Attachment-I.-Conflict-of-Interest-Affidavit.pdf
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- Attached to
- 26-MULTI-FS-MS-007 Laboratory Services
- Solicitation number
- BPM053317
- Issued by
- Maryland
About this file
This is a Conflict of Interest Affidavit form for the State of Maryland, specifically for a Laboratory Services contract (26-MULTI-FS-MS-007) under the Department of Juvenile Services. The affidavit, effective July 2024, requires offerors, contractors, consultants, and subcontractors at any tier to disclose any actual or potential conflicts of interest that could impair their objectivity or provide unfair competitive advantage in performing contract work. Offerors must warrant that no relevant facts or circumstances exist that would create a conflict of interest, except as disclosed in the affidavit. The form requires detailed explanation of any conflicts, with additional sheets available if necessary. Offerors must submit this completed affidavit with their bid or proposal and are obligated to immediately disclose in writing to the procurement officer any conflicts of interest that arise after the affidavit date, including descriptions of actions taken to mitigate or neutralize such conflicts.
The affidavit must be executed under penalty of perjury by an authorized representative and includes provisions requiring continued contract performance until the procurement officer directs otherwise, even if conflicts arise after contract award and performance has begun. This document adheres to COMAR 21.05.08.08 regulations and serves as a mandatory compliance requirement for all parties involved in the Laboratory Services procurement process supporting the Department of Juvenile Services' healthcare delivery to young people in its care.
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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 .