Colorado Division of Labor Standards and Statistics
ILLEGAL ALIENS AND PUBLIC CONTRACTS
(8-17.5-101 & 102, C.R.S.)
Street, Suite 600
Denver, Colorado 80202-2107
Telephone (303) 318-8441
Fax (303) 318-8400
Toll Free (888) 390-7936
This form is to be used to report contractors or subcontractors who may be in violation of 8-17.5-101 &
102, C.R.S. You must sign and date this form at the bottom.
Contact Information for Complainant (Your information is required. The Division does not accept anonymous claims.)
WHAT IS YOUR RELATIONSHIP TO THE CONTRACTOR/SUBCONTRACTOR?
Contact Information for Contractor or Subcontractor Allegedly Violating 8-17.5-101 & 102, C.R.S.
CONTRACTOR / SUBCONTRACTOR BUSINESS NAME
CONTRACTOR / SUBCONTRACTOR PHONE
OWNER OR SUPERVISOR’S NAME
CONTRACTOR / SUBCONTRACTOR FAX
CONTRACTOR / SUBCONTRACTOR BUSINESS MAILING ADDRESS
CONTRACTOR / SUBCONTRACTOR BUSINESS E-MAIL ADDRESS
NAME OF STATE AGENCY OR POLITICAL SUBDIVISION INVOLVED
STATE AGENCY PHONE NUMBER OR WEB SITE
Effective on and after August 7, 2006, 8-17.5-101 & 102, C.R.S. imposes requirements upon persons who have a public contract for services with state
agencies or political subdivisions. For more information, visit www.colorado.gov/cdle/pcs
Describe in detail the basis for your allegation that this contractor or subcontractor has violated 8-17.5-101 & 102, C.R.S. Please include copies of
any relevant documents or information and additional pages as necessary.