Attachment-I.-Conflict-of-Interest-Affidavit (Required).pdf
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- Solicitation number
- BPM055147
- Issued by
- Queen Anne's County, Maryland
About this file
This is a Conflict of Interest Affidavit form required for submission with bid proposals to the State of Maryland, specifically for the QACARP29SB Carpentry Services contract with the Maryland Department of Transportation State Highway Administration (MDOT SHA) Centreville facility. The affidavit requires offerors, contractors, consultants, subcontractors, and their employees or agents with authority over contract work to disclose any facts or circumstances that could create conflicts of interest, defined as situations where a person is unable to render impartial assistance, their objectivity may be impaired, or they possess an unfair competitive advantage. Offerors must warrant that no relevant conflicts of interest exist except as explicitly disclosed in the form, and they must immediately notify the procurement officer in writing if any actual or potential conflicts arise after the affidavit is signed.
The affidavit requires the authorized representative to execute the document under penalty of perjury, affirming that all disclosed information is true and correct to the best of their knowledge. The form references COMAR 21.05.08.08 and COMAR 21.01.02.01B(64) as regulatory guidance and must be submitted with all bid or proposal submissions. If a conflict of interest emerges after contract award and performance has begun, the contractor must continue performance until receiving contrary instructions from the procurement officer. The form includes designated spaces for disclosure of any potential conflicts and for the contractor's proposed mitigation or neutralization actions.
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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
File details come from the government source that posted it. Updated .