OMESFormCP076.pdf
PDF 56 KB Posted
- Attached to
- Water Testing Re-bid
- Solicitation number
- EV00000503
- Issued by
- Carter County, Asher Town, Oklahoma
About this file
This document is the OMES Form CP 076, a certification for a competitive bid and contract opportunity from the State of Oklahoma. The solicitation number is EV00000503. The form requires bidders to provide general information such as their Federal Employer Identification Number (FEI/SSN), Supplier ID, company name, contact details, and whether they are currently engaged in a boycott of goods or services from Israel. Bidders must also indicate if they are registered with the Oklahoma Secretary of State and provide workers' compensation insurance information. Additionally, the form asks if the bidder qualifies as a service-disabled veteran business enterprise under Oklahoma law.
The document outlines the requirements for the competitive bid process, including the need for the successful bidder to register with the Secretary of State prior to contract award. It also references applicable Oklahoma statutes related to the Workers' Compensation Act and the Disabled Veteran Business Enterprise Act. No other details about the specific products, services, or project are provided in this form.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit_A-Ardmore.pdf | ||
| StateGeneralTerms.pdf | ||
| Attachment_Price_Sheet.pdf | ||
| Water_Testing-RFP-FY25-REV.pdf | ||
| Exhibit_C-Norman.pdf | ||
| Exhibit_D-Sulphur.pdf | ||
| Exhibit_B-Clinton.pdf | ||
| Exhibit_E-Lawton.pdf |
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Text version
OMES FORM CP 076 Rev. 11/2020 PAGE 1 OF 2
Responding Bidder Information
“Certification for Competitive Bid and Contract” MUST be submitted along with the response to the Solicitation.
1. RE: Solicitation #
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 http://www.sos.ok.gov/ https://www.ok.gov/wcc/Insurance/index.html
OMES FORM CP 076 Rev. 11/2020 PAGE 2 OF 2
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 Title
| RE Solicitation: EV00000503 |
| FEI SSN: |
| Supplier ID: |
| Company Name: |
| Address: |
| City: |
| Zip Code: |
| Contact Name: |
| Contact Title: |
| Phone: |
| Fax: |
| Email: |
| Website: |
| Bidder currently engaged in a boycott of goods or services from Israel: Off |
| Registration with the Oklahoma Secretary of State: |
| YES Filing Number: Off |
| NO Prior to the contract award the successful bidder will be required to register with the Secretary of: Off |
| YES Include with the bid a certificate of insurance: Off |
| NO Exempt from the Workers Compensation Act pursuant to 85A OS 218b111 Attach a: Off |
| YES I am a servicedisabled veteran business as defined in 74 OS 8544E Include with the bid: Off |
| NO Do not meet the criteria as a servicedisabled veteran business: Off |
| Date: |
| Printed Name: |
| Title: |
| Text2: |
File details come from the government source that posted it. Updated .