Fillable_OMESFormCP076.pdf

PDF 224 KB Posted

Attached to
Integrated Data Dashboard State and local contract opportunity
Solicitation number
EV00000677
Issued by
Oklahoma

About this file

The document is an Oklahoma Office of Management & Enterprise Services (OMES) "Responding Bidder Information" form (OMES Form CP 076), a standardized state procurement document designed for potential vendors to complete when submitting a competitive bid. The form requires bidders to provide comprehensive company information, including contact details, federal identification numbers, and critical compliance declarations regarding Oklahoma state procurement regulations.

The form mandates several key declarations from bidders, including confirmation of whether they are currently engaged in a boycott of goods or services from Israel, verification of registration with the Oklahoma Secretary of State (for contracts over $25,000), and documentation of workers' compensation insurance coverage. Additionally, the form includes a section for bidders to declare whether they qualify as a service-disabled veteran business enterprise, which requires specific certifications of veteran ownership and management. These requirements ensure that potential contractors meet state-level legal, insurance, and diversity guidelines before being considered for contract award.

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Other files for this state and local contract opportunity

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Attachment_B_-_State_Full_Terms_.pdf PDF
OMESFormCP004.pdf PDF
VendorSecurityAssessment.xlsx XLSX spreadsheet
Attachment_G_-_Federal_Funding_Terms.pdf PDF
EV00000677_Agency_Non-negotiable_Bid_instructions.pdf PDF
Exhibit_03_-_Project_Timeline.pdf PDF
Exhibit_05_-_Cost_Proposal_.xlsx XLSX spreadsheet
Attachment_A_-_Agency-purpose.pdf PDF
Attachment_D_-_IT_Terms.pdf PDF
Exhibit_01_-_Proposal_Requirements.pdf PDF
Exhibit_02_-_Technical_Requirements.pdf PDF
Exhibit_04_-ThirdPartySupplierInfo_.xlsx XLSX spreadsheet
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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:
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:

File details come from the government source that posted it. Updated .