5. Exhibit E - Offeror Disclosure Stmt.pdf
PDF 172 KB Posted
- Attached to
- Dental Prosthetics
- Solicitation number
- IFB1 CAAA 2026000169 1
- Issued by
- Garfield County, Colorado
About this file
This is an Offeror Disclosure Statement form issued by the Colorado Department of Corrections for state procurement purposes. The document requires prospective vendors to disclose information regarding contract performance locations and any work anticipated to be performed outside the United States or the State of Colorado. The form applies to the Dental Prosthetics contract opportunity (IFB # 2026000169) and must be completed and returned by vendors prior to contracting or as a requirement of solicitation. The disclosure statement is not applicable to contracts under Medicare, the Colorado Medical Assistance Act, the Children Basic Health Plan Act, or the Colorado Indigent Care Program, nor is it required for construction contracts.
Vendors are required to identify all counties and states where services under the contract, including any subcontracts, will be performed. If services are anticipated to be performed outside the United States or Colorado, vendors must provide an explanation detailing why it is necessary or advantageous to perform work outside these jurisdictions. The completed form must be signed and dated by an authorized representative of the vendor, including the printed name and title of the signatory.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Exhibit E
Colorado Department of Corrections
State of Colorado – Contract Management Information
Offeror 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: IFB # 2026000169___________________________________________
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: _____________________________________
File details come from the government source that posted it. Updated .