Attachment-I.-Conflict-of-Interest-Affidavit.pdf
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- Solicitation number
- BPM058043
- Issued by
- Wicomico County, Maryland
About this file
This is a Conflict of Interest Affidavit form effective July 2024, governed by COMAR 21.05.08.08, required for submission with bids and proposals to the Maryland State Department of Education (MSDE) Division of Rehabilitation Services (DORS) for a Vehicle Equipment Adaptation Prescription Agreement (VEAPA) project. The affidavit requires the Offeror to warrant that no relevant facts or circumstances exist that would create a conflict of interest, defined as situations where a person's other activities or relationships impair their objectivity in performing contract work or provide an unfair competitive advantage. The form applies to all Offerors, Contractors, consultants, subcontractors, sub-consultants, and their employees or agents who have authority to control or supervise any portion of the work. Offerors must disclose all facts and circumstances that give rise to or could in the future give rise to a conflict of interest, providing detailed explanations and attaching additional documentation as necessary.
The affidavit further obligates the Offeror to immediately disclose in writing to the procurement officer any actual or potential conflict of interest that arises after the affidavit date, including a description of actions taken or proposed to avoid, mitigate, or neutralize such conflicts. If the contract has been awarded and performance has commenced, the Contractor must continue performance until directed otherwise by the procurement officer. The Offeror must execute the affidavit under penalties of perjury, certifying that all contents are true and correct to the best of their knowledge, information, and belief. This affidavit must be submitted with the bid or proposal and requires authorization by an authorized representative and affiant.
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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
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