5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 106 KB Posted
- Solicitation number
- DQ CFAA 2025000488
- Issued by
- Garfield County, Colorado
About this file
This document is a Vendor Disclosure Statement from the Colorado Department of Corrections for contract performance outside of the United States or Colorado. The form requires prospective vendors to disclose details about where contract services, including any subcontracts, will be performed. The document is specifically related to a solicitation for tab envelopes for motor vehicle registration, to be produced at the Colorado Correctional Industries (CCI) Tag Plant.
The disclosure statement is designed to ensure transparency about the geographical location of contract work, with specific exemptions for certain types of contracts such as those under Medicare, medical assistance, children's health plans, and construction contracts. Vendors must provide information about the counties and states where services will be performed, and if services are anticipated to be performed outside of the United States or Colorado, they must explain why such external performance is necessary or advantageous. The form requires the vendor's signature, printed name, and title, and is part of the contracting process for the Colorado Department of Corrections.
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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 2025__________________________________________________
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 .