5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- Fresh Eggs - Request for Quote
- Solicitation number
- DQ1 CAAA 2026000353 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 contracts. The form requires prospective vendors to disclose information regarding contract performance locations and any work performed outside the United States or Colorado prior to contract award. The disclosure statement applies to services contracts and must be completed and submitted to the contracting state agency, though it is not required for Medicare, Colorado Medical Assistance Act programs, Children Basic Health Plan Act programs, Colorado Indigent Care Program contracts, or construction contracts. The solicitation number referenced is DQ 2026, and vendors must identify all counties and states where contract services, including any subcontract work, will be performed.
If services are anticipated to be performed outside the United States or the State of Colorado, vendors are required to provide a written explanation detailing the necessity or advantage of performing work outside these geographic boundaries. The form requires vendor signature, printed name, title, and date of completion. This disclosure mechanism ensures the state has transparency regarding where contracted services will be delivered and allows for evaluation of whether out-of-state or international performance is justified for the contract opportunity.
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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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