6. Exhibit F - Non-Conflict of Interest.pdf

PDF 116 KB Posted

Attached to
Shotgun Transition
Solicitation number
DQ1 CAAA 2027000122 2
Issued by
Garfield County, Colorado

About this file

This is a Non-Conflict of Interest certification form required by the Colorado Department of Corrections for the Shotgun Transition contract opportunity in Colorado. Bidders must complete and return this document as part of their bid submission. The form requires the authorized signer to certify compliance with Colorado Revised Statutes sections 18-8-302, 18-8-306, 18-8-301, and 18-8-308, as well as the State of Colorado State Controller Policy on Procurement Conflicts of Interest. The signer must affirm the absence of any actual, potential, perceived, or apparent conflicts of interest and acknowledge understanding that the CDOC Procurement Official has authority to remove them from the procurement process at any time.

The certification further requires bidders to acknowledge receipt of State information and records, with the CDOC Procurement Official serving as the custodian of such information. Bidders certify they have no personal or beneficial interest in the services or property described and commit to immediately notifying the Procurement Agent of any situation that could alter their representations or create the appearance of conflict or impropriety. The form must be signed by an authorized representative of the bidding entity, whether a private employer employee or independent contractor under contract with the State of Colorado, and include the printed name of the signer and company name or doing-business-as designation.

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EXHIBIT F

COLORADO DEPARTMENT OF CORRECTIONS

STATE OF COLORADO

NON-CONFLICT OF INTEREST

(You must complete and return this document with Bid)

I have read Colorado Revised Statutes, 18-8-302, 18-8-306, 18-8-301, and 18-8-308, as amended, and no violations of such provisions are present.

I have read the State of Colorado State Controller Policy – Procurement conflicts of Interest

Policy (https://www.colorado.gov/pacific/osc/procurement-conflicts-interest-policy) and affirm I have no actual, potential, perceived or apparent conflicts of interest.

I understand the Procurement Official is empowered to remove me in any way he/she deems appropriate. I can request to be removed at any time, which can be granted or denied by the

Procurement Official.

I understand that as a participant in this process I may have access to State information and/or records. The CDOC Procurement Official is the custodian of records. Information shall not be distributed, sold or shared with any third party or used in any way except as expressly authorized.

I do not have any personal or beneficial interest in the service or property described in the attached Colorado Revised Statutes.

If I should become aware of any situation, which might arise, that could alter any of the representations above or that might otherwise create the appearance of a conflict or other impropriety, I will notify the Procurement Agent immediately.

I am an employee of a private employer or an independent contractor under contract with the

State of Colorado. I understand that I am receiving such information in such capacity.

Print Name of authorized signer and Signature of authorized signer

Print Company Name/dba

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