Appendix D Vendor Disclosure Statement.pdf

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Attached to
CPRG Accelerator Research and Best Practices
Solicitation number
RFP EFAA 2027000006 1
Issued by
Denver County, Denver City, Colorado

About this file

This is a Vendor Disclosure Statement form issued by the State of Colorado on July 19, 2024, required under Colorado Revised Statute 24-102-206 for the CPRG Accelerator Research and Best Practices contract opportunity. The form applies to all state contracts and solicitations for services executed after August 3, 2007, and requires vendors to disclose whether any services under the contract or related subcontracts will be performed outside the United States or Colorado. If work is to be performed outside these jurisdictions, vendors must specify the country or state where services will be performed and provide justification for performing work outside U.S. or Colorado boundaries.

The disclosure statement exempts certain contracts from the requirement, including those related to Medicare, the Colorado Medical Assistance Act, the Children's Basic Health Plan Act, and the Colorado Indigent Care Program. Vendors must provide their name, contract routing number, and complete all applicable sections of the form when returning it to the contracting agency.

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Text version

July 19, 2024

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

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