04_Attachment_A2_Form_CP076_Responding_Bidder_Information.pdf
PDF 227 KB Posted
- Attached to
- SW1045 Emerging Technologies
- Solicitation number
- EV00000871
- Issued by
- Oklahoma County, Hobart City, Oklahoma
About this file
This is a Responding Bidder Information form (OMES Form CP076) issued by the State of Oklahoma's Central Purchasing division for the SW1045 Emerging Technologies Master Agreement solicitation developed in collaboration with NASPO ValuePoint. The form serves as a certification document that bidders must submit alongside their response to the solicitation. The solicitation seeks qualified suppliers to provide emerging technologies consulting and services across two categories: Consulting services focused on advisory, planning, analysis, and implementation support; and Services focused on skilled professional resources for implementing, integrating, developing, and managing emerging technology solutions. The form does not specify response dates, due dates, site visits, bidders' conferences, award dates, or contract terms within its content.
The form requires bidders to provide general company information including FEIN/SSN, Supplier ID, and company name, along with contact details for the responding organization. Bidders must certify their status regarding several statutory and regulatory requirements, including disclosure of any boycott activities related to goods or services from Israel, registration status with the Oklahoma Secretary of State, workers' compensation insurance compliance or exemption status, and eligibility as a service-disabled veteran business enterprise if applicable. The form includes signature blocks requiring authorization by an authorized representative with date and title. No pricing information, set-asides, incumbent contractor details, or funding amounts are specified within this bidder information certification form.
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Text version
OMES Form CP076 (11/2024) RESPONDING BIDDER INFORMATION | Page 1 of 1
Central Purchasing
RESPONDING BIDDER INFORMATION
You must submit a Certification for Competitive Bid and Contract along with the response to the solicitation.
1. SOLICITATION
Solicitation #
2. BIDDER GENERAL INFORMATION
FEIN/SSN Supplier ID
Company name
3. BIDDER CONTACT INFORMATION
Address
Contact name Title
Email Phone Website Fax
4. BIDDER IS ENGAGED IN BOYCOTT OF GOODS OR SERVICES FROM ISRAEL
Yes No
5. REGISTRATION WITH THE OKLAHOMA SECRETARY OF STATE
Yes Filing number:
No Prior to the contract award, the successful bidder is required to register with the Secretary of State or must attach a signed statement that provides specific details supporting the exemption the supplier is claiming (sos.ok.gov or 405- 521-3911).
6. WORKERS’ COMPENSATION INSURANCE COVERAGE
Bidder is required to provide a certificate of insurance showing proof of compliance with the Oklahoma Administrative Workers’ Compensation Act.
Yes Include a certificate of insurance with the bid.
No Exempt from the Administrative Workers’ Compensation Act pursuant to 85A O.S. § 2(18)(b)(1-11). (Attach a written, signed and dated statement on letterhead stating the reason for the exempt status. For frequently asked questions concerning workers’ compensation insurance, visit wcc.ok.gov.)
7. DISABLED VETERAN BUSINESS ENTERPRISE ACT
Yes I am a service-disabled veteran business as defined in 74 O.S. § 85.44E.
Include the following with the bid response:
1. Certification of service-disabled veteran status as verified by the appropriate federal agency.
2. Verification of not less than 51% ownership by one or more service-disabled veterans.
3. Verification of the control of the management and daily business operations by one or more service-disabled veterans.
No I do not meet the criteria as a service-disabled veteran business.
8. SIGNATURE
Authorized signature Date
Name Title
File details come from the government source that posted it. Updated .