Fillable_OMESFormCP076.pdf
PDF 236 KB Posted
- Attached to
- Online Data Base, non-IT State and local contract opportunity
- Solicitation number
- EV00000674
- Issued by
- Oklahoma
About this file
This document is an Oklahoma Office of Management & Enterprise Services (OMES) "Responding Bidder Information" form for Solicitation #EV00000674, which is a standard state procurement document requiring bidders to provide comprehensive business and compliance information. The form requires bidders to disclose details about their company, including contact information, and confirm compliance with specific state requirements such as workers' compensation insurance coverage, registration with the Oklahoma Secretary of State, and potential boycott status regarding Israeli goods and services.
The form includes critical certification sections for businesses, specifically addressing the Disabled Veteran Business Enterprise Act, where bidders must verify if they qualify as a service-disabled veteran business by providing certification of service-disabled veteran status, ownership verification, and management control documentation. Additionally, the document mandates that bidders over $25,000 must be registered with the Oklahoma Secretary of State and provide proof of workers' compensation insurance, with options for exemption if specific conditions are met. The form serves as an official mechanism for vendors to attest to their business qualifications and legal compliance when responding to state solicitations.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Agency_Bid_Instructions_-final_copy.pdf | ||
| Attachment_C_-_Agency_Terms_R.F.P._Clean_01.16.2025.pdf | ||
| Attachment_A-AgencyPurposeScopeNonNegotiable_-_final_copy.pdf | ||
| Amendment_1_Vendor__Q_A.pdf | ||
| Attachment_B-NegotiableTerms_1.docx | DOCX document | |
| Exhibit_2-Cost_Sheet.pdf | ||
| BID_PACKET_ATTACHMENTS_INSTRUCTIONS.pdf | ||
| Exhibit1-ExecutiveSummaryWorksheet_(3).xlsx | XLSX spreadsheet | |
| OMESFormCP004.pdf |
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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 #: ______________________________________
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: (if over $25,000)
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
| Certification for Competitive Bid and Contract MUST be submitted along with the response to the Solicitation: |
| RE Solicitation: EV00000674 |
| FEI SSN: |
| Supplier ID: |
| Company Name: |
| Address: |
| City: |
| State: |
| Zip Code: |
| Contact Name: |
| Contact Title: |
| Phone: |
| Fax: |
| Email: |
| Website: |
| Bidder currently engaged in a boycott of goods or services from Israel: Off |
| Registration with the Oklahoma Secretary of State if over 25000: |
| YES Filing Number: Off |
| NO Prior to the contract award the successful bidder will be required to register with the Secretary of: Off |
| YES Include with the bid a certificate of insurance: Off |
| NO Exempt from the Workers Compensation Act pursuant to 85A OS 218b111 Attach a: Off |
| YES I am a servicedisabled veteran business as defined in 74 OS 8544E Include with the bid: Off |
| NO Do not meet the criteria as a servicedisabled veteran business: Off |
| Date: |
| Printed Name: |
| Title: |
| Signature2_es_:signer:signature: |
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