You are here

Conflict-of-Interest/Non-Disclosure Certificate For Reviewers Involved in the Selection of Subcontractors for NEUP Research and Development Funds

The Department of Energy has a policy that individuals with a conflict of interest cannot participate in the technical review of procurement proposals. This certification must be completed by individuals prior to their participation in the pre-application and/or proposal review processes.

1. I will not participate in the review of any pre-application or proposal involving a particular matter that would have a direct and predictable effect on any person, company or organization with which I have a relationship, financial or otherwise. For purposes of this statement, the interests of my spouse, my minor child, my general partner, any organization in which I serve as officer, director, trustee, general partner, or employee, and any person or organization with whom I am negotiating employment, are attributed to me.

2. Further, I will not participate in the review of any pre-application or proposal involving a particular person or a particular matter that I believe would cause a reasonable person with knowledge of the relevant facts to question my impartiality.

3. Prior to my participation as a reviewer, I agree that I will disclose any actual or perceived conflicts of interest that I may have with such duties. In addition, I agree to disclose any actual or perceived conflicts of interest as soon as I am aware of the conflict.

4. I certify that I will not disclose, except pursuant to the order of a court of competent jurisdiction, any information concerning the assessment and analysis or the content of applications/proposals either during the proceedings of the review of pre-applications or proposals or at any subsequent time, to anyone who is not authorized access to the information by the Department of Energy or by law or regulation, and then only to the extent that such information is required in connection with such person's official responsibilities. Furthermore, I will report to the BEA/DOE Official responsible for the process any communication concerning the assessment and analysis or the individuals involved in the assessment and selection and activities directed to me from any source outside this process.

5. I certify that I will use approved methods to destroy hard copies of any applications that I receive, generate, or review. Approved destruction methods include shredding using a paper shredder with cross-cutting capabilities (confetti-sized results) or by burning. If I am unable to destroy the applications, I will return them to the Merit Review Chairman for appropriate destruction. I certify that I will remove all electronic copies of the application proposals and rating forms from my electronic storage media.