D.6 Organizational Conflict of Interest.pdf
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- Solicitation number
- 36C26325R0004
About this file
This document is an Organizational Conflict of Interest (OCI) certification statement for a federal contract opportunity solicitation. The solicitation is for Onsite Audiology Health Technician Services for the Minneapolis VA Health Care System or TWIN PORT CBOC, with a period of performance from 12/12/2024 to 12/11/2025 with up to 4 option years. The contracting agency is the Department of Veterans Affairs, Veterans Health Administration, Veterans Integrated Service Network 23.
The OCI certification statement requires the contractor to disclose any present, planned, or past interests (financial, contractual, organizational, or otherwise) that could result in an actual or potential organizational conflict of interest relating to the services to be provided under the solicitation. The contractor must either certify that no such conflicts exist, or provide a detailed statement describing any relevant facts about such conflicts. This certification must also cover any consultants or subcontractors identified in the contractor's proposal.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C26325R0004_7.docx | DOCX document | |
| 36C26325R0004 0006.pdf | ||
| 36C26325R0004_6.docx | DOCX document | |
| 36C26325R0004 0005.pdf | ||
| 36C26325R0004_5.docx | DOCX document | |
| 36C26325R0004 0004.pdf | ||
| 36C26325R0004 0003.pdf | ||
| 36C26325R0004_4.docx | DOCX document | |
| 36C26325R0004 0002.pdf | ||
| 36C26325R0004_3.docx | DOCX document | |
| 36C26325R0004_2.docx | DOCX document | |
| 36C26325R0004 0001.pdf | ||
| S02 - 36C26325R0004.pdf | ||
| 36C26325R0004_1.docx | DOCX document | |
| D.1 VA Rules of Behavior.pdf | ||
| D.2 Background Investigation Procedure and Documents.pdf | ||
| D.3 Quality Assurance Surveillance Plan - QASP.pdf | ||
| D.5 VA Handbook 6500.6.pdf | ||
| D.4 Immigration and Nationality Act Requirement.pdf |
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Text version
D.6 – Attachment 6 – Organizational Conflicts of Interest
[CONTRACTOR NAME]
[ADDRESS]
SOLICITATION # 36C26325R0004, Onsite Audiology Health Technician Services , Minneapolis VAHCS or
TWIN PORT CBOC
CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT
[ ] _____________________(Contractor Name) represents that the individuals listed in the Key Personnel section of the solicitation 36C26325R0004, Audiology Health Technician 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 or TWIN PORT CBOC 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 or TWIN PORT CBOC 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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