Attachment 2 - Conflict of Interest Affidavit and Disclosure (24).pdf
PDF 57 KB Posted
- Attached to
- Elevator Maintenance and Inspections
- Solicitation number
- BPM057957
- Issued by
- Calvert County, San Mar CDP, Maryland
About this file
This is a Conflict of Interest Affidavit and Disclosure form required for the Elevator Maintenance and Inspections contract opportunity with Jefferson Patterson Park and Museum (JPPM) in Maryland. The affidavit serves as a declaration document that bidders must complete and submit as part of their proposal process. The form requires contractors to disclose any potential conflicts of interest related to the project, including financial interests, business relationships, or other circumstances that could compromise their objectivity or create ethical concerns in performing elevator maintenance and inspection services at the museum facility located in Saint Leonard, Maryland.
The disclosure requirements outlined in this affidavit are standard procurement practice for state and local government contracts in Maryland and are intended to ensure fair competition and maintain the integrity of the bidding process. Contractors, including those seeking Certified Small Business (CBS), Small Business Reserve (SBR), Small Business Preference (SBP), or Veteran-Owned Small Business Enterprise (VSBE) designations, must complete and submit this form as a mandatory requirement. Failure to disclose known conflicts of interest or submitting false information on this affidavit may result in bid rejection or disqualification from consideration for contract award.
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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)
Date:
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