Fillable ILLEGAL ALIENS AND PUBLIC CONTRACTS Colorado Division of (Colorado DORA)

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ILLEGAL ALIENS AND PUBLIC CONTRACTS Colorado Division of (Colorado DORA)

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Colorado Department of Regulatory Agencies (DORA) is responsible for professional licensing and consumer protection in Colorado USA.

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Colorado Division of Labor Standards and Statistics
ILLEGAL ALIENS AND PUBLIC CONTRACTS
COMPLAINT FORM
(8-17.5-101 & 102, C.R.S.)
633 17
th
Street, Suite 600
Denver, Colorado 80202-2107
Telephone (303) 318-8441
Fax (303) 318-8400
Toll Free (888) 390-7936
http://www.colorado.gov/cdle/pcs
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.)
YOUR FIRST NAME
YOUR HOME PHONE
YOUR LAST NAME
YOUR CURRENT WORK PHONE
YOUR MAILING ADDRESS
YOUR CURRENT CELL PHONE
CITY STATE ZIP CODE
YOUR E-MAIL ADDRESS
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
CITY STATE ZIP CODE
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.
I declare under penalty of perjury (C.R.S. 18-8-501 et seq.) that the information I have provided is true and correct.
Name
Signature
Date
Please send this complaint to: Division of Labor Standards and Statistics, 633 17
th
Street, Suite 600, Denver, Colorado 80202-2107
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ILLEGAL ALIENS AND PUBLIC CONTRACTS Colorado Division of (Colorado DORA)

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Completed 20 July 2020

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