Attachment B - Vendor Disclosure Stmt.pdf
PDF 642 KB Posted
- Attached to
- Program Developer for Peer Programs
- Solicitation number
- DQ 2024000056
- Issued by
- Lincoln County, Colorado
About this file
This document is a Vendor Disclosure Statement for the Colorado Department of Corrections (CDOC), specifically related to Solicitation Number DQ 2024000056. The form is a mandatory disclosure document under Colorado Revised Statutes §24-102-206, requiring prospective vendors to provide information about where contract services will be performed, including any subcontracts. The form is designed to capture details about service locations and potential performance outside of the United States or Colorado.
The disclosure statement is not required for certain types of contracts, including those under Medicare, medical assistance programs, children's health plans, and construction contracts. Vendors must complete the form prior to contracting or as part of the solicitation process, detailing the counties and states where services will be performed and explaining any anticipated work outside of the United States or Colorado. The form requires the vendor's signature, printed name, and title to validate the disclosed information.
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Text version
Attachment B State of Colorado – Contract Management Information
Vendor Disclosure Statement Colorado Revised Statues §24-102-206
Contract Performance Outside of the United States or Colorado Prior to contracting, or as a requirement for the solicitation of any contract for services from the State of Colorado, a prospective vendor is required to disclose the following information in a statement of work.
Completing this Form To the extent the following information has not previously been disclosed in a statement of work, a prospective vendor shall complete this Vendor Disclosure Statement and return it to the contracting state agency or institution of higher education (IHE).
This Disclosure Statement is not required for contracts under Medicare, the “Colorado Medical Assistance Act”, Articles 4 to 6 of Title 25.5 C.R.S., the “Children Basic Health Plant Act”, Article 8 of Title 25.5, C.R.S, or the “Colorado Indigent Care Program”, Part I of Article 3 of Title 25.5 C.R.S.
This Disclosure Statement is not required for Construction contract.
Solicitation Number:
State Agency Name:
1. DQ 2024000056 Colorado Department of Corrections
Vendor Name: _________________________________________________________________________
2. Where will the services under the contract, including any subcontracts, be performed?
List all county(ies) and state(s).
3. If it is anticipated that services under the contract or any subcontracts will be performed outside of the United States or the State of Colorado, explain why it is necessary or advantageous to go outside the Untied Stated or the State of Colorado to perform the contract or any subcontracts.
Signature Date
Printed Name Title
File details come from the government source that posted it. Updated .