Attachment_11_-_Conflict_of_Interest.pdf
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- Solicitation number
- 140D0422R0016
About this file
This document contains a conflict of interest certification form and details of a federal contract opportunity with the Department of State. The conflict of interest certification form requires the contractor employee to certify that they are not aware of any financial interests or employment arrangements that could present a conflict of interest or limit their ability to work on contracts in an objective manner. They must disclose any potential conflicts that arise after certification.
The federal contract opportunity is a solicitation from the Department of Interior's Interior Business Center on behalf of the Department of State. It is for performance management, evaluation, and learning services to support the Department of State. No further details are provided on requirements, response dates, or value. The solicitation number and name indicate it relates to Department of State performance management.
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Text version
IBCM-AQD-6920-007
Version 1.1Page 6 of 6 Property of the United States Government. This document contains sensitive but unclassified information. Do not remove this notice. Properly destroy when no longer needed.
June 11, 2020
Attachment 1
CERTIFICATE FOR CONFLICT OF INTEREST
TO:
Contracting Officer
THROUGH:
Company Project Manager
FROM:
(Name of contractor employee)
I certify that I am not aware of any matter that might limit my ability to work on contracts and related actions in an objective and unbiased manner or which might place me in a position of a conflict, actual, potential, or apparent, between my responsibilities as a support contractor.
In making this certification, I have considered all my stocks, bonds, and other financial interests, and employment arrangements (past, present, or under consideration) and, to the extent known by me, all the financial interests and employment arrangements of my spouse, my minor children, and other members of my immediate household.
If, after the date of this certification, any person, firm, or other organization with which, to my knowledge, I (including my spouse, minor children, and other members of my immediate household) have a financial interest, or with which I have (or had) an employment arrangement, becomes involved in the acquisition I am responsible for, I will notify the Contracting Officer of this apparent conflict of interest. In such case, until advised to the contrary, I will not participate further in any way (by rendering advice and making recommendations) on the applicable contract and/or related action.
(Signature)
Date
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