5. Exhibit D - Vendor Disclosure Stmt.pdf
PDF 122 KB Posted
- Attached to
- Manufacturing Space - CCi
- Solicitation number
- DQ1 CFAA 2026000001 3
- Issued by
- Garfield County, Colorado
About this file
This is a Vendor Disclosure Statement form issued by the Colorado Department of Corrections for state and local contract solicitation DQ 2026000001 related to Manufacturing Space services. The form requires prospective vendors to disclose information regarding contract performance locations and any work performed outside the United States or State of Colorado. Vendors must identify all counties and states where services, including any subcontracted work, will be performed. The disclosure statement applies to most state contracts but is specifically exempted from requirements for contracts under Medicare, the Colorado Medical Assistance Act, the Children Basic Health Plan Act, and the Colorado Indigent Care Program, as well as construction contracts.
If contract performance is anticipated to occur outside the United States or outside Colorado, vendors must provide a detailed explanation of why such geographic scope is necessary or advantageous. The form requires vendor signature, date, printed name, and title from an authorized representative. This disclosure mechanism ensures the state has visibility into vendor operations and supply chain locations prior to contract award, supporting the state's preference for in-state performance when feasible.
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Text version
Exhibit D
Colorado Department of Corrections
State of Colorado – Contract Management Information
Vendor Disclosure Statement
Contract Performance Outside of the United States of Colorado
Prior to Contracting, or as a requirement for the solicitation of any contract for services from the State of Colorado, a prospective vendor is required to disclose the following information in a statement of work.
Completing this Form
· To the extent the following information has not previously been disclosed in a statement of work, a prospective vendor shall complete this Vendor Disclosure Statement and return it to the contracting state agency or institution of higher education (IHE).
· This Disclosure Statement is not required for contracts under Medicare, the “Colorado Medical Assistance Act”, Articles 4 to 6 of Title 25.5 C.R.S., the “Children Basic Health Plan Act”, Article 8 of Title 25.5, C.R.S, or the “Colorado Indigent Care Program”, Part 1 of Article 3 of Title 25.5 C.R.S.
· This Disclosure Statement is not required for Construction contract.
1. Solicitation Number: DQ 2026000001
2. Vendor Name:_____________________________________________________________________
3. Where will the services under the contract, including any subcontracts, be performed? List all county(ies) and state(s).
4. If it is anticipated that services under the contract or any subcontracts will be performed outside of the United States or the State of Colorado, explain why it is necessary or advantageous to go outside the United States or the State of Colorado to perform the contract or any subcontracts.
Signature: __________________________________ Date:_____________________________________
Printed Name: ______________________________ Title: _____________________________________
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