5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- CDOC Warehouse Fresh Produce Order
- Solicitation number
- DQ CAAA 2026000177
- Issued by
- Garfield County, Colorado
About this file
This document is a Vendor Disclosure Statement from the Colorado Department of Corrections, specifically Exhibit E related to Contract Management Information. The form requires prospective vendors to disclose details about contract service performance locations, with specific exemptions for certain types of contracts including Medicare, medical assistance, children's health plans, and construction contracts. The form is designed to gather information about where contracted services will be performed, both within and outside of Colorado and the United States.
The disclosure form requires vendors to provide their solicitation number, vendor name, and details about service performance locations including counties and states. If services are anticipated to be performed outside of Colorado or the United States, vendors must explain why such external performance is necessary or advantageous. The document provides space for vendors to provide a signature, date, printed name, and title, indicating this is a formal documentation requirement for potential state contractors. The form appears to be part of a transparency and accountability process for state contract management.
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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 .