Attachment-I.-Conflict-of-Interest-Affidavit.pdf
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- Solicitation number
- BPM053561
- Issued by
- Maryland
About this file
This is a Conflict of Interest Affidavit form required for the Maryland Department of Juvenile Services (DJS) Invitation for Bids to procure contractors for Community-Based Behavioral Health Evaluations across multiple regions of Maryland. The affidavit, effective July 2024, requires all offerors, contractors, consultants, and subcontractors to warrant that no conflicts of interest exist that would impair their ability to render impartial assistance or advice to the State or compromise their objectivity in performing contract work. The form must be submitted with all bid and proposal submissions and serves as a binding declaration under the penalties of perjury that all disclosed information is true and accurate to the best of the affiant's knowledge.
The affidavit defines "conflict of interest" as situations where other activities or relationships prevent impartial performance or create unfair competitive advantages. Offerors must disclose any relevant facts or circumstances in Section D that give rise to or could potentially create conflicts of interest, with detailed explanations and supporting documentation as needed. Additionally, contractors are obligated to immediately disclose in writing to the procurement officer any actual or potential conflicts that arise after the affidavit is signed, including a description of actions taken or proposed to mitigate or neutralize such conflicts. The form must be signed by an authorized representative and affirmed under oath, with performance of contract work to continue until the procurement officer provides contrary instructions regarding conflict resolution.
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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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