07._OMESformCP076.pdf
PDF 180 KB Posted
- Attached to
- Equipment Simultors
- Solicitation number
- EV00000942
- Issued by
- Ottawa County, Tamaha Town, Oklahoma
About this file
This is an OMES Form CP076 Responding Bidder Information form used by the State of Oklahoma's Central Purchasing division for competitive bid and contract solicitations. The form functions as a standardized certification document that all bidders must complete and submit along with their response to a solicitation. The form requires bidders to provide general company information including Federal Employer Identification Number or Social Security Number, supplier identification number, company name, and contact details such as address, contact person, title, email, phone, website, and fax number. Solicitation EV00000942 is referenced on the partially completed version of the form included in this document.
The form contains several compliance and certification requirements that bidders must address, including declarations regarding boycotts of Israeli goods or services, registration status with the Oklahoma Secretary of State, workers' compensation insurance coverage under the Oklahoma Administrative Workers' Compensation Act, and eligibility status as a service-disabled veteran business enterprise as defined under Oklahoma Statutes. Bidders must indicate whether they meet each requirement or claim applicable exemptions, and must provide supporting documentation such as certificates of insurance, Secretary of State filing numbers, or signed statements explaining exempt status. An authorized representative must sign and date the completed form with their name and title. The form serves as a mandatory certification component of the bidding process and must accompany all competitive bid responses submitted to Oklahoma's Central Purchasing office.
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Other files
| File | Type | Posted |
|---|---|---|
| 06._Exhibit_3-Executive_Summary_and_Company_Info.xlsx | XLSX spreadsheet | |
| 03._Attachment_C_-Agency_Terms.pdf | ||
| 01._Attachment_A_.pdf | ||
| 00._Bid-instructions.pdf | ||
| 05._Exhibit_2_Heavy_equipment_simulator_.pdf | ||
| 08._OMES-form-CP004_.pdf | ||
| 02._Attachment-B-General-Terms.docx | DOCX document | |
| Amendment__1_Vendor_Q_A_EV942_.pdf | ||
| 04._Exhibit_1_collaborative_robotedcart_.pdf |
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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 https://www.sos.ok.gov/ https://www.wcc.ok.gov/
| Central Purchasing |
| RESPONDING BIDDER INFORMATION |
| Solicitation: EV00000942 |
| FEINSSN: |
| Supplier ID: |
| Company name: |
| Contact name: |
| Title: |
| Email: |
| Phone: |
| Website: |
| Fax: |
| 4 BIDDER IS ENGAGED IN BOYCOTT OF GOODS OR SERVICES FROM ISRAEL: Off |
| Prior to the contract award the successful bidder is required to register with the Secretary of State or must attach a: Off |
| Compensation Act: Off |
| 7 DISABLED VETERAN BUSINESS ENTERPRISE ACT: Off |
| Date: |
| Name: |
| Title_2: |
| Filing number: |
| Address: |
File details come from the government source that posted it. Updated .