36C26320R0089-018.pdf
PDF Posted
- Attached to
- Q501--Certified Nurse Anesthetist (2. 0 FTE)
- Solicitation number
- 36C26320R0089
About this file
This document includes an organizational conflict of interest certification statement and details of a federal contract opportunity for certified registered nurse anesthetist services. The organizational conflict of interest certification statement is to be completed by the contractor named [CONTRACTOR NAME] and addresses any potential conflicts of interest among key personnel related to the solicitation number 36C26320R0089 for certified registered nurse anesthetist services at the Minneapolis VA Health Care System.
The federal contract opportunity is solicitation number 36C26320R0089 issued by the Department of Veterans Affairs to provide two full-time certified registered nurse anesthetists at the Minneapolis VA Health Care System. The base period of performance is six months from July 1, 2020 to December 31, 2020 with one six-month option period. The contractor must be licensed to practice in the state and furnish services onsite. Questions regarding this presolicitation notice must be directed in writing to the point of contact provided.
36C26320R0089 D.6 Organizational Conflict of Interest.pdf
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Other files
| File | Type | Posted |
|---|---|---|
| 36C26320R0089-028.docx | DOCX document | |
| 36C26320R0089-029.pdf | ||
| 36C26320R0089-024.docx | DOCX document | |
| 36C26320R0089-025.pdf | ||
| 36C26320R0089-023.pdf | ||
| 36C26320R0089-022.docx | DOCX document | |
| 36C26320R0089-015.pdf | ||
| 36C26320R0089-014.pdf | ||
| 36C26320R0089-012.pdf | ||
| 36C26320R0089-017.pdf | ||
| 36C26320R0089-016.pdf | ||
| 36C26320R0089-011.docx | DOCX document | |
| 36C26320R0089-013.pdf | ||
| 36C26320R0089-019.pdf | ||
| 36C26320R0089-001.docx | DOCX document |
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Text version
D.6 – Attachment 6
Organizational Conflicts of Interest
[CONTRACTOR NAME]
[ADDRESS]
SOLICITATION # 36C26320R0008, Certified Registered Nurse Anesthetist Services Minneapolis VAHCS
CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT
[ ] ____[CONTRACTOR NAME]________________ represents that the individuals listed in the Key Personnel section of the solicitation 36C26320R0089, Certified Registered Nurse Anesthetist Services, 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 Minneapolis VA Health Care System 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 Minneapolis VA Health Care System 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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