About this file

This document is an Attachment D.4 - Organizational Conflicts of Interest for RFP 36C24224R0049, issued by the Department of Veterans Affairs Veterans Integrated Service Network 2 for a Community Based Outpatient Clinic (CBOC) in Auburn, NY.

The RFP requires the offeror to provide a statement disclosing any past, present, or planned interests (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The offeror must also provide the same information for any consultants and subcontractors. The Contracting Officer will evaluate the disclosed information to determine if an organizational conflict of interest exists that would disqualify the offeror, unless the conflict can be mitigated. Nondisclosure or misrepresentation of conflicts of interest may result in contract termination.

The CBOC must be located in Cayuga County, NY and provide primary care services to Veteran patients. The contract will cover a base year and nine one-year option periods. This is an unrestricted procurement with a single award. The NAICS code is 621498 - All other Outpatient Care Centers, with a $25.5 Million size standard.

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ATTACHMENT D.4 RFP 36C24224R0049

D.4 ORGANIZATIONAL CONFLICTS OF INTEREST

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.

852.209-70. 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 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.4 RFP 36C24224R0049

D.4 - APPENDIX A

[CONTRACTOR NAME]

[ADDRESS]

SOLICITATION # 36C24224R0049

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 36C24224R0049 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 Syracuse 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 Syracuse 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

D.4 ORGANIZATIONAL CONFLICTS OF INTEREST

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