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This document provides templates for organizational conflict of interest statements required in response to Request for Proposal 47QFCA23R0053 from the General Services Administration Federal Acquisition Service Assisted Acquisition Services Federal Systems Integration and Management Center. Offerors and their subcontractors, consultants, and teaming partners must complete either Sample Statement 1, affirming no awareness of actual or potential conflicts, or Sample Statement 2, disclosing any known conflicts along with existing mitigation plans. The RFP solicits proposals to provide services supporting the Military OneSource Program but does not specify required products or services, pricing terms, or award dates.

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ATTACHMENT 31

ORGANIZATIONAL CONFLICT OF INTEREST (OCI) STATEMENT

The offeror and each subcontractor, consultant, and/or teaming partner shall complete and sign an Organizational Conflict of Interest (OCI) Statement. All information pertaining to OCI is outlined in RFP Section 6.2.1.1.5.

The contractor shall represent either that:

1. It is not aware of any facts that create any actual or potential OCI relating to the award of this contract, or

2. It has included information in its proposal, providing all current information bearing on the existence of any actual or potential OCI.

If a contractor with an actual or potential OCI believes the conflict can be avoided, neutralized, or mitigated, the contractor shall submit a copy of the existing mitigation plan from the relevant awarded contract(s) to the Government for review.

Definition: FAR 2.101 “Organizational 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 Government, or the person’s objectivity in performing the contract work is or might be otherwise impaired, or a person has an unfair competitive advantage.

Version 02/02/2023

SAMPLE 1 – OFFEROR OCI STATEMENT

The following is an example of the OCI statement that each offeror shall complete and sign. All information pertaining to OCI is outlined in Request for Proposal (RFP) Section 6.2.1.1.5.

(Insert Offeror Name) is responding to RFP 47QFCA23R0053 for services supporting the Military OneSource Program. In accordance with RFP Section 6.2.1.1.5, (Inset Offeror Name) has reviewed the requirements of the solicitation and the Federal Acquisition Regulation (FAR) Subpart 9.5.

(Insert Offeror Name) is not aware of any facts which create any actual or potential OCI relating to the award of this contract. (Insert Offeror Name) agrees to immediately disclose all information concerning any actual or potential OCI during the performance of the contract.

Insert Offeror Name

_______________________________________________
Insert Offeror Point of Contact (POC) Name*Date

Insert POC Title

*Person must have the authority to bind the company.

SAMPLE 2 – SUBCONTRACTOR, CONSULTANT, TEAMING PARTNER OCI STATEMENT

The following is an example of the OCI statement that each subcontractor, consultant, and teaming partner shall complete and sign. All information pertaining to OCI is outlined in Request for Proposal (RFP) Section 6.2.1.1.5.

(Insert Company Name) is participating as a subcontractor, consultant, or teaming partner (choose one) to (Insert Offeror Name) in response to RFP 47QFCA23R0053 for services supporting the Military OneSource Program. In accordance with RFP Section 6.2.1.1.5, (Insert Company Name) has reviewed the requirements of the solicitation and the Federal Acquisition Regulation (FAR) Subpart 9.5.

(Insert Company Name) is not aware of any facts which create any actual or potential OCI relating to the award of this contract. (Insert Company Name) agrees to immediately disclose all information concerning any actual or potential OCI during the performance of the contract.

Insert Subcontractor, Consultant, or Teaming Partner Company Name

_______________________________________________
Insert Point of Contact (POC) Name*Date

Insert POC Title

*Person must have the authority to bind the company.

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