Attachment-N-Conflict Interest.doc
DOC document 48 KB Posted
- Attached to
- RFR LOT Number 1506 - MSLC - STRIPS
- Solicitation number
- BD-15-1062-LOT-00001-00000002534
- Issued by
- Norfolk County, Boston City, Massachusetts
About this file
This document is a certification of compliance concerning conflicts of interest for a contract to provide zero coupon non-callable U.S. Government securities (STRIPS) to the Massachusetts State Lottery Commission (MSLC) under RFR LOT # 1506. The Bidder/Contractor must certify that no relationships exist that would interfere with fair competition or create a conflict of interest, and they will not grant any personal interest in the contract to MSLC officials or employees. Breach of these certifications may be considered a material breach of the contract, allowing MSLC to exercise contractual remedies.
The related state and local contract opportunity is for MSLC to select qualified firms to be part of a pool eligible to provide STRIPS to MSLC through a competitive offering process. The contract is with the state of Massachusetts, and the procurement is being conducted by MSLC.
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Other files
| File | Type | Posted |
|---|---|---|
| RFQ STRIPS 1506~1.docx | DOCX document | |
| sdprplanform3reporting.xlsx | XLSX spreadsheet | |
| CommonwealthTermsConditions.doc | DOC document | |
| RFQ 1506 Response Template.docx | DOCX document | |
| Attachment_B_Standard_Contract.doc | DOC document | |
| Attachment_H_ContractorSignatoryForm.doc | DOC document | |
| Supplier_Diversity_Plan_From_2_Declaration_of_SDP_Partners.docx | DOCX document | |
| Supplier_Diversity_Plan_From_1_Commitment.docx | DOCX document | |
| newmass-w9.pdf | ||
| Attachment_M_MSLC_PersonalDataCetrification.doc | DOC document | |
| Attachment_E_TaxCompliance - Copy.doc | DOC document | |
| Attachment_L_Lottery_Disclosure_Statement~1.doc | DOC document | |
| Attachment_J_Invest_in_MA_Data_Form.docx | DOCX document | |
| Attachment_F_BusinessReferenceForm - Copy.doc | DOC document | |
| AttachmentJ1InvestinMAInstructio.doc | DOC document |
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Text version
OPEN and ROLLING PRE-QUALIFICATION OF STRIPS/ANNUITY PARTICIPATING FIRMS
CERTIFICATION OF COMPLIANCE CONCERNING
CONFLICTS OF INTEREST
RFR LOT # 1506
Attachment N
To contract with the Massachusetts State Lottery Commission (the “Lottery”) pursuant to the awarding of RFR LOT # RFR LOT # 1506 (“Contract”), __________________ (the “Bidder/Contractor) makes the following certifications and agrees to the following terms, under the penalties of perjury:
1. Conflict of Interest Certifications. With regard to all obligations to be performed under the terms of this Contract, the Bidder/Contractor certifies that:
a. No relationship exists between the Bidder/Contractor and The Lottery that interferes with fair competition or is a conflict of interest;
b. No relationship exists between the Bidder/Contractor and another person or organization that constitutes a conflict of interest with respect to a state contract;
c. The Bidder/Contractor will not grant or permit any of its affiliates to grant to an official or employee of The Commonwealth who exercises any function or responsibility in the review or approval of the undertaking or carrying out of this Contract, prior to the Bidder’s/Contractor’s completion of its obligations under this Contract, any personal interest, either directly or indirectly, in this Contract or proposed Contract;
d. The Bidder/Contractor has no present interest and shall not acquire any interest, either directly or indirectly, which will conflict in any manner or degree with the performance of its obligations under this Contract and that no person having any such known interests shall be employed by the Bidder/Contractor during the performance of this Contract.
2. Breach of Terms. Breach of these certifications and terms may be regarded as a material breach of this Contract, such that The Lottery may exercise any and all contractual rights and remedies, including without limitation, indemnification under Section 11 of the Commonwealth’s Terms and Conditions, withholding of payments, contract suspension, or termination.
Bidder/Contractor: ______________________________________________________ Bidder/Contractor Authorized Signature: ___________________________________ Printed Name and Title of Authorized Signatory: _____________________________
Date: __________________________________________________________________ COMMBUYS Bid Number: BD-15-1062-LOT-00001-00000002534 MSLC Document RFR 1506
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