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

PDF 95 KB Posted

Attached to
COMMUNITY-BASED BEHAVIORAL HEALTH EVALUATIONS FOR MULTIPLE REGIONS
Solicitation number
BPM053561
Issued by
Maryland

About this file

This Conflict of Interest Affidavit is a required submission document for the Maryland Department of Juvenile Services' procurement of behavioral health evaluation contractors serving three geographic regions (Eastern, Capital South, and Western) across the state. Offerors must certify under penalty of perjury that no conflicts of interest exist that would impair their ability to render impartial assistance to the State or provide an unfair competitive advantage, with the affidavit effective as of July 2024. The affidavit requires disclosure of any relevant facts or circumstances that could give rise to conflicts of interest, applies to all offerors, contractors, consultants, subcontractors, and their respective employees or agents with authority to control or supervise contract work, and must be completed and submitted with the bid or proposal by the April 1, 2026 deadline at 2:00 p.m. via eMMA. Offerors are obligated to immediately disclose in writing to the procurement officer any actual or potential conflicts of interest that arise after execution of the affidavit, including a detailed description of actions taken or proposed to mitigate or neutralize such conflicts; if a contract has been awarded and performance has commenced, the contractor shall continue performance until directed otherwise by the procurement officer.

No pricing, set-asides, funding sources, or renewal information is contained within this affidavit document; these details are addressed separately in the solicitation materials. The affidavit serves as a compliance and ethical certification requirement rather than a substantive procurement term document. All authorized representatives signing the affidavit must do so under the penalties of perjury, affirming the truthfulness and accuracy of the conflict of interest disclosures to the best of their knowledge, information, and belief.

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Appendix 6 Psychiatric Eval & Certificate of Need Templates.pdf PDF
Appendix 1 Abbreiviations and Definitions.pdf PDF
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Appendix 5 Updated TOJ Template January 2025.pdf PDF
Attachment-F.-Bidder-Offeror-Information-Sheet.pdf PDF
Attachment-A.-Bid-Proposal-Affidavit.pdf PDF
BID FORM- BH Evals Regions Capital, Eastern, Western 5 Year Contract- .xlsx XLSX spreadsheet
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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

File details come from the government source that posted it. Updated .