Form_CP076.pdf
PDF 293 KB Posted
- Solicitation number
- EV00000973
- Issued by
- Oklahoma
About this file
This is a Responding Bidder Information form (OMES Form CP076) used by the State of Oklahoma's Central Purchasing division for solicitation EV00000973. The form serves as a certification document that bidders must submit along with their response to a state solicitation. The form collects essential bidder identification information including FEIN/SSN, Supplier ID, company name, and complete contact details for the authorized representative. Bidders are required to provide their business address, contact person name and title, email, phone number, website, and fax information. The form does not specify particular products, services, quantities, response deadlines, site visits, or bidder conferences within its content, as it functions as a standardized certification instrument rather than a solicitation detail document.
The form includes several compliance certifications that bidders must address, including declarations regarding 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. Bidders claiming exemption from workers' compensation requirements must provide written, signed documentation on company letterhead detailing their exemption basis. Additionally, the form includes a section for bidders to certify disabled veteran business enterprise status as defined under 74 O.S. § 85.44E, requiring submission of federal service-disabled veteran certification, proof of at least 51% ownership by service-disabled veterans, and verification of management control. An authorized representative must sign and date the completed form to certify the accuracy of all provided information.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Event_00000425_AttachmentC.pdf | ||
| Event_00000425_Attachment_D.pdf | ||
| Bidder_Instructions.docx | DOCX document | |
| Event_00000425_Exhbit_1_Requirements.pdf | ||
| Event_00000425_Attachment_B.pdf | ||
| Event_00000425_Attachment_A_Solicitation.pdf | ||
| Amendment__1_Vendor-_Q_A__EV973.pdf | ||
| Event_00000425_Exhibit__2_Price_Template.xlsx | XLSX spreadsheet | |
| Form_CP004.docx | DOCX document |
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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: EV00000973 |
| 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 .