Conflict of Interest Certification - Google Docs.pdf
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- Attached to
- IT Managed Services
- Solicitation number
- BD-26-2123-AVC01-AVCMB-127722
- Issued by
- Massachusetts
About this file
This is a Conflict of Interest Certification form required for vendors submitting proposals to the Assabet Valley Collaborative in Massachusetts for IT Managed Services. The document serves as a legal attestation under perjury that vendors must complete and submit as part of their bid package. Vendors are required to certify either that they have no actual or potential conflicts of interest that would impair their independence, objectivity, or ability to perform the contracted services, or to fully disclose any such conflicts if they exist. Potential conflicts that must be disclosed include relationships with employees or officers of the issuing entity, prior or current employment of vendor personnel with the issuing entity, and any financial or personal interests that could influence contract performance.
The certification obligates vendors to comply with Massachusetts General Laws Chapter 268A regarding conflict of interest and requires ongoing disclosure of any conflicts that arise during the contract term. Vendors must also ensure that all subcontractors meet the same conflict of interest standards and disclosure requirements. The form requires an authorized representative's signature, printed name, title, and date to certify that the information provided is true and complete. This certification document does not contain pricing information, set-asides, funding sources, or contract term details, as those elements are specified in the related procurement opportunity.
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Text version
CONFLICT OF INTEREST CERTIFICATION
Procurement Name:_____________________COMMBUYS Bid #:___________________________
Contract Term:_______________________Vendor Name:________________________________
The undersigned, on behalf of the Vendor identified above, hereby certifies under the pains and penalties of perjury that:
No Conflict of Interest to Disclose The Vendor, its officers, employees, agents, and subcontractors have no actual or potential conflicts of interest that would impair their independence, objectivity, or ability to perform the services contemplated under this procurement.
Disclosure of Potential Conflicts The Vendor agrees to disclose any actual or potential conflicts of interest, including but not limited to:
Relationships with employees, officers, or agents of the issuing entity Prior or current employment of Vendor personnel with the issuing entity Financial or personal interests that could influence contract performance If any such conflicts exist, they must be fully described below:
Disclosure (if applicable):
3. Compliance with Law The Vendor acknowledges and agrees to comply with all applicable laws, including but not limited toMassachusetts General Laws Chapter 268A (Conflict of Interest Law).
4. Ongoing Obligation The Vendor agrees to promptly disclose any conflict of interest that arises during the term of the contract and to cooperate in any required mitigation.
5. Subcontractors The Vendor certifies that all subcontractors, if any, are subject to the same conflict of interest standards and disclosures.
Authorized Signature
I certify that I am authorized to bind the Vendor and that the information provided above is true and complete.
Signature:____________________________Printed Name:_________________________________
Title:_________________________________ Date:_______________________________________
File details come from the government source that posted it. Updated .