5. Exhibit E - Vendor Disclosure Stmt.pdf
PDF 616 KB Posted
- Attached to
- Watches & Glasses - Canteen
- Solicitation number
- DQ 2025000178
- Issued by
- Garfield County, Colorado
About this file
This document is a Vendor Disclosure Statement for the Colorado Department of Corrections (CDOC) related to a contract opportunity for Watches & Glasses through the Canteen Services program. The form is specifically designed to capture information about potential contract performance locations, with Solicitation Number DQ 2025000178. The disclosure statement requires vendors to provide details about where services will be performed, including any subcontractor locations, and to explain any need to perform services outside of the United States or Colorado.
The form includes exemptions for certain types of contracts, such as those under Medicare, Colorado Medical Assistance Act, Children's Basic Health Plan, and construction contracts. It requires prospective vendors to complete and return the disclosure statement to the contracting state agency, detailing the geographical locations of service performance and justifying any work performed outside of the specified regions. The document is part of the state's contract management process, ensuring transparency and accountability in vendor selection and service delivery.
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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 2025000178
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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