5. Exhibit E - Contract Performance Outside of the US.pdf
PDF 169 KB Posted
- Attached to
- Cable TV Call Out Repair Services
- Solicitation number
- DQ1 CFCA 2027000045 1
- Issued by
- Garfield County, Colorado
About this file
Exhibit E is a vendor disclosure and notification form issued by the Colorado Department of Corrections (CDOC) for State of Colorado contract opportunities. This form is required to be completed and returned with bids for non-construction contracts and serves as notice to the Department of Personnel when a vendor intends to perform services outside the United States or the State of Colorado. Bidders must disclose whether any services under the contract or subcontracts will be performed outside Colorado or the U.S., and if so, must specify the type of services, geographic locations where services will be performed, and the justification for performing work outside the specified jurisdictions. The form requires completion by the business's President, Board Chairperson, or Contract's Authorized Signatory.
The form contains fields for vendor signature, printed name, title, and date. A "For Procurement Use Only" section requires documentation of the solicitation number (2027000045 for the Cable TV Call Out Repair Services opportunity), contract type, type of services performed outside the U.S. or Colorado, and whether the vendor provided notice within 20 days of contracting or deciding to contract outside the U.S. or Colorado, as required by Colorado Revised Statutes 24-102-205 and 24-102-206. Completion and submission of this form is mandatory for bid consideration.
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Text version
EXHIBIT E
CONTRACT PERFORMANCE OUTSIDE THE UNITED STATES OR
COLORADO
COLORADO DEPARTMENT OF CORRECTIONS (CDOC)
STATE OF COLORADO
(You must complete and return this document with Bid)
VENDOR DISCLOSURE & NOTIFICATION (NON-CONSTRUCTION)
In accordance with the Colorado Revised Statues §24-102-206(1)(a) or CRS §24-102-206(b), this form serves as notice to the Department of Personnel, that the undersigned governmental body awarded a contract to a vendor that has provided written notice pursuant to CRS §24-102- 205(1)(a) or CRS §24-102-205(b) that the vendor or the vendor’s subcontractor will perform services under the contract outside the United States or the State of Colorado to perform such services.
The person completing this form should be the business’ President, Board Chairperson, Contract’s Authorized Signatory.
Contractor Name:
This form shall be completed and returned to the Sole Contact listed on the solicitation.
1. Are any services under the contract or any subcontracts anticipated to be performed outside the United States of Colorado? Please Answer Yes or No.
If “Yes”, please complete the following two questions and then sign the form.
If “No”, please sign the form.
2. Type of Service(s) Performed Outside of the U.S. or Colorado. Describe all services to be performed (e.g. Software, Hosting, Technical & Product Support, Server & Monitoring System, Design & Development, etc.).
3. Where will the services be performed under the PO/Contract, including any subcontracts?
(List country(ies) and/or state(s)).
4. Explain why it is necessary or advantageous to go outside the United States or the State of Colorado to perform the services under the contract or any subcontracts.
Signature:__________________________ Printed Name:________________________
Title: _____________________________ Date:_______________________________
FOR PROCUREMENT USE ONLY
Solicitation Number:2027000045 Type of Contract: Purchase Order Type of Services Performed Outside the U.S. or Colorado:
Did the vendor provide notice within 20 days of contracting or deciding to contract outside the US or Colorado Yes_________ No_______________
| EXHIBIT E | |
| CONTRACT PERFORMANCE OUTSIDE THE UNITED STATES OR COLORADO | |
| COLORADO DEPARTMENT OF CORRECTIONS (CDOC) | |
| STATE OF COLORADO | |
| (You must complete and return this document with Bid) | |
| VENDOR DISCLOSURE & NOTIFICATION (NON-CONSTRUCTION) | |
| In accordance with the Colorado Revised Statues §24-102-206(1)(a) or CRS §24-102-206(b), this form serves as notice to the Department of Personnel, that the undersigned governmental body awarded a contract to a vendor that has provided written notice pursuant to CRS §24-102-205(1)(a) or CRS §24-102-205(b) that the vendor or the vendor’s subcontractor will perform services under the contract outside the United States or the State of Colorado to perform such services. | |
| The person completing this form should be the business’ President, Board Chairperson, Contract’s Authorized Signatory. | |
| Contractor Name: | |
| This form shall be completed and returned to the Sole Contact listed on the solicitation. | |
| 1. Are any services under the contract or any subcontracts anticipated to be performed outside the United States of Colorado? Please Answer Yes or No. | |
| If “Yes”, please complete the following two questions and then sign the form. | |
| If “No”, please sign the form. | |
| 2. Type of Service(s) Performed Outside of the U.S. or Colorado. Describe all services to be performed (e.g. Software, Hosting, Technical & Product Support, Server & Monitoring System, Design & Development, etc.). | |
| 3. Where will the services be performed under the PO/Contract, including any subcontracts? (List country(ies) and/or state(s)). | |
| 4. Explain why it is necessary or advantageous to go outside the United States or the State of Colorado to perform the services under the contract or any subcontracts. | |
| Signature:__________________________ | Printed Name:________________________ |
| Title: _____________________________ | Date:_______________________________ |
| FOR PROCUREMENT USE ONLY | |
| Solicitation Number: | |
| Type of Contract: | |
| Type of Services Performed Outside the U.S. or Colorado: | |
| Did the vendor provide notice within 20 days of contracting or deciding to contract outside the US or Colorado Yes_________ No_______________ |
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