Attachment C Exhibit 3 - Individual COI and NDA.pdf
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- Solicitation number
- 36C10F26R0045
About this file
This is a template form for an Individual Conflict of Interest and Non-Disclosure Statement required in federal contracting.
The form must be completed by all contractor firm personnel, including subcontractor staff, who receive access to information or documents related to a task order. The form requires identification of the contractor, contract number, and order number. Section A addresses conflict of interest obligations, requiring signatories to acknowledge they have read the relevant conflict of interest clause and agree to comply with restrictions regarding actual or potential organizational conflicts of interest and personal financial interests. Section B covers nondisclosure of procurement-sensitive information, requiring acknowledgment that task order-related documents contain source selection information protected under Section 27 of the Office of Federal Procurement Policy Act (41 USC 423), and that unauthorized disclosure may result in contractual, civil, or criminal penalties. This section also references Federal Acquisition Regulation 9.505-4(b) requirements for protecting offeror information from unauthorized use or disclosure. Section C specifically addresses nondisclosure of proprietary information submitted by offerors in response to a Solicitation for Officers (SF0), prohibiting disclosure during or after task order performance, with potential penalties including fines, jail time, or contract termination. The form concludes with signature lines for typed name, signature, date, and title.
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EXHIBIT 3
Individual Conflict of Interest and Non-Disclosure Statement
(This form shall be completed by all parties in the contractor's firm (including subcontractor personnel) who are provided access to information or documents related to this task order.)
Contractor:
Contract Number:
Order Number:
A. Conflict of Interest
I have read the Conflict of Interest Clause in the above referenced solicitation/contract and understand and agree to abide with the restrictions regarding an actual or potential organizational conflict of interest or personal financial interest.
B. Nondisclosure of Procurement Sensitive Information
I understand that information and documents related to the work to be performed for the above referenced task order contain source selection information related to the conduct of a Federal agency procurement, the disclosure of which is restricted by Section 27 of the Office of Federal Procurement Policy Act (41 USC. 423). The unauthorized disclosure of such information may subject both the discloser and recipient of the information to contractual, civil, and/or criminal penalties as provided by law.
I further understand the requirements identified under Federal Acquisition Regulation 9.505-4(b) to entered into agreements with offerors to protect their information from unauthorized use or disclosure, and refrain from using their information for any purpose other than for which it was furnished.
Information regarding a task order is strictly prohibited and shall not be revealed to any source except to the extent authorized by the Lease Contracting Officer.
C. Nondisclosure of Information Submitted by Offerors in response to a Solicitation for Officers
(SF0).
I understand that disclosure of proprietary information submitted by an Offeror in response to an SF0 is strictly prohibited. It shall not be disclosed to any source either during or after performance on the task order. Disclosure of such information could result in a penalty of fine, jail time, or termination of this contract for breach.
(Typed) Name & Signature Date:
Title:
| EXHIBIT 1 |
| EXHIBIT 2 |
| EXHIBIT 3 |
| EXHIBIT 4 |
| Exhibit 5 |
| 1. SPECIAL REQUIREMENTS DESCRIPTION |
| a. Task Order Authorization |
| S02 Exhibit 5 VHA Real Property Leasing Guide (Rev 12-18-2018) (003).pdf |
| CHAPTER 1. INTRODUCTION |
| 1.1. Purpose |
| 1.2. Scope |
| 1.3. Applicability |
| 1.4. VA Leasing Authority |
| 1.5. VHA Mission Statement |
| 1.6. About VHA |
| 1.7. Special Situations |
| 1.8. Leasing Program Responsibility Alignment (VAIQ 7714305) |
| 1.9. VHA Center for Leasing Excellence |
| 1.9.1. Mission |
| 1.9.2. Responsibilities |
| 1.9.3. Goals |
| CHAPTER 2. TYPES OF LEASES, AUTHORITY FOR LEASE APPROVAL AND PROCUREMENT, GOVERNING REGULATION FOR FEDERAL REAL PROPERTY LEASE |
| 2.1 Types of Lease |
| 2.1.1 Assignments of Space by General Service Administration (GSA) |
| 2.1.2 VA Direct Leases |
| 2.2 Approval for Lease Procurement |
| 2.2.1 Approvals Pursuant to VA Directive 7815 |
| 2.2.2 Approval from Strategic Capital Investment Program (SCIP) |
| 2.2.3 For Build-To-Suit Leases and Leases of Existing Space below the Prospectus Threshold of $1,000,000 in Annual Unserviced Rent |
| 2.2.4 For Build-to-Suit Leases and Leases at and above the Prospectus Threshold of $1M in Annual Unserviced Rent |
| 2.3 Leases Procured by VHA & Leases Procured by ORP |
| 2.3.1 Leases Procured by VHA |
| 2.3.2 Leases Procured by VA Central Office (VACO) Office of Real Property (ORP) |
2.4 Laws, Statutes, Executive Orders (EO), and Regulations Governing VA Real Property Lease Acquisitions
| CHAPTER 3. LEASE PROCUREMENT PROCESS |
| 3.1. Pre-Acquisition |
| 3.2. Acquisition Planning |
| 3.2.1. Procurement Acquisition Lead Times (PALT) |
| 3.2.2. Receipt of Procurement Request Package from the Requesting Service |
| 3.2.3. Establishing the Acquisition Team |
| 3.2.4. Establishing the Requirements |
| 3.2.5. Priority Consideration for Government-Controlled Space |
| 3.2.6. Applicability of Veterans First Contracting Program (38 U.S.C. §§ 8127-8128). |
| 3.2.7. Creating Competition for VA Direct Lease Procurement |
| 3.2.8. Market Survey |
| 3.2.9. Other than Full and Open Competition (OFOC) |
| 3.2.10. Lease Scoring |
| 3.2.11. Request for Delegation of Authority to GSA through the GSA Real Estate Exchange (GREX) System |
| 3.2.12. Written Acquisition Plan |
| 3.3. Pre-Solicitation |
| 3.3.1. How to Build the Request for Lease Proposal |
| 3.3.2. RLP and Lease Forms |
| 3.3.3. Source Selection Plan (SSP) |
| 3.3.4. Mandatory Review & Approval of RLP Package and Lease File Checklists |
| 3.4. Solicitation |
| 3.4.1. Issuance of RLP Package |
| 3.4.2. Receipt and Handling of Proposals |
| 3.5. Source Selection |
| 3.6. Negotiation |
| 3.7. Proposal Revisions and Review of Final Offers |
| 3.8. Preparation for Award |
| 3.9. Lease Award Process |
| 3.10. Post-Award Debriefing/Protests |
| 3.10.1. Debriefing |
| 3.10.2. Protests Against Award |
| 3.11. Post-Award Notification |
| 3.12. Post-Award Design, Construction, and Acceptance |
| 3.12.1. Meeting to Commence Project |
| 3.12.2. Commencement of Design, Construction, and Acceptance Phase |
| 3.13. Lease Commencement and Closeout |
| 3.13.1. Overview |
| 3.13.2. Lease Activation |
| 3.13.3. Closeout of Existing Lease |
| CHAPTER 4. TYPES OF LEASE ACTIONS |
| 4.1. Simplified Lease Acquisition Procedure (SLAP) |
| 4.2. New or Replacing Leases Over the Simplified Lease Acquisition Threshold |
| 4.3. Succeeding and Superseding Lease |
| 4.4. Extension |
| 4.5. Expansion |
| 4.6. Renewal Options |
| 4.7. Warehouse Lease |
| 4.8. Parking Acquisition |
| 4.9. Hoteling |
| CHAPTER 5. ALTERATION IN LEASED SPACE |
| CHAPTER 6. LEASE ADMINISTRATION: RENT ADJUSTMENT, TAX ADJUSTMENT, NOVATION, SUBORDINATION NON-DISTURBANCE AND ATTORNMENT (SNDA), ESTOPPEL |
| CHAPTER 7. HOLDOVER AND STANDSTILL AGREEMENT |
| CHAPTER 8. LEASE CLOSEOUT |
| CHAPTER 9. SPECIAL TOPICS |
| 9.1 Strategic Capital Investment Program (SCIP) |
| 9.2 Sustainability |
| 9.3 Security |
| 9.4 Fire Protection and Life Safety |
| 9.5 Seismic Safety in Leasing |
| 9.6 National Broker Contract |
| 9.7 Determination of Operation and Capital Lease |
| 9.8 Government Self-Insurance for General Liability |
| 9.9 Obligation of Funds for Lease Actions |
| 9.10 Lease Ratification Process |
| CHAPTER 10. CONTRACT-RELATED SYSTEMS (eCMS, FPDS, GREX) |
| 10.1 Electronic Contract Management System (eCMS) |
| 10.2 Federal Procurement Data System-Next Generation (FPDS). |
| 10.3 GSA Real Estate Exchange (G-REX). |
| CHAPTER 11. FINANCIAL AND ACCOUNTING SYSTEM (FMS and IFCAP) |
| 11.1 Financial Management System (FMS) |
| 11.2 Integrated Funds Distribution, Control Point Activity, Accounting and Procurement (IFCAP) |
| CHAPTER 12. BACKGROUND INVESTIGATIONS |
| CHAPTER 13. LEASE TERMINOLOGY |
| CHAPTER 14. ADDITIONAL ABBREVIATIONS AND ACRONYMS |
| CHAPTER 15. REFERENCES |
| CHAPTER 16. APPENDIX/LIST OF ATTACHMENTS |
| Appendix A-P.pdf |
| GAO Decision B- 415137, Applicability of JWOD Act.pdf |
| Decision |
| S02 QASP Real Estate Acquisition Support Services.pdf |
| 1.0 Purpose |
| 1.1 Performance Management Approach |
| 1.2 Performance Management Strategy |
| 1.2.1 Performance Feedback |
| 2.0 Government Roles and Responsibilities |
| 3.0 Contractor Representatives |
| 4.0 Performance Standards |
| 5.0 Methods of QA Surveillance |
| 6.0 Acceptable Levels of Performance (ALP) |
| 7.0 Incentives |
| 8.0 Documenting Performance |
| 9.0 Frequency of Measurement |
| EVALUATION RATINGS DEFINITIONS |
| PERFORMANCE BASED SERVICE ASSESSMENT |
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