D.2 Key Personnel and Conflict of Interest.pdf
PDF 65 KB Posted
- Attached to
- Temporary Residential Shelter for Homeless Veterans (Shreveport Louisiana Catchment Area)
- Solicitation number
- 36C25624Q0478
About this file
This document appears to be a section titled "D.2 Key Personnel and Conflict of Interest" related to a federal contract opportunity. The key details are:
The contractor represents that the proposed key personnel have no current or planned conflicts of interest related to the services to be provided under the solicitation/contract for the Overton Brooks VA Medical Center. The document requests the name, title, and whether each key personnel is from the prime or subcontractor. It also asks for the average weekly hours worked by each physician, the percentage of their total effort that will be dedicated to VA obligations, and the percentage dedicated to non-VA obligations for the practice group. This information is being provided as part of the solicitation for "Temporary Residential Shelter for Homeless Veterans (Shreveport Louisiana Catchment Area)" issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16.
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Text version
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 Veterans Health Care System of the Ozarks 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 Overton Brooks VA Medical Center, under the solicitation/contract here in.
Please identify also, if they are an employee of the prime or subcontractor.
NAME TITLE PRIME OR SUBCONTRACTOR
Provide the number of hours worked weekly by each of the physicians. Do not limit the response to the number of hours expended or expected to be spent at VA; provide the total number of hours worked weekly by the physicians, including time spent in research, clinical, administrative, and other duties for the Practice group.
Provide the expected percentage of total effort for each proposed physician that will be provided fulfilling the duties and responsibilities specified in the Performance Work Statement.
Additionally, provide the percentage of total effort that each proposed physician will be expected to spend fulfilling non-VA obligations. This can be expressed as a percentage of the physician’s total annual effort.
PHYSICIAN
NAME
AVERAGE
WEEKLY
HOURS
PERCENT OF
EFFORT –VA
PERCENT OF
EFFORT –
PRACTICE
GROUP
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