26-25569 - Attachment-I.-Conflict-of-Interest-Affidavit.pdf
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- Attached to
- MEDICAL ADULT DAY CARE PRIVATE PAY SUBSIDY
- Solicitation number
- BPM058856
- Issued by
- Maryland
About this file
This is a Conflict of Interest Affidavit form required for the Maryland Adult Day Care Private Pay Subsidy contract opportunity (26-25569). The affidavit, effective July 2024, is governed by COMAR 21.05.08.08 and must be submitted with all bid or proposal submissions. The form requires offerors, contractors, consultants, subcontractors, sub-consultants, and their employees or agents with authority to control or supervise work to warrant that no relevant facts or circumstances exist that would create a conflict of interest, defined as circumstances that would impair a person's ability to render impartial assistance to the State or compromise objectivity in performing contract work.
Offerors must disclose any facts or circumstances that give rise or could give rise to conflicts of interest in a detailed section of the affidavit, with additional sheets attached as necessary. The affidavit further requires that offerors immediately notify the procurement officer in writing of any actual or potential conflicts of interest that arise after the affidavit date, including a description of actions taken or proposed to mitigate or neutralize such conflicts. The declaration must be executed under penalties of perjury by an authorized representative and submitted with the bid or proposal.
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Attachment I. Conflict of Interest Affidavit effective date: July 2024
Attachment I. Conflict of Interest Affidavit and Disclosure
Reference COMAR 21.05.08.08
A. “Conflict of interest” means that because of other activities or relationships with other persons, a person is unable or potentially unable to render impartial assistance or advice to the State, or the person’s objectivity in performing the contract work is or might be otherwise impaired, or a person has an unfair competitive advantage.
B. “Person” has the meaning stated in COMAR 21.01.02.01B(64) and includes a Offeror, Contractor, consultant, or subcontractor or sub-consultant at any tier, and also includes an employee or agent of any of them if the employee or agent has or will have the authority to control or supervise all or a portion of the work for which a Proposal is made.
C. The Offeror warrants that, except as disclosed in §D, below, there are no relevant facts or circumstances now giving rise or which could, in the future, give rise to a conflict of interest.
D. The following facts or circumstances give rise or could in the future give rise to a conflict of interest (explain in detail — attach additional sheets if necessary):
E. The Offeror agrees that if an actual or potential conflict of interest arises after the date of this affidavit, the Offeror shall immediately make a full disclosure in writing to the procurement officer of all relevant facts and circumstances. This disclosure shall include a description of actions which the Offeror has taken and proposes to take to avoid, mitigate, or neutralize the actual or potential conflict of interest. If the contract has been awarded and performance of the contract has begun, the Contractor shall continue performance until notified by the procurement officer of any contrary action to be taken.
I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE
CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE, INFORMATION, AND BELIEF.
Date: ____________________ By: ______________________________________
(Authorized Representative and Affiant)
SUBMIT THIS AFFIDAVIT WITH BID/PROPOSAL
File details come from the government source that posted it. Updated .