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Attachment D.3 - Organizational Conflict of Interest

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A Word document (24 KB) attached to 3D Image Reconstruction and Case Planning Services, from the Department of Veterans Affairs. Due Oct 28, 2026, 4:30 PM (UTC-4).

File name: S02 - Attachment D.3 - Organizational Conflict of Interest.docx

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Organizational Conflict of Interest

[CONTRACTOR NAME]

[ADDRESS]

SOLICITATION # 36C24826Q1057

CONTRACTOR CONFLICT OF INTEREST CERTIFICATION STATEMENT

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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