Attachment G -Conflict-of-Interest-Affidavit.pdf

PDF 264 KB Posted

Attached to
Residential Child Care Services
Solicitation number
BPM054507
Issued by
Maryland

About this file

This is a Conflict of Interest Affidavit form effective July 2024, required for submission with bids or proposals to the Maryland Department of Human Services, Social Services Administration (SSA) for Residential Child Care Services contracts. The affidavit requires offerors, contractors, consultants, and subcontractors at any tier to certify that no conflicts of interest exist that would impair their ability to render impartial assistance or advice to the State or compromise objectivity in performing contract work. The form defines "conflict of interest" as circumstances arising from other activities or relationships that could prevent impartial performance or create unfair competitive advantages. Offerors must disclose all relevant facts and circumstances that give rise to or could potentially give rise to conflicts of interest, with detailed explanations and supporting documentation as necessary.

The affidavit imposes an ongoing obligation on offerors and contractors to immediately notify the procurement officer in writing if an actual or potential conflict of interest arises after the affidavit is executed. Any such disclosure must include a comprehensive description of actions taken and proposed to mitigate, avoid, or neutralize the conflict. If a contract has already been awarded and performance has commenced, the contractor must continue performance until receiving contrary direction from the procurement officer. The affidavit must be executed under oath with penalties of perjury and signed by an authorized representative and affiant, then submitted with the bid or proposal.

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Attachment G Conflict of Interest Affidavit effective date: July 2024

Attachment G. Conflict of Interest Affidavit and Disclosure

Reference COMAR 21.05.08.08

A. “Conflict of interest” means that because of other activities or relationships with other persons, a person is unable or potentially unable to render impartial assistance or advice to the State, or the person’s objectivity in performing the contract work is or might be otherwise impaired, or a person has an unfair competitive advantage.

B. “Person” has the meaning stated in COMAR 21.01.02.01B(64) and includes a Offeror, Contractor, consultant, or subcontractor or sub-consultant at any tier, and also includes an employee or agent of any of them if the employee or agent has or will have the authority to control or supervise all or a portion of the work for which a Proposal is made.

C. The Offeror warrants that, except as disclosed in §D, below, there are no relevant facts or circumstances now giving rise or which could, in the future, give rise to a conflict of interest.

D. The following facts or circumstances give rise or could in the future give rise to a conflict of interest (explain in detail — attach additional sheets if necessary):

E. The Offeror agrees that if an actual or potential conflict of interest arises after the date of this affidavit, the Offeror shall immediately make a full disclosure in writing to the procurement officer of all relevant facts and circumstances. This disclosure shall include a description of actions which the Offeror has taken and proposes to take to avoid, mitigate, or neutralize the actual or potential conflict of interest. If the contract has been awarded and performance of the contract has begun, the Contractor shall continue performance until notified by the procurement officer of any contrary action to be taken.

I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE

CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY

KNOWLEDGE, INFORMATION, AND BELIEF.

Date: ____________________ By: ______________________________________

(Authorized Representative and Affiant)

SUBMIT THIS AFFIDAVIT WITH BID/PROPOSAL

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