7_OCI Disclosure Form_8May26.docx

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Attached to
Combat Development Systems Engineering and Technical Assistance (SETA) Support
Solicitation number
H9225726RE010
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This is an Organizational Conflict of Interest (OCI) Disclosure Form for the Marine Forces Special Operations Command (MARFORSOC) Combat Development Systems Engineering and Technical Assistance (SETA) Support contract (H9225726RE010). The form is a template designed to capture information about existing contracts or subcontracts held by the offeror or its affiliates that may create actual or potential conflicts of interest with the proposed work.

The form requires contractors to identify and disclose any current USSOCOM contracts or subcontracts being performed and assess whether they conflict with the proposed MARSOC or SOCOM contract work. Respondents must provide detailed information including the contractor/subcontractor name, contract title, contracting agency, contract number, and whether the firm is performing as prime or subcontractor. The form specifically addresses five categories of potential OCI issues: Systems Engineering and Technical Direction, preparation of specifications or work statements, technical evaluation of offers, access to proprietary information, and provision of products, hardware, or software to USSOCOM. Contractors must describe the scope of their existing work in sufficient detail to demonstrate how it relates to these categories and explicitly identify any actual or potential conflicts with the requested SETA support work. This disclosure is mandatory for each current USSOCOM contract or subcontract held by the firm or its affiliates.

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H9225726RE010

OCI Disclosure Form OCI Disclosure Form Attachment 7

INSTRUCTIONS FOR COMPLETING

NOTE: One Attachment to the OCI Disclosure Form shall be submitted for each USSOCOM contract or subcontract currently being performed. Place an "X" inside the appropriate parenthesis to indicate your responses.

Fill in the number and the short, official title by which the contract or subcontract requiring analysis and determination is formally known. This is work that has already been awarded, is being performed by your company, and requires a comparison with that work identified in the Statement of Work.

1. Please identify below the contract or subcontract held by your firm or affiliate and which may create an actual or potential OCI:

a. Contractor, Subcontractor or Affiliate’s Name:

b. Contract or Program Title:

c. Contracting Agency or Customer:

d. Contract Number:

e. Task Order Number (if applicable):

2. Your performance in the above contract is as a: Prime (__) or Subcontractor (__)

3. If Subcontractor, what is magnitude of work compared to overall contract value?

Percentage (%): _________Dollar Value: __________Number of MYEs: _______

4. If you performed as a Sub, provide Prime Contractor’s name: ________________________________

5. Describe below the scope of the contract or subcontract in sufficient detail to understand the breadth of the work, the period of performance and the value, as it relates to:

() Providing Systems Engineering and Technical Direction (FAR 9.505-1)
() Preparing Specifications or Work Statements (FAR 9.505-2)
() Providing Technical Evaluation of Offers for Products or Services (FAR 9.505-3)
() Obtaining Access to Proprietary Information (FAR 9.505-4)
() Providing products, hardware or software to USSOCOM

6. Scope (continue on additional pages if more space is necessary):

7. Does the scope of work for this contract or subcontract create an actual or potential conflict of interest with the work you wish to perform with MARSOC or SOCOM contracts? If so, describe the actual or potential conflict.

File details come from the government source that posted it. Updated .