D.2 Attachment Contractor Key Personnel.pdf
PDF 49 KB Posted
- Solicitation number
- 36C25626Q1162_1
About this file
This is a Conflict of Interest Certification form for Key Personnel and Temporary Emergency Substitutions related to solicitation 36C25626Q1162_1 for the Central Arkansas Veterans Health Care System.
The form requires the contractor to certify that all listed key personnel and temporary emergency substitutes have no present, currently planned, or past financial, contractual, organizational, or actual conflicts of interest relating to the services to be provided under this solicitation and contract. The contractor must complete a table identifying each physician by name, title, and employment status (prime contractor or subcontractor). This certification applies to the Central Arkansas Veterans Health Care System contract opportunity and serves as a compliance document to ensure personnel integrity and prevent conflicts of interest in the proposed contract performance.
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Other files
| File | Type | Posted |
|---|---|---|
| D.4 Attachment Rules of Behavior.pdf | ||
| D.3 Attachment QASP.pdf | ||
| 36C25626Q1162_1.pdf | ||
| D.1 Attachment Contractor Certification IMMI.pdf |
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Text version
Attachment D.2 36C25626Q1162_1
Contractor____________________ represents that the individuals listed below for Key
Personnel and Temporary Emergency Substitutions of this solicitation here in have no present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or organizational conflicts of interest relating to the services to be provided to the Central Arkansas
Veterans Health Care System under the solicitation/contract here in.
None of the employees listed below in this solicitation have a past interest (financial, contractual, organizational, or otherwise) or actual or organizational conflicts of interest relating to the services to be provided to the Central Arkansas Veterans Health Care System under the solicitation/contract here in.
Please identify also if they are an employee of the prime or subcontractor.
PHYSICIAN NAME TITLE PRIME OR SUBCONTRACTOR
File details come from the government source that posted it. Updated .