OMESFormCP021.docx

DOCX document 193 KB Posted

Attached to
Sallisaw Plumbing Repair
Solicitation number
EV00000875
Issued by
Texas County, Oklahoma

About this file

This is a Supplier Contract Certification form (OMES Form CP 021) from the State of Oklahoma, specifically for the Oklahoma Department of Veterans Affairs (ODVA) website project (Project #50854) under solicitation number EV00000875. The form requires the supplier to provide company information including name, address, city, state, zip code, and email address, along with authorization and certification signatures from a designated company representative.

The certification form includes two primary compliance requirements under Oklahoma Statutes. First, under 74 O.S. §85.42, the supplier must certify that no person involved in developing the contract while employed by the State of Oklahoma will be employed to fulfill services under the contract. Second, under 74 O.S. §85.41, if the contract involves professional services and results in a written proposal, report, or study, the supplier must certify that the final product does not substantially duplicate any previous work provided to the state agency or any other state agency. The supplier's authorized representative must sign and date the certification form and provide their printed name and title.

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Text version

DESIGN APPROVAL/SIGN-OFF

INFORMATION SERVICES

PROJECT: ODVA WEBSITE (50854)

Supplier Contract Certification

Solicitation or Purchase Order #:
EV00000875
Supplier name:
Address:
City:
State:
Zip Code:
Email address:

A. In accordance with 74 O.S. § 85.42, the supplier named herein certifies that no person who has been involved in any manner in the development of this contract while employed by the State of Oklahoma shall be employed by the supplier to fulfill any of the services provided for under said contract.

Supplier Authorized Representative Signature

Date

Supplier Authorized Representative Printed Name

Title

B. In accordance with 74 O.S. § 85.41, if this contract is for professional services as defined in 74 O.S. § 85.2, and if the final product is a written proposal, report, or study, the supplier named herein further certifies that (s)he has not previously provided the state agency or any other state agency with a final product that is a substantial duplication of the final product of the proposed contract.

OMES FORM [#] [ORIGINATING DEPARTMENT] | [REVISION DATE MM.YYYY]

OMES FORM CP 021 Rev. 03/2020 image1.jpeg image2.png

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