5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- Fresh Produce - Request for Quote
- Solicitation number
- DQ1 CAAA 2026000411 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 serves as a pre-contracting requirement for prospective vendors seeking to perform services for the State of Colorado, specifically related to solicitation number DQ 2026 for a Fresh Produce Request for Quote opportunity.
The disclosure statement requires vendors to provide information regarding where contract services, including any subcontract work, will be performed by listing all relevant counties and states. Additionally, vendors must explain the necessity or business advantage of performing any portion of the contract work outside the United States or the State of Colorado. The form exempts certain contract types from this disclosure requirement, including those funded under Medicare, the Colorado Medical Assistance Act, the Children Basic Health Plan Act, the Colorado Indigent Care Program, and construction contracts. Vendors must sign and date the completed disclosure statement with printed name and title, and return it to the contracting state agency prior to contract award.
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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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