5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- Fresh Eggs -Request for Quote
- Solicitation number
- DQ1 CAAA 2026000342 1
- Issued by
- Garfield County, Colorado
About this file
This is a Vendor Disclosure Statement form issued by the Colorado Department of Corrections for state contract opportunities. The document is a standardized disclosure requirement that prospective vendors must complete prior to contracting with the State of Colorado or any institution of higher education (IHE), unless the contract falls under specific exemptions including Medicare, Colorado Medical Assistance Act programs, the Children Basic Health Plan Act, the Colorado Indigent Care Program, or construction contracts. The form requires vendors to provide their solicitation number (DQ 2026), company name, and detailed information regarding where services will be performed, including all applicable counties and states.
The disclosure statement specifically requires vendors to identify whether any portion of contract performance, including subcontract work, will occur outside the United States or the State of Colorado, and if so, to provide a detailed explanation of the necessity or advantage of performing work outside these geographic boundaries. The completed form must be signed and dated by an authorized representative of the vendor with printed name and title included. This disclosure mechanism enables the state to maintain oversight of contract performance locations and ensure compliance with Colorado's preference for in-state service delivery while allowing for documented exceptions when external performance is justified.
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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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