NSF-XLabsOTASO-AttachmentB-COIStatementForm.pdf

Conflict of Interest Statement

Solicitation/Contract Number/Project: NSF X-Labs; NSF-OTASO-FY26-XLabsInitative

COIs are governed by the FAR Subpart 9.5. Organizational COIs (OCIs) are generally separated into three categories:

• Impaired Objectivity, which may arise where an Other Transaction (OT) contractor's work under one OT or contract involves assessing or evaluating itself, an affiliate, or a competitor, creating an economic incentive to provide biased advice under an OT transaction;

• Biased Ground Rules, which may occur when, as part of its work under one contract or transaction, the OT entity has helped set the ground rules, such as writing the statement of work or developing specifications, for an OT;

• Unequal Access to Information, which may occur when an OT entity obtains access to nonpublic, proprietary, or source selection sensitive government information as part of its performance under another contract or transaction, which gives it an advantage in a later competition for an OT.

By signing this form, the offeror acknowledges that:

We will immediately disclose any financial interest, employment or business relationship, personal relationship, prior involvement, or other circumstance that could create - or appear to create – an OCI.

This requirement applies to the lead organization, its employees, and any subcontractors/consultants proposed to perform work.

If, at any time, we identify an actual or potential OCI (using RFO FAR Subpart 9.5 as a framework) that has not been adequately disclosed and resolved (or waived in writing by NSF), the contractor must promptly provide full written disclosure to NSF’s Agreements Officer Representative (AOR). The disclosure must describe the conflict and the actions taken or proposed to resolve it.

Conflict disclosure

Check one:

☐ Our team is not aware of any actual, apparent, or potential organizational conflict of interest related to this proposal.

☐ Our team has disclosed a matter that may create an actual, apparent, or potential organizational conflict of interest below or in an attachment.

Explanation, if applicable:

Describe any actual, apparent, or potential financial interests of the lead organization that could create conflicts with the work proposed. This requirement applies to the lead organization, its employees, and any subcontractors/consultants proposed to perform work.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.acquisition.gov%2Ffar%2Fsubpart-9.5&data=05%7C02%7Cxlabs%40nsf.gov%7C27bbd5950ce14149f9d708dedde347e3%7C4939bd9435634244904d6e68ffc9b8cf%7C0%7C0%7C639192165583607059%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C80000%7C%7C%7C&sdata=AMsrLQAj6DG3J2vPrJLtGM7yfUV7mclmE2rB5Xv2U%2BU%3D&reserved=0

Relevant Prior Work, if applicable:

Describe any work performed on a previous or current contract or OT Agreement that could create conflicts with the work proposed. This requirement applies to the lead organization, its employees, and any subcontractors/consultants proposed to perform work.

Mitigation Plan, if applicable:

Describe how the lead organization will avoid, neutralize, or mitigate any potential or actual conflicts.

Certification and signature

I have read and understand this agreement. The information above is complete and accurate to the best of my knowledge, and I will promptly report any change.

Signature:

Date:

Printed Name:

Phone/Email: