5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 149 KB Posted
- Attached to
- Fresh Eggs - Request for Quote
- Solicitation number
- DQ1 CAAA 2026000412 1
- Issued by
- Grand County, Colorado
About this file
This is a Vendor Disclosure Statement form issued by the Colorado Department of Corrections for state contract solicitation DQ 2026. The form requires prospective vendors to disclose information regarding contract performance locations and any work performed outside the United States or State of Colorado. Vendors must complete the disclosure statement prior to contracting or as part of the solicitation process and return it to the contracting state agency. The form requests identification of all counties and states where services, including any subcontract work, will be performed. The disclosure statement is not required for contracts funded under Medicare, the Colorado Medical Assistance Act, the Children Basic Health Plan Act, or the Colorado Indigent Care Program, nor is it required for construction contracts.
If services under the contract or any subcontracts are anticipated to be performed outside the United States or the State of Colorado, vendors must provide a detailed explanation of why such outside performance is necessary or advantageous. The completed form, including vendor name, solicitation number, service locations, and authorized signature with printed name and title, must be submitted to the contracting state agency as part of the vendor's proposal package for the Fresh Eggs Request for Quote 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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