Att D4 - Key Personnel and COI.docx

This is a Key Personnel and Conflict of Interest (COI) declaration form for the Phlebotomy Staffing Services solicitation at the Michael E. DeBakey VA Medical Center (MEDVAMC) in Houston, Texas. The form requires contractors to identify all Key Personnel and Temporary Emergency Substitutions while certifying that these individuals have no present, planned, past, financial, contractual, organizational, or actual conflicts of interest relating to the services to be provided under this contract in accordance with VAAR 852.209-70. Contractors must also designate whether each listed employee is associated with the prime contractor or a subcontractor.

The form is a template designed to document personnel information for the five-year phlebotomy staffing services contract (Solicitation Number 36C25626Q0476SSN) requiring 33,280 phlebotomist hours annually, with an option to increase by 11,050 additional hours through contract modification based on operational needs at the MEDVAMC. This attachment does not contain specific response dates, pricing information, or award terms; rather, it serves as a compliance document to ensure contractor personnel meet federal conflict of interest standards and organizational requirements established by the Department of Veterans Affairs.