OMESFormCP076.docx
DOCX document 67 KB Posted
- Attached to
- Masticating Head
- Solicitation number
- EV00000591
- Issued by
- Logan County, Oklahoma
About this file
This document is the "Responding Bidder Information 'Certification for Competitive Bid and Contract'" form for Solicitation # EV00000591 issued by the State of Oklahoma. The form requires bidders to provide general information about their company, including Federal Employer Identification Number (FEI) or Social Security Number (SSN), Supplier ID, company name, contact information, and whether the bidder is currently engaged in a boycott of goods or services from Israel. The form also requires bidders to indicate if they are registered with the Oklahoma Secretary of State and to provide proof of workers' compensation insurance coverage or a written statement of exemption. Additionally, bidders are asked to indicate if they qualify as a service-disabled veteran business enterprise.
The form does not provide details about the specific products or services being procured, quantities, response deadlines, contract term, or pricing requirements. However, it outlines the necessary documentation and certifications that bidders must submit as part of their response to the solicitation.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| OMESFormCP021.docx | DOCX document | |
| Attachment_B_State_General_Terms.pdf | ||
| Exhibit_1_Bid_Masticating_Head.docx | DOCX document | |
| OMES-FORM-CP-004.pdf | ||
| Bidder_Instructions.docx | DOCX document | |
| SolicitationContractAttachmentA.docx | DOCX document | |
| a7d777e65d787fd0061e1de34254b0a5.pdf |
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Text version
Responding Bidder Information
“Certification for Competitive Bid and Contract” MUST be submitted along with the response to the Solicitation.
1. RE: Solicitation # EV00000591
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:
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
OMES FORM CP 076 Rev. 11/2020
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
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