ORGANIZATIONAL CONFLICTS OF INTEREST
PRE-PROCUREMENT FACT SHEET
REQUESTER: PROCUREMENT SPECIALIST:
M/S: TEL: M/S: TEL:
PURCHASE REQUEST NO.: DATE:
The work in your requested procurement activity appears to fall within one or more of the following
categories. Because subcontracts for work in these categories must be subjected to Organization Conflict
of Interest (OCI) review and a DOE finding obtained before subcontract award, a Pre-Procurement Fact
Sheet needs to be completed to facilitate recognition of an OCI.
Evaluation Services or Activities: Any work or effort, having as its principal purpose, the independent
study of a technology, process, product, or policy which entails the assessment, appraisal, or survey of
such technology, process, product, or policy for purposes of comparison.
Technical Consulting and Management Support Services: Any work or effort, having as its principal
purpose, providing internal assistance to any program element or other organizational component of the
Laboratory in the formulation or administration of its programs, projects, or policies, where it is necessary
to give the subcontractor access to privileged information (Government/University/Laboratory
information which is not to be disclosed outside the Laboratory) and/or proprietary information
(information which belongs to others but has been given to the University and may not be disclosed).
Such services typically include assistance in the preparing of program plans; evaluation, monitoring, or
review of subcontractors' activities or proposals submitted by prospective subcontractors; and preparation
of preliminary designs, specifications, or statements of work.
Professional Services: Specialized services such as legal or medical services, but excluding architect/
engineering and other services defined elsewhere within this Fact sheet.
Other: Contractual situations where there is a reasonable possibility that an OCI may exist or arise.
Complete Sections A, B, and C of this Fact Sheet and return it to the Procurement Specialist listed above.
The Procurement Specialist will use it in gathering information from offerors concerning potential OCIs.
This information will be used by the Procurement Specialist and the DOE Contracting Officer in their
OCI review. It is expected that the Procurement Specialist will assist you in filling out the Fact Sheet.
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1. Laboratory groups to be served by the subcontractor.
2. Brief description and purpose of the procurement and how the Laboratory will use the subcontractor's services
and work products:
3. Brief description of work:
4. If this is a follow-on effort to another subcontract, please give the subcontract no.:
POTENTIAL ORGANIZATIONAL CONFLICT OF INTEREST
Following are questions used to determine if the possibility of an OCI exists in this procurement. A
"yes" response does not automatically constitute an OCI. Please use a supplemental sheet to explain
1. Does work involve preparation of specifications? · YES · NO
2. Does the work involve preparation of a statement of work? · YES · NO
3. Does the work involve formulation of a detailed plan for specific
approaches or methodologies that are to be employed in or
incorporated into future procurement activity or involve access
to specifications, statements of work, or plans? · YES · NO
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4. On a supplemetal sheet, briefly state the relationship between
1, 2, and 3 and any possible future procurement(s). Indicate if other
Laboratory or government contractors or third parties may assist
the subcontractor in the development of 1, 2, or 3.
5. a) Will the subcontractor provide software? · YES · NO
b) If so, will the use of the software require the acquisition of new
automated data processing equipment? · YES · NO
6. a) Will performance of the subcontract provide access to privileged
information (such as unpublished information which has not been
disclosed outside the Laboratory and internal information concerning
Laboratory or government plans and programs)? · YES · NO
b) If yes, identify categories of information and the program elements
7. a) Will performance of the subcontract provide access to proprietary
information (confidential information of others)? · YES · NO
b) If yes, identify categories of information.
8. a) Will the subcontractor's work products be used in connection with the
formulation of Laboratory or government plans and strategies? · YES · NO
b) If yes, please describe the work products and the manner in which they
will be used.
9. a) Will the subcontractor's performance include review, analysis, or
evaluation of services or products of Laboratory subcontractors or
government contractors? · YES · NO
b) If yes, briefly identify such services and products.
I hereby certify that the information I have provided above is true and accurate to the best of my
Laboratory Requester's Signature Date
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