5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- Fresh Eggs - Request for Quote
- Solicitation number
- DQ1 CAAA 2026000395 1
- Issued by
- Garfield County, Colorado
About this file
This is a Vendor Disclosure Statement form required by the Colorado Department of Corrections for prospective vendors bidding on state contracts. The form mandates that vendors disclose information regarding contract performance locations and any work performed outside the United States or State of Colorado prior to contract award. Vendors must identify all counties and states where services, including subcontract work, will be performed. The solicitation applies to Contract Number DQ 2026 and requires completion and return of the disclosure statement to the contracting state agency or institution of higher education. The form is not applicable to contracts funded through Medicare, the Colorado Medical Assistance Act, the Children Basic Health Plan Act, or the Colorado Indigent Care Program, nor does it apply to construction contracts.
Vendors must explain the necessity or advantage of performing any contract or subcontract work outside the United States or Colorado if such performance is anticipated. The disclosure statement requires vendor name, signature, printed name, title, and date of completion. This document serves as a transparency mechanism to ensure the state understands where contracted services will be delivered and the rationale for any work performed outside state or national borders.
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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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