Attachment 2 - Conflict of Interest Affidavit and Disclosure (27).pdf
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- Attached to
- Septic Pump Station Repairs
- Solicitation number
- BPM058677
- Issued by
- Calvert County, Maryland
About this file
This is a Conflict of Interest Affidavit and Disclosure form required for bidders and offerors on a Septic Pump Station Repairs project at Jefferson Patterson Park & Museum (JPPM) in Maryland. The affidavit requires bidders to warrant that no conflicts of interest exist, except as disclosed in the form, and to define "conflict of interest" as circumstances where a person is unable or potentially unable to render impartial assistance to the State, where objectivity in performing contract work is impaired, or where an unfair competitive advantage exists. A mandatory prebid meeting is scheduled for September 15, 2026, at 9:00 am in the Maintenance Office, and any bid received from offerors who did not attend this meeting will not be accepted. The repair work involves the septic pump station located near the MAC Lab at 10505 Mackall Road, with project specifications provided in the Invitation for Bid.
Bidders and offerors must complete this affidavit, which includes certification under penalties of perjury that all information provided is true and correct. The form defines "person" to include bidders, offerors, contractors, consultants, subcontractors, and their employees or agents with authority to control or supervise any portion of the work. Bidders are required to immediately disclose any actual or potential conflicts of interest that arise after the affidavit date in writing to the procurement officer, including a description of actions taken to avoid, mitigate, or neutralize the conflict. Preference for award is given to Certified Small Business and Veteran-Owned Small Business Enterprises. The affidavit must be signed by an authorized representative and affiants, with the form serving as Attachment 2 to the overall bid package.
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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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