GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
Estimated
Provide
quantity per Gas Specifications (Yes/No)
year
Argon Gas
Purity 99,99%
Chemical Formula Ar
Molecular Weight 39.95 g/mol 120
Weight/ Size 16-18 Kg
Synthetic Air/Zero Air
Purity 20% Oxygen, balance Nitrogen
Synonyms Compressed Air, Zero Air, Instrument Air
Molecular Weight 28.96 g/mol 24
Weight/ Size 10-12 Kg
Acetylene
Chemical Family Unsaturated Hydrocarbon
Synonyms Dissolved Acetylene (DA)
Chemical Formula C2H2
Molecular Weight 26.038 g/mol 24
Purity 99,99%
Weight/ Size 8-12 Kg
Liquid Petroleum Gas
Product Name HANDIGAS (LIQUEFIED PETROLEUM GAS)
Chemical Formula C3H8 PLUS C4 H10 PLUS C3 H6
Chemical Name Butane / Propane / Propylene
Nitrous Oxide
Purity 99,90%
Chemical Formula N2O
Molecular Weight 44 g/mol 24
Weight/ Size 30-32 Kg
Nitrogen Gas
Purity 99,99%
Chemical Formula N
Molecular Weight 14.007 g/mol
Weight/ Size 16-18 Kg
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
Project Proposals By The Bidder(optional)
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
SPECIAL PROPOSALS / REQUESTS BY BIDDER (OPTIONAL)
Any proposal, request or condition that should be taken into account during consideration of
the Proposal.
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
FINANCIAL AND CONTRACTUAL ARRANGEMENTS
• The following conditions are set by the Gert Sibande District Municipality:
• The Council accepts the original bid price will be valid for 90 days (3 months).
• Payment will be made within 30 days after receipt of invoices.
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
FUNCTIONALITY EVALUATION
NOTAPPLICABLE
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
Part B: Returnable Documents
The following documents are to be completed and returned as they constitute the tender. Whilst
many of the returnable are required (Compulsory to be completed and submitted) for the purpose of
evaluating the tenders, some will form part of the subsequent contract, as they form the basis of the
tender offer. For this reason, it is very important that tenderers return all information requested.
RETURNABLE DOCUMENTS REQUIRED FOR TENDER EVALUATION PURPOSES
MBD 1: INVITED TO BID ( Compulsory)................................................................................06
Form A: Declaration of Bidder’s Past Supply Chain Management Practices ................................. 24
Form B: Declaration of Interest(Compulsory) ................................................................................ 26
Form C: Authority of Signatory(Compulsory) ................................................................................. 30
Form D: SARS Declaration of Good standing (CSD Registrered )(Compulsory ) ........................ 33
Form E: Financial References / Bank Details ............................................................................... 35
Form F: Municipal Utility Account (Compulsory)..................................................................37
FormG: Preference Schedule .........................................................................................39
Form H: Contract Form ................................................................................................................. 45
Form I: Certificate of Independent Bidder Dertemination .............................................................. 47
Form J: Declaration of Procurement above 10 Million .................................................................. 50
Form K: Record of Addenda ......................................................................................................... 53
Form L: Bill of Quantities (Compulsory)...................................................................................... .... 54
Form M: Form of Offer (Compulsory)...........................................................................61
• Submit registration certificate of the bidding company issued by the Gas Regulator as
per the Gas Act of 2001, Act no. .
• Submit DMRE 38 wholesale license of the bidding company
• Submit Vehicle Transport Dangerous Permit for the bidding company
• Bidder to provide Current vehicle registration documents and compliance certificate
issued by the Local municipality for the Vehicle.
• Bidder to provide PDP for driver for Dangerous goods/Permit.
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
ATTACH THE FOLLOWING DOCUMENTS AS AN ANNEXURE TO THE TENDER DOCUMENT
WITH REFERENCE TO THE APPLICABLE RETURNABLE SCHEDULE – MBD 1:
1. For Closed Corporations
• CK1 or CK2 as applicable (Founding Statement)
2. For Companies
• A copy of the Certificate of Incorporation
• Certified Copies of the ID’s of the Directors and
• the shareholders register
3. For Joint Venture Agreements
• Copy of the Joint Venture Agreement between all the parties,
• as well as the documents in (1) or (2) of each Joint Venture member.
4. For Partnership
• Certified Copies of the ID’s of the partners
5. One-person Business / Sole trader
• Certified Copy of ID
6. B-BBEE CERTIFICATE OR SWORN AFFIDAVIT (Compulsory)
.
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
FORM A: DECLARATION OF BIDDER’S PAST SUPPLY CHAIN MANAGEMENT PRACTICES
1. This Municipal Bidding Document must form part of all bids invited.
2. It serves as a declaration to be used by municipalities and municipal entities in ensuring that
when goods and services are being procured, all reasonable steps are taken to combat the
abuse of the supply chain management system.
3. The bid of any bidder may be rejected if that bidder, or any of its directors have:
a) abused the municipality’s / municipal entity’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 ).
4. In order to give effect to the above, the following questionnaire must be completed
and submitted with the bid.
Item Question Yes No
4.1 Is the bidder or any of its directors listed on the National Treasury’s Yes No
Database of Restricted Suppliers as companies or persons prohibited
from doing business with the public sector?
(Companies or persons who are listed on this Database were informed
in writing of this restriction by the Accounting Officer/Authority of the
institution that imposed the restriction after the audialterampartem rule
was applied).
The Database of Restricted Suppliers now resides on the National
Treasury’s website (www.treasury.gov.za) and can be accessed by
clicking on its link at the bottom of the home page.
4.1.1 If so, furnish particulars:
4.2 Is the bidder or any of its directors listed on the Register for Tender Yes No
Defaulters in terms of section 29 of the Prevention and Combating of
Corrupt Activities Act (No )?
The Register for Tender Defaulters can be accessed on the National
Treasury’s website (www.treasury.gov.za) by clicking on its link at the
bottom of the home page.
4.2.1 If so, furnish particulars:
4.3 Was the bidder or any of its directors convicted by a court of law Yes No
(including a court of law outside the Republic of South Africa) for fraud
or corruption during the past five years?
4.3.1 If so, furnish particulars:
4.4 Does the bidder or any of its directors owe any municipal rates and Yes No
taxes or municipal charges to the municipality / municipal entity, or to
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
any other municipality / municipal entity, that is in arrears for more than
three months?
4.4.1 If so, furnish particulars:
4.5 Was any contract between the bidder and the municipality / municipal Yes No
entity or any other organ of state terminated during the past five years
on account of failure to perform on or comply with the contract?
4.7.1 If so, furnish particulars:
CERTIFICATION
I, the undersigned (name)
certify that the information furnished on this declaration form is true and correct.
I accept that the state may reject the bid or act against me in terms of paragraph 23 of the
general conditions of contract should this declaration prove to be false.
Signature Date
Position Name of bidder
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
FORM B: DECLARATION OF INTEREST
1 Any legal person, including persons employed by the State1, or persons having a kinship with
persons employed by the State, including a blood relationship, may make an offer or offers in
terms of this invitation to bid (includes a price quotation, advertised competitive bid, limited bid
or proposal). In view of possible allegations of favouritism, should the resulting bid, or part
thereof, be awarded to persons employed by the State, or to persons connected with or related
to them, it is required that the bidder or his/her authorised representative declare his/her position
in relation to the evaluating/adjudicating authority where:
• the bidder is employed by the State; and/or
• the legal person on whose behalf the bidding document is signed, has a relationship
with persons/a person who are/is involved in the evaluation and or adjudication of the
bid(s), or where it is known that such a relationship exists between the person or
persons for or on whose behalf the declarant acts and persons who are involved with
the evaluation and or adjudication of the bid.
2 In order to give effect to the above, the following questionnaire must be completed and submitted
with the bid.
2.1 Full Name of bidder or his or her representative:
2.2 Identity Number:
2.3 Position occupied in the Company (director, trustee, shareholder2):
2.4 Company Registration Number:
2.5 Tax Reference Number:
2.6 VAT Registration Number:
2.6.1 The names of all directors / trustees / shareholders / members, their individual identity
numbers, tax reference numbers and, if applicable, employee / persal numbers must be
indicated in paragraph 3 below
1“State” means:
a) 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. );
b) any municipality or municipal entity;
c) provincial legislature;
d) National Assembly or the National Council of Provinces; or
e) Parliament.
2 “Shareholder” means a person who owns shares in the company and is actively involved in the management of the
enterprise or business and exercises control over the enterprise.
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
2.7 Are you or any person connected with the bidder presently employed by YES / NO
the state?
2.7.1 If so, furnish the following particulars:
Name of person / director / trustee / shareholder/ member:
Name of state institution at which you or the person connected to the
bidder is employed:
Position occupied in the state institution:
Any other particulars:
2.7.2 If you are presently employed by the state, did you obtain the YES / NO
appropriate authority to undertake remunerative work outside
employment in the public sector?
2.7.2.1 If yes, did you attach proof of such authority to the bid document? YES / NO
(Note: Failure to submit proof of such authority, where applicable, may
result in the disqualification of the bid.)
2.7.2.2 If no, furnish reasons for non-submission of such proof:
2.8 Did you or your spouse, or any of the company’s directors / trustees / YES / NO
shareholders / members or their spouses conduct business with the state
in the previous twelve months?
2.8.1 If so, furnish particulars:
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
2.9 Do you, or any person connected with the bidder, have any relationship YES / NO
(family, friend, other) with a person employed by the state and who may
be involved with the evaluation and or adjudication of this bid?
2.9.1 If so, furnish particulars:
2.10 Are you, or any person connected with the bidder, aware of any YES / NO
relationship (family, friend, other) between any other bidder and any
person employed by the state who may be involved with the evaluation
and or adjudication of this bid?
2.10.1 If so, furnish particulars:
2.11 Do you or any of the directors / trustees / shareholders / members of the YES / NO
company have any interest in any other related companies whether or
not they are bidding for this contract?
2.11.1 If so, furnish particulars:
GSDM discourages fraud and corruption.
PROVISION OF VARIOUS GAS CYLINDERS INCLUDING GAS CYLINDER RENTALS TO THE GERT SIBANDE
DISTRICT MUNICIPALITY WATER LABORATORY AS AND WHEN REQUIRED FOR A PERIOD OF 36 MONTHS (RE-
ADVERT) GSDM: 05/2025
2. Full details of directors / trustees / members / shareholders.
Full Name Identity Number Personal Tax State Employee
Reference Number /
Number Personal Number