6. Exhibit F - Non-Conflict of Interest.pdf
PDF 169 KB Posted
- Attached to
- Fresh Produce - Request for Quote
- Solicitation number
- DQ1 CAAA 2027000084 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 bid submission. The form requires authorized signers to certify compliance with Colorado Revised Statutes 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 declare they have no actual, potential, perceived, or apparent conflicts of interest related to the procurement. The form must be completed and returned with the bid submission and requires the printed name, signature of an authorized signer, and the company name or doing-business-as designation.
The certification acknowledges that signers understand the Procurement Official's authority to remove participants as deemed appropriate and that participants may request removal at any time, subject to approval or denial by the Procurement Official. Signers confirm they do not have personal or beneficial interest in the services or property described in the procurement and agree to notify the Procurement Agent immediately if any situation arises that could alter these representations or create the appearance of conflict or impropriety. The form specifies that signers are employees of private employers or independent contractors under contract with the State of Colorado and are receiving information in that capacity, with the CDOC Procurement Official serving as custodian of records and prohibiting distribution, sale, or sharing of information with third parties except as expressly authorized.
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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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