OMESFormCP076.pdf
PDF 214 KB Posted
- Attached to
- AUTOPILOT AND SAS AIRBUS
- Solicitation number
- EV00000598
- Issued by
- Cleveland County, Oklahoma City, Oklahoma
About this file
This is a Responding Bidder Information form (OMES FORM CP 076) from the Oklahoma Office of Management & Enterprise Services (OMES) for Solicitation #EV00000598. The form requires bidders to submit key business information and certifications along with their bid response. The form must be accompanied by a "Certification for Competitive Bid and Contract" document.
The form requires bidders to provide general company information, contact details, and several mandatory certifications including: confirmation of whether they are engaged in a boycott of goods/services from Israel, registration status with the Oklahoma Secretary of State (required if bid is over $250,000), workers' compensation insurance coverage documentation, and verification of service-disabled veteran business status under the Disabled Veteran Business Enterprise Act. The form requires bidders to provide proof of compliance with various state regulations and includes requirements for specific supporting documentation depending on the bidder's status in each category.
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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 #EV00000598
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 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 .