5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- Beige Bed Sheeting Fabric - CCi Garment Shop
- Solicitation number
- DQ CFAA 2026000091
- Issued by
- Larimer County, Colorado
About this file
The document is a Vendor Disclosure Statement from the Colorado Department of Corrections, specifically Exhibit E for Contract Management Information regarding contract performance outside of the United States or Colorado. This form is a mandatory disclosure requirement for prospective vendors seeking to contract with the State of Colorado, with the purpose of identifying where contracted services will be performed. 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.
The disclosure statement requires vendors to provide detailed information about the geographic locations where contract services will be performed, including all counties and states. If services are anticipated to be performed outside of the United States or Colorado, vendors must explain the necessity or advantages of performing work outside these jurisdictions. The form includes fields for the solicitation number, vendor name, service locations, explanation of out-of-state/country work, and requires a signature, printed name, and title of the vendor representative completing the disclosure.
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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 2026__________________________________________________
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 .