07_-_OMES_Form_CP076.pdf
PDF 248 KB Posted
- Attached to
- The Youth Transitional Living Program
- Solicitation number
- EV00000894
- Issued by
- Oklahoma County, Oklahoma
About this file
This is a Responding Bidder Information form (OMES Form CP076) submitted by the Office of Management and Enterprise Services Central Purchasing Division on behalf of the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) for the Youth Transitional Living Program solicitation EV00000894. The solicitation seeks qualified service providers to deliver comprehensive transitional housing and support services to individuals aged 18 to 24 years experiencing homelessness and co-occurring mental health or substance use disorders. The program aims to provide immediate transitional housing coupled with intensive recovery support services, treatment connections, supported employment and education assistance, family and natural support engagement, and pathways to permanent independent housing. The contract resulting from this solicitation may be designated as a Statewide Contract under Oklahoma Statute 74 O.S. § 85.5(G)(3).
The form requires bidders to provide company information, certification of compliance with Oklahoma workers' compensation insurance requirements, and disclosure of boycott status regarding goods or services from Israel. Bidders must register with the Oklahoma Secretary of State prior to contract award unless claiming an exemption. The form includes provisions for service-disabled veteran business enterprises, requiring documentation of veteran status certification, verification of at least 51 percent ownership by service-disabled veterans, and confirmation of management control by service-disabled veterans. All responding bidders must submit this certification form along with their solicitation response and include authorized signature, date, name, and title of the signatory official.
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Other files
| File | Type | Posted |
|---|---|---|
| 08_-_OMES_Form_CP004.pdf | ||
| 03_-_Attachment_B_-_General_Terms.docx | DOCX document | |
| 04_-_Attachment_C_-_Agency_Specific_Terms.pdf | ||
| 02_-_Attachment_A_-_Purpose.pdf | ||
| 01_-_Agency_Bid_Instructions.pdf | ||
| 05_-_Exhibit_1_-_Bidder_Response_Template.xlsx | XLSX spreadsheet | |
| 06_-_Exhibit_2_-_Price_Template.xlsx | XLSX spreadsheet |
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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: EV00000894 |
| 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 .