13_OMESformCP076.pdf
PDF 293 KB Posted
- Attached to
- Cloud-Based Mentoring Program
- Solicitation number
- EV00000979
- Issued by
- Oklahoma
About this file
This is an OMES Form CP076 Responding Bidder Information form for a cloud-based mentoring program platform solicitation submitted to the Oklahoma State Department of Health (OSDH) Allied Health Service through the Office of Management and Enterprise Services (OMES) Central Purchasing division. The solicitation, numbered EV00000979, seeks a comprehensive multi-user software platform capable of creating and managing structured, scalable, and measurable mentoring initiatives with functionality including participant registration, onboarding, technical skills development, and assessment-based mentoring across multiple programs. The contract resulting from this solicitation may be designated for use as a statewide contract under 74 O.S. § 85.5(G)(3) and will be awarded to a single supplier. No specific response dates, due dates, site visits, bidder meetings, award dates, or contract terms are detailed in this particular form.
The form serves as the bidder certification document requiring responding suppliers to provide general company information, contact details, and Federal Employer Identification Number or Social Security Number along with their solicitation response. Bidders must certify their workers' compensation insurance compliance status, disclose any boycott of Israeli goods or services, confirm registration or exemption status with the Oklahoma Secretary of State, and verify disabled veteran business enterprise status if applicable. The form does not contain pricing information, set-asides, incumbent details, funding sources, or budget amounts, as these elements would typically appear in separate solicitation documents or amendments.
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Other files
| File | Type | Posted |
|---|---|---|
| 09_EXHIBIT_04_EXCSUM_Mentoring_Program_Platform.xlsx | XLSX spreadsheet | |
| 08_EXHIBIT_03_PRICE_TEMPLATE_Mentoring_Progrm_Platform.xlsx | XLSX spreadsheet | |
| 12_EXHIBIT_07_THIRDPARTY_Mentoring_Program_Platform.xlsx | XLSX spreadsheet | |
| 07_EXHIBIT_02_PREBID_CONFERENCE_Mentoring_Program_Platform.docx | DOCX document | |
| 04_ATTACHMENT_C_-_AGY_TERMS_Mentoring_Program_Platform.docx | DOCX document | |
| 05_ATTACHMENT_D_-_IT_TERMS_Mentoring_Program_Platform.docx | DOCX document | |
| 02_ATTACHMENT_A_-_PURPOSE_Mentoring_Program_Platform.pdf | ||
| 10_EXHIBIT_05_RSPNWRKSHT_Mentoring_Program_Platform.xlsx | XLSX spreadsheet | |
| 06_EXHIBIT_01_SCOPE_Mentoring_Program_Platform.pdf | ||
| 11_EXHIBIT_06_REF_SHEET_Mentoring_Program_Platform.pdf | ||
| 14_OMESformCP004.pdf | ||
| 03_ATTACHMENT_B_-_GEN_TERMS_Mentoring_Program_Platform.docx | DOCX document | |
| 01_BID_INSTRUCTIONS_Mentoring_Program_Platform.pdf |
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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: EV00000979 |
| 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 .