9. Exhibit - Non-conflict of Interest - Respondent.pdf
PDF 152 KB Posted
- Attached to
- Fresh Produce - Request for Quote
- Solicitation number
- DQ1 CAAA 2026000411 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 (CDOC) for respondents participating in a Fresh Produce Request for Quote procurement process. The form requires authorized signatories to 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's Procurement Conflicts of Interest Policy. Respondents must affirm that they have no actual, potential, perceived, or apparent conflicts of interest related to the service or property described in the procurement opportunity. The certification acknowledges that participants may have access to State information and records, which must not be distributed, sold, shared with third parties, or used except as expressly authorized.
The form serves as a binding attestation that the respondent understands the Procurement Official's authority to remove them from the process and acknowledges their right to request removal at any time, subject to the Procurement Official's approval or denial. Signatories must declare their employment status as either a private employer employee or independent contractor under contract with the State of Colorado and agree to notify the Procurement Agent immediately if any situation arises that could alter their representations or create the appearance of conflict or impropriety. The form requires the printed name and signature of an authorized signer as well as the company name or doing business as (dba) designation.
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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 .