8300029083_OMESFormCP076.docx
DOCX document 61 KB Posted
- Attached to
- Roger County - Claremore - Janitorial
- Solicitation number
- EV00000537
- Issued by
- Rogers County, Oklahoma
About this file
This document is a "Responding Bidder Information" form related to Solicitation # EV00000537 for a state or local government contract opportunity. The form requires bidders to provide general information such as their Federal Employer Identification Number (FEI)/Social Security Number, Supplier ID, company name, contact details, and whether they are currently engaged in a boycott of goods or services from Israel. The form also indicates that prior to the contract award, the successful bidder will be required to register with the Oklahoma Secretary of State or provide details supporting an exemption. Additionally, the bidder must provide a certificate of insurance showing proof of compliance with the Oklahoma Workers' Compensation Act, or a written, signed, and dated statement on letterhead stating the reason for the exempt status.
The document further states that if the bidder is a service-disabled veteran business as defined in 74 O.S. 85.44E, they must include 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, and 3) verification of the control of the management and daily business operations by one or more service-disabled veterans.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 8300029083_Rogers_Janit_Exhibit_1.pdf | ||
| 8300029083_Attachment_B.pdf | ||
| 8300029083_OMESFormCP004.pdf | ||
| 8300029083_Rogers_Janit_Attachment_A.docx | DOCX document | |
| 8300029083_Rogers_Janit_Exhibit_Pricing.docx | DOCX document | |
| 8300029083_Rogers_Janit_Bidder_Instructions.docx | DOCX document | |
| 8300029083_Rogers_Janit_Exhibit_2.pdf |
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Text version
Responding Bidder Information
“Certification for Competitive Bid and Contract” MUST be submitted along with the response to the Solicitation.
1. RE: Solicitation # EV00000537
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
OMES FORM CP 076 Rev. 11/2020
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
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