Attachment 3 - OCI Representation Disclosure Statement.pdf
PDF 69 KB Posted
- Attached to
- Consulting Engineering Geologist Services for the U. S. Federal Energy Regulatory Commission
- Solicitation number
- 89603026Q0061
About this file
This file is an Organizational Conflict of Interest (OCI) representation and disclosure template for federal contract solicitations. The attachment presents two mutually exclusive certification options that respondents must complete, but not both.
The OCI Representation Statement allows a respondent to certify that no facts exist relevant to past, present, or currently planned interests or activities that would create a possible conflict of interest regarding the ability to render impartial, technically sound, and objective assistance or advice, or to provide an unfair competitive advantage. The OCI Disclosure Statement provides an alternative for respondents who cannot make an unqualified representation and must instead disclose all relevant facts concerning potential conflicts. When selecting the disclosure option, respondents must organize information into four categories (organizational, contractual, financial, or other) and provide a brief description of the relationship, the period of the relationship, the extent of the relationship (including financial value or work percentages), and a mitigation plan if necessary. Both statements require signature, date, name, title, and organization information from the certifying representative. The template includes a footnote clarifying that an unfair competitive advantage does not include normal benefits resulting from contract performance.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 7- RFQ 89603026Q0061 Pricing Template.xlsx | XLSX spreadsheet | |
| 89603026Q0061.pdf | ||
| Attachment 5 - FERC NDA Contractors Employee Mar 2022.docx | DOCX document | |
| Attachment 4 - Contractors CEII Non-Disclosure Agreement.docx | DOCX document | |
| Attachment 8 - Questions Template.xlsx | XLSX spreadsheet | |
| Attachment 2 - OCI Questionnaire.pdf | ||
| Attachment 1 - Statement of Work Engineering Geologist.pdf | ||
| Attachment 6 - FERC NDA Contractor Mar 2022.docx | DOCX document |
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Text version
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ATTACHMENT 3
COMPLETE EITHER THE REPRESENTATION OR THE DISCLOSURE –
NOT BOTH
OCI Representation Statement
I hereby certify (or as a representative of my organization, I hereby certify) that, to the best of my knowledge and belief, no facts exist relevant to any past, present or currently planned interest or activity (financial, contractual, personal, organizational or otherwise) that relate to the proposed work; and bear on whether I have (or the organization and any of its affiliates has) a possible conflict of interest with respect to (1) being able to render impartial, technically sound, and objective assistance or advice; or (2) being given an unfair1 competitive advantage.
Signature : Date :
Name : Title :
Organization :
OCI Disclosure Statement
I hereby certify (or as a representative of my organization, I hereby certify) that, to the best of my knowledge and belief, all relevant facts -- concerning past, present, or currently planned interests or activities (financial, contractual, organizational or otherwise) that relate to the proposed work and bear on whether I have (or the organization has) a possible conflict of interest with respect to (1) being able to render impartial, technically sound, and objective assistance or advice, or (2) being given an unfair competitive advantage—are fully disclosed on the following page(s) and formatted to show:
For ease of presentation, the OCI information is divided into four parts, indicating whether the possible OCI is: organizational, contractual, financial, or other;
The company, agency, organization in which I (or my organization) have a past, present, or currently planned interest or activity (financial, contractual, organizational, or otherwise);
1 An unfair competitive advantage does not include the normal flow of benefits from the performance of the contract.
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A brief description of the relationship;
The period of the relationship;
The extent of the relationship (such as value of financial interest of work;
percent of total holdings, total work, etc.); and A mitigation plan, if necessary.
Signature : Date :
Name : Title :
Organization :
File details come from the government source that posted it. Updated .