Supply and delivery of chlorine gas for fika patso water treatment plant

RE-ADVERTISEMENT : SUPPLY AND DELIVERY OF CHLORINE GAS FOR FIKA PATSO

WATER TREATMENT PLANT: MAPW RFQ 024 /2025/26

Material/ Service description Quantity

Name Chlorine gas 4

CAS No 7782-50-5

Chemical Formula Cl2

Kilogram 925

Evaluation criteria

Points for this bid shall be awarded for:

(a) Price; and

(b) Specific goals

The maximum points for this bid are allocated as follows:

POINTS

PRICE 80

SPECIFIC GOALS 20

TOTAL POINTS FOR PRICE AND SPECIFIC GOALS MUST 100

NOT EXCEED

Specific goals for the tender and points claimed are indicated per the table below

The specific goals allocated in terms of this Number Number Number Number of

tender of points of points of points points

allocated allocated allocate allocated

(90/10 (80/20 d (90/10 (80/20

system) system) system) system) to

to be to be to be be

complete complete complet completed

d by the d by the ed by by the

organ of organ of the tenderer

state state tenderer

At least 50% HDI ownership 5

At least 50% Youth ownership 5

At least 50% Woman ownership 4

Locality: 6

Maluti a phofung -6

Thabo Mofutsanyna-4

Free State -2

Outside Free State-0

Total 20

MBD 1

INVITATION TO BID

YOU ARE HEREBY INVITED TO BID FOR REQUIREMENTS OF THE (NAME OF MUNICIPALITY/ENTITY)

BID NUMBER: ..................... CLOSING DATE: ........................ CLOSING TIME: ..............

DESCRIPTION................................................................................................................................................

The successful bidder will be required to fill in and sign a written Contract Form (MBD 7).

BID DOCUMENTS MAY BE POSTED TO:

...........................................................................................................

..........................................................................................................

OR

DEPOSITED IN THE BID BOX SITUATED AT (STREET ADDRESS)

.....................................................................................................................................................................

.....................................................................................................................................................................

Bidders should ensure that bids are delivered timeously to the correct address. If the bid is late, it will not be accepted

for consideration.

The bid box is generally open 24 hours a day, 7 days a week.

ALL BIDS MUST BE SUBMITTED ON THE OFFICIAL FORMS – (NOT TO BE RE-TYPED)

THIS BID IS SUBJECT TO THE PREFERENTIAL PROCUREMENT POLICY FRAMEWORK ACT AND THE PREFERENTIAL

PROCUREMENT REGULATIONS, 2011, THE GENERAL CONDITIONS OF CONTRACT (GCC) AND, IF APPLICABLE, ANY

OTHER SPECIAL CONDITIONS OF CONTRACT

NB: NO BIDS WILL BE CONSIDERED FROM PERSONS IN THE SERVICE OF THE STATE (as defined in Regulation 1 of

the Local Government: Municipal Supply Chain Management Regulations)

THE FOLLOWING PARTICULARS MUST BE FURNISHED

(FAILURE TO DO SO MAY RESULT IN YOUR BID BEING DISQUALIFIED)

NAME OF BIDDER .......................................................................................................................................

POSTAL ADDRESS ..................................................................................................................................

STREET ADDRESS .................................................................................................................................

TELEPHONE NUMBER CODE...............NUMBER............................................................................................

CELLPHONE NUMBER .................................................................................................................................

FACSIMILE NUMBER CODE ............ .NUMBER.............................................................................................

E-MAIL ADDRESS ...................................................................................................................................

VAT REGISTRATION NUMBER .................................................................................................................................

HAS AN ORIGINAL AND VALID TAX CLEARANCE CERTIFICATE BEEN ATTACHED? (MBD 2) YES/NO

HAS A B-BBEE STATUS LEVEL VERIFICATION CERTIFICATE BEEN SUBMITTED? (MBD 6.1) YES/NO

IF YES, WHO WAS THE CERTIFICATE ISSUED BY?

AN ACCOUNTING OFFICER AS CONTEMPLATED IN THE CLOSE CORPORATION ACT (CCA) □

A VERIFICATION AGENCY ACCREDITED BY THE SOUITH AFRICAN NATIONAL ACCREDITATION SYSTEM (SANAS) □

A REGISTERED AUDITOR □

(Tick applicable box)

(A B-BBEE STATUS LEVEL VERIFICATION CERTIFICATE MUST BE SUBMITTED IN ORDER TO QUALIFY FOR PREFERENCE POINTS FOR

B-BBEE)

ARE YOU THE ACCREDITED REPRESENTATIVE

IN SOUTH AFRICA FOR THE GOODS/SERVICES/WORKS OFFERED ?

YES/NO

(IF YES ENCLOSE PROOF)

SIGNATURE OF BIDDER ................................................................................................................................

DATE ................................................................................................................................

CAPACITY UNDER WHICH THIS BID IS SIGNED .................................................................................................................................

TOTAL BID PRICE.......................................... TOTAL NUMBER OF ITEMS OFFERED .......................................

_____________________________________________________________________________________________________________________

ANY ENQUIRIES REGARDING THE BIDDING PROCEDURE MAY BE DIRECTED TO:

Municipality / Municipal Entity: ...............................................................................

Department: .........................................................................................................

Contact Person: ...................................................................................................

Tel: .....................................................................................................................

Fax: ....................................................................................................................

ANY ENQUIRIES REGARDING TECHNICAL INFORMATION MAY BE DIRECTED TO:

Contact Person: ...................................................................................................

Tel: .....................................................................................................................

Fax: ....................................................................................................................

MBD 2

TAX CLEARANCE CERTFICATE REQUIREMENTS

It is a condition of bid that the taxes of the successful bidder must be in order, or that

satisfactory arrangements have been made with South African Revenue Service (SARS) to meet

the bidder’s tax obligations.

1 In order to meet this requirement bidders are required to complete in full the attached form TCC 001

“Application for a Tax Clearance Certificate” and submit it to any SARS branch office nationally. The Tax

Clearance Certificate Requirements are also applicable to foreign bidders / individuals who wish to submit

bids.

2 SARS will then furnish the bidder with a Tax Clearance Certificate that will be valid for a period of 1 (one) year

from the date of approval.

3 The original Tax Clearance Certificate must be submitted together with the bid. Failure to submit the original

and valid Tax Clearance Certificate will result in the invalidation of the bid. Certified copies of the Tax

Clearance Certificate will not be acceptable.

4 In bids where Consortia / Joint Ventures / Sub-contractors are involved, each party must submit a separate

Tax Clearance Certificate.

5 Copies of the TCC 001 “Application for a Tax Clearance Certificate” form are available from any SARS branch

office nationally or on the website www.sars.gov.za.

6 Applications for the Tax Clearance Certificates may also be made via eFiling. In order to use this provision,

taxpayers will need to register with SARS as eFilers through the website www.sars.gov.za.

MBD 3.1

PRICING SCHEDULE – FIRM PRICES

(PURCHASES)

NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES

SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED

IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A

SEPARATE PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY

POINT

Name of Bidder.......................................... Bid Number........................

Closing Time ................ ..... Closing Date .............................

OFFER TO BE VALID FOR.........DAYS FROM THE CLOSING DATE OF BID.

__________________________________________________________________________

ITEM QUANTITY DESCRIPTION BID PRICE IN RSA CURRENCY

NO. **(ALL APPLICABLE TAXES INCLUDED)

- Required by: ........................................

- At: ........................................

.......................................

- Brand and Model ........................................

- Country of Origin

........................................

- Does the offer comply with the specification(s)? *YES/NO

- If not to specification, indicate deviation(s) ........................................

- Period required for delivery ........................................

*Delivery: Firm/Not firm

- Delivery basis ...........................................

Note: All delivery costs must be included in the bid price, for delivery at the prescribed destination.

** “all applicable taxes” includes value- added tax, pay as you earn, income tax, unemployment

insurance fund contributions and skills development levies.

*Delete if not applicable

MBD 3.2

PRICING SCHEDULE – NON-FIRM PRICES

(PURCHASES)

NOTE: PRICE ADJUSTMENTS WILL BE ALLOWED AT THE PERIODS AND TIMES SPECIFIED IN THE

BIDDING DOCUMENTS.

IN CASES WHERE DIFFERENT DELIVERY POINTS INFLUENCE THE PRICING, A SEPARATE

PRICING SCHEDULE MUST BE SUBMITTED FOR EACH DELIVERY POINT

Name of Bidder............................................. Bid number.......................................

Closing Time ........................... Closing Date ................................................

OFFER TO BE VALID FOR.........DAYS FROM THE CLOSING DATE OF BID.

---------------------------------------------------------------------------------------------------------------------------------------------------------

ITEM QUANTITY DESCRIPTION BID PRICE IN RSA CURRENCY

NO. **(ALL APPLICABLE TAXES INCUDED)

---------------------------------------------------------------------------------------------------------------------------------------------------------

- Required by: ................................................

- At: .................................................

- Brand and model ................................................

-

- Country of origin .................................................

- Does the offer comply with the specification(s)? *YES/NO

- If not to specification, indicate deviation(s) .................................................

- Period required for delivery .................................................

- Delivery: *Firm/Not firm

** ”all applicable taxes” includes value- added tax, pay as you earn, income tax, unemployment insurance fund

contributions and skills development levies.

*Delete if not applicable

MBD 3.2

PRICE ADJUSTMENTS

A NON-FIRM PRICES SUBJECT TO ESCALATION

1. IN CASES OF PERIOD CONTRACTS, NON FIRM PRICES WILL BE ADJUSTED (LOADED) WITH

THE ASSESSED CONTRACT PRICE ADJUSTMENTS IMPLICIT IN NON FIRM PRICES WHEN

CALCULATING THE COMPARATIVE PRICES

2. IN THIS CATEGORY PRICE ESCALATIONS WILL ONLY BE CONSIDERED IN TERMS OF THE

FOLLOWING FORMULA:

 R1t R2t R3t R4t  Pa  1  V Pt D1  D2  D3  D4   VPt

 R1o R2o R3o R4o 

Where:

Pa = The new escalated price to be calculated.

(1-V) Pt = 85% of the original bid price. Note that Pt must always be the

original bid price and not an escalated price.

D1, D2.. = Each factor of the bid price eg. labour, transport, clothing, footwear,

etc. The total of the various factors D1,D2...etc. must add up to

100%.

R1t, R2t...... = Index figure obtained from new index (depends on the number of

factors used).

R1o, R2o = Index figure at time of bidding.

VPt = 15% of the original bid price. This portion of the bid price remains firm

i.e. it is not subject to any price escalations.

3. The following index/indices must be used to calculate your bid price:

Index.......... Dated.......... Index.......... Dated.......... Index.......... Dated..........

Index.......... Dated.......... Index.......... Dated.......... Index.......... Dated..........

4. FURNISH A BREAKDOWN OF YOUR PRICE IN TERMS OF ABOVE-MENTIONED FORMULA. THE

TOTAL OF THE VARIOUS FACTORS MUST ADD UP TO 100%.

FACTOR

PERCENTAGE OF BID PRICE

(D1, D2 etc. eg. Labour, transport etc.)

MBD 3.2

B PRICES SUBJECT TO RATE OF EXCHANGE VARIATIONS

1. Please furnish full particulars of your financial institution, state the currencies used in the conversion of

the prices of the items to South African currency, which portion of the price is subject to rate of

exchange variations and the amounts remitted abroad.

AMOUNT I

PORTION OF

FOREIGN

PARTICULARS OF FINANCIAL PRICE

ITEM NO PRICE CURRENCY RATE CURRENC

INSTITUTION SUBJECT TO

REMITTED

ROE

ABROAD

ZAR=

ZAR=

ZAR=

ZAR=

ZAR=

ZAR=

2. Adjustments for rate of exchange variations during the contract period will be calculated by using the

average monthly exchange rates as issued by your commercial bank for the periods indicated

hereunder: (Proof from bank required)

DATE FROM WHICH NEW

DATE DOCUMENTATION DATE UNTIL WHICH NE

AVERAGE MONTHLY EXCHANGE RATES FOR THE CALCULATED PRICES

MUST BE SUBMITTED CALCULATED PRICE

PERIOD: WILL BECOME

TO THIS OFFICE WILL BE EFFECTIVE

EFFECTIVE

MBD 3.3

PRICING SCHEDULE

(Professional Services)

Name of Bidder:............................................................ Bid Number: ..............................................

Closing Time: ...................................... Closing Date ................................................

OFFER TO BE VALID FOR ............DAYS FROM THE CLOSING DATE OF BID.

ITEM DESCRIPTION BID PRICE IN RSA CURRENCY

NO **(ALL APPLICABLE TAXES INCLUDED)

1. The accompanying information must be used for the formulation

of proposals.

2. Bidders are required to indicate a ceiling price based on the total

estimated time for completion of all phases and including all

expenses inclusive of all applicable taxes for the project. R..........................

3. PERSONS WHO WILL BE INVOLVED IN THE PROJECT AND

RATES APPLICABLE (CERTIFIED INVOICES MUST BE

RENDERED IN TERMS HEREOF)

4. PERSON AND POSITION HOURLY RATE DAILY RATE

-------------------------------------------------------------------------------------- R------------------------------ ---------------------------------

-------------------------------------------------------------------------------------- R------------------------------ ---------------------------------

-------------------------------------------------------------------------------------- R------------------------------ ---------------------------------

-------------------------------------------------------------------------------------- R------------------------------ ---------------------------------

-------------------------------------------------------------------------------------- R------------------------------ ---------------------------------

5. PHASES ACCORDING TO WHICH THE PROJECT WILL BE

COMPLETED, COST PER PHASE AND MAN-DAYS TO BE

SPENT

------------------------------------------------------------------------------- R------------------------------ -------------------------- days

------------------------------------------------------------------------------- R------------------------------ -------------------------- days

------------------------------------------------------------------------------- R------------------------------ -------------------------- days

------------------------------------------------------------------------------- R------------------------------ -------------------------- days

5.1 Travel expenses (specify, for example rate/km and total km, class

of airtravel, etc). Only actual costs are recoverable. Proof of the

expenses incurred must accompany certified invoices.

DESCRIPTION OF EXPENSE TO BE INCURRED RATE QUANTITY AMOUNT

-------------------------------------------------------------------------------- ................... ................. R....................

-------------------------------------------------------------------------------- ................... ................. R....................

-------------------------------------------------------------------------------- ................... ................. R....................

-------------------------------------------------------------------------------- ................... ................. R....................

**“all applicable taxes” includes value-added taxes, pay as you earn, income tax, unemployment insurance fund

contributions and skills development levies.

-2-

5.2 Other expenses, for example accommodation (specify, eg. Three

star hotel, bed and breakfast, telephone cost, reproduction cost,

etc.). On basis of these particulars, certified invoices will be checked

for correctness. Proof of the expenses must accompany invoices.

DESCRIPTION OF EXPENSE TO BE INCURRED RATE QUANTITY AMOUNT

---------------------------------------------------------------------------------- ................... ................. R....................

---------------------------------------------------------------------------------- ................... ................. R....................

---------------------------------------------------------------------------------- ................... ................. R....................

---------------------------------------------------------------------------------- ................... ................. R....................

TOTAL: R..........................................

6. Period required for commencement with project after

acceptance of bid .........................................................................

7. Estimated man-days for completion of project .........................................................................

8. Are the rates quoted firm for the full period of contract? ...................................................*YES/ NO.

9. If not firm for the full period, provide details of the basis on which

adjustments will be applied for, for example consumer price index......................................................

.........................................................................

.........................................................................

.........................................................................

*Delete if not applicable

MBD 4

DECLARATION OF INTEREST

1. No bid will be accepted from persons in the service of the state1.

2. Any person, having a kinship with persons in the service of the state, including a blood

relationship, may make an offer or offers in terms of this invitation to bid. In view of possible

allegations of favouritism, should the resulting bid, or part thereof, be awarded to persons

connected with or related to persons in service of the state, it is required that the bidder or

their authorised representative declare their position in relation to the evaluating/adjudicating

authority.

3 In order to give effect to the above, the following questionnaire must be completed

and submitted with the bid.

3.1 Full Name of bidder or his or her representative:.....................................................

3.2 Identity Number: ..............................................................................................

3.3 Position occupied in the Company (director, trustee, hareholder2):.............................

3.4 Company Registration Number: .........................................................................

3.5 Tax Reference Number:....................................................................................

3.6 VAT Registration Number: ..............................................................................

3.7 The names of all directors / trustees / shareholders members, their individual identity

numbers and state employee numbers must be indicated in paragraph 4 below.

3.8 Are you presently in the service of the state? YES / NO

3.8.1 If yes, furnish particulars. .........................................................................

...........................................................................................................

1MSCM Regulations: “in the service of the state” means to be –

(a) a member of –

(i) any municipal council;

(ii) any provincial legislature; or

(iii) the national Assembly or the national Council of provinces;

(b) a member of the board of directors of any municipal entity;

(c) an official of any municipality or municipal entity;

(d) an employee of any national or provincial department, national or provincial public entity or

constitutional institution within the meaning of the Public Finance Management Act, 1999 (Act

No.);

(e) a member of the accounting authority of any national or provincial public entity; or

(f) an employee of Parliament or a provincial legislature.

2 Shareholder” means a person who owns shares in the company and is actively involved in the

management of the company or business and exercises control over the company.

3.9 Have you been in the service of the state for the past twelve months? .........YES / NO

3.9.1 If yes, furnish particulars...........................................................................

..........................................................................................................

3.10 Do you have any relationship (family, friend, other) with persons

in the service of the state and who may be involved with

the evaluation and or adjudication of this bid? ....................................... YES / NO

3.10.1 If yes, furnish particulars.

..........................................................................................

..........................................................................................

3.11 Are you, aware of any relationship (family, friend, other) between

any other bidder and any persons in the service of the state who

may be involved with the evaluation and or adjudication of this bid? YES / NO

3.11.1 If yes, furnish particulars

.............................................................................................

.......................................................................................................

3.12 Are any of the company’s directors, trustees, managers,

principle shareholders or stakeholders in service of the state? YES / NO

3.12.1 If yes, furnish particulars.

...........................................................................................

...........................................................................................

3.13 Are any spouse, child or parent of the company’s directors

trustees, managers, principle shareholders or stakeholders

in service of the state? YES / NO

3.13.1 If yes, furnish particulars.

...........................................................................................

...........................................................................................

3.14 Do you or any of the directors, trustees, managers,

principle shareholders, or stakeholders of this company

have any interest in any other related companies or

business whether or not they are bidding for this contract. YES / NO

3.14.1 If yes, furnish particulars:

.........................................................................................

.........................................................................................

4. Full details of directors / trustees / members / shareholders.

Full Name Identity Number State Employee

Number

......................................... ............................................

Signature Date

........................................ .............................................

Capacity Name of Bidder

MBD 5

DECLARATION FOR PROCUREMENT ABOVE R10 MILLION (ALL APPLICABLE TAXES INCLUDED)

For all procurement expected to exceed R10 million (all applicable taxes included), bidders must

complete the following questionnaire:

1 Are you by law required to prepare annual financial

statements for auditing?

1.1 If yes, submit audited annual financial statements for the

past three years or since the date of establishment if

established during the past three years. *YES / NO

........................................................................

........................................................................

2 Do you have any outstanding undisputed commitments for

municipal services towards any municipality for more than

three months or any other service provider in respect of

which payment is overdue for more than 30 days?

2.1 If no, this serves to certify that the bidder has no undisputed

commitments for municipal services towards any municipality

for more than three months or other service provider in

respect of which payment is overdue for more than 30 days.

2.2 If yes, provide particulars.

........................................................................

.........................................................................

.........................................................................

3 Has any contract been

....................................................................... awarded to you by an organ

of state during the past five

* Delete if not applicable years, including particulars

of any material non-

*YES / NO compliance or dispute

concerning the execution of

such contract?

3.1 If yes, furnish particulars

.........................................................................

............................................................

*YES / NO

4. Will any portion of goods or services be sourced from outside *YES / NO

the Republic, and, if so, what portion and whether any portion

of payment from the municipality / municipal entity is expected to be

transferred out of the Republic?

4.1 If yes, furnish particulars

..............................................................

..............................................................

CERTIFICATION

I, THE UNDERSIGNED (NAME) .................................................................................

CERTIFY THAT THE INFORMATION FURNISHED ON THIS DECLARATION FORM IS CORRECT.

I ACCEPT THAT THE STATE MAY ACT AGAINST ME SHOULD THIS DECLARATION PROVE TO BE

FALSE.

......................................... ............................................

Signature Date

............................................ ...........................................

Position Name of Bidder

MBD 6.1

PREFERENCE POINTS CLAIM FORM IN TERMS OF THE PREFERENTIAL

PROCUREMENT REGULATIONS 2022

This preference form must form part of all tenders invited. It contains general information

and serves as a claim form for preference points for specific goals.

NB: BEFORE COMPLETING THIS FORM, TENDERERS MUST STUDY THE

GENERAL CONDITIONS, DEFINITIONS AND DIRECTIVES APPLICABLE IN

RESPECT OF THE TENDER AND PREFERENTIAL PROCUREMENT

REGULATIONS, 2022

1. GENERAL CONDITIONS

1.1 The following preference point systems are applicable to invitations to tender:

- the 80/20 system for requirements with a Rand value of up to R50 000 000 (all

applicable taxes included); and

- the 90/10 system for requirements with a Rand value above R50 000 000 (all

applicable taxes included).

1.2 To be completed by the organ of state

(delete whichever is not applicable for this tender).

a) The applicable preference point system for this tender is the 90/10 preference point

system.

b) The applicable preference point system for this tender is the 80/20 preference point

system.

c) Either the 90/10 or 80/20 preference point system will be applicable in this tender.

The lowest/ highest acceptable tender will be used to determine the accurate

system once tenders are received.

1.3 Points for this tender (even in the case of a tender for income-generating contracts)

shall be awarded for:

(a) Price; and

(b) Specific Goals.

1.4 To be completed by the organ of state:

The maximum points for this tender are allocated as follows:

POINTS

PRICE

SPECIFIC GOALS

Total points for Price and SPECIFIC GOALS 100

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1.5 Failure on the part of a tenderer to submit proof or documentation required in terms of

this tender to claim points for specific goals with the tender, will be interpreted to mean

that preference points for specific goals are not claimed.

1.6 The organ of state reserves the right to require of a tenderer, either before a tender is

adjudicated or at any time subsequently, to substantiate any claim in regard to

preferences, in any manner required by the organ of state.

2. DEFINITIONS

(a) “tender” means a written offer in the form determined by an organ of state in

response to an invitation to provide goods or services through price quotations,

competitive tendering process or any other method envisaged in legislation;

(b) “price” means an amount of money tendered for goods or services, and

includes all applicable taxes less all unconditional discounts;

(c) “rand value” means the total estimated value of a contract in Rand, calculated at the

time of bid invitation, and includes all applicable taxes;

(d) “tender for income-generating contracts” means a written offer in the form

determined by an organ of state in response to an invitation for the origination of

income-generating contracts through any method envisaged in legislation that will

result in a legal agreement between the organ of state and a third party that produces

revenue for the organ of state, and includes, but is not limited to, leasing and disposal

of assets and concession contracts, excluding direct sales and disposal of assets

through public auctions; and

(e) “the Act” means the Preferential Procurement Policy Framework Act, 2000 (Act No.

).

3. FORMULAE FOR PROCUREMENT OF GOODS AND SERVICES

3.1. POINTS AWARDED FOR PRICE

3.1.1 THE 80/20 OR 90/10 PREFERENCE POINT SYSTEMS

A maximum of 80 or 90 points is allocated for price on the following basis:

80/20 or 90/10

Pt−Pmin Pt−Pmin

Ps= 80(1− ) or Ps= 90(1− )

Pmin Pmin

Where

Ps = Points scored for price of tender under consideration

Pt = Price of tender under consideration

Pmin = Price of lowest acceptable tender

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3.2. FORMULAE FOR DISPOSAL OR LEASING OF STATE ASSETS AND INCOME

GENERATING PROCUREMENT

3.2.1. POINTS AWARDED FOR PRICE

A maximum of 80 or 90 points is allocated for price on the following basis:

80/20 or 90/10

Pt−Pmax Pt−Pmax

Ps= 80(1+ ) or Ps= 90(1+ )

Pmax Pmax

Where

Ps = Points scored for price of tender under consideration

Pt = Price of tender under consideration

Pmax = Price of highest acceptable tender

4. POINTS AWARDED FOR SPECIFIC GOALS

4.1. In terms of Regulation 4(2); 5(2); 6(2) and 7(2) of the Preferential Procurement

Regulations, preference points must be awarded for specific goals stated in the tender.

For the purposes of this tender the tenderer will be allocated points based on the goals

stated in table 1 below as may be supported by proof/ documentation stated in the

conditions of this tender:

4.2. In cases where organs of state intend to use Regulation 3(2) of the Regulations, which

states that, if it is unclear whether the 80/20 or 90/10 preference point system applies,

an organ of state must, in the tender documents, stipulate in the case of—

(a) an invitation for tender for income-generating contracts, that either the 80/20

or 90/10 preference point system will apply and that the highest acceptable

tender will be used to determine the applicable preference point system; or

(b) any other invitation for tender, that either the 80/20 or 90/10 preference point

system will apply and that the lowest acceptable tender will be used to

determine the applicable preference point system,

then the organ of state must indicate the points allocated for specific goals for both the

90/10 and 80/20 preference point system.

of 5

Table 1: Specific goals for the tender and points claimed are indicated per the table

below.

(Note to organs of state: Where either the 90/10 or 80/20 preference point system is

applicable, corresponding points must also be indicated as such.

Note to tenderers: The tenderer must indicate how they claim points for each

preference point system.)

Number of Number of Number of

Number of points points points

points claimed claimed allocated

allocated (80/20 (90/10 (90/10 system) The specific goals (80/20 system) system)

allocated points in system) (To be (To be

terms of this tender (To be completed (To be completed completed by by the completed by the the organ of tenderer) by the organ tenderer) state)

of state)

DECLARATION WITH REGARD TO COMPANY/FIRM

4.3. Name of company/firm...............................................................................

4.4. Company registration number: .....................................................................

4.5. TYPE OF COMPANY/ FIRM

 Partnership/Joint Venture / Consortium

 One-person business/sole propriety

 Close corporation

 Public Company

 Personal Liability Company

 (Pty) Limited

 Non-Profit Company

 State Owned Company

[TICK APPLICABLE BOX]

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4.6. I, the undersigned, who is duly authorised to do so on behalf of the company/firm,

certify that the points claimed, based on the specific goals as advised in the tender,

qualifies the company/ firm for the preference(s) shown and I acknowledge that:

i) The information furnished is true and correct;

ii) The preference points claimed are in accordance with the General Conditions as

indicated in paragraph 1 of this form;

iii) In the event of a contract being awarded as a result of points claimed as shown

in paragraphs 1.4 and 4.2, the contractor may be required to furnish documentary

proof to the satisfaction of the organ of state that the claims are correct;

iv) If the specific goals have been claimed or obtained on a fraudulent basis or any

of the conditions of contract have not been fulfilled, the organ of state may, in

addition to any other remedy it may have –

(a) disqualify the person from the tendering process;

(b) recover costs, losses or damages it has incurred or suffered as a

result of that person’s conduct;

(c) cancel the contract and claim any damages which it has suffered

as a result of having to make less favourable arrangements due

to such cancellation;

(d) recommend that the tenderer or contractor, its shareholders and

directors, or only the shareholders and directors who acted on a

fraudulent basis, be restricted from obtaining business from any

organ of state for a period not exceeding 10 years, after the audi

alteram partem (hear the other side) rule has been applied; and

(e) forward the matter for criminal prosecution, if deemed necessary.

..............................................

SIGNATURE(S) OF TENDERER(S)

SURNAME AND NAME: ................................................................

DATE: ...............................................................

ADDRESS: ...............................................................

...............................................................

...............................................................

...............................................................

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MBD 7.1

CONTRACT FORM - PURCHASE OF GOODS/WORKS

THIS FORM MUST BE FILLED IN DUPLICATE BY BOTH THE SUCCESSFUL BIDDER (PART 1) AND THE

PURCHASER (PART 2). BOTH FORMS MUST BE SIGNED IN THE ORIGINAL SO THAT THE

SUCCESSFUL BIDDER AND THE PURCHASER WOULD BE IN POSSESSION OF ORIGINALLY SIGNED

CONTRACTS FOR THEIR RESPECTIVE RECORDS.

PART 1 (TO BE FILLED IN BY THE BIDDER)

1. I hereby undertake to supply all or any of the goods and/or works described in the attached bidding

documents to (name of institution).......................................... in accordance with the requirements

and specifications stipulated in bid number...................... at the price/s quoted. My offer/s remain

binding upon me and open for acceptance by the purchaser during the validity period indicated and

calculated from the closing time of bid.

2. The following documents shall be deemed to form and be read and construed as part of this agreement:

(i) Bidding documents, viz

- Invitation to bid;

- Tax clearance certificate;

- Pricing schedule(s);

- Technical Specification(s);

- Preference claims for Broad Based Black Economic Empowerment Status Level of

Contribution in terms of the Preferential Procurement Regulations 2011;

- Declaration of interest;

- Declaration of bidder’s past SCM practices;

- Certificate of Independent Bid Determination;

- Special Conditions of Contract;

(ii) General Conditions of Contract; and

(iii) Other (specify)

3. I confirm that I have satisfied myself as to the correctness and validity of my bid; that the price(s) and

rate(s) quoted cover all the goods and/or works specified in the bidding documents; that the price(s) and

rate(s) cover all my obligations and I accept that any mistakes regarding price(s) and rate(s) and

calculations will be at my own risk.

4. I accept full responsibility for the proper execution and fulfilment of all obligations and conditions

devolving on me under this agreement as the principal liable for the due fulfillment of this contract.

5. I declare that I have no participation in any collusive practices with any bidder or any other person

regarding this or any other bid.

6. I confirm that I am duly authorised to sign this contract.

NAME (PRINT) .................................................

WITNESSES

CAPACITY .................................................

1 ......................

SIGNATURE .................................................

2. ........................

NAME OF FIRM .................................................

DATE: .........................

DATE .................................................

MBD 7.1

CONTRACT FORM - PURCHASE OF GOODS/WORKS

PART 2 (TO BE FILLED IN BY THE PURCHASER)

1. I............................................. in my capacity as.................................................................

accept your bid under reference number ..................dated...........................for the supply of

goods/works indicated hereunder and/or further specified in the annexure(s).

2. An official order indicating delivery instructions is forthcoming.

3. I undertake to make payment for the goods/works delivered in accordance with the terms and conditions

of the contract, within 30 (thirty) days after receipt of an invoice accompanied by the delivery note.

PRICE (ALL B-BBEE THRESHOLD

DESCRIPTION OF APPLICABLE COMPLETION STATUS LEVEL FOR LOCAL

SERVICE TAXES DATE OF PRODUCTION

INCLUDED) CONTRIBUTION AND CONTENT

(if applicable)

I confirm that I am duly authorised to sign this contract.

SIGNED AT ............................................. ON ......................................

NAME (PRINT) .................................................

SIGNATURE ................................................

OFFICIAL STAMP WITNESSES

1 ......................................

2 .......................................

DATE: ...................................

MBD 7.3

CONTRACT FORM - SALE OF GOODS/WORKS

THIS FORM MUST BE FILLED IN DUPLICATE BY BOTH THE SUCCESSFUL BIDDER (PART 1) AND THE

SELLER (PART 2). BOTH FORMS MUST BE SIGNED IN THE ORIGINAL SO THAT THE SUCCESSFUL

BIDDER AND THE SELLER WOULD BE IN POSSESSION OF ORIGINALLY SIGNED CONTRACTS FOR

THEIR RESPECTIVE RECORDS.

PART 1 (TO BE FILLED IN BY THE BIDDER)

I hereby undertake to purchase all or any of the goods and/or works described in the attached bidding

documents from (name of institution)............................................ in accordance with the

requirements stipulated in (bid number)...................... at the price/s quoted. My offer/s remain binding

upon me and open for acceptance by the seller during the validity period indicated and calculated from

the closing time of bid.

The following documents shall be deemed to form and be read and construed as part of this agreement:

(i) Bidding documents, viz

Invitation to bid;

Tax clearance certificate;

Pricing schedule(s);

Declaration of interest;

Declaration of Bidder’s past SCM practices;

Special Conditions of Contract;

(ii) General Conditions of Contract; and

(iii) Other (specify)

I confirm that I have satisfied myself as to the correctness and validity of my bid; that the price(s) quoted

cover all the goods and/or works specified in the bidding documents; that the price(s) cover all my

obligations and I accept that any mistakes regarding price(s) and calculations will be at my own risk.

I accept full responsibility for the proper execution and fulfilment of all obligations and conditions

devolving on me under this agreement as the principal liable for the due fulfillment of this contract.

I undertake to make payment for the goods/works as specified in the bidding documents.

I declare that I have no participation in any collusive practices with any bidder or any other person

regarding this or any other bid.

I confirm that I am duly authorised to sign this contract.

NAME (PRINT) .................................................

WITNESSES

CAPACITY .................................................

1 ..............................

SIGNATURE .................................................

.............................

NAME OF FIRM .................................................

DATE: .............................

DATE .................................................

MBD 7.3

CONTRACT FORM - SALE OF GOODS/WORKS

PART 2 (TO BE FILLED IN BY THE SELLER)

I........................... in my capacity as.................................................................

accept your bid under reference number ..................dated...........................for the purchase of

goods/works indicated hereunder and/or further specified in the annexure(s).

I undertake to make the goods/works available in accordance with the terms and conditions of the

contract.

PRICE (ALL

ITEM

DESCRIPTION APPLICABLE

NO.

TAXES INCLUDED)

I confirm that I am duly authorized to sign this contract.

SIGNED AT .............................................ON......................................

NAME (PRINT) ...........................................

SIGNATURE ...........................................

OFFICIAL STAMP WITNESSES

............................

............................

DATE ............................

MBD 8

DECLARATION OF BIDDER’S PAST SUPPLY CHAIN

MANAGEMENT PRACTICES

1 This Municipal Bidding Document must form part of all bids invited.

2 It serves as a declaration to be used by municipalities and municipal entities in

ensuring that when goods and services are being procured, all reasonable steps are

taken to combat the abuse of the supply chain management system.

3 The bid of any bidder may be rejected if that bidder, or any of its directors have:

abused the municipality’s / municipal entity’s supply chain management

system or committed any improper conduct in relation to such system;

been convicted for fraud or corruption during the past five years;

willfully neglected, reneged on or failed to comply with any government,

municipal or other public sector contract during the past five years; or

been listed in the Register for Tender Defaulters in terms of section 29 of the

Prevention and Combating of Corrupt Activities Act (No ).

4 In order to give effect to the above, the following questionnaire must be

completed and submitted with the bid.

Item Question Yes No

4.1 Is the bidder or any of its directors listed on the National Treasury’s Database of Restricted Suppliers as Yes No

companies or persons prohibited from doing business with the public sector?

(Companies or persons who are listed on this Database were informed in writing of

this restriction by the Accounting Officer/Authority of the institution that imposed the

restriction after the audi alteram partem rule was applied).

The Database of Restricted Suppliers now resides on the National Treasury’s

website(www.treasury.gov.za) and can be accessed by clicking on its link at the

bottom of the home page.

4.1.1 If so, furnish particulars:

4.2 Is the bidder or any of its directors listed on the Register for Tender Defaulters in Yes No

terms of section 29 of the Prevention and Combating of Corrupt Activities Act (No )?

The Register for Tender Defaulters can be accessed on the National Treasury’s

website (www.treasury.gov.za) by clicking on its link at the bottom of the home

page.

4.2.1 If so, furnish particulars:

4.3 Was the bidder or any of its directors convicted by a court of law (including a court of Yes No

law outside the Republic of South Africa) for fraud or corruption during the past five

years?