Att_III_Organizational_COI_Cert.docx

Attachment III Organizational Conflict of Interest Certification

Organizational Conflict of Interest Certification By signing this Conflict of Interest Certification Statement, the contractor certifies that, to the best of its knowledge and belief, there are no relevant facts or circumstances that could give rise to an organizational or personal conflict of interest for the below named business entity, any of its staff, subcontractors, or partners. Further, the contractor attests that it has provided the Contracting Officer written disclosure of all relevant information pertaining to such a conflict of interest to the extent it appears to exist to a reasonable person with knowledge of the relevant facts.

The contractor, _______________________________________ , hereby represents that, to the best of its knowledge and belief, there are no present or currently planned interests (financial, contractual, organizational, or otherwise) relating to the work to be performed under the contract or any task order issued thereto that would create any actual or potential conflict of interest that would impinge on its ability to render impartial, technically sound, and objective assistance/advice or result in an unfair competitive advantage. The contractor further certifies that it has and will continue to exercise due diligence in identifying, removing, or mitigating, to the Government's satisfaction, such conflicts of interest.

Contractor’s Name _________________________________________

Contract # ________________________________________________

Signature

Title

Date