5. Exhibit E - Vendor Disclosure Stmt.pdf

PDF 114 KB Posted

Attached to
Vivotek Camera Products
Solicitation number
2025000395
Issued by
Garfield County, Colorado

About this file

This document is an Exhibit E Vendor Disclosure Statement from the Colorado Department of Corrections, designed to capture information about contract performance locations for state solicitation DQ 2025000395. The form requires prospective vendors to disclose where services under the contract, including any subcontracts, will be performed, and to explain any necessity for performing work outside of the United States or Colorado. The disclosure is mandatory for most state service contracts, with specific exemptions for certain healthcare-related contracts and construction contracts.

The form provides a template for vendors to detail their service locations and justify any work performed outside of Colorado or the United States. Vendors must complete the document, including their company name, service locations, and potential rationale for out-of-state or out-of-country work. The document requires a signature, printed name, and title, serving as an official disclosure mechanism for the Colorado Department of Corrections to understand the geographical scope of potential contract work.

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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 2025000395

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 .