OMESformCP076.pdf
PDF 180 KB Posted
- Attached to
- HPLC-MSMS 6470 Service Contract
- Solicitation number
- EV00000932
- Issued by
- Oklahoma County, Hobart City, Oklahoma
About this file
This is an OMES Form CP076 Responding Bidder Information form used by the State of Oklahoma's Central Purchasing division for solicitation submissions. The form serves as a standardized certification document that bidders must submit along with their response to state and local contract opportunities in Oklahoma.
The form collects essential bidder information including company name, FEIN/SSN, Supplier ID, contact details, and website information. Bidders must address specific certification requirements including disclosure of any boycott engagement with goods or services from Israel, registration status with the Oklahoma Secretary of State (or documentation of exemption), and Workers' Compensation Insurance compliance under the Oklahoma Administrative Workers' Compensation Act. Additionally, bidders must indicate whether they qualify as a service-disabled veteran business enterprise as defined under 74 O.S. § 85.44E, which requires submission of appropriate federal certification, proof of at least 51% ownership by service-disabled veterans, and verification of management control by service-disabled veterans. The form requires authorized signature, date, signer name, and title to certify the accuracy of all submitted information.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit_1_Specifications.pdf | ||
| Attachment_C_Agency_Terms.pdf | ||
| Agency_Bid_Instructions.pdf | ||
| Attachment_A_Agency_Solicitations.pdf | ||
| Attachment_B_General_Terms.pdf | ||
| omes-form-cp004(5).docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .