6. Exhibit F - Non-Conflict of Interest.pdf
PDF 116 KB Posted
- Solicitation number
- DQ1 CAAA 2027000003 1
- 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 participation in a state procurement process for Boiler Water Chemicals & Treatment services. The form mandates that bidders 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's Procurement Conflicts of Interest Policy. Bidders must affirm they have no actual, potential, perceived, or apparent conflicts of interest and must return the completed and signed document with their bid submission.
The certification requires bidders to acknowledge their understanding of restrictions on information access and distribution, confirm they have no personal or beneficial interest in the services described, and commit to immediately notifying the Procurement Agent of any circumstances that could create conflicts or impropriety. Bidders must also acknowledge that the CDOC Procurement Official retains authority to remove them from the process as deemed appropriate and that they are participating either as employees of private employers or as independent contractors under contract with the State of Colorado. The form requires the signature and printed name of an authorized signer as well as the company name or doing business as designation.
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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 .