OMESformCP076.pdf
PDF 299 KB Posted
- Attached to
- Slip-In Prover Units
- Solicitation number
- EV00000970
- Issued by
- Oklahoma
About this file
This document is the OMES Form CP076 (Central Purchasing Responding Bidder Information form) issued by the Oklahoma Office of Management and Enterprise Services for Solicitation EV00000970. The form serves as a certification and bidder information submission required from all respondents to state purchasing solicitations. Bidders must complete sections documenting their company information, contact details, FEIN/SSN, and supplier identification number. The form does not specify particular products or services, project scope details, quantities, response deadlines, site visits, or contract terms, as it functions as a standardized bidder certification form rather than a detailed solicitation document.
The form includes mandatory compliance certifications covering boycott status regarding Israel, Oklahoma Secretary of State registration requirements, workers' compensation insurance coverage under the Oklahoma Administrative Workers' Compensation Act, and disabled veteran business enterprise status under 74 O.S. § 85.44E. Bidders must declare their status in each category and provide supporting documentation as applicable, including certificates of insurance, exemption statements, or veteran certification and ownership verification as required. The form requires authorized signature and dates but contains no information regarding pricing terms, contract amounts, funding sources, incumbent contractors, or other financial or award specifics.
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Other files
| File | Type | Posted |
|---|---|---|
| Solicitation_Prover_System_-_FY_2027.docx | DOCX document | |
| omes-form-cp004.pdf | ||
| attachment-a-agency-purpose_(5).pdf | ||
| attachment-b-general-terms_(2).pdf |
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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: EV00000970 |
| 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: |
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