09_-_Fillable_OMESFormCP076.pdf
PDF 230 KB Posted
- Attached to
- Water Level Equipment State and local contract opportunity
- Solicitation number
- EV00000671
- Issued by
- Oklahoma
About this file
This document is a "Responding Bidder Information" form from the Oklahoma Office of Management & Enterprise Services (OMES) for solicitation number EV00000671. The form is a standard procurement document that requires bidders to provide key information about their business, including contact details, compliance with state regulations, and specific certifications. The form covers several mandatory declarations, such as whether the bidder is engaged in a boycott of goods from Israel, registration status with the Oklahoma Secretary of State, workers' compensation insurance coverage, and verification of service-disabled veteran business status.
The document does not contain specific details about the contract's scope, pricing, or services being procured. Instead, it is a standardized compliance form that bidders must complete and submit with their bid response. Key requirements include providing proof of workers' compensation insurance, confirming registration with the Secretary of State for contracts over $25,000, and potentially demonstrating status as a service-disabled veteran-owned business. Bidders must check applicable boxes and provide supporting documentation as needed to meet Oklahoma state procurement requirements.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 04_-_Attachment_C-Agency_Terms_and_Conditions.pdf | ||
| 06_-_Exhibit_1_Water_Level_Recorder.pdf | ||
| 07_-_Exhibit_2_Pricing_Sheet.xlsx | XLSX spreadsheet | |
| 00_-_BID_PACKET_ATTACHMENTS_INSTRUCTIONS.pdf | ||
| 02_-_Corr_Attachment_A-AgencyPurposeScopeNonNegotiable.pdf | ||
| 08_-_OMESFormCP004.pdf | ||
| 01_-_Agency_Bid_Instructions.pdf | ||
| 03_-_Attachment_B-NegotiableTerms.docx | DOCX document | |
| 05_-_Attachment_G-Federal_Funding_Terms.pdf |
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Text version
OMES FORM CP 076 Rev. 11/2020 PAGE 1 OF 2
Responding Bidder Information
“Certification for Competitive Bid and Contract” MUST be submitted along with the response to the Solicitation.
1. RE: Solicitation #: ______________________________________
2. Bidder General Information:
FEI / SSN : Supplier ID:
Company Name:
3. Bidder Contact Information:
Address:
City: State: Zip Code:
Contact Name:
Contact Title:
Phone #: Fax #:
Email: Website:
4. Bidder currently engaged in a boycott of goods or services from Israel.
YES
NO
5. Registration with the Oklahoma Secretary of State: (if over $25,000)
YES - Filing Number:
NO - Prior to the contract award, the successful bidder will be 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 (www.sos.ok.gov or 405-521-3911).
6. Workers’ Compensation Insurance Coverage:
Bidder is required to provide with the bid a certificate of insurance showing proof of compliance with the Oklahoma Workers’ Compensation Act.
YES – Include with the bid a certificate of insurance.
NO – Exempt from the 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.1
1 For frequently asked questions concerning workers’ compensation insurance, see https://www.ok.gov/wcc/Insurance/index.html http://www.sos.ok.gov/ https://www.ok.gov/wcc/Insurance/index.html
OMES FORM CP 076 Rev. 11/2020 PAGE 2 OF 2
7. Disabled Veteran Business Enterprise Act
YES – I am a service-disabled veteran business as defined in 74 O.S. §85.44E. Include with the bid response 1) certification of service-disabled veteran status as verified by the appropriate federal agency, and 2) verification of not less than 51% ownership by one or more service-disabled veterans, and 3) verification of the control of the management and daily business operations by one or more service-disabled veterans.
NO – Do not meet the criteria as a service-disabled veteran business.
Authorized Signature Date
Printed Name Title
| Certification for Competitive Bid and Contract MUST be submitted along with the response to the Solicitation: |
| RE Solicitation: EV00000671 |
| FEI SSN: |
| Supplier ID: |
| Company Name: |
| Address: |
| City: |
| State: |
| Zip Code: |
| Contact Name: |
| Contact Title: |
| Phone: |
| Fax: |
| Email: |
| Website: |
| Bidder currently engaged in a boycott of goods or services from Israel: Off |
| Registration with the Oklahoma Secretary of State if over 25000: |
| YES Filing Number: Off |
| NO Prior to the contract award the successful bidder will be required to register with the Secretary of: Off |
| YES Include with the bid a certificate of insurance: Off |
| NO Exempt from the Workers Compensation Act pursuant to 85A OS 218b111 Attach a: Off |
| YES I am a servicedisabled veteran business as defined in 74 OS 8544E Include with the bid: Off |
| NO Do not meet the criteria as a servicedisabled veteran business: Off |
| Date: |
| Printed Name: |
| Title: |
| Signature2_es_:signer:signature: |
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