14_OMES_Form_CP076.pdf
PDF 293 KB Posted
- Attached to
- SW0041 DISHWASHING RENTALS COMP
- Solicitation number
- EV00000947
- Issued by
- Oklahoma
About this file
This is a Responding Bidder Information form (OMES Form CP076) issued by the Office of Management and Enterprise Services (OMES) Central Purchasing division in Oklahoma for solicitation EV00000947 regarding dishwasher rentals and related services. The form serves as a certification document that bidders must submit along with their response to the statewide contract opportunity. The contract seeks suppliers to provide dishwasher rentals and leases, related maintenance services, and dietary and dishwashing cleaning compounds and dispensers to support operational needs of state agencies, educational institutions, and eligible affiliates including school districts, cities, counties, and higher education institutions throughout Oklahoma. The specific response deadlines, award dates, and contract terms are not detailed in this particular form.
The form requires bidders to provide general company information including FEIN/SSN, Supplier ID, contact details, and website information. Bidders must certify compliance with multiple requirements including whether they are engaged 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. The form also requires disclosure regarding Disabled Veteran Business Enterprise status as defined under Oklahoma Statutes 74 O.S. § 85.44E, with provisions for submitting relevant certifications and ownership verification if applicable. All responses must be signed by an authorized representative with date and title, and the completed form must accompany the bid submission to Central Purchasing.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 11_-_Exhibit_5_-_References.pdf | ||
| 10_-_Exhibit_4_-_Pricing_Template.xlsx | XLSX spreadsheet | |
| EV00000947_Amendment_1.pdf | ||
| 06_-_Attachment_H_-_Master_Lease_Agreement.pdf | ||
| 12_-_Exhibit_6_-Third_Party_Supplier_Info.xlsx | XLSX spreadsheet | |
| 07_-_Exhibit_1_-_Executive_Summary.xlsx | XLSX spreadsheet | |
| 05_-_Attachment_G_Federal_Terms.pdf | ||
| 02_-_Attachment_A.pdf | ||
| 08_-_Exhibit_2_-_Technical_Response.pdf | ||
| 01_-_Bidder_Instructions.pdf | ||
| 13_OMES_Form_CP004.docx | DOCX document | |
| 04_-_Attachment_C_Statewide_Terms.pdf | ||
| 09_-_Exhibit_3_-_Mandatory_Specifications.pdf | ||
| 03_-_Attachment_B_General_Terms.docx | DOCX document | |
| EV00000947_Amendment_2_Q_A.pdf |
Show all 15
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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: EV00000947 |
| 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 .