11_OMESformCP076.pdf

PDF 286 KB Posted

Attached to
Marketing Strategy
Solicitation number
EV00000981
Issued by
Oklahoma

About this file

This is a Responding Bidder Information form (OMES Form CP076) issued by the Oklahoma Office of Management and Enterprise Services Central Purchasing division on behalf of the Department of Commerce for a Marketing Strategy contract solicitation. The form serves as the standardized bidder certification document that must accompany all bid responses to this solicitation. The form requires bidders to provide general company information including FEIN/SSN, Supplier ID, company name, and complete contact details for the primary bidder representative. Bidders must also complete certifications regarding business status, insurance coverage, and veteran-owned business qualifications prior to contract award.

Bidders are required to certify their compliance with several Oklahoma statutory requirements, including disclosure of any involvement in boycotts of Israeli goods or services, registration status with the Oklahoma Secretary of State, and workers' compensation insurance coverage under the Oklahoma Administrative Workers' Compensation Act or documentation of exemption status. Additionally, bidders must declare whether they qualify as service-disabled veteran businesses as defined under 74 O.S. § 85.44E, with appropriate supporting documentation required if claiming such status. The form requires an authorized signature and must be submitted with the bid response to be considered for the statewide contract award, which may be designated for use across Oklahoma government entities under 74 O.S. § 85.5(G)(3).

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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:
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:

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