Attachment 3 Contractor Organization Conflict of Interest Certification.docx
DOCX document 23 KB Posted
- Solicitation number
- 36C25924R0126
About this file
This document is a Contractor Organization Conflict of Interest Certification that must be completed in response to a federal contract opportunity. The certification requires the contractor to disclose any past, present, or planned financial, contractual, organizational, or other interests that could create an organizational conflict of interest relating to the services to be provided under the solicitation. The contractor must either certify it has no such conflicts of interest, or provide a statement describing any relevant facts about potential conflicts. The contracting officer will review the information to determine if an organizational conflict of interest exists that would disqualify the contractor, or if the conflict can be mitigated.
The related federal contract opportunity is for on-site intraoperative neuromonitoring (IONM) services and instrumentation for the beneficiaries of the Rocky Mountain Regional VA Medical Center, under Solicitation Number 36C25924R0126. The contract will be awarded by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 19.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25924R0126 0001.docx | DOCX document | |
| Attachment 4 Wage Determination.pdf | ||
| Attachment 2 Immigration Certification.docx | DOCX document | |
| 36C25924R0126.docx | DOCX document | |
| Attachment 1 Intraoperative Neuromonitoring Services QASP.docx | DOCX document |
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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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