Attachment-I.-Conflict-of-Interest-Affidavit.pdf
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- Solicitation number
- BPM058944
- Issued by
- Prince George's County, Choptank CDP, Maryland
About this file
This is a Conflict of Interest Affidavit form required by the Maryland Department of Transportation State Highway Administration (MDOT SHA) for the Chestertown Shop electrician on-call contract opportunity. The affidavit, effective July 2024, requires offerors to disclose any facts or circumstances that could create conflicts of interest, including situations where the offeror's objectivity in performing contract work might be impaired or where an unfair competitive advantage exists. The document defines "conflict of interest" and "person" according to COMAR regulations, applying to offerors, contractors, consultants, subcontractors, and their employees or agents with authority to control or supervise work. Offerors must warrant that no relevant facts or circumstances exist that would create conflicts, unless disclosed in the affidavit.
The affidavit requires offerors to immediately notify the procurement officer in writing if an actual or potential conflict of interest arises after the affidavit's date, including detailed descriptions of actions taken to avoid, mitigate, or neutralize the conflict. The document must be signed under penalty of perjury by an authorized representative and submitted with the bid or proposal. No specific response dates, award dates, or contract terms are included in this affidavit form itself; however, it applies to the electrician on-call contract for MDOT SHA Chestertown Shop, which requires licensed master, journeyman, and apprentice electricians at specified hourly rates for both regular scheduled work and emergency services, with materials billed at fair and reasonable MSRP pricing and no subcontracting allowed without pre-approval.
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Text version
Attachment I. Conflict of Interest Affidavit effective date: July 2024
Attachment I. 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
File details come from the government source that posted it. Updated .