Attachment 2 Conflict of Interest Statement.pdf

3 MB Posted

Attached to
St. Cloud, Certified Registered Nurse Anesthetist (CRNA) Services
Solicitation number
36C26324Q0024
Issued by

About this file

Written by GovTribe AI ·

This document contains a conflict of interest certification statement and information about a federal contract opportunity for certified registered nurse anesthetist (CRNA) services. The conflict of interest certification statement requires the contractor to disclose any present or planned conflicts of interest relating to the services to be provided under solicitation number 36C26324Q0024. This solicitation is being offered by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 23 and is seeking CRNA services at the St. Cloud VA Health Care System. The solicitation number, agency details, and requirement for CRNA services provide key information about the federal contracting opportunity addressed in this document.

View the file

Other files

File Type Posted
36C26324Q0024 0001.pdf PDF
36C26324Q0024 St. Cloud CRNA Services RFQ.pdf PDF
Attachment 3 Contractor Rules of Behavior.pdf PDF
Attachment 5 Local St. Cloud Policy Documents.zip ZIP file
Attachment 7 Past Performance.pdf PDF
Attachment 6 Offeror Proposed Pricing.xlsx XLSX spreadsheet
36C26323Q0613 St. Cloud CRNA Services RFQ.pdf PDF
Attachment 1 - Quality Assurance Surveillance Plan.pdf PDF
Attachment 4 Immigration and Nationality Act Certification.pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

SOLICITATION #:

CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT

] ____________________________________ represents that no individuals involved with the solicitation ________________________________ in have no present, or currently planned interest

(financial, contractual, organizational, or otherwise) or actual or organizational conflicts of interest relating to the services to be provided to the St. Cloud VA Health Care System under the referenced solicitation.

None of the employees listed in the solicitation have a past interest (financial, contractual, organizational, or otherwise) or actual or organizational conflicts of interest relating to the services to be provided to the St. Cloud VA Health Care System under the referenced solicitation.

OR

[ ] Statement attached describing, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided under this solicitation. The offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.

NAME OF CERTIFYING OFFICIAL

TITLE

SIGNATURE DATE

Organizational Conflicts of Interest Contractor Certification

CONTRACTOR NAME:

ADDRESS:

Text3:
Contractor Company:
Solicitation#: 36C26324Q0024
Address:
No COI affirmation: Choice1
Date7_af_date:

File details come from the government source that posted it. Updated .