Provision of insurance services for properties and liabilities – 36-Month contract – northern cape tender

{"name":null,"email":null,"phone":null,"department":"Supply Chain Management","address":"ays; or a lease agreement"}

Returnable Documents: million (all applicable taxes included) completed and signed? (MBD 5), 23. Did you attach the annual financial statements as required in MBD 5?,  Proof of CSD registration, older than 90 days; or a lease agreement where the tenderer is the lessee; or an official, 12. Bidders are required to be registered on the Central Supplier Database (CSD).

Bidders must be registered on the Central Supplier Database (CSD). Persons in the service of the state are not eligible to bid. Bidders must have a valid tax clearance certificate (or satisfactory arrangements with SARS). For functionality, bidders must achieve a minimum of 70 points out of 100. Bidders must demonstrate relevant experience (at least 2-3 appointment letters for related work) and provide CVs of team members, including an underwriting manager. Financial capacity is required, with a bank letter of good standing. For consortia/joint ventures, each party must be eligible and provide separate tax clearance certificates.

Supply Chain Management Regulations (Government Gazette May 2005)

Bid NO: 01-2026/27

Provision of insurance services

3 or more appointment letters = 30 points

RELATED WORK 2 - 3 appointment letters = 15 points 30 Points

EXPERIENCE Below two reference letter = 0 points

Please attach appointment letters.

Underwriting manager = 35 points

CVs OF TEAM MEMBERS

Proposed for the

PANEL Please attach Certificate(s) as a proof. 35 Points

MAXIMUM POSSIBLE POINTS FOR FUNCTIONALITY 100 points

MINIMUM QUALIFYING THRESHOLD SCORE 70 points

Only bidders that have achieved the minimum qualifying points of 70 out of 100 for

functionality and will be evaluated further in accordance with the 80/20 Preference

Point System as indicated below:

8.4 Phase 3: evaluation on price and specific goals

Points

Price 80

SPECIFIC GOALS: Black people 10

SPECIFIC GOALS: Residing in JTG District Municipality 10

Total points for Price and Specific goals 100

Venture ............................................................................................................................................... 5

6. Invitation to bid (mbd 1) ................................................................................................................ 6

7. Tax clearance requirements (mbd 2) ..................................................................................... 9

8. Pricing schedule – firm prices (mbd 3.1) .............................................................................. 12

9. Previous work experience of a similar nature.............................................................. 18

10. Declaration of interest (mbd 4) ............................................................................................. 19

11. Declaration for procurement above r10 million (all applicable taxes

Included) (mbd 5) ............................................................................................................................ 21

Company profile(s) to be submitted (in case of a joint Venture, all

companies must submit separate profiles) indicating the Lead

Company demonstrating experience and technical ability in the 20 Points

Please attach company Profile(s).

experience:

3 or more appointment letters = 30 points

RELATED WORK 2 - 3 appointment letters = 15 points 30 Points

EXPERIENCE Below two reference letter = 0 points

List main work experience of a similar nature to this bid successfully executed and completed (or on-going) in the last five (5) years:

The service provider will be expected to add and insure new assets as and when required upon

approval of the proposed premium(s) by the Accounting Officer.

Bid Price in RSA

Item Currency (all

Quantity Description of Goods / services required

No. applicable taxes

included**)

POLICY TYPE Total Premium Excess

Buildings combined

Fire and allied perils

Office contents

Business interruption

Theft/buglary

Money

Goods in transit

Business all risk

Accidental damage

Public liability

Employers’ liability

Motor fleet

Electronic equipment

Commercial house

Owners

Total all policy types

SASRIA Total Premium Excess

Councillors

House owners

All risk

Motor fleet

Total sasria

Buildings combined section

Buildings address insured

Amount

Kuruman Campus C/O Voortrekker R 3 200 000.00

street and Rose

Avenue, Kuruman

Municipal Building: Basic C/O Voortrekker and R 1 870 000.00

Services and infrastructure Product way,

Kuruman

Municipal Building: Offices Federale, Mynbou R 19 900 000.00

Street, Kuruman

Municipal Building: Disaster Federale, Mynbou R 3 410 000.00

Centre Street, Kuruman

Municipal Building: NYDA Federale, Mynbou R 2 600 000.00

Street, Kuruman

Portion 70 of the Farm Kalahari Oos no. 410, R 116 910.00

Kuruman

Farm Surprise no. 33, Kuruman R 116 135.00

Fire section

Buildings address insured

Amount

Kuruman Campus C/O Voortrekker R 3 200 000.00

Street and Rose

Avenue, Kuruman

Main building Federale, Mynbou R 11 912 608.00

Street, Kuruman

Municipal Building: NYDA Federale, Mynbou R 2 600 000.00

Street, Kuruman

Portion 70 of the Farm Kalahari Oos no. 410, R 116 910.00

Kuruman

Farm Surprise no. 33, Kuruman R 116 135.00

Municipal Building: Basic C/O Voortrekker and R 1 870 000.00

Services and infrastructure Product way,

Kuruman

Municipal Building: Disaster Federale, Mynbou R 3 410 000.00

Centre Street, Kuruman

Office contents

Contents insured amount

Contents of the insured R 2 871 309

buildings

Business interruption

Business interruption insured amount

Gross Profit/12 months R 1 000 000

Theft section

Theft/burglary insured amount

Contents of the insured

buildings

Alarm, CCTV Camera System, R 20 000.00

Security Gates

Money section

Money insured amount

Limit

Standard Category Safe R 50 000.00

Goods in transit section

Goods in transit insured amount

All risk limit R 200 000

Commercial crime section

Commercial crime insured amount

1. Employee theft R 1 000 000.00

2.Employee fraud and

dishonesty

3.Third party computer fraud

Business all risks section

All risks insured amount

1. Tools and Instrument
2. Laptops and Tablets R 2 716 030.20

Accidental damage section

Accidental damage insured amount

Accidental loss or damage R100 000

Public liability section

Public liability insured amount

Legal liability for any one R 5 000 000.00

event or series of events

Employers liability section

Employers liability insured amount

Limit of liability R 1 000 000

Personal injury section

Personal injury benefit

Council and Partners R 120 000.00

Mayor and Spouse R 120 000.00

Electronic equipment section

Electronic equipment insured amount

Sub Section A – Material R 4 717 244.00

Damage

(All Electronic Equipment)

Sub Section B – Consequential R 20 000.00

loss (Reinstatement of data/

programs)

Motor fleet section

Motor fleet insured amount

Number of vehicles 21 14 383 875.72

Number of trailers 3 3 607 259.15

Commercial house owners section

Commercial house insured amount

Owners

Building

Delivery to/ travel and subsistence costs

Other (State nature): Profit at_____________%

Nett price (EXCLUSIVE OF VAT)

VAT

Does offer comply with the specifications? *YES / NO

• Delete if not applicable

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

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

Period required for delivery: ........................................ *Delivery: Firm/not firm

• Delete if not applicable

Delivery basis: ...............................................

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

9. Previous work experience of a similar nature

List main work experience of a similar nature to this bid successfully executed and completed (or on-going) in the last five (5) years:

Date

completed

Date (indicate Project value in Name and contact details of contact person /

No Institution / client / employer Project description

started projected Rand reference at institution

completion

if on-going)

Representatives of the #Municipality# are hereby authorized to contact the above contact persons / references of the various institutions to verify the correctness of the information as supplied.

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

Signature Date

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

Position Name of Bidder

Mbd 4

10. Declaration of interest (mbd 4)

11. No bid will be accepted from persons in the service of the state*.

12. 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 and/or take an oath

declaring his/her interest.

3. In order to give effect to the above, the following questionnaire must be completed and submitted with the bid:

3.1 Full Name: ............................................................................................................................................

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

3.3 Company Registration Number: .................................................................................................................

3.4 Tax Reference Number: .................................................................................................................

3.5 VAT Registration Number: .................................................................................................................

3.6 Are you presently in the service of the state *YES / NO

• Delete if not applicable

3.6.1 If so, furnish particulars.

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

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

3.7 Have you been in the service of the state for the past twelve months *YES / NO

• Delete if not applicable

3.7.1 If so, furnish particulars.

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

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

3.8 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

• Delete if not applicable

3.8.1 If so, furnish particulars.

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

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

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

• Delete if not applicable

3.9.1 If so, furnish particulars

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

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

 MSCM 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.

Mbd 4

3.10 Are any of the company’s directors, managers, principal shareholders or stakeholders in service of the state? *YES / NO

• Delete if not applicable

3.10.1 If so, furnish particulars.

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

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

3.11 Are any spouse, child or parent of the company’s directors, managers, principal shareholders or stakeholders in service of the

state? *YES / NO

• Delete if not applicable

3.11.1 If so, 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 5

11. Declaration for procurement above r10 million (all

Applicable taxes included) (mbd 5)

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? *YES / NO

• Delete if not applicable

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.

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

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

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? *YES / NO

• Delete if not applicable

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 years, including particulars of any material non-

compliance or dispute concerning the execution of such contract? *YES / NO

• Delete if not applicable

3.1.1 If yes, furnish particulars

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

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

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

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

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

• Delete if not applicable

4.1 If yes, furnish particulars

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

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

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

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

Mbd 5

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 80

SPECIFIC GOALS: Black people 10

SPECIFIC GOALS: Residing in JTG District Municipality 10

Total points for Price and Specific goals 100

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

or

Where

Ps = Points scored for price of tender under consideration

Pt = Price of tender under consideration

Pmin = Price of lowest acceptable tender

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

or

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.

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 points Number of points claimed (80/20

system)

allocated

The specific goals allocated (To be completed by the tenderer)

points in terms of this tender (80/20 system)

(To be completed by the organ of

state)

SPECIFIC GOALS : Black people

SPECIFIC GOALS: Residing in

10 JTG District Municipality

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]

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: ...............................................................

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

Mbd 6.2 ...............................................................

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

Declaration certificate for local production and content for

Designated sectors

This Municipal Bidding Document (MBD) may form part of all bids invited. It contains general

information and serves as a declaration form for local content (local production and local content

are used interchangeably).

Before completing this declaration, bidders must study the General Conditions, Definitions,

Directives applicable in respect of Local Content as prescribed in the Preferential Procurement

Regulations, 2017, the South African Bureau of Standards (SABS) approved technical

specification number SATS 1286:2011 (Edition 1) and the Guidance on the Calculation of Local

Content together with the Local Content Declaration Templates [Annex C (Local Content

Declaration: Summary Schedule), D (Imported Content Declaration: Supporting Schedule to Annex

C) and E (Local Content Declaration: Supporting Schedule to Annex C)].

1. General Conditions

1.1. Preferential Procurement Regulations, 2017 (Regulation 8) make provision for the promotion

of local production and content.

1.2. Regulation 8.(2) prescribes that in the case of designated sectors, organs of state must

advertise such tenders with the specific bidding condition that only locally produced or

manufactured goods, with a stipulated minimum threshold for local production and content

will be considered.

1.3. Where necessary, for tenders referred to in paragraph 1.2 above, a two-stage bidding

process may be followed, where the first stage involves a minimum threshold for local

production and content and the second stage price and B-BBEE.

1.4. A person awarded a contract in relation to a designated sector, may not sub-contract in such

a manner that the local production and content of the overall value of the contract is reduced

to below the stipulated minimum threshold.

1.5. The local content (LC) expressed as a percentage of the bid price must be calculated in

accordance with the SABS approved technical specification number SATS 1286: 2011 as

follows:

LC = [1 - x / y]

• 100

Where

x is the imported content in Rand

y is the bid price in Rand excluding value added tax (VAT)

Prices referred to in the determination of x must be converted to Rand (ZAR) by using the

exchange rate published by South African Reserve Bank (SARB) on the date of

advertisement of the bid as indicated in paragraph 3.1 below.

The SABS approved technical specification number SATS 1286:2011 is accessible on

http:/www.thedti.gov.za/industrial development/ip.jsp at no cost.

1.6. A bid may be disqualified if this Declaration Certificate and the Annex C (Local Content

Declaration: Summary Schedule) are not submitted as part of the bid documentation;

Mbd 6.2

2. The stipulated minimum threshold(s) for local production and content (refer to Annex

A of SATS 1286:2011) for this bid is/are as follows:

Description of services, works or goods Stipulated minimum threshold

_______________________________ _______%

_______________________________ _______%

_______________________________ _______%

3. Does any portion of the goods or services offered

have any imported content?

(Tick applicable box)

Yes NO

3.1 If yes, the rate(s) of exchange to be used in this bid to calculate the local content as

prescribed in paragraph 1.5 of the general conditions must be the rate(s) published by

SARB for the specific currency on the date of advertisement of the bid.

The relevant rates of exchange information are accessible on www.resbank.co.za

Indicate the rate(s) of exchange against the appropriate currency in the table below (refer to

Annex A of SATS 1286:2011):

Currency Rates of exchange

US Dollar

Pound Sterling

Euro

Yen

Other

NB: Bidders must submit proof of the SARB rate (s) of exchange used.

4. Where, after the award of a bid, challenges are experienced in meeting the stipulated

minimum threshold for local content the dti must be informed accordingly in order for the dti to

verify and in consultation with the AO/AA provide directives in this regard.

Mbd 6.2

Local content declaration

(Refer to annex b of sats 1286:2011)

Local content declaration by chief financial officer or other

Legally responsible person nominated in writing by the chief

Executive or senior member/person with management responsibility

(Close corporation, partnership or individual)

In respect of bid NO. .................................................................................

ISSUED BY: (Procurement Authority / Name of Institution):

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

Nb

1 The obligation to complete, duly sign and submit this declaration cannot be

transferred to an external authorized representative, auditor or any other third party

acting on behalf of the bidder.

2 Guidance on the Calculation of Local Content together with Local Content

Declaration Templates (Annex C, D and E) is accessible on

http://www.thedti.gov.za/industrial_development/ip.jsp. Bidders should first complete

Declaration D. After completing Declaration D, bidders should complete Declaration

E and then consolidate the information on Declaration C. Declaration C should be

submitted with the bid documentation at the closing date and time of the bid in

order to substantiate the declaration made in paragraph (c) below. Declarations

D and E should be kept by the bidders for verification purposes for a period of at

least 5 years. The successful bidder is required to continuously update Declarations

C, D and E with the actual values for the duration of the contract.

I, the undersigned, ..................................................................................... (full names),

do hereby declare, in my capacity as ............................................. ...........

of ...............................................................................................................(name of bidder

entity), the following:

(a) The facts contained herein are within my own personal knowledge.

(b) I have satisfied myself that:

(i) the goods/services/works to be delivered in terms of the above-specified bid

comply with the minimum local content requirements as specified in the bid,

and as measured in terms of SATS 1286:2011; and

(c) The local content percentage (%) indicated below has been calculated using the

formula given in clause 3 of SATS 1286:2011, the rates of exchange indicated in

paragraph 3.1 above and the information contained in Declaration D and E which has

been consolidated in Declaration C:

Bid price, excluding VAT (y) R

Imported content (x), as calculated in terms of SATS 1286:2011 R

Stipulated minimum threshold for local content (paragraph 3 above)

Local content %, as calculated in terms of SATS 1286:2011

If the bid is for more than one product, the local content percentages for each

product contained in Declaration C shall be used instead of the table above.

The local content percentages for each product has been calculated using the

formula given in clause 3 of SATS 1286:2011, the rates of exchange indicated in

paragraph 3.1 above and the information contained in Declaration D and E.

name of the tenderer not older than 90 days; or a lease agreement

where the tenderer is the lessee; or an official letter from the bank

confirming the registered business address of the tenderer.

20. Does the product/service offered conform to the Bid Specifications?
21. Is Pricing Schedule completed? (MBD 3.1)
22. Where applicable, is the Declaration for Procurement Above R10

million (all applicable taxes included) completed and signed? (MBD 5)

23. Did you attach the annual financial statements as required in MBD 5?

(For Procurements above R10 million)

 Proof of CSD registration

 Provide the municipal rates account or proof of residence in the name of the tenderer not

older than 90 days; or a lease agreement where the tenderer is the lessee; or an official

letter from the bank confirming the registered business address of the tenderer.

stipulated in the bid documents (which shall be taken as part of, and incorporated into this bid) at the prices reflected in the Pricing

to register with SARS as e-Filers through the website www.sars.gov.za.

Mbd 2

Mbd 2

Mbd 3.1

8. Pricing schedule – firm prices (mbd 3.1)

(Purchases)

Note: only firm prices will be accepted. Non-firm prices (including prices subject to rates of

Exchange variations) will not be considered

Price 80

SPECIFIC GOALS: Black people 10

SPECIFIC GOALS: Residing in JTG District Municipality 10

Total points for Price and Specific goals 100

Pricing schedule

I, the undersigned, ..................................................................................... (full names),

do hereby declare, in my capacity as ............................................. ...........

of ...............................................................................................................(name of bidder

entity), the following:

(a) The facts contained herein are within my own personal knowledge.

(b) I have satisfied myself that:

(i) the goods/services/works to be delivered in terms of the above-specified bid

comply with the minimum local content requirements as specified in the bid,

and as measured in terms of SATS 1286:2011; and

(c) The local content percentage (%) indicated below has been calculated using the

formula given in clause 3 of SATS 1286:2011, the rates of exchange indicated in

paragraph 3.1 above and the information contained in Declaration D and E which has

been consolidated in Declaration C:

Bid price, excluding VAT (y) R

Imported content (x), as calculated in terms of SATS 1286:2011 R

Stipulated minimum threshold for local content (paragraph 3 above)

Local content %, as calculated in terms of SATS 1286:2011

formula given in clause 3 of SATS 1286:2011, the rates of exchange indicated in

paragraph 3.1 above and the information contained in Declaration D and E.

valid tax clearance certificate?

Valid tax clearance certificate been attached? (Mbd 2) *yes / NO

CSD NUMBER: Yes

CSD registration

Central supplier Database (CSD)?

Central Supplier Database (CSD)

Central Supplier Database (CSD) Registration

VAT registration certificates?

joint venture agreement and contract with the John Taolo Gaetsewe District Municipality in respect of the project under item 1

appointment letters as proof of related work

appointment letters = 30 points

appointment letters = 15 points 30 Points

appointment letters

Tax clearance requirements (mbd 2)

Clearance Certificate” and submit it to any SARS branch office nationally. The Tax Clearance Certificate Requirements are also

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

3 In bids where Consortia / Joint Ventures / Sub-contractors are involved; each party must submit a separate Tax Clearance

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

5 Applications for the Tax Clearance Certificates may also be made via e-Filing. In order to use this provision, taxpayers will need

8. Pricing schedule – firm prices (mbd 3.1)

In cases where different delivery points influence the pricing, a separate pricing schedule

Please attach company Profile(s).

Please attach letter from the bank.

Bidders must attach appointment letters as proof of related work

3 or more appointment letters = 30 points

RELATED WORK 2 - 3 appointment letters = 15 points 30 Points

Please attach appointment letters.

CVs OF TEAM MEMBERS

PANEL Please attach Certificate(s) as a proof. 35 Points

Pricing schedule

Points Allocation: 90 points

B-BBEE Details: .........................

Facsimile number code......................NUMBER.............................................................................................

E-mail address .........................................................................................................................................

VAT registration number..................................................................................................................................

Has an original and valid tax clearance certificate been attached? (Mbd 2) *yes / NO

• Delete if not applicable

Has a b-bbee status level verification certificate been submitted? (Mbd 6.1) *Yes / NO

• Delete if not applicable

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 South 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

• Delete if not applicable

(If yes enclose proof)

Signature of bidder .................................................................................................................

Date .................................................................................................................

Capacity under which this bid is signed .................................................................................................................

Total bid price r.....................................

Total number of items offered .......................................

sign as follows:

(Specimen Signature)

be, and is hereby, authorised to sign the BID and/or all other documents and/or correspondence in connection with and

relating to the BID, as well as to sign any contract, and/or all documentation resulting from the award of the BID to the

enterprise mentioned above.

Note: The resolution must be signed by all the directors or members/partners of the bidding enterprise. Should the space provided

below not be sufficient for all directors to sign, please provide a separate sheet in the same format as below.

joint venture agreement and contract with the John Taolo Gaetsewe District Municipality in respect of the project under item 1:

(Physical Address)

Note: The resolution must be signed by all the directors or members / partners of the bidding enterprise. Should the space provided

below not be sufficient for all directors to sign, please provide a separate sheet in the same format as below.

Mbd 5

11. Declaration for procurement above r10 million (all

Applicable taxes included) (mbd 5)

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? *YES / NO

• Delete if not applicable

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.

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

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

3.1 If yes, the rate(s) of exchange to be used in this bid to calculate the local content as

prescribed in paragraph 1.5 of the general conditions must be the rate(s) published by

Regulations 2011 (mbd 6.1) .......................................................................................................... 23

13. Declaration of bidder’s past supply chain management practices (mbd 8) ..... 30

14. Certificate of independent bid determination (mbd 9) ................................................. 32

15. Annexure a: government procurement: general conditions of contract (july

2010. ..................................................................................................................................................... 34

i

3.1 This bid and its acceptance shall be subject to the terms and conditions contained in the in the John Taolo Gaetsewe District

Municipality’s Supply Chain Management Policy;

3.2 if I/we withdraw my/our bid within the period for which I/we have agreed that the bid shall remain open for acceptance, or fail

to fulfil the contract when called upon to do so, the John Taolo Gaetsewe District Municipality may, without prejudice to its

other rights, agree to the withdrawal of my/our bid or cancel the contract that may have been entered into between me/us and

the John Taolo Gaetsewe District Municipality and I/we will then pay to the John Taolo Gaetsewe District Municipality any

additional expense incurred by the John Taolo Gaetsewe District Municipality having either to accept any less favourable bid

or, if fresh bids have to be invited, the additional expenditure incurred by the invitation of fresh bids and by the subsequent

acceptance of any less favourable bid; the John Taolo Gaetsewe District Municipality shall also have the right to recover such

additional expenditure by set-off against moneys which may be due or become due to me/us under this or any other bid or

contract or against any guarantee or deposit that may have been furnished by me/us or on my/our behalf for the due fulfilment

of this or any other bid or contract and pending the ascertainment of the amount of such additional expenditure to retain such

moneys, guarantee or deposit as security for any loss the John Taolo Gaetsewe District Municipality may sustain by reason of

my/our default;

3.3 If my/our bid is accepted the acceptance may be communicated to me/us by letter or order by certified mail or registered mail.

Such posting shall be deemed to be proper service of such notice with effect from the date of posting/dispatch of such notice;

3.4 The law of the Republic of South Africa shall govern the contract created by the acceptance of my/our bid and that I/we

choose domicilium citandi et executandi in the Republic of South Africa, where any and all legal notices may be served at (full

street address of this place):

4. I/we furthermore confirm that I/we have satisfied myself/ourselves as to the correctness and validity of my/our bid; that the price(s)

and rate(s) Bid cover all the work/item(s) specified in the bid documents and that the price(s) and rate(s) cover all my/our

obligations under a resulting contract and that I/we accept that any mistakes regarding price(s) and calculations will be at my/our

risk.

3. The enterprise in the form of a consortium or joint venture accept jointly and several liability with parties under item 1 above

for the fulfilment of the obligations of the joint venture deriving from, and in any way connected with the contract to be entered

into with the John Taolo Gaetsewe District Municipality in respect of the project described above under item 1.

Bid number: 01-2026/27

CLOSING DATE AND TIME: Friday, 04 September 2026 at 12H00

Bid description: provision of insurance services of properties and liabilities for the john

Taolo gaetsewe district municipality for a period of 36 months

The Successful bidder will be required to fill in and sign a written Contract Form (MDB 7)

NB: Bids must be properly received and deposited in the bid box of the John Taolo Gaetsewe District Municipality on or before the

closing date and before the closing time. Bid offers must be submitted in a sealed envelope properly marked in terms of the bid number

and bid description as indicated above. No bid offers will be accepted via e-mail, facsimile (fax) or telegram.

Name of Bidder: ....................................................................................................................................................

BID number: 01-2026/27

Closing day and time: Friday, 04 September 2026

Bid description: PROVISION OF INSURANCE SERVICES OF PROPERTIES AND LIABILITIES FOR THE JOHN

Taolo gaetsewe district municipality for a period of 36 months

Offer to be valid for 90 days from the closing date of bid.

Employers’ liability

Legal liability for any one R 5 000 000.00

event or series of events

Limit of liability R 1 000 000

months or any other service provider in respect of which payment is overdue for more than 30 days? *YES / NO

• Delete if not applicable

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.

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

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

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

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

compliance or dispute concerning the execution of such contract? *YES / NO

• Delete if not applicable

3.1.1 If yes, furnish particulars

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

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

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

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

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]

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: ...............................................................

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

Mbd 6.2 ...............................................................

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

x is the imported content in Rand

y is the bid price in Rand excluding value added tax (VAT)

Prices referred to in the determination of x must be converted to Rand (ZAR) by using the

exchange rate published by South African Reserve Bank (SARB) on the date of

advertisement of the bid as indicated in paragraph 3.1 below.

The SABS approved technical specification number SATS 1286:2011 is accessible on

http:/www.thedti.gov.za/industrial development/ip.jsp at no cost.

1.6. A bid may be disqualified if this Declaration Certificate and the Annex C (Local Content

Declaration: Summary Schedule) are not submitted as part of the bid documentation;

Mbd 6.2

2. The stipulated minimum threshold(s) for local production and content (refer to Annex

A of SATS 1286:2011) for this bid is/are as follows:

Bid evaluation

The evaluation of this bid will be conducted in the following three (3) phases.

non-responsive and disqualified from further evaluation on functionality.

Phase 2: evaluation on functionality

Criteria sub criteria points

Company demonstrating experience and technical ability in the 20 Points

1. Category A =15 15 Points

3 or more appointment letters = 30 points

RELATED WORK 2 - 3 appointment letters = 15 points 30 Points

EXPERIENCE Below two reference letter = 0 points

Underwriting manager = 35 points

PANEL Please attach Certificate(s) as a proof. 35 Points

MAXIMUM POSSIBLE POINTS FOR FUNCTIONALITY 100 points

MINIMUM QUALIFYING THRESHOLD SCORE 70 points

Only bidders that have achieved the minimum qualifying points of 70 out of 100 for

functionality and will be evaluated further in accordance with the 80/20 Preference

8.4 Phase 3: evaluation on price and specific goals

SPECIFIC GOALS: Black people 10

SPECIFIC GOALS: Residing in JTG District Municipality 10

Total points for Price and Specific goals 100

nt letters = 30 points

Municipal Building: Basic C/O Voortrekker and R 1 870 000.00

Portion 70 of the Farm Kalahari Oos no. 410, R 116 910.00

part of all tenders invited. It contains general information and serves as a claim form for preference

points for specific goals.