7. Exhibit H - Non-conflict of Interest - Respondent.pdf
PDF 150 KB Posted
- Attached to
- Dental Prosthetics
- Solicitation number
- IFB1 CAAA 2026000169 3
- Issued by
- Garfield County, Colorado
About this file
This is a Non-Conflict of Interest certification form required by the State of Colorado, Department of Corrections (CDOC) for respondents participating in the Dental Prosthetics procurement process. The form requires signatories to affirm 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'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. The form acknowledges that participants may have access to State information and records, which are custodied by the CDOC Procurement Official and may not be distributed, sold, shared, or used except as expressly authorized.
The certification requires an authorized signer to affirm they are an employee of a private employer or an independent contractor under contract with the State of Colorado and that they have no personal or beneficial interest in the services or property described in the attached Colorado Revised Statutes. Signatories must commit to notifying the Procurement Agent immediately should any situation arise that could alter their representations or create the appearance of a conflict or impropriety. The form further acknowledges that the Procurement Official retains authority to remove participants as deemed appropriate, and participants may request removal at any time, subject to approval or denial by the Procurement Official.
View the file
Other files
Show all 11
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .