5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- Fresh Produce - Request for Quote
- Solicitation number
- DQ1 CAAA 2026000390 1
- Issued by
- Grand County, Colorado
About this file
This is a Vendor Disclosure Statement form issued by the Colorado Department of Corrections for the State of Colorado, designed to gather information from prospective vendors prior to contract execution. The document serves as a mandatory disclosure requirement for all state contracts for services, though it explicitly exempts contracts related to Medicare, the Colorado Medical Assistance Act, the Children Basic Health Plan Act, and the Colorado Indigent Care Program, as well as construction contracts. The form requires vendors to complete and return the disclosure statement to the contracting state agency or institution of higher education.
The Vendor Disclosure Statement requests four key pieces of information: the solicitation number (listed as DQ 2026), the vendor's name, the specific county(ies) and state(s) where contract services and any subcontract work will be performed, and a detailed explanation if services are anticipated to be performed outside the United States or the State of Colorado, including justification for why such out-of-state or international performance is necessary or advantageous. The form requires signature, date, printed name, and title of the authorized representative completing the disclosure. This disclosure mechanism ensures transparency regarding service delivery locations and enables the state to maintain oversight of contract performance and enforce local service requirements when applicable.
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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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