6. Exhibit F - Non-Conflict of Interest.pdf
PDF 116 KB Posted
- Solicitation number
- DQ1 CAAA 2027000048 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 the Boiler Chemicals & Treatment procurement at DWCF/DRDC. The document serves as a certification that the authorized signer has reviewed Colorado Revised Statutes 18-8-302, 18-8-306, 18-8-301, and 18-8-308, and affirms compliance with the State of Colorado State Controller Policy on Procurement Conflicts of Interest. Bidders must complete and return this document with their bid submission as a mandatory requirement of participation in the procurement process.
The signatory certifies the absence of actual, potential, perceived, or apparent conflicts of interest and acknowledges understanding that the CDOC Procurement Official has authority to remove them from the process at any time. The declarant also agrees to maintain confidentiality of any State information or records accessed during the procurement process and commits to immediately notifying the Procurement Agent of any situations that could alter the representations made or create an appearance of conflict or impropriety. The form requires the printed name, signature of an authorized signer, and the company name or dba, confirming the bidder's status as either a private employer employee or independent contractor 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
File details come from the government source that posted it. Updated .