Attachment 03 OCI Disclosure and Analysis Form.docx
DOCX document 31 KB Posted
- Attached to
- Cyber Training and Education Pilot
- Solicitation number
- FA701425Q0048
About this file
The document is an Organizational Conflict of Interest (OCI) Disclosure and Analysis Form for the United States Space Force (USSF). The form is designed to help contractors self-identify and disclose potential conflicts of interest across six key areas, including systems engineering, technical direction, specification preparation, technical evaluations, proprietary information access, and product/hardware provision. Contractors are instructed to complete a separate form for each functional area, providing details about their company, specific contract numbers, and a comprehensive assessment of actual or potential organizational conflicts.
The form requires detailed documentation of potential conflicts, including a summary of work performed, a determination of whether an actual or potential OCI exists, and proposed mitigation actions to neutralize any identified conflicts. Contractors must save the completed form using a specific naming convention (OCI-Company Name or Abbreviation) and are expected to reference the specific solicitation for guidance on form submission and use. The form serves as a critical compliance mechanism for contractors to transparently disclose and address potential organizational conflicts that could impact their ability to perform contract work objectively and ethically.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
USSF
OCI Disclosure and Analysis Form
Instructions: Use the "Tab" key and /or mouse pointer to navigate this form. Upon completing this form save using the following name format: "OCI-Company Name or Abbreviation". Reference solicitation for guidance on use and submittal of this form.
NOTE: Submit one OCI Disclosure and Analysis Form for EACH functional area or sub-area requiring analysis and a Government OCI determination.
Blocks 1 - 3: Self Explanatory
Block 4(a-f): Place an "X" in the appropriate box for the types of work where you believe conflicts of interest, real or perceived, exist. Immediately to the right, list the USSF contract/subcontract numbers with titles needing analysis and a Contracting Officer determination.
Block 4: Provide brief summaries of the work performed under the contract/subcontract(s) listed in Block 5. Include the period of performance and the total contract value.
Block 6: Circle applicable statement if you believe an OCI exists - If neither is believed to exist, there is no need to submit this form.
Block 7: If you circle either statement in Block 6, provide a description of the OCI and proposed mitigation actions to avoid or neutralize the conflict. (May be submitted as an attachment to this form.)
| 1. Solicitation/Contract Number: |
| 2. Program Title |
3. Your Company's Name, Address, and POC:
a. Company Name
b. Address
c. City
d. State
e. Zip Code
f. POC Name
g. Phone
h. POC E-mail
4. Areas of work that could cause a conflict for your company (complete only one area per form):
a. Providing Systems Engineering and Technical Direction
b. Preparing Specifications or Work Statements
c. Providing Technical Evaluation or Advisory & Assistance Services
d. Access to Proprietary Information of Others
e. Providing products, hardware, or software to USSF or another contractor for use within USSF
f. USSF Contracts/USSF Funded Contracts
5. Summary/Description of work performed under contracts identified in Block 4:
6. OCI Evaluation and Assessment:
| Actual OCI Exists |
| Potential for OCI exists |
7. Descriptive summary of each actual/potential OCI, including mitigation actions planned to avoid or neutralize the conflict:
File details come from the government source that posted it. Updated .