S02 - Attachment 5 Key Personnel.pdf

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Attached to
36C25626Q0231 Medical Physicist and Radiation Safety Officer Services
Solicitation number
36C25626Q0231
Issued by

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This document is Attachment 4 for a solicitation requiring contractors to disclose key personnel and potential conflicts of interest (COI) for a contract with the Gulf Coast Veterans Health Care System. The form requires contractors to list their key personnel and temporary emergency substitutes, and explicitly declare that these individuals have no present, planned, or past financial, contractual, organizational, or other conflicts of interest related to the services being procured. Contractors must also indicate whether each listed personnel is an employee of the prime or subcontractor, using a three-column table to capture name, title, and organizational affiliation.

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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 .