OMESFormCP076.pdf
PDF 286 KB Posted
- Attached to
- SW0003 Water Treatment Chemicals Supplemental
- Solicitation number
- EV00000649
- Issued by
- Oklahoma
About this file
This is a Responding Bidder Information form (Form CP076) from the Oklahoma Office of Management & Enterprise Services (OMES) Central Purchasing division. The form is a required document that must be submitted along with a Certification for Competitive Bid and Contract as part of a solicitation response. It collects essential bidder information across eight key sections including general company information, contact details, and various compliance certifications.
The form requires bidders to declare whether they are engaged in boycotts of goods/services from Israel, confirm registration with the Oklahoma Secretary of State, provide proof of workers' compensation insurance coverage, and indicate if they qualify as a service-disabled veteran business under the Disabled Veteran Business Enterprise Act. For service-disabled veteran businesses, specific documentation is required including federal agency certification, proof of 51% ownership by service-disabled veterans, and verification of management control. The form includes requirements for business registration with the Secretary of State (sos.ok.gov) and compliance with workers' compensation requirements, with options for claiming exemptions under specific statutory provisions.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| OMES-FORM-CP-011-Amendment_Q_A.docx | DOCX document | |
| Attachment_C-StatewideTerms.pdf | ||
| Attachment_B-NegotiableTerms.docx | DOCX document | |
| BID_PACKET_ATTACHMENTS_INSTRUCTIONS.pdf | ||
| Statewide_Bidder_Instuctions.pdf | ||
| Exhibit_1_Specifications_and_Pricing.xlsx | XLSX spreadsheet | |
| OMESFormCP004.pdf | ||
| Attachment_A-StatewidePurposeNonNegotiable.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: |
| 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: |
File details come from the government source that posted it. Updated .