ATTM 005.docx
DOCX document 27 KB Posted
- Attached to
- EXTERNAL QUALITY REVIEWS
- Solicitation number
- 5400024117
- Issued by
- Richland County, South Carolina
About this file
This is an Organizational Conflict of Interest Disclosure form for a Request for Proposal issued by the State of South Carolina for External Quality Reviews (RFP 5400024117). The form requires all offerors, including their affiliates, proposed consultants, and subcontractors at any tier, to disclose any past, present, or currently planned financial, contractual, or organizational interests that could create conflicts of interest or provide unfair competitive advantages in performing the work.
Offerors must either provide a detailed narrative disclosure statement describing all relevant facts concerning potential conflicts of interest or submit a representation certifying that no such conflicts exist. The State of South Carolina reserves the right to review submitted disclosures, request additional information, and determine whether an award would create an organizational conflict of interest. Based on this evaluation, the State may impose conditions to mitigate conflicts, disqualify the offeror, or proceed with the award if deemed in the State's best interest. Failure to provide required disclosures or misrepresentation of relevant interests may result in disqualification before award or contract termination and debarment from future contracts if discovered after award. No award will be made until the disclosure or representation has been evaluated and approved by the State.
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Other files
| File | Type | Posted |
|---|---|---|
| Amendment 1.pdf | ||
| ATTM 001.pdf | ||
| ATTM 002.pdf | ||
| ATTM 006.pdf | ||
| ATTM 007.docx | DOCX document | |
| Amendment 2.pdf | ||
| EQR RFP Amd 3.pdf | ||
| ATTM 004.pdf | ||
| EQR RFP Solicitation.pdf | ||
| Q&A Responses.pdf | ||
| ATTM 003.docx | DOCX document |
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Text version
ATTACHMENT 005
Organizational Conflict of Interest Disclosure
| I. | INSTRUCTIONS | ||
| Read Part II carefully. If a disclosure statement is required, please provide a narrative statement in Part III. If a representation is submitted, please complete Part IV. Complete Part V in every case. | |||
| II. | ORGANIZATIONAL CONFLICT OF INTEREST DISCLOSURE OR REPRESENTATION | ||
| It is the policy of State of South Carolina (State) to avoid situations which place an Offeror in a position where its judgment may be biased because of any past, present, or currently planned interest, financial or otherwise, the Offeror may have which relates to the work performed pursuant to this solicitation or where the Offeror’s performance of such work may provide it with an unfair competitive advantage. (As used herein “Offeror” means the proposer or any of its affiliates or proposed consultants or subcontractors of any tier.) | |||
| Therefore: | |||
| (a) | The Offeror shall provide a statement which describes in a concise manner all relevant facts concerning any past, present or currently planned interest (financial, contractual, organizational, or otherwise) relating to the work to be performed hereunder and bearing on whether the Offeror has a possible organizational conflict of interest with respect to (1) being able to render impartial, technically sound, and other objective assistance or advise, or (2) being given an unfair competitive advantage. The Offeror may also provide relevant facts that demonstrate how possible organizational conflict of interest relating to other divisions or sections of the organization(s) or its existing organizational structure or system might be avoided or mitigated. This information should be provided in narrative form in Part III. | ||
| (b) | In the absence of any relevant interest referred to above, the Offeror shall submit a statement certifying that to its best knowledge and belief no such facts exist relevant to possible organizational conflicts of interest. The Offeror’s statement pursuant to this paragraph as well as any statement required to be submitted under (a) above shall include statements form proposed consultants and subcontractors at any tier if relevant. Offeror is responsible for submitting all such information as part of its certification. | ||
| (c) | The State will review the statement submitted and may require additional relevant information from the Offeror. All such information, and any other relevant information will be used by State to determine whether an award to the Offeror may create an organizational conflict of interest. If found to exist, State may (1) impose appropriate conditions which avoid such conflict, (2) disqualify the Offeror, or (3) determine that it is otherwise in the best interest of the State to contract with the Offeror by including appropriate conditions mitigating such conflict in the contract awarded. | ||
| (d) | The refusal to provide the disclosure or representation of any additional information as required shall result in disqualification of the Offeror for award. The nondisclosure or misrepresentation of any relevant interest may also result in the disqualification of the Offeror for award, or if such nondisclosure or misrepresentation is discovered after award, the State may terminate the contract for default, disqualify the contractor from subsequent related contracts, or subject the contractor to such other remedial actions as may be permitted or provided by law. | ||
| (e) | No award shall be made until the disclosure or representation has been evaluated by State. |
III. DISCLOSURE STATEMENT: (attach additional pages if more space is needed)
(Offeror to provide a concise narrative of any potential conflicts)
IV. REPRESENTATION
The Offeror, ___________________________________________________, hereby represents that it is aware of no past, present, or currently planned interest (financial, contractual, organizational, or otherwise) relating to the work to be performed under the contract resulting from Request for Proposal No. 5400024117 that would indicate any impingement upon its ability to render impartial, technically sound, and objective assistance or advice or result in it being given an unfair competitive advantage. This representation applies to all affiliates of the Offeror and its proposed consultants or subcontractors of any tier.
V. SIGNATURE
| Offeror’s Name___________________________________________________________________ |
| RFP/Contract No. RFP 5400024117 |
| Signature___________________________________________________________________ |
| Title_______________________________________________________________________ |
Date_______________________________________________________________________
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