12_-_OMESFormCP076.pdf
PDF 188 KB Posted
- Attached to
- UP Publishing Services
- Solicitation number
- EV00000519
- Issued by
- Tulsa County, Oklahoma
About this file
This document is a "Certification for Competitive Bid and Contract" form from the Oklahoma Office of Management and Enterprise Services (OMES). It pertains to a state solicitation, as the bidder is required to register with the Oklahoma Secretary of State if the contract exceeds $250,000. The form collects information about the bidder, including their name, contact details, and whether they are currently engaged in a boycott of goods or services from Israel. The form also requires the bidder to provide proof of workers' compensation insurance coverage or claim an exemption, and to indicate if they qualify as a service-disabled veteran business enterprise.
The document does not provide details about the specific products or services being procured, the project overview, quantities, response dates, award dates, or contract term. It focuses solely on the administrative requirements for submitting a bid in response to a state solicitation in Oklahoma.
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Other files
| File | Type | Posted |
|---|---|---|
| 11_-_OMESFormCP004.pdf | ||
| 00_-_BID_PACKET_ATTACHMENTS_INSTRUCTIONS.pdf | ||
| 01_-_EV00000519_-_Bidder_Instructions.docx | DOCX document | |
| 02_-_Attachment_A-_Solicitation.docx | DOCX document | |
| 04_-_Attachment_B_-_Negotiable.docx | DOCX document | |
| 05_-_Attachment_C_-_Agency_Terms.pdf | ||
| 08_-_Exhibit_3_-_Pricing_Document.pdf | ||
| 06_-_Exhibit_1_-_Scope_of_Work.docx | DOCX document | |
| 07_-_Exhibit_2_-_Company_Information.xlsx | XLSX spreadsheet | |
| 03_-_Attachment_A-1_-_Lockdown_Language.docx | DOCX document | |
| 09_-_Exhibit_4_-_References.docx | DOCX document | |
| 10_-_Exhibit_5_-_3rd_Party_Supplier_Info_Template_.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 $250,000)
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
EV00000519
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
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