D.2 CONTRACTOR ORGANIZATION CONFLICT OF INTEREST CERTIFICATION.docx

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Radiation Safety Officer for the Eastern Oklahoma VA Health Care System
Solicitation number
36C25927R0005
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This document is a Contractor Organization Conflict of Interest Certification form required for the Radiation Safety Officer (RSO) position at the Eastern Oklahoma VA Health Care System under Solicitation Number 36C25927R0005. The certification implements VAAR 852.209-70 (Organizational Conflicts of Interest) and requires offerors to disclose any past, present, or currently planned financial, contractual, organizational, or other interests that could create conflicts or impair objectivity in performing RSO duties at the facility.

Offerors must certify either that key personnel, consultants, and subcontractors identified in their proposal have no conflicts of interest, or provide a detailed statement describing all relevant facts concerning any actual or potential conflicts. The certification must address conflicts relating to services provided to the Eastern Oklahoma VA Health Care System locations (Jack C Montgomery VA Medical Center in Muskogee, Ernest Childers VA Outpatient Clinic in Tulsa, and James Mountain Inhofe VA Medical Center in Tulsa). The form requires signature by a certifying official and warns that nondisclosure or misrepresentation of conflicts may result in contract termination. The Contracting Officer retains authority to determine whether conflicts warrant disqualification, request mitigation measures, or seek a waiver under FAR 9.503 if award is deemed in the Government's best interest.

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Other files

File Type Posted
D.3 CONTRACTOR RULES OF BEHAVIOR.docx DOCX document
S02 36C25927R0005_RELEASED FOR SOLICITATION_13OCT.docx DOCX document
D.1 IMMIGRATION CERTIFICATION.docx DOCX document
D.4 QUALITY ASSURANCE SURVEILLANCE PLAN _QASP.docx DOCX document

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852.209-70. ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

All healthcare contracts require response to the following provision as prescribed in VAAR 809.507-1(b). Please use the form in APPENDIX A to provide response.

ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

(a) It is in the best interest of the Government to avoid situations which might create an organizational conflict of interest or where the Offeror's performance of work under the contract may provide the Contractor with an unfair competitive advantage. The term 'organizational conflict of interest' means that because of other activities or relationships with other persons, a person is unable to render impartial assistance or advice to the Government, or the person's objectivity in performing the contract work is or might be otherwise impaired, or the person has an unfair competitive advantage.

(b) The Offeror shall provide a statement with its offer which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided under this solicitation. The Offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The Offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.

(c) Based on this information and any other information solicited or obtained by the Contracting Officer, the Contracting Officer may determine that an organizational conflict of interest exists which would warrant disqualifying the Contractor for award of the contract unless the organizational conflict of interest can be mitigated to the Contracting Officer's satisfaction by negotiating terms and conditions of the contract to that effect. If the conflict of interest cannot be mitigated and if the Contracting Officer finds that it is in the best interest of the United States to award the contract, the Contracting Officer shall request a waiver in accordance with FAR 9.503.

(d) Nondisclosure or misrepresentation of actual or potential organizational conflicts of interest at the time of the offer or arising as a result of a modification to the contract, may result in the termination of the contract at no expense to the Government.

(End of provision)

APPENDIX A

[CONTRACTOR NAME]

[ADDRESS]

SOLICITATION #

CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT

[ ] ____[CONTRACTOR NAME]________________ represents that the individuals listed in the Key Personnel and Temporary Emergency Substitutions section of the solicitation [____Solicitation # and Service Type___] 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 ___[NAME OF VAMC] _________ Veterans Administration under the referenced solicitation.

None of the employees listed in the 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___NAME OF VAMC _________ Veterans Administration under the referenced solicitation.

OR

[ ] Statement attached describing, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided under this solicitation. The offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.

NAME OF CERTIFYING OFFICIAL

TITLE

SIGNATURE DATE

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