S02 - Attachment 5 _ Key Personnel.pdf

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Attached to
36C25626Q0007 Gulf Coast Medical Physicist and Radiation Safety Officer Services
Solicitation number
36C25626Q0007
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This document is Attachment 4, a Contractor Key Personnel & Conflicts of Interest (COI) form for a solicitation with the Gulf Coast Veterans Health Care System. The form requires the contractor to disclose and represent that the listed key personnel and temporary emergency substitutes have no present, planned, or past financial, contractual, organizational, or other conflicts of interest related to the services being provided. The form includes blank fields for contractors to fill in the names, titles, and employment status (prime or subcontractor) of their key personnel, ensuring transparency and potential conflict identification in the contract procurement process.

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D.4 ATTACHMENT 4: CONTRACTOR KEY PERSONNEL & COI

Contractor____________________ represents that the individuals listed below for Key Personnel and Temporary Emergency Substitutions of this solicitation here in 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 GULF COAST VETERANS HEALTH CARE SYSTEM under the solicitation/contract here in.

None of the employees listed below in this 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 GULF COAST VETERANS HEALTH CARE SYSTEM under the solicitation/ contract here in.

Please identify also, if they are an employee of the prime or subcontractor.

NAME TITLE PRIME OR SUBCONTRACTOR

File details come from the government source that posted it. Updated .