Attachment 3 - Contractor Certification (Conflict of Interest).docx

DOCX document 23 KB Posted

Attached to
Onsite Apheresis Treatment Services Federal contract opportunity
Solicitation number
36C25923Q0494
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 19

About this file

This document contains a contractor certification form regarding organizational conflicts of interest related to solicitation number 36C25923Q0494 for onsite apheresis treatment services. The form requires the contractor to certify whether its key personnel identified in the solicitation have any past, present or planned financial, contractual, organizational or other interests that could present an organizational conflict of interest relating to providing the services. If conflicts exist, the contractor must provide a statement describing the relevant facts and how it will avoid or mitigate any actual or potential conflicts of interest. The contracting officer may determine a disqualifying conflict exists and request a waiver, or the conflict cannot be mitigated, in which case the contract could be terminated at no cost to the government.

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Other files for this federal contract opportunity

Other files attached to Onsite Apheresis Treatment Services, newest first.
File Type Posted
36C25923Q0494 0001 - Apheresis Amdt 1.pdf PDF
Attachment 2 - Contractor Certification (Immigration).docx DOCX document
Attachment 1 - Quality Assurance Surveillance Plan - Apheresis.doc DOC document
36C25923Q0494 - Denver Apheresis RFQ.pdf PDF

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Text version

852.209-70. ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

All healthcare contracts require response to the following provision as prescribed in VAAR 809.507-1(b). Please use the form in APPENDIX A to provide response.

ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

(a) It is in the best interest of the Government to avoid situations which might create an organizational conflict of interest or where the Offeror's performance of work under the contract may provide the Contractor with an unfair competitive advantage. The term 'organizational conflict of interest' means that because of other activities or relationships with other persons, a person is 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 the person has an unfair competitive advantage.

(b) The Offeror shall provide a statement with its offer which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided under this solicitation. The Offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The Offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.

(c) Based on this information and any other information solicited or obtained by the Contracting Officer, the Contracting Officer may determine that an organizational conflict of interest exists which would warrant disqualifying the Contractor for award of the contract unless the organizational conflict of interest can be mitigated to the Contracting Officer's satisfaction by negotiating terms and conditions of the contract to that effect. If the conflict of interest cannot be mitigated and if the Contracting Officer finds that it is in the best interest of the United States to award the contract, the Contracting Officer shall request a waiver in accordance with FAR 9.503.

(d) Nondisclosure or misrepresentation of actual or potential organizational conflicts of interest at the time of the offer or arising as a result of a modification to the contract, may result in the termination of the contract at no expense to the Government.

(End of provision)

APPENDIX A

[CONTRACTOR NAME]

[ADDRESS]

SOLICITATION #

CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT

[ ] ____[CONTRACTOR NAME]________________ represents that the individuals listed in the Key Personnel and Temporary Emergency Substitutions section of the solicitation [____Solicitation # and Service Type___] in have no present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or organizational conflicts of interest relating to the services to be provided to the ___[NAME OF VAMC] _________ Veterans Administration under the referenced solicitation.

None of the employees listed in the solicitation have a past interest (financial, contractual, organizational, or otherwise) or actual or organizational conflicts of interest relating to the services to be provided to the___NAME OF VAMC _________ Veterans Administration under the referenced solicitation.

OR

[ ] Statement attached describing, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided under this solicitation. The offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.

NAME OF CERTIFYING OFFICIAL

TITLE

SIGNATURE DATE

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