6. Exhibit F - Non-Conflict of Interest.pdf
PDF 169 KB Posted
- Attached to
- Fresh Produce - Request for Quote
- Solicitation number
- DQ1 CAAA 2027000016 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 bidders participating in a Fresh Produce Request for Quote procurement process. The document requires authorized signatories to certify compliance with Colorado Revised Statutes sections 18-8-302, 18-8-306, 18-8-301, and 18-8-308, and to affirm adherence to the State of Colorado State Controller Policy on Procurement Conflicts of Interest. Bidders must confirm they have no actual, potential, perceived, or apparent conflicts of interest related to the procurement opportunity and acknowledge understanding that the Procurement Official has authority to remove them from the process as deemed appropriate.
The form obligates signatories to disclose any personal or beneficial interest in the services or property being procured and requires immediate notification to the Procurement Agent if any situation arises that could alter prior representations or create the appearance of conflict or impropriety. Bidders certify they are employees of private employers or independent contractors under contract with the State of Colorado and acknowledge receiving procurement information in that capacity. The Colorado Department of Corrections Procurement Official serves as the custodian of records, and all information provided is restricted from distribution, sale, or sharing with third parties except as expressly authorized. This completed certification must be submitted with the bid as a mandatory submission 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 by
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
| 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 do not have any personal or beneficial interest in the service or property described in the attached Colorado Revised Statutes. |
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