D.3 ORGANIZATIONAL CONFLICT OF INTEREST CERTIFICATION Medical Physicist Finger Lakes 36C24226Q0905.pdf

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Attached to
Q201--HCR- Medical Physicist Contract for Radiology and Dental (VA-26-00023708) Base Contract year 11/01/2026-10/31/2027 VA Finger Lakes
Solicitation number
36C24226Q0905
Issued by

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This is an Organizational Conflict of Interest Certification attachment for Request for Quotation (RFQ) 36C24226Q0905 for Medical Physicist Services at the VA Finger Lakes Medical Center.

The document establishes requirements under Federal Acquisition Regulation (FAR) clause 852.209-70 for offerors to disclose any past, present, or currently planned financial, contractual, organizational, or other interests that could create organizational conflicts of interest. Offerors must provide statements for themselves, identified consultants, and subcontractors that will provide services under the solicitation. The clause defines organizational conflict of interest as situations where an offeror cannot render impartial assistance or advice to the Government, where objectivity in performance may be impaired, or where the offeror would gain an unfair competitive advantage. The contracting officer may disqualify an offeror if a conflict exists and cannot be mitigated through contract negotiations. If conflicts cannot be mitigated but award is deemed in the Government's best interest, the contracting officer may request a waiver. Nondisclosure or misrepresentation of conflicts at offer time or through contract modifications may result in contract termination at no cost to the Government. Appendix A provides a certification statement template requiring the offeror's authorized representative to either certify no conflicts exist among key personnel or to submit an attached detailed statement describing any actual or potential conflicts and mitigation measures.

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Attachment D.3- Organizational Conflict of Interest Certification RFQ

D.3 ORGANIZATIONAL CONFLICT OF INTEREST CERTIFICATION

852.209-70.ORGANIZATIONAL CONFLICTS OF INTEREST (JAN 2008)

(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 quote 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 and 48 CFR 809.503.

(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.

https://www.acquisition.gov/far/current/html/Subpart%209_5.html#wp1078823 https://www.acquisition.gov/far/current/html/Subpart%209_5.html#wp1078823

Attachment D.3- Organizational Conflict of Interest Certification RFQ

APPENDIX A

CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT

SOLICITATION #: 36C24226Q0905

[ ] ______________________________________ represents that the individuals listed in the Key Personnel section of the solicitation 36C24226Q0905 Medical

Physicist Services 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 VA Finger Lakes Medical Center 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 Finger Lakes VA Medical Center 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 quote and which will provide services under the solicitation. The offeror may also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.

NAME AND TITLE DATE

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