Attachment B_Vendor Disclosure Statement_AHEC-17922-R.pdf

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Attached to
AHEC-17922-R - Transport Gas Contracting
Solicitation number
RFP GMAA 2017000272 2
Issued by
Denver County, Denver City, Colorado

About this file

This is a Vendor Disclosure Statement form required by Colorado Revised Statute 24-102-206 for state contracts involving services potentially performed outside the United States or Colorado. 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 subcontracts are anticipated to be performed outside the United States or Colorado. If services are to be performed outside these jurisdictions, vendors must specify the country or state where work will occur and provide justification for performing work outside the United States or Colorado. The form requires vendors to reference the contract routing number and identify the vendor name.

The disclosure requirement does not apply to certain categories of contracts, specifically those related to Medicare, the Colorado Medical Assistance Act, the Children's Basic Health Plan Act, or the Colorado Indigent Care Program. This form serves as a compliance mechanism to ensure transparency regarding offshore or out-of-state service performance and allows the contracting agency to evaluate the necessity and advantages of such arrangements before contract execution.

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ATTACHMENT B

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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