5. Exhibit E - Offeror Disclosure Stmt.pdf
PDF 127 KB Posted
- Solicitation number
- IFB1 CAAA 2026000190 1
- Issued by
- Garfield County, Colorado
About this file
This is an Offeror Disclosure Statement issued by the Colorado Department of Corrections for state and local contract opportunities. The form is required for prospective vendors seeking contracts with the State of Colorado prior to contracting or as a solicitation requirement, except for contracts related to Medicare, the Colorado Medical Assistance Act, the Children Basic Health Plan Act, or the Colorado Indigent Care Program, and construction contracts are exempted from this requirement.
The disclosure statement requires vendors to provide the solicitation number, vendor name, and 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 the State of Colorado, vendors must explain why such performance outside these jurisdictions is necessary or advantageous. The completed form must be signed and dated by an authorized representative of the vendor, including their printed name and title, and returned to the contracting state agency.
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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 # __________________________________________________________
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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