5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 160 KB Posted
- Attached to
- Women's Specialty Items - Canteen
- Solicitation number
- DQ 2025000119
- Issued by
- Garfield County, Colorado
About this file
The document is a Vendor Disclosure Statement from the Colorado Department of Corrections for the Solicitation Number DQ 2025000119, which is part of the Women's Specialty Items - Canteen contract opportunity. The form requires prospective vendors to disclose information about where contract services will be performed, including any services conducted outside of the United States or Colorado.
The disclosure statement is specifically designed to gather transparency about potential contract performance locations and any advantages of performing services outside of Colorado or the United States. The form is not required for certain types of contracts, including those under Medicare, Colorado Medical Assistance Act, Children's Basic Health Plan Act, Colorado Indigent Care Program, or construction contracts. Vendors must complete the form by listing the counties and states where services will be performed and provide explanations if any services are anticipated to be performed outside of Colorado or the United States.
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Text version
Exhibit E
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 2025000119
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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