C. Attachment 3 - OCI Representation Disclosure Statement.pdf
PDF 129 KB Posted
- Attached to
- Consulting Flood Hydrologist Services for the U. S. Federal Energy Regulatory Commission
- Solicitation number
- 89603026Q0062
About this file
This file is an Organizational Conflict of Interest (OCI) representation and disclosure template for federal contract proposals.
The attachment presents two mutually exclusive certification options that respondents must complete. The OCI Representation Statement allows organizations to certify that no facts exist regarding past, present, or currently planned interests or activities that would create a possible conflict of interest regarding impartial and objective assistance, or unfair competitive advantage. The OCI Disclosure Statement is used when potential conflicts exist and requires full disclosure of all relevant facts organized into four categories: organizational, contractual, financial, or other. For disclosed conflicts, respondents must provide the affected company or organization name, a description of the relationship, the period of the relationship, the extent of the relationship quantified by metrics such as financial value or percentage of total holdings, and a mitigation plan if necessary. Both statements require signature, date, name, title, and organization information from the certifying individual or representative. The document is marked as CUI//PROCURE, indicating controlled unclassified information related to federal procurement.
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Other files
| File | Type | Posted |
|---|---|---|
| 89603026Q0062 0003.pdf | ||
| 89603026Q0062 0002.pdf | ||
| QA Summary 89603026Q0062.pdf | ||
| 89603026Q0062 0001.pdf | ||
| C. Attachment 10 - Questions Template.xlsx | XLSX spreadsheet | |
| C. Attachment 6 - FERC NDA Contractor Mar 2022.docx | DOCX document | |
| C. Attachment 5 - FERC NDA Contractors Employee Mar 2022.docx | DOCX document | |
| C. Attachment 2 - OCI Questionnaire.pdf | ||
| C. Attachment 8 - Pricing Template.xlsx | XLSX spreadsheet | |
| C. Attachment 9 - Past Performance Questionnaire.docx | DOCX document | |
| C. Attachment 7 - E.1 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO QUOTERS 071326.docx | DOCX document | |
| C. Attachment 4 - Contractors CEII Non-Disclosure Agreement.docx | DOCX document | |
| C. Attachment 1 - Statement of Work Flood Hydrologist Consultant.docx | DOCX document | |
| 89603026Q0062.pdf |
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Text version
ATTACHMENT 3
COMPLETE EITHER THE REPRESENTATION OR THE DISCLOSURE –
NOT BOTH
OCI Representation Statement
I hereby certify (or as a representative of my organization, I hereby certify) that, to the best of my knowledge and belief, no facts exist relevant to any past, present or currently planned interest or activity (financial, contractual, personal, organizational or otherwise) that relate to the proposed work; and bear on whether I have (or the organization and any of its affiliates has) a possible conflict of interest with respect to (1) being able to render impartial, technically sound, and objective assistance or advice; or (2) being given an unfair1 competitive advantage.
Signature : Date :
Name : Title :
Organization :
OCI Disclosure Statement
I hereby certify (or as a representative of my organization, I hereby certify) that, to the best of my knowledge and belief, all relevant facts -- concerning past, present, or currently planned interests or activities (financial, contractual, organizational or otherwise) that relate to the proposed work and bear on whether I have (or the organization has) a possible conflict of interest with respect to (1) being able to render impartial, technically sound, and objective assistance or advice, or (2) being given an unfair competitive advantage—are fully disclosed on the following page(s) and formatted to show:
For ease of presentation, the OCI information is divided into four parts, indicating whether the possible OCI is: organizational, contractual, financial, or other;
The company, agency, organization in which I (or my organization) have a past, present, or currently planned interest or activity (financial, contractual, organizational, or otherwise);
1 An unfair competitive advantage does not include the normal flow of benefits from the performance of the contract.
CUI//PROCURE
A-1
PROCURE
A brief description of the relationship;
The period of the relationship;
The extent of the relationship (such as value of financial interest of work;
percent of total holdings, total work, etc.); and A mitigation plan, if necessary.
Signature : Date :
Name : Title :
Organization :
CUI//PROCURE
A-2
PROCURE
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