6. Exhibit F - Non-Conflict of Interest.pdf
PDF 116 KB Posted
- Solicitation number
- DQ1 CAAA 2027000003 2
- Issued by
- Garfield County, Colorado
About this file
This is a Non-Conflict of Interest declaration form required by the Colorado Department of Corrections for bidders participating in a Boiler Water Chemicals & Treatment documented quote procurement. The document serves as a mandatory compliance certification that must be completed and submitted with bids. Bidders must affirm they have reviewed Colorado Revised Statutes sections 18-8-302, 18-8-306, 18-8-301, and 18-8-308, and certify they have no actual, potential, perceived, or apparent conflicts of interest in accordance with the State of Colorado State Controller's Procurement Conflicts of Interest Policy. The form confirms the bidder's understanding that the CDOC Procurement Official reserves the right to remove them from the procurement process at any time and that bidders may request removal at the Procurement Official's discretion.
The declaration requires bidders to acknowledge they may have access to State information and records during the procurement process, which must be treated as confidential and not distributed, sold, shared with third parties, or used except as expressly authorized. Signatories must represent they have no personal or beneficial interest in the services described and commit to immediately notifying the Procurement Agent if any situation arises that could alter their representations or create an appearance of conflict or impropriety. The form designates the CDOC Procurement Official as the custodian of records and applies to employees of private employers or independent contractors under contract with the State of Colorado.
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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
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