Attachment 2 - Conflict of Interest Affidavit and Disclosure (2).pdf
PDF 27 KB Posted
- Solicitation number
- BPM054328
- Issued by
- Calvert County, Maryland
About this file
This Conflict of Interest Affidavit and Disclosure form is required by Jefferson Patterson Park & Museum (JPPM), a Maryland state agency, for all contractors bidding on the dry valve replacement project in Building 8. Contractors must complete and submit this affidavit along with other required documentation including a bid/proposal affidavit, proof of licenses or certifications, certificates of insurance, and acknowledgment of any amendments to the Invitation for Bid (IFB). The form serves as a mandatory submission requirement, and bids received without this completed documentation will be deemed non-responsive. Bids must be submitted by the specified due date via mail, fax, or email to Eric Frere (Assistant Director), Derek Mathieson (Maintenance Chief), or Dimitrios Papadakis (Maintenance Director) at JPPM.
The conflict of interest disclosure requires contractors to formally attest to any potential conflicts of interest that could affect their performance on the project or their ability to act impartially in the bidding process. No specific pricing, set-aside provisions, or incumbent information is detailed in this document, as it functions solely as a compliance and disclosure form rather than a pricing or award document. The form is a standard prerequisite for participation in the procurement process and does not establish financial terms, contract duration, or renewal options, which would be addressed in the primary IFB and resulting contract agreement.
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Text version
CONFLICT OF INTEREST AFFIDAVIT AND DISCLOSURE
A. "Conflict of interest" means that because of other activities or relationships with other persons, a person is unable or potentially unable to render impartial assistance or advice to the State, or the person's objectivity in performing the contract work is or might be otherwise impaired, or a person has an unfair competitive advantage.
B. "Person" has the meaning stated in COMAR 21.01.02.01B(64) and includes a bidder, offeror, contractor, consultant, or subcontractor or subconsultant at any tier, and also includes an employee or agent of any of them if the employee or agent has or will have the authority to control or supervise all or a portion of the work for which a bid or offer is made.
C. The bidder or offeror warrants that, except as disclosed in §D, below, there are no relevant facts or circumstances now giving rise or which could, in the future, give rise to a conflict of interest.
D. The following facts or circumstances give rise or could in the future give rise to a conflict of interest (explain detail—attach additional sheets if necessary):
E. The bidder or offeror agrees that if an actual or potential conflict of interest arises after the date of this affidavit, the bidder or offeror shall immediately make a full disclosure in writing to the procurement officer of all relevant facts and circumstances. This disclosure shall include a description of actions which the bidder or offeror has taken and proposes to take to avoid, mitigate, or neutralize the actual or potential conflict of interest. If the contract has been awarded and performance of the contract has begun, the contractor shall continue performance until notified by the procurement officer of any contrary action to be taken.
I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE
CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE,
INFORMATION, AND BELIEF.
Date:____________________
By:______________________________________ (Authorized Representative and Affiant)
File details come from the government source that posted it. Updated .