OMESFormCP076.pdf

PDF 201 KB Posted

Attached to
Purchase of Commercial grade Indoor Fitness Equip
Solicitation number
EV00000572
Issued by
Ottawa County, Oklahoma

About this file

This document is the "Certification for Competitive Bid and Contract" form required by the Oklahoma Office of Management and Enterprise Services (OMES) for state and local contract opportunities. It outlines the requirements for bidders, including providing their Federal Employer Identification Number or Social Security Number, company information, contact details, and confirmation of compliance with various state regulations. Key details include confirmation of whether the bidder is currently engaged in a boycott of goods or services from Israel, registration with the Oklahoma Secretary of State if the contract is over $250,000, and proof of workers' compensation insurance coverage or exemption. The form also addresses the Disabled Veteran Business Enterprise Act, allowing bidders to certify their eligibility under this program.

The pricing and other commercial terms are not explicitly stated in this document, as it is focused on the administrative and compliance requirements for bidders. However, the form does indicate that the successful bidder will be required to register with the Oklahoma Secretary of State prior to the contract award.

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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: (if over $250,000)

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

EV00000572

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

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