ATTM 005 ORGANIZATION COI.docx
DOCX document 26 KB Posted
- Attached to
- INDEPENDENT VERIFICATION & VALIDATION State and local contract opportunity
- Solicitation number
- 5400024113
- Issued by
- Richland County, South Carolina
About this file
This is an Organizational Conflict of Interest Disclosure form for the State of South Carolina's Independent Verification & Validation contract opportunity (RFP 5400024113). The form establishes the state's policy to prevent situations where an offeror's judgment may be compromised by past, present, or planned interests that could bias their performance or provide unfair competitive advantage. Offerors must disclose all relevant facts concerning financial, contractual, organizational, or other interests related to the work being performed, including any interests held by affiliates, proposed consultants, or subcontractors at any tier. The disclosure must address whether the offeror can render impartial and technically sound assistance or advice and whether performance of the work would create an unfair competitive advantage.
Offerors must either provide a detailed narrative disclosure statement describing potential conflicts or submit a representation certifying that no such conflicts exist. The State reserves the right to request additional information from offerors to evaluate potential conflicts and may impose conditions to mitigate conflicts, disqualify offerors, or determine that contracting is in the state's best interest despite identified conflicts. Failure to provide required disclosures or misrepresentation of relevant interests may result in disqualification from award, contract termination for default, disqualification from future related contracts, or other remedial actions permitted by law. No award shall be made until the disclosure or representation has been evaluated by the State. The form requires completion of all sections including offeror name, signature, title, and date.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| ATTM 003 CERTIFICATION.docx | DOCX document | |
| Amendment 1.pdf | ||
| ATTM 007 QUESTIONS.docx | DOCX document | |
| ATTM 001.pdf | ||
| ATTM 009 SOW.pdf | ||
| ATTM 004 HIPAA BAA.pdf | ||
| ATTM 010 Bidding Schedule.xlsx | XLSX spreadsheet | |
| ATTM 008 SPSAQ.docx | DOCX document | |
| Award Extension.pdf | ||
| ATTM 006.pdf | ||
| IV&V FPB Solicitation.pdf | ||
| Award Extension 2.doc | DOC document | |
| ATTM 002.pdf |
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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. 5400024113 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 5400024113 |
| Signature___________________________________________________________________ |
| Title_______________________________________________________________________ |
Date_______________________________________________________________________
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