5. Exhibit E - Vendor Disclosure Stmt.pdf

PDF 149 KB Posted

Attached to
September Meat & Cheese Request for Quote
Solicitation number
DQ1 CAAA 2027000009 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 is required for prospective vendors prior to contracting or as a requirement for solicitation of any contract for services from the State of Colorado, with the exception of contracts under Medicare, the Colorado Medical Assistance Act, the Children Basic Health Plan Act, the Colorado Indigent Care Program, or construction contracts. The solicitation number referenced is DQ 2026. Vendors are required to disclose the locations where services under the contract and any subcontracts will be performed, listing all applicable counties and states.

The primary disclosure requirement of this form pertains to contract performance outside the United States or the State of Colorado. If services are anticipated to be performed outside these geographic boundaries, vendors must provide a detailed explanation of why it is necessary or advantageous to perform work outside the United States or Colorado. Vendors must complete the form by providing their company name, identifying the performance locations, and submitting a signed statement with the printed name, title, and date of the authorized representative. This disclosure mechanism serves to ensure transparency regarding vendor operations and subcontract arrangements before the state enters into contractual agreements.

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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: _____________________________________

File details come from the government source that posted it. Updated .