

Printed name: ______

10bitworks Hackerspace
1020 Roosevelt
San Antonio TX 78210
10bitworks@gmail.com
10bitworks.com