Att D4 - Key Personnel and COI 1.docx
DOCX document 19 KB Posted
- Attached to
- G004--Transitional Housing - Health Care for Homeless Veterans (HCHV) Shreveport, Louisiana
- Solicitation number
- 36C25626Q0949
About this file
This is a Key Personnel and Conflict of Interest (COI) declaration form required as Attachment D4 to the solicitation for transitional housing and healthcare services for homeless veterans. The form requires contractors to certify that all identified key personnel have no present, planned, or past financial, contractual, organizational, or other conflicts of interest relating to services to be provided to the Overton Brooks Veterans Affairs Medical Center (OBVAMC) in Shreveport, Louisiana, in compliance with VAAR 852.209-70 Organizational Conflict of Interest regulations.
Contractors must list all key personnel and any temporary emergency substitutes on the form, clearly indicating whether each individual is employed by the prime contractor or a subcontractor. The form serves as a certification mechanism to ensure compliance with federal conflict of interest requirements for this solicitation (36C25626Q0949) for transitional housing and therapeutic/rehabilitative services for veterans with serious mental illness, including homeless veterans, within the Veterans Health Administration's Veterans Integrated Service Network 16.
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Other files
| File | Type | Posted |
|---|---|---|
| Att D5 - CONTRACTOR CERTIFICATION IMM.docx | DOCX document | |
| Att D2 Past Performance Reference rv.pdf | ||
| ATT D.1 QASP rv9 22.pdf | ||
| WD 2015-5191 REV 32 DTD 21 AUG 2026.pdf | ||
| Att D3 - Contractor Rules of Behavior.pdf | ||
| RFQ 36C25626Q0949- HCHV rv 9 22 .pdf |
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Text version
ATTACHMENT D4- Key Personnel and COI Contractor____________________ represents that the individuals listed below for Key Personnel and Temporary Emergency Substitutions of this solicitation here 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 Overton Brooks Veteran Affairs Medical Center (OBVAMC) in Shreveport, LA under the solicitation/contract here in and in accordance with VAAR 852.209-70 Organizational Conflict of Interest (COI).None of the employees listed below in this 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 OBVAMC under the solicitation/contract here in.
Please identify also if they are an employee of the prime or subcontractor.
| NAME |
| Position/TITLE |
| PRIME OR SUBCONTRACTOR |
File details come from the government source that posted it. Updated .