6. Exhibit F - Non-Conflict of Interest.pdf
PDF 91 KB Posted
- Attached to
- Cable TV Call Out Repair Services
- Solicitation number
- DQ1 CFCA 2027000045 1
- 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 the Cable TV Call Out Repair Services contract opportunity. The form serves as a mandatory certification that must be completed and submitted with all bids. Bidders must attest that they have reviewed Colorado Revised Statutes sections 18-8-302, 18-8-306, 18-8-301, and 18-8-308, and confirm compliance with the State of Colorado State Controller Policy on Procurement Conflicts of Interest. The signatory affirms the absence of any actual, potential, perceived, or apparent conflicts of interest related to the contract opportunity.
The declaration requires that authorized signatories acknowledge understanding of their obligations regarding access to State information and records, which are custodied by the CDOC Procurement Official and may not be distributed, sold, shared with third parties, or used except as expressly authorized. Signatories must disclose any personal or beneficial interest in the services described and commit to immediately notifying the Procurement Agent of any situation that could alter the representations made or create the appearance of conflict or impropriety. The form applies to employees of private employers or independent contractors under contract with the State of Colorado and must include the printed name, signature of an authorized signer, and 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 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
File details come from the government source that posted it. Updated .