D.6 - Attachment 6 - Organizational Conflict of Interest.pdf
PDF 142 KB Posted
- Attached to
- Q522--Diagnostic Radiology Technician Services
- Solicitation number
- 36C26324R0008
About this file
This document contains an organizational conflict of interest certification statement for solicitation number 36C26324R0008 for diagnostic radiologic technologists services at the Minneapolis VA Health Care System. The contractor must disclose any past, present or planned interests or conflicts relating to the services required under the solicitation. Specifically, the contractor must certify that the key personnel listed in the solicitation have no conflicts of interest or disclose any relevant facts regarding conflicts in an attached statement. The contractor must also provide conflict of interest disclosures for any consultants or subcontractors. The solicitation is seeking diagnostic radiology technician services and is being conducted by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 23.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C26324R0008 0003.pdf | ||
| 36C26324R0008_4.docx | DOCX document | |
| 36C26324R0008 0002.pdf | ||
| 36C26324R0008_3.docx | DOCX document | |
| 36C26324R0008_2.docx | DOCX document | |
| 36C26324R0008 0001.pdf | ||
| D.2 Attachment 2 - Background Investigation Procedure and Documents.pdf | ||
| D.1 Attachment 1 - VA Rules of Behavior.pdf | ||
| D.4 Attachment 4 - Immigration and Nationality Act Requirement.pdf | ||
| 36C26324R0008_1.docx | DOCX document | |
| S02 - 36C26324R0008.pdf | ||
| D.5 Attachment 5 - Security Checklist - 6500.6.pdf | ||
| D.3 - Attachment 3 - QASP.pdf |
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Text version
D.6 – Attachment 6 – Organizational Conflicts of Interest
[CONTRACTOR NAME]
[ADDRESS]
SOLICITATION # 36C26324R0008, Diagnostic Radiologic Technologists Services, Minneapolis VAHCS
CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT
[ ] _____________________(Contractor Name) represents that the individuals listed in the Key Personnel section of the solicitation 36C26324R0008, Diagnostic Radiologic Technologists 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 Minneapolis VA Health Care System 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 Minneapolis VA Health Care System 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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