13_-_OMES_Form_CP076.pdf
PDF 186 KB Posted
- Attached to
- SW0012-Books and Related Products
- Solicitation number
- EV00000971
- Issued by
- Oklahoma County, Hobart City, Oklahoma
About this file
This is a Responding Bidder Information Form (OMES Form CP076) issued by the State of Oklahoma's Central Purchasing division for Solicitation EV00000971. The form serves as a certification document that bidders must submit along with their response to a state solicitation. The form captures essential bidder identification information, including FEIN/SSN, Supplier ID, company name, and complete contact details for the bidding organization and its representative. Additionally, the form requires bidders to confirm their registration status with the Oklahoma Secretary of State prior to contract award, provide proof of workers' compensation insurance coverage in compliance with the Oklahoma Administrative Workers' Compensation Act, and declare whether they qualify as a service-disabled veteran business enterprise as defined under 74 O.S. § 85.44E.
The form also requires bidders to certify whether their company is engaged in any boycott of goods or services from Israel, as mandated by Oklahoma law. For service-disabled veteran business enterprises, bidders must provide certification of service-disabled veteran status from the appropriate federal agency, verification of at least 51% ownership by service-disabled veterans, and documentation demonstrating management and operational control by service-disabled veterans. The form concludes with a signature block requiring authorization by the bidder's representative, including name, title, and date. This form is a compliance and eligibility verification document rather than a solicitation for specific goods or services, and its submission is mandatory for all bidders responding to Oklahoma state procurement opportunities.
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Other files
| File | Type | Posted |
|---|---|---|
| 07_-_Exhibit_2_-_Technical_Response.docx | DOCX document | |
| 10_-_Exhibit_5_-_References.pdf | ||
| 11_-_Exhibit_6_-Third_Party_Supplier_Info.xlsx | XLSX spreadsheet | |
| 08_-_Exhibit_3_-_Specifications.docx | DOCX document | |
| 12_-_OMES_Form_CP004.docx | DOCX document | |
| 01_-_Bidder_Instructions.pdf | ||
| Amendment__1_-_CLOSING_DATE_change__EV971.pdf | ||
| 06_-_Exhibit_1_-_Executive_Summary.xlsx | XLSX spreadsheet | |
| 03_-_Attachment_B_General_Terms.docx | DOCX document | |
| 02_-_Attachment_A.pdf | ||
| 04_-_Attachment_C_Statewide_Terms.docx | DOCX document | |
| 09_-_Exhibit_4_-_Pricing_Template.xlsx | XLSX spreadsheet | |
| 05_-_Attachment_G_Federal_Terms.docx | DOCX document |
Show all 13
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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: EV00000971 |
| 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 .