11_-_Fillable_OMESFormCP076.pdf
PDF 230 KB Posted
- Attached to
- VuLink Data Logger & Telemetry System State and local contract opportunity
- Solicitation number
- EV00000673
- Issued by
- Oklahoma
About this file
This document is an Oklahoma Office of Management & Enterprise Services (OMES) Responding Bidder Information form for Solicitation #EV00000673. The form is a standard procurement document requiring bidders to provide company details, contact information, and certifications for participating in a state contract opportunity. The form requires bidders to disclose information about workers' compensation insurance coverage, registration with the Oklahoma Secretary of State, and potential status as a service-disabled veteran business enterprise.
The form includes several key compliance certifications, such as whether the bidder is currently engaged in a boycott of goods or services from Israel, and verification of workers' compensation insurance. For contracts over $25,000, bidders must be registered with the Oklahoma Secretary of State. The document also provides an option for service-disabled veteran businesses to self-identify, which may qualify them for special consideration. Bidders must complete all sections, provide required documentation, and include an authorized signature to be considered for the contract opportunity.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 02_-_Attachment_A-AgencyPurposeScopeNonNegotiable_(002).pdf | ||
| 08_-_EXHIBIT_1_TELEMETRY_EQUIPMENT_BID.pdf | ||
| 04_-_Attachment_C-Agency_Terms_and_Conditions.pdf | ||
| 10_-_OMESFormCP004.pdf | ||
| 01_-_Agency_Bid_Instructions.pdf | ||
| 05_-_AttachmentD-ITTerms.pdf | ||
| 06_-_AttachmentG_FederalFundingTerms.pdf | ||
| 00_-_BID_PACKET_ATTACHMENTS_INSTRUCTIONS.pdf | ||
| 03_-_AttachmentB-NegotiableTerms_(2).docx | DOCX document | |
| 09_-_Exhibit_2_Telemetry_Bid_Sheet_2025-_Pricing.xlsx | XLSX spreadsheet |
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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: EV00000673 |
| 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: |
File details come from the government source that posted it. Updated .