OMESformCP076.pdf
PDF 181 KB Posted
- Attached to
- Farmers market plastic bags
- Solicitation number
- EV00000903
- Issued by
- Oklahoma County, Hobart City, Oklahoma
About this file
This is an OMES Form CP076 Responding Bidder Information form from the State of Oklahoma's Central Purchasing division for Solicitation EV00000903, pertaining to a farmers market plastic bags contract for t-shirt and produce bags. The form serves as the official bidder certification document that must accompany all responses to this state procurement solicitation.
The form requires respondents to provide essential bidder information including FEIN/SSN, supplier ID, company name, and complete contact details. Bidders must certify their status regarding several statutory requirements: whether they are engaged in a boycott of Israeli goods or services; their registration status with the Oklahoma Secretary of State; compliance with the Oklahoma Administrative Workers' Compensation Act; and eligibility under the Disabled Veteran Business Enterprise Act. An authorized representative must sign and date the certification. All responses must include the completed form along with supporting documentation as applicable, including certificates of insurance for workers' compensation coverage or exemption statements, Secretary of State registration documentation or exemption justification, and service-disabled veteran certifications if claiming veteran business enterprise status. This form ensures bidder compliance with Oklahoma procurement regulations and state-mandated business certification requirements prior to contract award.
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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: EV00000903 |
| 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 .