7. Exhibit H - Non-conflict of Interest - Respondent.pdf
PDF 150 KB Posted
- Attached to
- Dental Prosthetics
- Solicitation number
- IFB1 CAAA 2026000169 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 (CDOC) for respondents participating in the Dental Prosthetics state and local contract opportunity in Colorado. The form serves as an attestation that the signatory has reviewed applicable Colorado Revised Statutes sections 18-8-302, 18-8-306, 18-8-301, and 18-8-308, and affirms compliance with the State of Colorado State Controller's Procurement Conflicts of Interest Policy. Respondents must certify that they have no actual, potential, perceived, or apparent conflicts of interest related to the procurement process.
The declaration requires authorized signatories to acknowledge their understanding that the CDOC Procurement Official has authority to remove participants as deemed appropriate and that participants may request removal at any time. Respondents must also confirm they understand that access to State information and records may be granted during the procurement process and that such information cannot be distributed, sold, or shared with third parties except as expressly authorized. The form requires signatories to commit to notifying the Procurement Agent immediately if any situation arises that could alter representations made or create the appearance of conflict or impropriety. The signatory must also certify that they are either an employee of a private employer or an independent contractor under contract with the State of Colorado and are receiving information in that capacity.
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Text version
NON-CONFLICT OF INTEREST
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 .