5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- CDOC Warehouse Fresh Produce Order
- Solicitation number
- DQ CAAA 2026000137
- Issued by
- Garfield County, Colorado
About this file
This document is a Vendor Disclosure Statement from the Colorado Department of Corrections, designed to capture information about potential contract performance locations for state solicitations. The form requires prospective vendors to disclose the geographic locations where contract services, including subcontractor work, will be performed. Specific exemptions are noted for certain types of contracts, including those related to Medicare, medical assistance, children's health plans, and construction contracts.
The disclosure form requires vendors to list all counties and states where services will be performed, and if any work is anticipated to occur outside of the United States or Colorado, vendors must explain the necessity or advantages of performing work outside these jurisdictions. Vendors must complete the form prior to contracting or as part of a service solicitation, signing and dating the document to certify the accuracy of their disclosed information. The form includes fields for solicitation number, vendor name, service locations, explanation of out-of-state/country work, signature, printed name, and title.
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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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