ATTACHMENT 2 - CONTRACTOR CONFLICT OF INTEREST.doc
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- Solicitation number
- 36C25724Q0141_2
About this file
This document includes an attachment requiring disclosure of potential organizational conflicts of interest as part of a solicitation for urology physician services. The solicitation seeks a board certified, robotics trained urologist to provide full scope operative services at the Olin E. Teague Veterans Medical Center in Temple, Texas. Offerors must complete the attachment certification statement disclosing any past, present or planned financial, contractual, organizational or other interests that could present an actual or potential conflict of interest relating to the services solicited. Relevant facts showing how the offeror would avoid or mitigate any conflicts of interest may also be provided.
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Other files
| File | Type | Posted |
|---|---|---|
| S02 AMENDMENT 0001 - 36C25724Q0141.docx | DOCX document | |
| ATTACHMENT 3 - CONTRACTOR CERTIFICATION - IMMIGRATION AND NATIONALITY ACT.pdf | ||
| 36C25724Q0141_2 3 Jan 24.docx | DOCX document | |
| ATTACHMENT 4 - CONTRACTOR RULES OF BEHAVIOR.pdf | ||
| ATTACHMENT 1 - QASP - UROLOGY PHYSICIAN.docx | DOCX document |
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Text version
All healthcare contracts require response to the following provision as prescribed in VAAR 809.507‐1(b). Please use the form in Attachment 2 to provide response.
852.209‐70 Organizational Conflicts of Interest (OCT 2020)
(a) It is in the best interest of the Government to avoid situations which might create an organizational conflict of interest or where the Offeror's performance of work under the contract may provide the Contractor with an unfair competitive advantage. The term “organizational conflict of interest” means that because of other activities or relationships with other persons, a person is unable to render impartial assistance or advice to the Government, or the person's objectivity in performing the contract work is or might be otherwise impaired, or the person has an unfair competitive advantage.
(b) The Offeror shall provide a statement with its offer which describes, 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.
(c) Based on this information and any other information solicited or obtained by the Contracting Officer, the Contracting Officer may determine that an organizational conflict of interest exists which would warrant disqualifying the Contractor for award of the contract unless the organizational conflict of interest can be mitigated to the Contracting Officer's satisfaction by negotiating terms and conditions of the contract to that effect. If the conflict of interest cannot be mitigated and if the Contracting Officer finds that it is in the best interest of the United States to award the contract, the Contracting Officer shall request a waiver in accordance with FAR 9.503.
(d) Nondisclosure or misrepresentation of actual or potential organizational conflicts of interest at the time of the offer or arising as a result of a modification to the contract, may result in the termination of the contract at no expense to the Government.
Attachment 2
SOLICITATION: 36C25724Q0141
CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT
[ ] ______________________ represents that the individual(s) listed in the Key Personnel and Temporary Emergency Substitutions section of the solicitation [36C25724Q0141 – Urology Physician Services] and 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 Central Texas 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 Central Texas 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
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