A02.12 COI Form - IEPR Little Blue River.DOCX
DOCX document 16 KB Posted
- Solicitation number
- W912HQ25R0016
About this file
The document is a Conflicts of Interest (COI) Questionnaire for an Independent External Peer Review (IEPR) of the Little Blue River Flood Risk Management Study. The form is designed to help the U.S. Army Corps of Engineers identify potential organizational conflicts of interest early in the acquisition process. The questionnaire requires firms to disclose potential conflicts across five key areas: involvement in study preparation, interests in the study area or outcome, reviewer selection, potential future project affiliations, and any additional relevant background information that might impact the firm's objectivity or create an unfair competitive advantage.
The related federal contract opportunity (Solicitation Number W912HQ25R0016) is for an Independent External Peer Review of the Little Blue River Flood Risk Management Study in Cass and Jackson Counties, Missouri. The government anticipates awarding a firm-fixed-price contract, with the requirement that the contractor must be an eligible 501(c)(3) organization. The Performance Work Statement requires contractors to establish an expert panel to conduct peer reviews in accordance with the National Academy of Science's policy and USACE guidance, specifically aligning with the Water Resources Development Act of 2007 and subsequent amendments.
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Other files
| File | Type | Posted |
|---|---|---|
| B08.03 Answers to Questions Solicitation W912HQ25R0016 IEPR LBR.docx | DOCX document | |
| B08.02 W912HQ25R0016 form SF33 dated 2025.07.11.pdf | ||
| B08.02 Price Sheet Template - IEPR LBR.xlsx | XLSX spreadsheet | |
| A02.12 Charge Questions - IEPR Little Blue River FRM.docx | DOCX document | |
| B08.02 W912HQ24R0015 Attachment 2 USACE PPQ.pdf | ||
| A02.12 PWS Little Blue River FRM dated 2025.07.07 - SAM.gov.docx | DOCX document |
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Text version
Conflicts of Interest Questionnaire Independent External Peer Review Independent External Peer Review (IEPR) for the Little Blue River FRM Study
The purpose of this document is to help the U.S. Army Corps of Engineers identify potential organizational conflicts of interest on a task order basis as early in the acquisition process as possible. Complete the questionnaire with background information and fully disclose relevant potential conflicts of interest. Substantial details are not necessary; USACE will examine additional information if appropriate. Affirmative answers will not disqualify your firm from this or future procurements.
NAME OF FIRM: _____________________________
REPRESENTATIVE’S NAME: _____________________________
TELEPHONE: ___________________
ADDRESS: __________________________________________________________
EMAIL ADDRESS: ___________________________________________________
I. INDEPENDENCE FROM WORK PRODUCT. Has your firm been involved in any aspect of the preparation of the subject study report and associated analyses (field studies, report writing, supporting research etc.) No Yes (if yes, briefly describe):
II. INTEREST IN STUDY AREA OR OUTCOME. Does your firm have any interests or holdings in the study area, or any stake in the outcome or recommendations of the study, or any affiliation with the local sponsor? No Yes (if yes, briefly describe):
III. REVIEWERS. Do you anticipate that all expert reviewers on this task order will be selected from outside your firm? No Yes (if no, briefly describe the difficulty in identifying outside reviewers):
IV. AFFILIATION WITH PARTIES THAT MAY BE INVOLVED WITH PROJECT IMPLEMENTATION. Do you anticipate that your firm will have any association with parties that may be involved with or benefit from future activities associated with this study, such as project construction? No Yes (if yes, briefly describe):
V. ADDITIONAL INFORMATION. Report relevant aspects of your firm’s background or present circumstances not addressed above that might reasonably be construed by others as affecting your firm’s judgment. Please include any information that may reasonably: impair your firm’s objectivity; skew the competition in favor of your firm; or allow your firm unequal access to nonpublic information.
YOUR SIGNATURE DATE
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