OCI_Disclosure_Form_.docx
DOCX document 30 KB Posted
- Attached to
- MARFORSOC Chaplain Retreats Federal contract opportunity
- Solicitation number
- H9225725R0003
- Issued by
- United States Special Operations Command
About this file
This is an Organizational Conflict of Interest (OCI) disclosure form template that contractors must complete to identify any actual or potential conflicts of interest with USSOCOM contracts. The form requires contractors to provide details about existing contracts or subcontracts that could create conflicts, including the contractor name, contract/program title, contracting agency, contract number, and task order number. Contractors must specify whether they are prime or subcontractors, indicate the magnitude of work as a percentage and dollar value, and describe the scope of work particularly as it relates to systems engineering, technical direction, specifications preparation, technical evaluation of offers, access to proprietary information, or providing products/hardware/software to USSOCOM.
The form is related to a MARFORSOC Chaplain Retreats solicitation (H9225725R0003) for the Marine Forces Special Operations Command Family and Spiritual Fitness Program in the Camp Lejeune, North Carolina area. This OCI form would need to be completed by offerors to disclose any potential conflicts with existing contracts they hold.
View the file
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
OCI Disclosure Form OCI Disclosure Form
INSTRUCTIONS FOR COMPLETING
NOTE: One Attachment to the OCI Disclosure Form shall be submitted for each USSOCOM contract or subcontract currently being performed. Place an "X" inside the appropriate parenthesis to indicate your responses.
Fill in the number and the short, official title by which the contract or subcontract requiring analysis and determination is formally known. This is work that has already been awarded, is being performed by your company, and requires a comparison with that work identified in the Statement of Work.
1. Please identify below the contract or subcontract held by your firm or affiliate and which may create an actual or potential OCI:
a. Contractor, Subcontractor or Affiliate’s Name:
b. Contract or Program Title:
c. Contracting Agency or Customer:
d. Contract Number:
e. Task Order Number (if applicable):
2. Your performance in the above contract is as a: Prime (__) or Subcontractor (__)
3. If Subcontractor, what is magnitude of work compared to overall contract value?
Percentage (%): _________Dollar Value: __________Number of MYEs: _______
4. If you performed as a Sub, provide Prime Contractor’s name: ________________________________
5. Describe below the scope of the contract or subcontract in sufficient detail to understand the breadth of the work, the period of performance and the value, as it relates to:
| ( | ) Providing Systems Engineering and Technical Direction (FAR 9.505-1) |
| ( | ) Preparing Specifications or Work Statements (FAR 9.505-2) |
| ( | ) Providing Technical Evaluation of Offers for Products or Services (FAR 9.505-3) |
| ( | ) Obtaining Access to Proprietary Information (FAR 9.505-4) |
| ( | ) Providing products, hardware or software to USSOCOM |
6. Scope (continue on additional pages if more space is necessary):
7. Does the scope of work for this contract or subcontract create an actual or potential conflict of interest with the work you wish to perform? If so, describe the actual or potential conflict.
File details come from the government source that posted it. Updated .