5. Exhibit E - Offeror Disclosure Stmt.pdf
PDF 172 KB Posted
- Attached to
- Dental Prosthetics
- Solicitation number
- IFB1 CAAA 2026000169 3
- Issued by
- Garfield County, Colorado
About this file
This is an Offeror Disclosure Statement issued by the Colorado Department of Corrections for a state contract opportunity (IFB #2026000169) related to Dental Prosthetics. The document requires prospective vendors to disclose information regarding contract performance locations and any work anticipated to be performed outside the United States or State of Colorado. Vendors must complete the form by providing their name, identifying all counties and states where services will be performed under the contract and any subcontracts, and explaining the necessity or business advantage of performing work outside the United States or Colorado if applicable. The disclosure statement is mandatory for all prospective vendors prior to contract award, with specific exemptions for Medicare-related contracts, Colorado Medical Assistance Act programs, Children Basic Health Plan Act programs, Colorado Indigent Care Program contracts, and construction contracts.
The disclosure statement does not establish pricing terms, set-asides, funding amounts, or other financial conditions. Rather, it serves as a compliance and transparency document requiring vendor certification through signature and printed name with title. This form must be returned to the contracting state agency and represents a prerequisite requirement for solicitation participation, ensuring the state maintains visibility into where contract performance will occur and can evaluate the appropriateness of any out-of-state or international service delivery arrangements.
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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: _____________________________________
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