Attachment_3_-_OCI_Statement_Updated_05_20_2025.docx
DOCX document 26 KB Posted
- Attached to
- Benefit Connect Licenses Federal contract opportunity
- Solicitation number
- 16PBGC25Q0057
- Issued by
- Pension Benefit Guaranty Corporation
About this file
This document is an Organizational Conflict of Interest (OCI) Statement template for a federal contract opportunity (RFQ 16PBGC25Q0057) issued by the Pension Benefit Guaranty Corporation (PBGC). The template provides two sample OCI statements - one for the primary offeror and another for subcontractors, consultants, and teaming partners. Both samples require the signatory to affirm they are not aware of any actual or potential conflicts of interest related to the contract and commit to immediately disclosing any such conflicts that may arise during contract performance.
The associated federal contract opportunity is a sole source solicitation for Benefit Connect (BC) licenses and system support from Willis Towers Watson (WTW). The purpose is to provide PBGC staff with a benefit administration support system that allows access to critical data for conducting research, performing benefit calculations, and managing benefits for approximately 90,000 participants in the Sears Pension plans. The OCI statement is a mandatory component of the solicitation, requiring all parties involved in the bid to certify their conflict-free status.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_16PBGC25Q0057_Amd_0002.pdf | ||
| 16PBGC25Q0057 0002 Attachment 4 - Question and Answer_Final.xlsx | XLSX spreadsheet | |
| Sol_16PBGC25Q0057_Amd_0001_signed.pdf | ||
| Sol_16PBGC25Q0057_Amd_0001.pdf | ||
| Sol_16PBGC25Q0057.pdf | ||
| 16PBGC25Q0057_Attachment_2_-__Pricing_Schedule.xlsx | XLSX spreadsheet | |
| 16PBGC25Q0057_Attachment_5_-_Sole_Source_Justification_Redacted.pdf | ||
| 16PBGC25Q0057_Attachment_1_-_Statement_of_Work.pdf | ||
| 16PBGC25Q0057_Attachment_4_-__Question_and_Answer_Template.xlsx | XLSX spreadsheet |
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Text version
ATTACHMENT 3
ORGANIZATIONAL CONFLICT OF INTEREST (OCI) STATEMENT
SAMPLE 1 – The following is an example of the OCI statement that each offeror shall complete and sign. All information pertaining to OCI is outlined in Section 11.4.7.
(Insert Offeror Name) is responding to Request for Quote (RFQ) 16PBGC25Q0057. In accordance with solicitation Section 11.4.4, (Inset Offeror Name) has reviewed the requirements of the RFQ and the Federal Acquisition Regulation (FAR) Subpart 9.5.
(Insert Offeror Name) is not aware of any facts which create any actual or potential OCI relating to the award of this contract. (Insert Offeror Name) agrees to immediately disclose all information concerning any actual or potential OCI during the performance of the contract.
Insert Offeror Name
| __________________________________ | _____________ | |
| Insert Offeror Point of Contact (POC) Name* | Date |
POC Title
*Person must have the authority to bind the company.
SAMPLE 2 - The following is an example of the OCI statement that each subcontractor, consultant, and teaming partner shall complete and sign. All information pertaining to OCI is outlined in Section 11.4.7.
(Insert Company Name) is participating as a subcontractor to (Insert Offeror Name) in response to Request for Quote (RFQ) 16PBGC25Q0057. In accordance with solicitation Section 11.4.7, (Insert Company Name) has reviewed the requirements of the contract and the Federal Acquisition Regulation (FAR) Subpart 9.5.
(Insert Company Name) is not aware of any facts which create any actual or potential OCI relating to the award of this contract. (Insert Company Name) agrees to immediately disclose all information concerning any actual or potential OCI during the performance of the contract.
Subcontractor, Consultant, Teaming Partner
| __________________________________ | _____________ | |
| Point of Contact (POC) Name* | Date |
POC Title
*Person must have the authority to bind the company.
File details come from the government source that posted it. Updated .