Attachment 4 - Vendor Disclosure Statement.doc
DOC document 34 KB Posted
- Attached to
- Topper Bid
- Solicitation number
- DQ1 AADA 2016000735 6
- 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 for contract DQ1-4100-2016-735. The form applies to all state contracts and solicitations for services executed after August 3, 2007, and must be completed by vendors who have not disclosed relevant information in the Statement of Work. The form requires vendors to disclose whether any services under the contract or subcontracts will be performed outside the United States or Colorado, and if so, to identify the specific countries and states where work will occur and provide justification for performing work outside these jurisdictions.
The disclosure requirement does not apply to contracts involving Medicare, the Colorado Medical Assistance Act, the Children's Basic Health Plan Act, or the Colorado Indigent Care Program. Vendors are required to return the completed form to the contracting agency, providing their name, the contract routing number, and responses to all applicable questions regarding out-of-state or out-of-country service performance.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment 1- Process Guide for Contractors- Agencies- SCO Form- 2008.pdf | ||
| DQ1-AADA-2016-735 Pickup Truck Toppers.pdf | ||
| Attachment 3 - Contractor Affirmation- SCO Form- 2008.pdf | ||
| Attachment 6 - Insurance Requirements.doc | DOC document | |
| Addendum_2 version 2.doc | DOC document | |
| Addendum_1.doc | DOC document | |
| Exhibit B - PO_Terms_&_Conditions_1-1-09.pdf | ||
| Attachment 5_ W-9.pdf | ||
| Attachment 2 - Notice to Participate- SCO Form- 2008.pdf | ||
| Addendum_3.doc | DOC document |
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Text version
DQ1-4100-2016-735
Attachment 4
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
This Page Must Be Completed and Returned.
File details come from the government source that posted it. Updated .