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

PDF 116 KB Posted

Attached to
Boiler Chemicals & Treatment SRVS at TCF - Documented Quote
Solicitation number
DQ1 CAAA 2027000037 3
Issued by
Larimer County, Colorado

About this file

This document is a Non-Conflict of Interest certification form issued by the Colorado Department of Corrections. The form requires bidders to acknowledge 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's Procurement Conflicts of Interest Policy. Bidders must affirm that they have no actual, potential, perceived, or apparent conflicts of interest and understand that the Procurement Official has authority to remove them from the process as deemed appropriate. The form emphasizes that participants may have access to State information and records, which must not be distributed, sold, shared with third parties, or used except as expressly authorized, with the CDOC Procurement Official serving as the custodian of records.

Signers certify that they have no personal or beneficial interest in the services or property described and commit to immediately notifying the Procurement Agent if any situation arises that could alter their representations or create the appearance of conflict or impropriety. The signatory must be an authorized representative of either a private employer or an independent contractor under contract with the State of Colorado. The completed and signed document must be returned with the bid submission as a mandatory requirement.

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Text version

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 .