Exhibit 3 - Vendor Disclosure Statement Form.pdf

This is a Vendor Disclosure Statement Form issued by the State of Colorado on January 24, 2008, requiring disclosure of contract performance activities conducted outside the United States or Colorado in accordance with Colorado Revised Statute 24-102-206. The form applies to all state contracts and solicitations for services executed after August 3, 2007. Vendors must disclose whether any services under the contract or subcontracts will be performed outside the United States or Colorado, and if applicable, identify the specific countries and states where work will occur and provide justification for performing services outside the state or country.

The form exempts certain contracts from the disclosure requirement, specifically 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 and the contract routing number on the completed form before submission to the contracting agency. This disclosure requirement ensures transparency regarding offshore and out-of-state service delivery and allows the state to evaluate the necessity and advantages of such arrangements prior to contract award.