S02 - Attachment D6 - 852.209-70 ORGANIZATIONAL CONFLICT OF INTEREST.pdf

VAAR Clause PDF 205 KB Posted

Attached to
G004--Solicitation Notice for Healthcare for Homeless Veterans Medical Respite Care for the Richard L Roudebush, VA Medical Center in Indianapolis, Indiana
Solicitation number
36C25023Q0759
Issued by

About this file

This document contains an organizational conflict of interest certification statement template for solicitation number 36C25023Q0759 regarding medical respite care housing services for homeless veterans. Key personnel proposed under the solicitation must be disclosed, along with a statement certifying whether any past, present or planned organizational conflicts of interest exist relating to the services to be provided. If conflicts do exist, relevant facts must be provided describing them and how the offeror's system would avoid or mitigate any actual or potential issues. Failure to disclose conflicts accurately may result in contract termination. The solicitation seeks these services from the Richard L. Roudebush VA Medical Center in Indianapolis, Indiana, and is issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 10.

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File Revision Posted Attached to
S02 - Attachment D4 - 852.209-70. ORGANIZATIONAL CONFLICTS OF INTEREST _OCT 2020.pdf Oct 2020 Q301--Board-Certified Diagnostic Medical Physicist Services for Richard L. Roudebush, VAMC in Indianapolis, IN
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Attachment D2 - VAAR 852.209-70 Organizational Conflicts of Interest (OCT 2020).pdf Oct 2020 Radiation Oncology Physician Services
S02 - ATTACHMENT 7 - VAAR 852.209-70 Organizational Conflicts of Interest OCT 2020.docx Oct 2020 DA10--WMC Application Management System Re-Compete - Shelko/Rhodes (VA-24-00059799)
Attachment D2 - VAAR 852.209-70 Organizational Conflicts of Interest _ OCT 2020.pdf Oct 2020 HCHV Housing for Male and Female Veterans
S02 - ATTACHMENT 7 - VAAR 852.209-70 Organizational Conflicts of Interest OCT 2020.docx Oct 2020 DA10--WMC Application Management System Re-Compete - Rios/Rhodes (VA-24-00059799)
S02 - Attachment D1 - 852.209-70. ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020).pdf Oct 2020 Q522--Radiation Oncology Services for the VA Northern Indiana Health Care System in Fort Wayne, IN.
Attachment D2 - VAAR 852.209-70 Organizational Conflicts of Interest (OCT 2020).pdf Oct 2020 HCHV CERS – Ft. Wayne – NIHCS
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Attachment D6 - 852.209-70. ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

All healthcare contracts require response to the following provision as prescribed in VAAR 809.507-1(b).

Please use the form in APPENDIX A to provide response.

852.209-70. ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

(a) It is in the best interest of the Government to avoid situations which might create an organizational conflict of interest or where the Offeror’s performance of work under the contract may provide the Contractor with an unfair competitive advantage. The term “organizational conflict of interest” means that because of other activities or relationships with other persons, a person is unable to render impartial assistance or advice to the Government, or the person’s objectivity in performing the contract work is or might be otherwise impaired, or the person has an unfair competitive advantage.

(b) The Offeror shall provide a statement with its offer which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided under this solicitation. The Offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The Offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.

(c) Based on this information and any other information solicited or obtained by the Contracting Officer, the Contracting Officer may determine that an organizational conflict of interest exists which would warrant disqualifying the Contractor for award of the contract unless the organizational conflict of interest can be mitigated to the Contracting Officer’s satisfaction by negotiating terms and conditions of the contract to that effect. If the conflict of interest cannot be mitigated and if the Contracting Officer finds that it is in the best interest of the United States to award the contract, the Contracting Officer shall request a waiver in accordance with FAR 9.503.

(d) Nondisclosure or misrepresentation of actual or potential organizational conflicts of interest at the time of the offer or arising as a result of a modification to the contract, may result in the termination of the contract at no expense to the Government.

APPENDIX A

Name of Vendor/Contractor Address of Vendor/Contractor City, State, Zip of Vendor/Contractor

SOLICITATION # 36C25023Q0759

CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT

[ ] ____________________________(Contractor Name) represents that the individuals listed in the Key Personnel and Temporary Emergency Substitutions section of the solicitation 36C25023Q0759 – Medical Respite Care Housing for HCHV 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 Richard L. Roudebush VA Medical Center, Department of Veterans Affairs Medical Center Veterans Administration under the referenced solicitation.

None of the employees listed in the 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 Richard L. Roudebush VA Medical Center, Department of Veterans Affairs Medical Center Veterans Administration under the referenced solicitation.

OR

[ ] Statement attached describing, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided under this solicitation. The offeror shall also provide statements with its offer containing the same information for any consultants and subcontractors identified in its proposal and which will provide services under the solicitation. The offeror may also provide relevant facts that show how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest.

NAME OF CERTIFYING OFFICIAL

TITLE:_____________________________

SIGNATURE DATE

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