OMESformCP076.pdf
PDF 180 KB Posted
- Attached to
- Dual HPLC Service Contract
- Solicitation number
- EV00000933
- Issued by
- Oklahoma County, Hobart City, Oklahoma
About this file
This document is a Responding Bidder Information Form (OMES Form CP076) issued by the State of Oklahoma's Central Purchasing division for use in competitive bidding processes. The form serves as a certification document that bidders must submit along with their solicitation responses. It functions as a standardized intake form to collect essential bidder information including company identification, contact details, Federal Employer Identification Number (FEIN) or Social Security Number (SSN), and supplier identification. The form requires bidders to confirm their registration status with the Oklahoma Secretary of State prior to contract award or provide documentation of exemption from registration requirements.
The form includes several compliance certifications and declarations required of all bidders. Bidders must disclose whether they are engaged in any boycott of goods or services from Israel, provide proof of workers' compensation insurance coverage in compliance with the Oklahoma Administrative Workers' Compensation Act or submit a signed exemption statement, and declare their status as a service-disabled veteran business enterprise if applicable, which would require submission of appropriate federal verification documentation and proof of ownership and management control by service-disabled veterans. The form concludes with a signature block requiring authorized approval and dating by the bidder's representative.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment_A_Agency_Solicitations.pdf | ||
| Exhibit_1_Specifications.pdf | ||
| Attachment_B_General_Terms.pdf | ||
| omes-form-cp004(5).docx | DOCX document | |
| Bidder_Instructions.pdf | ||
| Attachment_C_Agency_Terms.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 .