Exhibit E - Vendor Disclosure Statement.pdf
PDF 41 KB Posted
- Attached to
- CMS #211060 RFQ Pre-Disaster DRR
- Solicitation number
- RFQ NLAA 2027000003 3
- 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 and solicitations for services executed after August 3, 2007. The form applies to all Colorado state contracts unless specifically exempted under Medicare, the Colorado Medical Assistance Act, the Children's Basic Health Plan Act, or the Colorado Indigent Care Program. Vendors are required to disclose whether any services under the contract or subcontracts will be performed outside the United States or Colorado. If services will be performed outside these jurisdictions, vendors must identify the specific countries and/or states where work will occur and provide a detailed explanation of why it is necessary or advantageous to perform the contract or subcontracts outside the United States or Colorado.
The form requires vendor completion and submission to the contracting agency prior to contract award, with the contract or purchase order number to be entered following award notification. Vendors must sign the completed form, provide printed name and title, and include the date of submission. The document does not impose pricing restrictions, set-asides, or specific funding requirements but serves as a disclosure mechanism to ensure transparency regarding offshore or out-of-state contract performance and to maintain state oversight of service delivery locations.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
DPA SB-228 VDS Form Updated 2/14/2008
EXHIBIT E
VENDOR DISCLOSURE STATEMENT
Contract Performance Outside the United States or Colorado
Colorado Revised Statute 24-102-206
Company Name:________________________. Contract or Purchase Order Number:________________ (Contract or PO to be entered after award)
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 “No”, please sign the form.
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.
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
Signature: Printed Name
Title: Date:
RETURN THIS FORM WITH TO THE ADDRESS BELOW
Return to: ______________________________
RETURN THIS FORM WITH TO THE ADDRESS BELOW
File details come from the government source that posted it. Updated .