2.1_-_Responding_Bidder_Info_-_CP076_-_Cable_Mats.pdf
PDF 168 KB Posted
- Attached to
- Concrete Cable Mats
- Solicitation number
- EV00000538
- Issued by
- Muskogee County, Bowring CDP, Oklahoma
About this file
This document is the Responding Bidder Information Form for Solicitation/Event # EV00000538 - Concrete Cable Mats, a state and local contract opportunity. The form requires general information about the bidding company, including Federal Employer Identification Number, Supplier ID, contact details, and registration status with the Oklahoma Secretary of State. The form also addresses workers' compensation insurance coverage and whether the bidder is a service-disabled veteran business enterprise. The successful bidder will be required to register with the Oklahoma Secretary of State prior to the contract award unless they can provide specific details supporting an exemption. Bidders must also provide a certificate of insurance showing compliance with the Oklahoma Workers' Compensation Act or, if exempt, submit a written, signed, and dated statement on letterhead stating the reason for the exemption.
The document outlines the requirements for bidders to certify whether they are currently engaged in a boycott of goods or services from Israel. It also provides information on how bidders can claim status as a service-disabled veteran business enterprise and the necessary documentation to support that claim.
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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/Event # : EV00000538 – Concrete Cable Mats
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:
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 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
File details come from the government source that posted it. Updated .