Atttachment 4 - Conflict of Interest.docx

ATTACHMENT 4: CONFLICT OF INTEREST CERTIFICATE

Department of Commerce, National Oceanic and Atmospheric Administration, SECO/OCAO

Contract #:_______________________ Call Order #: _____________________

To: Contracting Officer

I certify that I am not aware of any matter that might limit my ability to participate objectively and in an unbiased manner in the acquisition initiated by NOAA. I further certify that, with respect to this acquisition, I am not aware of any matter that might place me in a position of conflict, real or apparent, between my responsibilities and other interests.

In making this certification, I have considered all my stocks, bonds, other financial interests, and employment arrangements (past, present, or under consideration) and, to the extent known by me, all the financial interests and employment arrangements of my spouse, my minor children, and other members of my immediate household.

If, after the date of this certification, any person, firm, or other organization with which, to my knowledge, I (including my spouse, minor children, and other members of my immediate household) have a financial interest, or with which I have or had an employment arrangement, submits a proposal or otherwise becomes involved in the acquisition, I will notify the contracting officer of this apparent conflict of interest. Until advised to the contrary, I will not participate further in any way (by rendering advice, making recommendations, voting or otherwise) in the work of this acquisition.

Name (please Print)

Signature and date

Organization and/or Affiliation