5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- CDOC Warehouse Fresh Produce Order
- Solicitation number
- DQ CAAA 2026000114
- Issued by
- Colorado
About this file
This document is a Vendor Disclosure Statement from the Colorado Department of Corrections requiring prospective vendors to disclose information about contract performance locations. The form is specifically designed for contract solicitations involving services from the State of Colorado, with specific exemptions for certain types of contracts including Medicare, medical assistance, children's health plans, and construction contracts. The document requires vendors to provide details about where contract services will be performed, including listing all counties and states involved.
The disclosure form mandates that if services are anticipated to be performed outside of the United States or Colorado, the vendor must explain why such external performance is necessary or advantageous. The form must be completed and returned to the contracting state agency or institution of higher education prior to or as part of the contract solicitation process. The form includes fields for the solicitation number, vendor name, performance locations, explanation of external service performance, and requires a signature, printed name, and title of the vendor representative.
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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: _____________________________________
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