Marietta_-_OMES_form_CP076.pdf
PDF 286 KB Posted
- Solicitation number
- EV00000912
- Issued by
- Logan County, Maud City, Oklahoma
About this file
This is an OMES Form CP076 Responding Bidder Information certification form used by the State of Oklahoma's Central Purchasing office for competitive bid and contract solicitations. The form requires bidders responding to solicitations to provide comprehensive bidder information and certifications, including general company details, contact information, federal employer identification numbers or social security numbers, and supplier identification numbers. Bidders must disclose whether they are engaged in boycotts of Israeli goods or services, confirm registration status with the Oklahoma Secretary of State, and provide proof of workers' compensation insurance coverage or documentation of exemption from the Oklahoma Administrative Workers' Compensation Act. The form applies to the janitorial services contract for weekly cleaning of the Love County Port of Entry in Marietta, Oklahoma.
The certification form requires successful bidders to complete several mandatory compliance declarations prior to contract award. Bidders must identify whether they qualify as service-disabled veteran businesses as defined under 74 O.S. § 85.44E and, if applicable, provide certification of service-disabled veteran status verified by appropriate federal agencies, documentation of at least 51 percent ownership by one or more service-disabled veterans, and verification of management control by service-disabled veterans. The form must be signed by an authorized representative and submitted with the bid response to the solicitation. The document serves as the official certification mechanism for Oklahoma state and local contract opportunities and ensures bidder compliance with state statutory requirements regarding workers' compensation, veteran status, and corporate registration before contract execution.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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: |
| 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 .