12._CCHCS-MC-412_Conflict_of_Interest.pdf
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- Attached to
- On-Site Dialysis Request for Proposal SD23-00097
- Solicitation number
- 0000032853
About this file
This document is a Conflict of Interest Compliance Certificate related to a contract opportunity with the California Department of Corrections and Rehabilitation (CDCR) and California Correctional Health Care Services (CCHCS), Proposal Number SD23-00097. The certificate outlines the CCHCS' intent to avoid conflicts of interest on the part of the proposer/contractor, subcontractors, or any of their stakeholders. It defines what constitutes a conflict of interest, including instances where the proposer/contractor has an interest that is contrary to the goals and objectives of the agreement, or where a public official has a financial interest. The certificate requires the proposer/contractor to disclose any suspected or potential conflicts of interest and provide a plan to address them. If a conflict of interest is determined and cannot be resolved, it will be grounds for the proposal to be deemed non-responsive or the termination of the agreement.
The certificate must be signed by an authorized representative of the proposer/contractor and included in the proposal submission. Subcontractors are also required to provide a completed certificate prior to approval by CCHCS. The proposer/contractor and subcontractors must notify CCHCS of any changes to the information provided on the certificate within 10 working days.
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California Department of Corrections and Rehabilitation (CDCR)/ Proposal Number: SD23-00097 California Correctional Health Care Services (CCHCS)
CCHCS-MC-412 Page 1 of 2 Rev. 06/26/2017
CONFLICT OF INTEREST COMPLIANCE CERTIFICATE
1. CCHCS intends to avoid conflicts of interest or the appearance of conflicts of interest on the part of the proposer/contractor, subcontractors, or any of their stakeholders. Thus, CCHCS reserves the right to determine, in its sole discretion, whether any information received from any source indicates the existence of a conflict of interest.
a. Conflict of interest include, but is not limited to:
(1) An instance where the proposer/contractor, subcontractors, or any of their stakeholders has an interest, financially or for any purpose that is contrary to the goals and objectives of the Agreement, whereby the use or disclosure of information obtained while performing service under the Agreement would allow for private or personal benefit.
(2) Where pursuant to the Political Reform Act (Government Code Section §87100-87505), no public official at any level shall make, participate in making, or in any way attempt to use their official position to influence a governmental decision in which he or she knows or has reason to know he or she has a financial interest.
(3) Where pursuant to Government Code Section §1090 et seq., CCHCS officials shall not be financially interested or participate in the making of an Agreement with the proposer/contractor.
2. CCHCS’ determination of a suspected or potential conflict of interest will be based on all of the proposers/contractor’s business affiliations and contractual relationships.
3. If CCHCS is aware of a known or suspected conflict of interest, the proposer/contractor will be given the opportunity to submit additional information to resolve the conflict. A proposer/contractor with a suspected conflict of interest will have five (5) working days from the date of notification by CCHCS to provide complete information regarding the suspected conflict. If a conflict of interest is determined to exist by CCHCS and cannot be resolved to the satisfaction of CCHCS, before or after the award of the Agreement, the conflict will be grounds for the proposal to be deemed non-responsive and/or termination of the Agreement.
4. The proposer/contractor shall place this certificate in the Appendix Section of its narrative proposal response to this Request for Proposal (RFP). This Certificate shall contain the original signature of an official or employee of the proposer/contractor who is authorized to bind the proposer/contractor.
5. This Certificate will be incorporated into the Agreement, if any, awarded from this IFB. It is understood that this requirement shall be in effect for the entire term of the Agreement. The proposer/contractor shall obtain a completed Certificate from any proposed subcontractor and submit it to CCHCS prior to approval of the subcontractor by CCHCS.
6. The proposer/contractor and each subcontractor shall notify CCHCS, Direct Care Contracts
Section, at P.O. Box 588500 Elk Grove, CA 95758 within ten (10) working days of any change to the information provided on this Certificate.
CDCR/CCHCS Proposal Number: SD23-00097 Conflict of Interest Compliance Certificate
CCHCS-MC-412 Page 2 of 2 Rev. 06/26/2017
7. If the proposer/contractor has a suspected or potential conflict of interest, the proposer shall attach a description of the relationship, a plan for ensuring that such a relationship will not adversely affect CCHCS, and procedures to guard against the existence of an actual conflict of interest.
The undersigned hereby affirms that: (check one)
The statements above have been read and that no conflict of interest exists.
A suspected or potential conflict of interest does exist, and additional information (as described in Paragraph 7 above) is attached along with a plan to address the possible conflict of interest.
Signed: __________________________________________________________
Title: ____________________________________________________________
Date: ____________________________________________________________
Type or Print Name of Authorized Representative:
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