D.3 36C26126R0014 Organizational Conflict of Interest.docx
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- Attached to
- Community Based Outpatient Clinic - Yreka, CA
- Solicitation number
- 36c26126r0014
About this file
This is an Organizational Conflict of Interest (OCI) certification form required for healthcare contracts under the Department of Veterans Affairs Acquisition Regulation (VAAR). The form implements Federal Acquisition Regulation (FAR) clause 852.209-70 and requires all offerors to disclose past, present, and currently planned financial, contractual, organizational, or other interests that could create conflicts of interest in performing services under the solicitation.
Offerors must certify either that key personnel and identified subcontractors have no conflicts of interest, or provide a detailed statement describing any actual or potential conflicts and explain how their organizational and management systems would mitigate such conflicts. The form notes that nondisclosure or misrepresentation of conflicts may result in contract termination at no expense to the Government, and the Contracting Officer may disqualify an offeror unless conflicts can be mitigated to the Government's satisfaction. If mitigation is impossible but award is deemed in the Government's best interest, the Contracting Officer will request a waiver per FAR 9.503. This particular certification applies to solicitation 36C26125R0078 for Radiology Physician services at the San Francisco VA Medical Center, though the file is associated with solicitation 36C26126R0014 for a Community Based Outpatient Clinic in Yreka, California under the VA Northern California Health Care System. The form requires certification by an authorized official with signature and date.
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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 # 36C26125R0078
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 36C26125R0039, for Radiology Physician services, 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 San Francisco VA Medical Center 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 San Francisco VA Medical Center 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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