Appendix D - Service Disclosure Form.pdf
PDF 173 KB Posted
- Attached to
- Caterpillar Construction Equipment OEM P@S
- Solicitation number
- IFB 26-025 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), designed to determine the independent contractor status of a potential vendor. The form requires the contractor to disclose information about service performance locations, specifically noting percentages of work performed outside of Colorado and outside the United States. The form includes a comprehensive checklist of yes/no/not applicable questions to evaluate the contractor's business practices, independence, and relationship with the state.
The questionnaire covers various aspects of the contractor's business operations, including client diversity, business registration, employment practices, service delivery methods, insurance coverage, billing practices, and operational autonomy. Key areas of inquiry include whether the state is the contractor's only client, if the contractor has their own place of business, determines service performance methods, offers services to the general public, has proper insurance, and bills by hourly rate or lump sum. The form appears to be part of CDOT's vendor qualification and compliance process, aimed at ensuring proper classification of independent contractors and transparency in service procurement.
View the file
Other files
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
Page | 1 of 2
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?
Page | 2 of 2
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?
File details come from the government source that posted it. Updated .