D.2 ORGANIZATIONAL CONFLICT OF INTEREST.pdf
PDF 266 KB Posted
- Attached to
- Autotransfusion Services - Kansas City VAMC
- Solicitation number
- 36C25525Q0473
About this file
This document is an Organizational Conflict of Interest (OCI) Certification Statement for a Veterans Administration Medical Center (VAMC) solicitation. The form provides two options for contractors: (1) certify that no individuals involved in the solicitation have any past, present, or planned conflicts of interest related to the services, or (2) attach a detailed statement describing any potential conflicts of interest. The solicitation number is 36C25525Q0473, and the form requires the contractor to disclose any financial, contractual, organizational, or other interests that might create a conflict in providing services to the Veterans Administration. The document includes spaces for the contractor's name, address, certifying official's name, title, signature, and date of certification.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25525Q0473 0001.pdf | ||
| D.4 CONTRACTOR RULES OF BEHAVIOR.pdf | ||
| D.1 QASP.pdf | ||
| D.5 CONTRACTOR CERTIFICATION IMMIGRATION AND NATIONALITY ACT.pdf | ||
| 36C25525Q0473.docx | DOCX document | |
| D.3 PAST PERFORMANCE CONTACTS.pdf | ||
| D.6 WAGE DETERMINATIONS.pdf |
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Text version
Organizational Conflict of Interest
[CONTRACTOR NAME]
[ADDRESS]
SOLICITATION # 36C25525Q0473
CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT
[ ] ____[CONTRACTOR NAME]________________ represents that no individuals involved with 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
Attachment D.2 Organizational Conflict of Interest
File details come from the government source that posted it. Updated .