Appendix D - Service Disclosure Form.pdf
PDF 173 KB Posted
- Attached to
- John Deere Construction OEM P@S
- Solicitation number
- IFB 26-026 RM
- Issued by
- Denver County, Denver City, Colorado
About this file
This document is a Service Disclosure Form from the Colorado Department of Transportation (CDOT) requiring vendors to provide detailed information about their independent contractor status. The form is designed to verify compliance with Colorado Revised Statute 24-102-206, which mandates disclosure of service performance locations both outside Colorado and outside the United States.
The form requires contractors to provide percentages and monetary values of services performed outside Colorado and the United States, and answer a comprehensive series of yes/no/not applicable questions about their business operations. These questions cover aspects such as client diversity, business registration, use of retired state employees, business ownership, service offerings, training requirements, work performance autonomy, property usage, equipment provisioning, insurance coverage, billing methods, and organizational structure. The goal appears to be determining the precise nature of the contractor's relationship with the state and ensuring proper classification of their working arrangement.
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APPENDIX D - SERVICE DISCLOSURE
FORM
Vendor Disclosure Statement
In compliance the Contractor Performance Outside the United States or Colorado, CRS 24-102-206, the awarded Supplier is required to disclose information on where the services will be performed under this award.
Indicate percent and value of Services Performed:
Outside Colorado - ___________% $_________________ value
Outside United States - ___________% $_________________ value
Independent contractor information. Please select Yes, No, or NA (Not applicable) for each question.
YES NO NA
Is the State the only client the contractor works with?
Is the contractor registered with the Secretary of
State’s Office and/or the IRS to conduct business as an independent contractor?
Does the contractor hire retired state employees to perform the work?
Does the contractor have their own place of business?
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YES NO NA
Does the contractor offer services to the general public and have other clients?
Does the contractor need to be trained by the State to be able to provide the service?
Does the contractor determine how and when the services will be performed?
Does the contractor work on state property?
Does the State control the route or location where the work must be performed?
Does the State provide the contractor with equipment, tools or materials to conduct the work?
Does the contractor have unemployment and workers’ compensation insurance?
Does the contractor have direct daily control over state employees?
Is your company a sole proprietor?
Does the contractor bill by an hourly rate?
Does the contractor bill by a lump sum?
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