points Proposed work plan (approach and methodology) 20 Expertise of key personnel 40 Availability/ allocation of resources 10 Track record of tenderer (with respect to projects of similar nature) 30 Total evaluation points for quality (MS) 100 The minimum number of evaluation points for quality is 60. Tender offer that fails to score the minimum number of evaluation points for quality will be rejected. Schedule for evaluating quality Maximum number Quality Criteria Sub-Criteria of points Approach paper which responds to the proposed scope of work / project Technical approach and design and outlines methodology 10 proposed approach / methodology and work plan complete with time frames Proposed Work Plan 10 Expertise of key personnel in relation to the scope of Qualifications and experience of work Director / Team Leader 10 At least one director or team Qualifications and experience of leader must be registered Project Managers 10 Maximum number Quality Criteria Sub-Criteria of points with SACAP as a At least one team member with an Professional Architecture / NQF Level 7 qualification in LIC – Technologist Develop and Promote Labour Intensive Construction Strategies. 10 Qualifications and experience of construction Monitors 10 Availability / Allocation of Organisation and Staffing Resources • Technical Directors - SACAP Registered 4 • Project Management Staff 2 • Design Staff 2 • Resources - Design Software; Plotters; Printers; Office space; etc. 2 Relevant Experience of the 5 points will be scored for each PSP with respect to specific comparable project completed, aspect of the project / preferably for Organs of State. comparable projects. Attach References to be clearly stated Appointment letter and together with contact persons and Completion Certificates numbers 30 Total evaluation points for quality (Ms) 100 A more detailed explanation of the quality criteria is given below: Proposed work plan A proposed work plan must be provided with the tender submission which must be of sufficient detail (but preferably not more than 5 pages in length) to indicate that the project brief has been understood. The proposed work plan must respond to the scope of work and outline the proposed approach / methodology including that relating to health and safety. The approach paper should articulate what values add the tenderer will provide in achieving the stated objectives for the project. The proposed Reception Hall with waiting area 64m2, Hall (Classroom setting) accommodating 30 people, Store room 30m2, Office 5.6m2, Office 9.6m2, Office 13m2, Kitchen with cupboards 9m2, Ablution facilities 3 for males plus 2 urinals and 3 for ladies with basins and General Renovation to the existing Building. The approach paper should explain the methodologies which are to be adopted, demonstrate the compatibility of those methodologies with the proposed approach. The approach should also include a quality plan which outlines processes, procedures and associated resources, applied by whom and when, to meet the requirements and indicate how risks will be managed and what contribution can be made regarding value management. Expertise of key personnel As the work required in terms of this tender is considered to be of a technically complex nature, requiring considerable expertise, it is essential that suitably qualified and experienced personnel be assigned to this project. The personnel must currently be registered as professionals with the South African Council for the Architectural Profession. Besides the minimum requirements specified in the eligibility criteria, it would be extremely advantageous if the key personnel can demonstrate recent experience related to specific aspects of this project. Aside from submitting a general CV for each of the key personnel must submit a statement for each of the key personnel which highlights any particular fields of specialization and experience that is relevant to this particular project. Allocation of resources Tenderers must indicate what resources (human and otherwise) that they have available and intend allocating to this project, and on what basis (that is, for what aspect of the work, and whether full or part time), if successful. This will include the key personnel, plus others (for example, a tender documentation specialist, site monitoring staff). Other resources, for example, would be the type of software package intended for use on this project, whether or not it is owned or licensed to the tenderer, or whether it is available through some other means. Tenderers should note that, during the course of any contract arising from this tender, any of the personnel listed at tender stage may only be replaced with personnel of similar qualification and experience, subject to the approval of the employer. Track Record Tenderers must complete Schedule which is a list all relevant projects that have been successfully completed in their local office in the past three years, or that are underway at present. Attach appointment letters and Completion certificates. Note: Where the entity tendering is a joint venture a score for track record will be awarded to each party to the joint venture, which will then be combined in proportion to the percentage contribution of each party to the joint venture. 4. BID DECLARATION 1. I/we Mr/Mrs/Messrs _____________________________________________________ duly assigned to represent the bidder for the purpose of this bid, hereby bid to supply the goods and/or render services described in the attached documents to the Ramotshere Moiloa Local Municipality on terms and conditions stipulated in this bid and in accordance with the specifications stipulated in the bid documents (which shall be taken as part of, and incorporated into this bid) at the prices reflected in the Pricing Schedule. 2. I/we agree that this offer shall remain valid for a period of 90 days commencing from the closing date and time of this bid. 3. I/We further agree that: 3.1 This bid and its acceptance shall be subject to the terms and conditions contained in the in the Ramotshere Moiloa Local Municipality 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, Ramotshere Moiloa Local 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 Ramotshere Moiloa Local Municipality and I/we will then pay to Ramotshere Moiloa Local Municipality any additional expense incurred by the Ramotshere Moiloa Local 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 Ramotshere Moiloa Local 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 Ramotshere Moiloa Local 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) quoted 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. 5. I/we hereby accept full responsibility for the proper execution and fulfilment of all obligations and conditions devolving on me/us under this agreement as the Principal(s) liable for the due fulfilment of this contract. 6. I/we agree that any action arising from this contract may in all respects be instituted against me/us and I/we hereby undertake to satisfy fully any sentence or judgment which may be pronounced against me/us as a result of such action. 7. I/we declare that I/we have participation/no participation* in the submission of any other offer for the supplies/services described in the attached documents. *If in the affirmative, state name(s) of bid(s) involved. ____________________________________________________________________________________________ ____________________________________________________________________________________________ Name of Bidder: ____ Signature __ 5. RESOLUTION TAKEN BY THE BOARD OF DIRECTORS / MEMBERS / PARTNERS RESOLUTION of a meeting of the Board of Directors / Members / Partners of (Name of Bidder) Held at On (Place) (Date) RESOLVED THAT: 1. The enterprise submits a Bid to the Ramotshere Moiloa Local Municipality in respect of the following project: RMLM SCM:2025/2026: COMM-03B EXPRESSION OF INTEREST: PROVISION OF THE PROFESSIONAL ARCHITECTURAL SERVICES FOR PLANNING; DESIGN; TENDER DOCUMENTATION; CONSTRUCTION AND SUPERVISION FOR THE EXTENSION AND RENOVATION OF RAMOTSHERE MOILOA LOCAL MUNUCIPALITY DRIVING LICENSE TESTION CENTRE (DLTC). 2. Mr/Mrs/Ms In his/her capacity as and who will 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. Name Capacity Signature Enterprise Stamp 6. RESOLUTION TAKEN BY THE BOARD OF DIRECTORS OF A CONSORTIUM OR JOINT VENTURE RESOLUTION of a meeting of the Board of Directors / Members / Partners of (Name of Bidder) Held at On (Place) (Date) RESOLVED THAT: 1. The enterprise submits a Bid to the Ramotshere Moiloa Local Municipality in respect of the following project: RMLM SCM:2025/2026 COMM-03B EXPRESSION OF INTEREST: PROVISION OF THE PROFESSIONAL ARCHITECTURAL SERVICES FOR PLANNING; DESIGN; TENDER DOCUMENTATION; CONSTRUCTION AND SUPERVISION FOR THE EXTENSION AND RENOVATION OF RAMOTSHERE MOILOA LOCAL MUNUCIPALITY DRIVING LICENSE TESTION CENTRE (DLTC). As a Consortium/Joint Venture comprising (list all the legally correct full names and registration numbers, if applicable, of the Enterprises forming the Consortium/Joint Venture) (Enterprise full Name and Registration Number) (Enterprise full Name and Registration Number) 2. Mr/Mrs/Ms In his/her capacity as and who will 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 Consortium/Joint Venture enterprise mentioned above. 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 #Municipality# in respect of the project described above under item 1. 4. The Consortium/Joint venture enterprise chooses as its domicilium citandi et executandi for all purposes arising from this joint venture agreement and contract with Ramotshere Moiloa Local 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. Name Capacity Signature Enterprise Stamp MBD 1 7. INVITATION TO BID (MBD 1) YOU ARE HEREBY INVITED TO BID FOR REQUIREMENTS OF RAMOTSHERE MOILOA LOCAL MUNICIPALITY BID NUMBER: BID NO: RMLM SCM:2025/2026 COMM -03B CLOSING DATE AND TIME: Thursday,05th of February 2026 at 11h00 BID DESCRIPTION: EXPRESSION OF INTEREST: PROVISION OF THE PROFESSIONAL ARCHITECTURAL SERVICES FOR PLANNING; DESIGN; TENDER DOCUMENTATION; CONSTRUCTION AND SUPERVISION FOR THE EXTENSION AND RENOVATION OF RAMOTSHERE MOILOA LOCAL MUNUCIPALITY DRIVING LICENSE TESTION CENTRE (DLTC). The Successful bidder will be required to fill in and sign a written Contract Form (MDB 7) NB: A compulsory site inspection and bid briefing meeting with representatives of the Municipality will be held not be held. NB: Bids must be properly received and deposited in the bid box of Ramotshere Moiloa Local 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. DEPOSITED IN THE BID BOX SITUATED AT: Ramotshere Moiloa Local Municipality Cnr Coetzee and President str, Zeerust 2865 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 available during office hours (Monday to Friday, 07H30 to 16H00). 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 * 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 ....................................... ____________________________________________________________________________________________________________ ANY ENQUIRIES REGARDING THE BIDDING PROCEDURE MAY BE DIRECTED TO: Municipality: Ramotshere Moiloa Local Municipality Department: Budget and treasury Unit (Supply Chain Management) Email: basetsana.nkgothoe@ramotshere.gov.za Contact Person: Ms B C Nkgothoe Tel: 018 001 1100 TECHNICAL ENQUIRIES MAY BE DIRECTED TO: Contact Person: Mr T Mtshali Email: rmtshali@gmail.com Department: Technical services Tel: 018 001 1100 MBD 2 8. TAX CLEARANCE REQUIREMENTS (MBD 2) 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 2 9. 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 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: BID NO: RMLM SCM:2025/2026 COMM -03B Closing day and time: Thursday 05th of January 2026 at 11h00 Bid description: EXPRESSION OF INTEREST: PROVISION OF THE PROFESSIONAL ARCHITECTURAL SERVICES FOR PLANNING; DESIGN; TENDER DOCUMENTATION; CONSTRUCTION AND SUPERVISION FOR THE EXTENSION AND RENOVATION OF RAMOTSHERE MOILOA LOCAL MUNUCIPALITY DRIVING LICENSE TESTION CENTRE (DLTC). OFFER TO BE VALID FOR 90 DAYS FROM THE CLOSING DATE OF BID. 1. EXECUTIVE SUMMARY Bids are hereby requested from registered and accredited Architectural Service Providers for the extension and renovation of the existing driving license testing centre in Zeerust to the ramotshere moiloa Local Municipality.

The Background of the project the existing Driving License Testing Centre is very small to accommodate learners who are writing tests these results in the loss of revenue, thus the extension and renovation will increase the number of leaners writing test and increase the Municipal Revenue. 4. SCOPE AND PARAMETERS Reception Hall with waiting area 64m2, Hall (Classroom setting) accommodating 30 people, Store room 30m2, Office 5.6m2, Office 9.6m2, Office 13m2, Kitchen with cupboards 9m2, Ablution facilities 3 for males plus 2 urinals and 3 for ladies with basins and General Renovation to the existing Building. 5. BILL OF QUANTITIES The pricing schedule is attached to the document and the final pricing must be transferred to this section. 6. PRICING SCHEDULE / SUMMARIZED BILL OF QUANTITIES Bid Price in RSA Item Currency (all Quantity Description of Goods / services required No. applicable taxes included**) Inception Concept and Viability Design Development Documentation and Procurement Contract Administration and Inspection Close - Out 7 Construction Cost Disbursements 9 Nett price (Excluding VAT) 10 VAT Total bid price (Including VAT) (Carry forward to front cover of this bid document) MBD 3.1 Required by: ........................................ At: ........................................ 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. ______________________________________________________________________________________________ ** “all applicable taxes” includes value- added tax, pay as you earn, income tax, unemployment insurance fund contributions and skills development levies. 10. 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 11. DECLARATION OF INTEREST (MBD 4) 1. No bid will be accepted from persons in the service of the state*. 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 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. 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 12. 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 .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. .............................................................................................................................................................. 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 13. PREFERENCE POINTS CLAIM FORM IN TERMS OF THE PREFERENTIAL PROCUREMENT REGULATIONS 2011 (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 a) The applicable preference point system for this tender is the 80/20 preference point system. b) 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) Functionality; 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 20 Total points for FUNCTIONALITY 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.) MBD 6.1 Number of points Number of allocated points claimed (80/20 system) CRITERIA SUB-CRITERIA (80/20 system) (To be (To be completed by completed by the organ of the tenderer) state) Locality 4 Gender 4 SPECIFIC GOALS Disability 4 Youth 4 Race 4 SUB-CRITERIA POINT Ramotshere Moiloa Local Municipality 4 Ngaka Modiri Molema District Municipality 3 LOCALITY North West Province 2 Republic of South Africa 1 SUB-CRITERIA POINT Male 2 GENDER Female 4 SUB-CRITERIA POINT YOUTH <35 4 SUB-CRITERIA POINT South African 4 NATIONALITY Non-South African 0 SUB-CRITERIA POINT Subject to proof of Disability 4 DISABILITY TOTAL 20 6. 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 8 14. DECLARATION OF BIDDER’S PAST SUPPLY CHAIN MANAGEMENT PRACTICES (MBD 8) 1. This serves as a declaration 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. 2. The bid of any bidder may be rejected if that bidder or any of its directors have: a. abused the municipality’s supply chain management system or committed any improper conduct in relation to such system; b. been convicted for fraud or corruption during the past five years; c. wilfully neglected, reneged on or failed to comply with any government, municipal or other public sector contract during the past five years; or d. been listed in the Register for Tender Defaulters in terms of section 29 of the Prevention and Combating of Corrupt Activities Act (No ). 3 In order to give effect to the above, the following questionnaire must be completed and submitted with the bid. Item Question Yes No 3.1 Is the bidder or any of its directors listed on the National Treasury’s database as a company or person Yes No 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. 3.1.1 If so, furnish particulars: 3.2 Is the bidder or any of its directors listed on the Register for Tender Defaulters in terms of section 29 of Yes No 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. 3.2.1 If so, furnish particulars: 3.3 Was the bidder or any of its directors convicted by a court of law (including a court of law outside the Yes No Republic of South Africa) for fraud or corruption during the past five years? 3.3.1 If so, furnish particulars: 3.4 Does the bidder or any of its directors owe any municipal rates and taxes or municipal charges to the Yes No municipality / municipal entity, or to any other municipality / municipal entity, that is in arrears for more than three months? 3.4.1 If so, furnish particulars: 3.5 Was any contract between the bidder and the municipality or any other organ of state terminated during Yes No the past five years on account of failure to perform on or comply with the contract? 3.5.1 If so, furnish particulars: CERTIFICATION I, THE UNDERSIGNED (FULL NAME) ..................................................................................................... CERTIFY THAT THE INFORMATION FURNISHED ON THIS DECLARATION FORM TO BE TRUE AND CORRECT. I ACCEPT THAT, IN ADDITION TO CANCELLATION OF A CONTRACT, ACTION MAY BE TAKEN AGAINST ME SHOULD THIS DECLARATION PROVE TO BE FALSE. ................................................. ......................................... Signature Date ................................................. ............................................................................ Position Name of Bidder

Expression of Interest: Provision of the Professional Architectural Services for Planning; Design; Tender Documentation; Construction and Supervision for the Extension and Renovation of Ramotshere Moiloa Local Munucipality Driving License Testion Centre (dltc

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