Appendix D - Vendor Disclosure Statement.pdf
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- Solicitation number
- DQ1 GMAA 2027000105 4
- Issued by
- Denver County, Denver City, Colorado
About this file
This is a Vendor Disclosure Statement form required by the State of Colorado under Colorado Revised Statute 24-102-206, applicable to all state contracts and solicitations for services executed after August 3, 2007. The form requires vendors to disclose whether any services under a contract or subcontracts will be performed outside the United States or Colorado. If services are to be performed outside these jurisdictions, vendors must identify the specific countries and states where work will occur and provide a detailed explanation of the necessity or advantage of performing work outside the United States or Colorado. The form also requires vendors to provide their name and the contract routing number for tracking purposes.
The disclosure statement is not required for contracts related to specific Colorado programs, including Medicare, the Colorado Medical Assistance Act, the Children's Basic Health Plan Act, and the Colorado Indigent Care Program. This form serves as a compliance and transparency mechanism to ensure the State of Colorado has visibility into offshore or out-of-state service delivery before contract execution.
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Text version
August 11, 2026
VENDOR DISCLOSURE STATEMENT
Contract Performance Outside the United States or Colorado
Colorado Revised Statute 24-102-206
To the extent the vendor has not disclosed the following information in the Statement of Work, this form shall be completed and returned to the contracting agency. This applies to all state contracts and solicitation for services executed after August 3, 2007.
1. Are any services under the contract or any subcontracts anticipated to be performed outside the United States or Colorado?
Yes No
If “Yes”, please complete the following three questions:
2. Where will the services be performed under the contract, including any subcontracts?
(List country(ies) and/or state(s).
3. Explain why it is necessary or advantageous to go outside of the United States or the State of Colorado to perform the contract or any subcontracts.
4. Contract Routing Number:
Vendor Name:
Not required for contracts to which the State is a party under:
• Medicare
• The “Colorado Medical Assistance Act”, Articles 4 to 6 of Title 25.5 CRS
• The “Children/s Basic Health Plan Act”, Article 8 of Title 25.5, CRS
• The “Colorado Indigent Care Program”, Part I of Article 4 of Title 25.5, CRS
APPENDIX D
AP
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