Attachment 3 - Declaration of Independence and Conflict of Interest Statement.pdf

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AMENDMENT 0002
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2031LL20R00002
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This document contains a Declaration of Independence and Conflict of Interest Statement required for a Treasury attestation engagement contract. The statement requires the contractor to certify independence and a lack of conflicts of interest with respect to the Department of the Treasury or any of its bureaus except the Internal Revenue Service. The contractor must disclose any current or previous contracts with Treasury over the past three years. Independence standards set by the Government Accountability Office must also be followed. By signing the statement, the contractor agrees to maintain independence, avoid conflicts of interest, and not impair objectivity. Failure to comply may result in termination, penalties, or debarment from future federal contracts.

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Attachment 3

DECLARATION OF INDEPENDENCE AND CONFLICT OF INTEREST STATEMENT

Department of the Treasury

General Provision

To perform a Treasury attestation engagement, the Contractor must be independent and objective with respect to the Department of the Treasury (Treasury). The Contractor must certify that it is not aware of any conflict of interest situations at the time the contract is awarded. To maintain independence and objectivity with respect to Treasury, the Contractor shall also agree not to enter into any contract that will create or appear to create a conflict of interest, impair independence or objectivity, or create the appearance that independence or objectivity has been impaired.

Requirements

The Contractor shall comply with the following requirements:

a. The Contractor shall notify the Treasury OIG of the identity of all contracts, current and completed during the past three years, with Treasury or any Treasury bureau or component, and provide information concerning specific work performed. This information shall be submitted with the contractor’s proposal and updated prior to the award of any option year. Since the

Internal Revenue Service (IRS) is not within the scope of this contract, the Contractor shall not be required to provide information pertaining to contracts with the IRS. In general, contracts with the IRS will not be considered to impair independence or create a conflict of interest.

b. The Contractor shall notify the Treasury OIG of any potential new contract with Treasury or with any Treasury bureau or component, except IRS.

c. The Contractor shall comply with all contract independence and conflict of interest clauses contained in the Performance Work Statement.

d. The Contractor shall comply with the independence standards set forth in Government Auditing

Standards, issued by the Comptroller General of the United States, and its successors.

e. The Contractor shall sign this Declaration of Independence and Conflict of Interest Statement and submit with its proposal.

f. The Contractor shall sign an updated Declaration of Independence and Conflict of Interest

Statement (same form), prior to the award of the option years of this contract.

Penalties

If the Contractor fails to comply with the above requirements, it may be considered a material breach of contract subject to monetary penalty, termination for default, and other legal action, such as debarment from future Federal contracts.

Certification

The Contractor certifies and represents the following:

a. The Contractor has read and fully understood the above information and what is required concerning conflict of interest, independence and objectivity.

http://www.gao.gov/yellowbook/overview http://www.gao.gov/yellowbook/overview

Attachment 3

b. The Contractor represents that it is independent and objective with respect to Treasury.

c. The Contractor is in compliance with the requirements set forth above.

d. The Contractor shall not enter into any contract that will create or appear to create a conflict of interest, impair independence or objectivity, or create the appearance that independence or objectivity has been impaired.

Signature of Engagement Partner, Shareholder or Proprietor Date

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