6. Exhibit F - Non-Conflict of Interest.pdf
PDF 116 KB Posted
- Solicitation number
- DQ1 CAAA 2027000071 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 procurement process for Boiler Chemicals & Treatment Services at a Facilities Care Facility through a documented quote solicitation. The form mandates that all bidders certify compliance with Colorado Revised Statutes sections 18-8-302, 18-8-306, 18-8-301, and 18-8-308, as well as the State of Colorado State Controller Policy on Procurement Conflicts of Interest. Bidders must affirm they have no actual, potential, perceived, or apparent conflicts of interest and acknowledge understanding that the CDOC Procurement Official has authority to remove them from the process at any time. The form requires signature and authorization from the bidder's representative and must be submitted with the bid.
The declaration obligates bidders to maintain confidentiality of any State information or records accessed during the procurement process and prohibits distribution, sale, or sharing of such information with third parties except as expressly authorized. Bidders must affirm they have no personal or beneficial interest in the services described and commit to immediately notifying the Procurement Agent of any situations that could create conflicts of interest or appearances of impropriety. The form applies to employees of private employers and independent contractors under contract with the State of Colorado, establishing the framework for ethical participation in this documented quote procurement for boiler chemical treatment services.
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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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