Attachment I. Conflict of Interest Affidavit.pdf
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- Solicitation number
- BPM058745
- Issued by
- Baltimore City, Maryland
About this file
This is a Conflict of Interest Affidavit form issued by the Maryland State Department of Education, Division of Rehabilitation Services for procurement R00B7600017 regarding Personal Care Assistants (PCAs) for the Workforce and Technology Center located in Baltimore, Maryland. The affidavit requires offerors, contractors, consultants, subcontractors, and their employees or agents with control or supervisory authority over contract work to disclose any actual or potential conflicts of interest that could impair their objectivity or render impartial assistance to the State. Offerors must warrant that no relevant facts or circumstances exist that could give rise to conflicts of interest, except as disclosed in the affidavit. The form must be completed and submitted with all bid or proposal submissions.
The affidavit requires offerors to immediately disclose in writing to the procurement officer any actual or potential conflicts of interest that arise after the affidavit date, including a detailed description of actions taken or proposed to avoid, mitigate, or neutralize such conflicts. The affiant must solemnly declare under penalties of perjury that the contents are true and correct to the best of their knowledge. This procurement is designated as a Certified Small Business (CSB), formerly known as Small Business Reserved (SBR), restricting bidding eligibility to qualified small businesses only.
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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
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