Atch 6 - OCI Disclosure Form.docx
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- Solicitation number
- H9240021R0007
- Issued by
-
United States Special Operations Command
About this file
This solicitation requests proposals for the follow-on Hostile Forces - Tagging, Tracking, and Locating technical collection and communication services contract. The United States Special Operations Command will award an indefinite-delivery/indefinite-quantity contract with cost-plus-fixed-fee and labor hour task orders to provide systems engineering, technical direction, specifications development, technical evaluation, proprietary information access, and hardware and software products. Offerors must submit proposals by October 1, 2021 and the contract includes small business subcontracting goals. To obtain the statements of work, offerors must verify facility and personnel security clearances and provide contact information to the contracting office by September 24. Classified proposal materials must follow the packaging guidance in Attachment 13.
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Text version
TCC/FSR H9240021R0007 OCI Disclosure Form
TCC/FSR Offeror (Prime Contractor or Proposed Subcontractor):
1. Name of Company:
2. Address:
3. Point of Contact and Telephone:
4. E-mail:
5. Size Status: Small ( ) Large ( )
6. List Affiliates:
Attachment 6 27 July 2021
OCI DISCLOSURE ATTACHMENT
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 Paragraph 6 of OCI Disclosure Form.
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:
1. Your performance in the above contract is as a: Prime (__) or Subcontractor (__) Contract Number: _________________________ Task Order Number (if applicable):
2. If Subcontractor under 1, what is magnitude of work compared to overall contract value? Percentage (%): Dollar Value: Number of MYEs:
3. If you performed as a Sub, provide Prime Contractor’s name: ________________________________
4. 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 |
Scope (continue on additional pages if more space is necessary):
5. 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 under the HF-TTL contract? If so, describe the actual or potential conflict.
File details come from the government source that posted it. Updated .