Appointment of a service provider to render medical assessments for a period 36 months as when required

{"name":"Ms N. Vinger","email":null,"phone":null,"department":"Supply Chain Management","address":"and Bid"}

Returnable Documents: Only the documents in SECTION A are treated as grounds for immediate disqualification (non-responsive bids) in terms of, SECTION A: MANDATORY (non-submission will result in disqualification), 1 Signed and completed Form of Offer and Acceptance MANDATORY, 2 Completed and signed Pricing Schedule — all pricing fields completed in non- MANDATORY, 3 Completed and signed MBD 1 — Invitation to Bid MANDATORY, 4 Completed and signed MBD 4 — Declaration of Interest MANDATORY, 5 Completed and signed MBD 6.1 — Preference Point Claim Form (PPR 2022) MANDATORY, 6 Completed and signed MBD 8 — Declaration of Bidder's Past SCM Practices MANDATORY, 7 Completed and signed MBD 9 — Certificate of Independent Bid Determination MANDATORY,

• A valid signed lease agreement which is in the name of the company, that clearly shows the business address (not,
• A tenderer must submit a copy of their CIPC company registration and /o, MBD 8 - DECLARATION OF BIDDER’S PAST SUPPLY CHAIN, DECLARATION OF BIDDER’S PAST SUPPLY CHAIN MANAGEMENT PRACTICES

Criteria inside

tender

document

Phokwane Local Municipality invites bids from suitably qualified and experienced service providers for the above-

mentioned tender.

Phokwane Local Municipality Supply Chain Policy and Preferential Procurement policy 2022 will apply, and bids

will be evaluated in terms of the 80/20 points system as set out in the PPPFA. A maximum of 20 points (80/20

preference points system) will be allocated for specific goals. These goals are: Contracting with persons, or

categories of persons, historically disadvantaged by unfair discrimination on the basis of race, gender or disability,

50% of the 20 points will be allocated to promote this goal. The other 50% of the 20 points will be allocated to

promote the goal of Local labour and/ or promotion of enterprises located in the municipal area.

The Municipality shall adjudicate and award tenders in accordance with the Preferential Procurement Policy

Framework Act as amended. Tenders will remain valid for 90 (ninety) days.

Bid Documents will be downloadable for free from the 03 of August 2026 from the E-Tender portal at

https://www.etenders.gov.za/ or municipal website www.phokwane.gov.za. The bid document will not be printed

or acquired from the SCM office.

Duly completed tender documents sealed in an envelope marked with the Bid Name, Bid Number and Bid

Description are to be deposited into the tender box located on the ground floor at Phokwane Local Municipality,

24 Hertzog Street, Hartswater, 8570, by no later than 12h00 pm on the 03 September 2026. Enquiries on

technicalities may be directed to Ms N. Vinger (053) 474 9700 and for supply chain matters to Mrs M Viljoen at tel.

(053) 474 9700 during office hours.

Please note that faxed, e-mailed or late submission will not be accepted.

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Phokwane Local Municipality does not bind itself to accept the lowest or any tender, or to furnish any reason for

the acceptance or rejection of a tender. The municipality reserves the right to appoint or not to appoint to lowest

bidder in an event the bidder is below the market related rates.

This tender is drawn up in line with the Municipality’s Supply Chain Management Policy.

Mr. Z Nikani

Municipal Manager

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Returnable documents checklist

The table below lists all documents required with this bid. Bidders are advised to tick each row and verify submission

before depositing the bid.

Only the documents in SECTION A are treated as grounds for immediate disqualification (non-responsive bids) in terms of

the Municipal Finance Management Act, No. (MFMA), the Municipal Supply Chain Management Regulations

(GN ), Phokwane Local Municipality's SCM Policy, and National Treasury prescripts.

Documents in SECTION B are required to score functionality and/or claim preference points. A bidder who fails to submit a

B-BBEE certificate will NOT be disqualified but will receive zero (0) preference points for that specific goal. Documents in

SECTION C may be requested/verified after closing and before award in line with MFMA SCM Regulation 21(c) and

National Treasury Circular MFMA No. 104.

No. Required Document / Requirement Status Tick (X)

SECTION A: MANDATORY (non-submission will result in disqualification)

1 Signed and completed Form of Offer and Acceptance MANDATORY

2 Completed and signed Pricing Schedule — all pricing fields completed in non- MANDATORY

erasable black ink

3 Completed and signed MBD 1 — Invitation to Bid MANDATORY

4 Completed and signed MBD 4 — Declaration of Interest MANDATORY

5 Completed and signed MBD 6.1 — Preference Point Claim Form (PPR 2022) MANDATORY

6 Completed and signed MBD 8 — Declaration of Bidder's Past SCM Practices MANDATORY

7 Completed and signed MBD 9 — Certificate of Independent Bid Determination MANDATORY

8 Completed Schedule 1A — Authority of Signatory (company resolution / power MANDATORY

of attorney for JV / sole-proprietor certificate)

9 Completed Schedule 1B — Compulsory Enterprise Questionnaire MANDATORY

10 Proof of registration with legal Practice Council LPC of SA MANDATORY

11 Proof of active registration on the National Treasury Central Supplier Database MANDATORY

(CSD Report) showing MAAA number (NT Instruction 4A of 2016/17)

12 Valid SARS Tax Compliance Status (TCS) PIN — will be verified electronically MANDATORY

by the Municipality on the SARS eFiling system

13 Municipal Rates & Taxes account (company and directors) not older than 3 MANDATORY

months, or signed lease stating rates are included, or tribal-authority letter if rural

— must not be in arrears for more than 3 months at award stage

14 Every page of the bid document initialed by the authorized signatory MANDATORY

15 Health professionals’ council of south Africa HPCSA MANDATORY

16 In the case of a Consortium / Joint Venture: signed and dated JV Agreement MANDATORY (if applicable)

specifying profit, liability and workshare

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SECTION B: EVALUATION DOCUMENTS (Required for scoring of functionality and/or preference points)

17 Experience and Capacity of the Organisation: Number of years in FOR FUNCTIONALITY

operation providing similar medical assessment services, Number

of completed projects related to the scope of work (traceable

references required), Company profile and organogram detailing

project members and their roles

18 Qualifications and Expertise of key staff: Certified copies of FOR FUNCTIONALITY

practitioners’ qualifications in the relevant field (e.g Occupational

Health), Proof of registration with relevant professionals’ bodies

(e.g Health professionals council of south Africa HPCSA), CVs and

experience of key personnel

19 Methodology and quality assurance: Proposed methodology and FOR FUNCTIONALITY

service delivery plan, Quality assurance measures and

accreditation (e.g an assurance review plan)

20 Presentation: The presentation must cover the proposed FOR FUNCTIONALITY

methodology, project approach, capability and capacity with

deliverables and timelines to successfully

The presentation must cover how they are going to add value to

the project.

21 B-BBEE Status Level Verification Certificate or sworn affidavit (only for FOR PREFERENCE

preference-point claim — non-submission does NOT disqualify; zero preference POINTS ONLY

points will be awarded)

SECTION C: PRE-AWARD / VERIFICATION (These may be verified by the Municipality after closing — non-submission does

not automatically disqualify, but failure to produce before award will disqualify)

22 Certified copies of Identity Documents of all directors / members / partners VERIFIED AT AWARD

(certification not older than 3 months)

23 CIPC Company / Close Corporation registration documents VERIFIED AT AWARD

24 Valid Letter of Good Standing from the Compensation Fund (COIDA) VERIFIED AT AWARD

25 Banking details confirmation (bank-stamped letter or cancelled cheque) VERIFIED AT AWARD

Declaration by bidder

I, the undersigned, confirm that I have read and understood the requirements of this tender and have attached all the

documents as ticked above.

Signature: ___________________________________ Date: ________________________

Name (print): ________________________________ Capacity: ____________________

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Tender No: PLM/TMED/0208 - 2026

Description: APPOINTMENT OF A SERVICE PROVIDER TO RENDER MEDICAL

Assessments for a period 36 months as when required.

Stage 1 – Functionality

Quality / Functionality: 100 points

1. This bid is subject to functionality scoring.

2. Bidders must obtain a minimum functionality scoring of 75 out of 100 points (75%) in order for bids to

be marked as responsive. Bids that do not meet the minimum functionality scoring as indicated, will be

regarded as non-responsive and not be evaluated on price and preference points.

3. Applicable criteria:

Key performances element weight scoring matrix

Area

Experience and Capacity Number of years in 30

of the Organisation operation providing

similar medical

assessment services =

10 points

Number of completed

projects related to the

scope of work (traceable

references required) = 10

points

Company profile and

organogram detailing

project members and

their roles= 10 points

Qualifications and Certified copies of 30

Expertise of key staff practitioners’

qualifications in the

relevant field (e.g

Occupational Health) =

10 points

Proof of registration with

relevant professionals’

bodies (e.g Health

professionals council of

south Africa HPCSA). =

10 points

CVs and experience of

key personnel = 10

points

Methodology and quality Proposed methodology 20

assurance and service delivery plan

= 10 points

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1. Scope

This Bid is for Appointment of a service provider to render medical assessments for a period of 36

months as when required

We hereby request the service providers to quote for the above-mentioned tender through a competitive bidding

process.

Phokwane Local Municipality requires a service provider to render medical assessments for a period of 36

months as when required. The work allocation to the successfully appointed service providers will be based

reasonably on the ‘as an when ‘basis.

Background and motivation

The Municipality recognizes the importance of ensuring the health and well-being of it employees. To achieve

this, we are seeking the service of a medical assessment provider to conduct comprehensive evaluations this

assessment will help identity potential health risks, determine fitness for work, and inform health and wellness

initiatives. By investing in the health of our employees, we aim to promote productivity, safety, and overall quality

of life.

The medical surveillances service involves periodic health assessments of employees, particularly those

exposed to hazardous environments, to:

• Detect occupational diseases at an early stage
• Monitor the effects of exposure to health risks in the workplace
• Biological monitoring
• Ensuring employees are medically fit for specific tasks
• Reduce absenteeism and long-term illness through early interventions
• Support legal compliance with the Occupational Health and Safety

The service will help employers to promote a healthy and productive workplace while reducing liability and

enhancing overall workplace safety.

Key Services to be provided

Entry and exit medical examination

The primary goal is to assess the employee’s health and fitness for the job, ensuring they can perform their

duties without risking their own health. The employee’s health status when leaving the organization, providing a

reference point for future employment.

Annual Eye Tests

Municipal drivers present logistical challenges they are a critical safety measures to protect drivers, to reduce

accident risks and ensuring compliances.

Lung Function Test

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Employee’s who working in sewer. Water Treatment, and Refuse Operations are exposed to respiratory

hazards. Detecting early signs of respiratory issues and ensuring workplace safety and compliance.

Audio Metric Test

Drivers operating municipal vehicles are exposed to prolonged noise, increasing risk of hearing loss. Detect

hearing impairment early to prevent accident.

Tetanus injects

Employee’s who are exposed to soil, waste have s high chance of tetanus risk. Therefore, its recommended for

the employee’s get vaccinated.

Completion of drug and alcohol dependency documents

As part of our commitment to a safe and a healthy work environment, all employees are required to submit

completed drug and alcohol dependency forms.

Medical evaluation for incapacity to work investigation

The municipality needs to conduct an incapacity investigation to assess the employee’s ability to perform their

duties. This evaluation requires fitness for accurate role. It needs to support for workplace safety and

productivity.

Completion of disability application forms

The municipality cares about their employee’s wellbeing and committed to support those who are struggling with

the alcohol and drug abuse. If needs be employees needs to be rehabilitated.

Full medical examination which includes hearing test, lung function test, eye vision screening, blood

pressure screening, blood glucose screening, urine test chest x-rays, ecg test, and issue certificate of

fitness for work.

Employees need to undergo medical check-ups especially those who works at sewer, water plant and refuse as

they utilize chemicals daily, to ensure medical fitness for work and to verify if employees are fit for the specific

work, also for occupational health evaluation.

Follow ups and referrals, when necessary, by the service provider

The service provider needs to work hand in hand with HR Department for follow ups and referrals and also

confirm engagement of the employees. Needs to give updates monthly.

First Aid Level

In the case, having a First Aid training in the municipality is essential because it enables employees to respond

to emergency and provide basic care, assist colleague and the public in need and to enhance workplace safety

and reduce the risk, providing immediate care until medical professional arrive.

Incident and Investigations

Incidents and investigation will be crucial in our municipality as they promote accountability, transparency and

learning. By investigating incidents, municipalities can identity areas for improvement, implement corrective

actions and reduce the risk of similar incidents occurring in the future.

Hazard identification and risk assessment

Hazard identification and risk assessment are crucial process in the municipality to identify potential hazard,

assess risk and implement controls to mitigate or eliminate them. This helps prevent injuries, illness and

damages to property and the environment. This proactive approach will enhance public safety, employee’s wellbeing and resilience.

OHS induction

Occupational Health Inspection induction provides a comprehensive induction, whereby municipalities

demonstrate their commitment to employee safety, reduce liability and promote a culture of safety awareness,

ultimately enhancing productivity and compliance with regulatory requirements.

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Tests Frequency

Annual eye tests Once a year

Lung function test Two tests per year

Audio metric test Once a year

Tetanus injections Once a year

Additional tests As required

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key personnel = 10

points

Methodology and quality Proposed methodology 20

assurance and service delivery plan

= 10 points

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Quality assurance

measures and

accreditation (e.g an

assurance review plan)

= 10 points

Presentation The presentation must 20

cover the proposed

methodology, project

approach, capability and

capacity with deliverables

and timelines to

successfully

measures and

accreditation (e.g an

assurance review plan)

= 10 points

Presentation The presentation must 20

cover the proposed

methodology, project

approach, capability and

capacity with deliverables

and timelines to

successfully

The presentation must

cover how they are going

to add value to the

project.

Total 100

NB: No tender will be regarded as an acceptable tender/responsive if it fails to achieve the minimum qualifying score

for functionality of 75 out of a maximum of 100 points.

NB: Failure to comply with these conditions will result in your offer being disqualified. All above mentioned

conditions are compulsory.

Contact person (technical / specification related enquiries)

Wellness Officer: Ms. N. Vinger

Tel: 053 474 9700

Email: [email protected]

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Stage 2 – Price & preference

The 80/20 preference points System will be used, where 80 points will be allocated to price and 20

points to specific goals.

Pricing schedule for services

Instructions:

1. Only firm prices will be accepted. Non-firm prices will not be considered.
2. All delivery costs MUST be included in the bid price, for delivery at the prescribed

destination.

3. Document MUST be completed in non-erasable black ink.
4. NO correction fluid/tape may be used.
5. In the event of a mistake having been made, it shall be crossed out in ink and be

accompanied by an initial at each and every alteration.

6. The Bidder MUST indicate whether he/she/the entity is a registered VAT Vendor or not.

a) In the case of the Bidder not being a registered VAT Vendor, both columns

Indicate with an “x”

Are you/is the firm a registered VAT Vendor YES NO

If “YES”, please provide VAT number

I / We ____________________________________________________________ (full name of Bidder) the

undersigned in my capacity as ____________________________________ of the firm hereby offer to

Phokwane Municipality to render the services as described, in accordance with the specification and conditions

of contract to the entire satisfaction of the Phokwane Municipality and subject to the conditions of tender, for the

amounts indicated hereunder (Attach quote on company letter head):

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Form of offer and acceptance

Contract NO: PLM/TMED/0208-2026

Appointment of a service provider to render medical assessments for a

Period 36 months as and when required

Offer

The Employer, identified in the Acceptance signature block below, has solicited offers to enter into a Contract in respect of

the following works:

Appointment of a service provider to render medical assessments for a

Period 36 months as when required

The Tenderer, identified in the Offer signature block below, has examined the documents listed in the Tender Data and any

addenda thereto as listed in the Tender Schedules, and by submitting this Offer has accepted the Conditions of Tender.

By the representative of the Tenderer, deemed to be duly authorised, signing this part of this Form of Offer and Acceptance,

the Tenderer offers to perform all the obligations and liabilities of the Contractor under the Contract, including compliance

with all its terms and conditions according to their true intent and meaning, for an amount to be determined in accordance

with the Conditions of Contract identified in the Contract Data.

The offered total of the prices inclusive of value-added tax for the thirtysix (36) month contract is:

________________________________________________________________________ Rand (in words)

R ________________________________________________________________________ (in figures)

This Offer may be accepted by the Employer by signing the Acceptance part of this Form of Offer and Acceptance and

returning one copy of this document to the Tenderer before the end of the period of validity stated in the Tender Data,

whereupon the Tenderer becomes the party named as the Contractor in the Conditions of Contract identified in the Contract

Data.

Signature(s): _______________________________ ______________________________________________________

Name(s): __________________________________ ______________________________________________________

Capacity: __________________________________ ______________________________________________________

For (Name and address of organisation): _________________________________________________________________

Name and signature of witness: ________________________________________________________________________

Date: _____________________________________________________________________________________________

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Acceptance

By signing this part of this Form of Offer and Acceptance, the Employer identified below accepts the Tenderer's Offer. In

consideration thereof, the Employer shall pay the Contractor the amount due in accordance with the Conditions of Contract

identified in the Contract Data. Acceptance of the Tenderer's Offer shall form an agreement between the Employer and the

Tenderer upon the terms and conditions contained in the Agreement and in the Contract that is the subject of this Agreement.

The terms of the Contract are within the Tender Document.

The Tenderer shall, within two (2) weeks after receiving a completed copy of this Agreement (including the Schedule of

Deviations, if any), contact the Employer's agent (whose details are given in the Contract Data) to arrange the delivery of any

bonds, guarantees, proof of insurance and other documentation to be provided in terms thereof.

Notwithstanding anything contained herein, this Agreement comes into effect on the date when the Tenderer receives one

fully completed original copy of this document. Unless the Tenderer (now Service Provider) within five (5) working days of

the date of such receipt notifies the Employer in writing of any reason why it cannot accept the contents of this Agreement,

this Agreement shall constitute a binding Contract between the parties.

For and on behalf of Phokwane Local Municipality:

Signature: __________________________________ ___________________________________________________

Name: _____________________________________ ___________________________________________________

Capacity: __________________________________ ___________________________________________________

Phokwane Local Municipality, 24 Hertzog Street, Hartswater, 8570

Name and signature of witness: _____________________________________________________________________

Date: __________________________________________________________________________________________

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Mbd 1 – invitation to bid

Invitation to submit bid

You are hereby invited to bid for requirements of the phokwane local municipality.

03 september closing

Bid number: PLM/TMED/0208-2026 closing date: 2026 time: 12h00 pm

Appointment of a service provider to render medical assessments

Description for a period 36 months as when required

The successful bidder will be required to fill in and sign a written contract form (mbd7.1)

The BID should be clearly marked: PLM/TMED/0208-2026

Supplier information

Name of bidder

Postal address

Street address

Telephone number code number

Cellphone number

Facsimile number code number

E-mail address

VAT registration

Number

TAX COMPLIANCE STATUS TCS PIN: AND CSD No:

B-BBEE STATUS LEVEL ☐ Yes B-BBEE STATUS LEVEL ☐ Yes

Verification certificate

Sworn affidavit

[Tick applicable box]

☐ No ☐ No

[A B-BBEE STATUS LEVEL VERIFICATION CERTIFICATE/ SWORN AFFIDAVIT (FOR EMES & QSEs) MUST BE SUBMITTED IN

Order to qualify for preference points for b-bbee]

Are you a foreign

ARE YOU THE ACCREDITED BASED SUPPLIER FOR ☐Yes ☐No

REPRESENTATIVE IN SOUTH ☐Yes ☐No THE GOODS

Africa for the goods

/Services /works [if yes, answer part b:3

/Services /works

[If yes enclose proof] offered? ]

Offered?

Total number of items

Offered total bid price r

Signature of bidder

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

Capacity under which

This bid is signed

Bidding procedure enquiries may be directed to: technical information may be directed to:

Supply chain

Department management department corporate service

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Contact person m. Viljoen contact person n. Vinger

Telephone

Telephone number 0534749700 number 0534749700

E-MAIL ADDRESS [email protected] E-MAIL ADDRESS [email protected]

Part b

Terms and conditions for bidding

Bid submission:

Bids must be delivered by the stipulated time to the correct address. Late bids will not be accepted for

Consideration.

All bids must be submitted on the official forms provided–(not to be re-typed) or online

This bid is subject to the preferential procurement policy framework act and the preferential

Procurement regulations, 2017, the general conditions of contract (gcc) and, if applicable, any other

Special conditions of contract.

Tax compliance requirements

Bidders must ensure compliance with their tax obligations.

Bidders are required to submit their unique personal identification number (pin) issued by SARS to enable

The organ of state to view the taxpayer’s profile and tax status.

Application for the tax compliance status (tcs) certificate or pin may also be made via e-filing. In order

To use this provision, taxpayers will need to register with SARS as e-filers through the website

Www.SARS.GOV.ZA.

Foreign suppliers must complete the pre-award questionnaire in part b:3.

Bidders may also submit a printed tcs certificate together with the bid.

In bids where consortia / joint ventures / sub-contractors are involved, each party must submit a

Separate tcs certificate / pin / csd number.

Where NO tcs is available but the bidder is registered on the central supplier database (csd),

A csd number must be provided.

Questionnaire to bidding foreign suppliers

Is the entity a resident of the republic of south africa (RSA)? ☐ yes ☐ NO

Does the entity have a branch in the RSA? ☐ yes ☐ NO

Does the entity have a permanent establishment in the RSA? ☐ yes ☐ NO

Does the entity have any source of income in the RSA? ☐ yes ☐ NO

Is the entity liable in the RSA for any form of taxation? ☐ Yes ☐ NO

If the answer is “NO” to all of the above, then IT is not a requirement to register for a

Tax compliance status system pin code from the south african revenue service (SARS) and

If not register as per 2.3 Above.

Nb: failure to provide any of the above particulars may render the bid invalid.

NO bids will be considered from persons in the service of the state.

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

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

Date: ....................................................

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Mbd 2 — tax compliance status

It is a condition of this bid that:

• The tax matters of the successful bidder must be in order, or a satisfactory arrangement must have been

made with the South African Revenue Service (SARS) to meet its tax obligations.

• Bidders must obtain a Tax Compliance Status (TCS) PIN from SARS eFiling. The Municipality will

verify the bidder's tax-compliance status electronically using this PIN on the SARS eFiling system.

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

separate TCS PIN.

• Failure to submit a TCS PIN, or a finding of non-compliance on verification, will result in the bid being

disqualified at the award stage.

1. Name of taxpayer / bidder

2. Trading name

3. Identification Number (sole proprietor)

4. Company / CC / Trust Registration Number

5. Income Tax Reference Number

6. VAT Registration Number (if applicable)

7. PAYE Employer Registration Number (if applicable)

8. Tax compliance status (tcs) pin

Signature: ___________________________________ Date: ________________________

Name (print): ________________________________ Capacity: _____________________

Name of Bidder: _____________________________________________________________

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Mbd 4 – declaration of interest

Declaration of interest

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 favoritism, should the

resulting bid, or part thereof, be awarded to persons connected with or related to persons in the service of the

state, it is required that the bidder or their authorised representative declare their position in relation to the

evaluating/adjudicating authority.

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

the bid.

3.1 Full Name of bidder or his / her representative:

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

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

3.3 Position occupied in the Company (director, trustee, shareholder2):

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

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

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

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

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

employee numbers (where applicable) must be indicated in paragraph 4 below.

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

3.8.1 If yes, furnish particulars:

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

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

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

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

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

1 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;

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(c) an official or 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 entity; or

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

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

company or business and exercise control over the company.

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

If yes, furnish particulars:

3.9.1 .....................................................................................................................

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

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

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

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

3.10 Do you have any relationship (family, friend, other) with persons in the service of the state YES / NO

and who may be involved with the evaluation and or adjudication of this bid?

3.10.1 If yes, furnish particulars:

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

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

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

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

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

3.11 Are you, aware of any relationship (family, friend, other) between any other bidder and any YES / NO

persons in the service of the state who may be involved with the evaluation and or

adjudication of this bid?

3.11.1

If yes, furnish particulars:

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

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

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

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

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

3.12 Are any of the company’s directors, trustees, managers, principle shareholders or YES / NO

stakeholders in the service of the state?

3.12.1 If yes, furnish particulars:

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

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

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

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

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

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3.13 Are any spouse, child or parent of the company’s directors, trustees, managers, principle YES / NO

shareholders or stakeholders in the service of the state?

3.13.1 If yes, furnish particulars:

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

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

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

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

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

3.14 Do you or any of the directors, trustees, managers, principle shareholders, or stakeholders of YES / NO

this company have any interest in any other related companies or business whether or not

they are bidding for this contract?

3.14.1 If yes, furnish particulars:

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

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

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

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

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

Full details of directors / trustees / members / shareholders

Full Name Identity Number State Employee Number

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

Signature Date

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

Capacity Name of the bidder

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Mbd 6.1 – Preference point claim (ppr 2022)

Preference points claim form in terms of the preferential procurement

Regulations 2022

This preference form must form part of all bids invited. It contains general information and serves as a

claim form for preference points for Previously disadvantaged person/(s).

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 all bids:

• 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 a) The value of this bid is estimated not to exceed R50 000 000 (all applicable taxes included) and

therefore the 80/20 preference point system shall be applicable; or

1.3 Points for this bid shall be awarded for:

(a) Price; and

(b) Specific Goals.

1.4 The maximum points for this bid are allocated as follows:

Points

Price 80

Specific goals 20

Total points for Price and Specific Goals must 100

not exceed

1.5 Failure on the part of a Bidder 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 purchaser reserves the right to require of a bidder, either before a bid is adjudicated or at any time

subsequently, to substantiate any claim in regard to preferences, in any manner required by the purchaser.

2. Definitions

“tender” means a written offer in the form determined by an organ of state in response to an invitation to provide goods or

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services through price quotations, competitive tendering process or any other method envisaged in legislation;

“price” means an amount of money tendered for goods or services, and includes all applicable taxes less all

unconditional discounts;

“rand value” means the total estimated value of a contract in Rand, calculated at the time of bid invitation, and includes all

applicable taxes;

“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

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

Formulae for procurement of goods and services

3. Points awarded for price

3.1 The 80/20 or 90/10 preference point systems

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

80/20 or 90/10

Pt−Pmin Pt−Pmin

Ps= 80(1− ) or Ps= 90(1− )

Pmin Pmin

Where

Ps = Points scored for price of tender under consideration

Pt = Price of tender under consideration

Pmin = Price of lowest acceptable tender

Formulae for disposal or leasing of state assets and income generating

Procurement

3.2 Points awarded for price

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

80/20 or 90/10

Pt−Pmax Pt−Pmax

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

Pmax Pmax

Where

Ps = Points scored for price of tender under consideration

Pt = Price of tender under consideration

Pmax = Price of highest acceptable tender

4. Points awarded for specific goals

4.1 In terms of Regulation 4(2); 5(2); 6(2) and 7(2) of the Preferential Procurement Regulations, preference points must

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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.

Phokwane Local Municipality has identified the following specific goals for this tender:

Number of

Number of points

points claimed

allocated (80/20

The specific goals allocated points in terms of this tender (80/20 system) system)

(To be (To be completed

completed by the organ of

by the state)

tenderer)

Specific Goal 1 — Local Economic Development (maximum 10 points)

Registered office within the boundaries of Phokwane Local Municipality: 10 points 10

Within Frances Baard District (but outside Phokwane): 7 points 7

Within Northern Cape Province (but outside Frances Baard): 4 points 4

Outside Northern Cape Province: 2 points 2

Specific Goal 2: Woman ownership of a company (Max 5 points)

100% Woman ownership 5

31% - 50 % Woman ownership 3

Less than 30% Woman ownership OR no valid evidence submitted 0

Specific Goal 3: Youth ownership (Max 5 points)

100% Youth Ownership 5

31% - 50 % Youth Ownership 3

Less than 30% Youth Ownership OR no valid evidence submitted 0

Notes to complete table for specific goals:

The following documents must be attached as proof of the points claimed.

Goal 1: Locality of supplier. Tenderers should complete one relevant row for points claimed.

• The municipal rates and taxes statement, which is in the name of the company, not older than three (3) months;

or

• The Clearance Certificate issued by the bidding companies’ local municipality, which is in the name of the

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company, not older than three (3) months; or

• The completed Municipal Form with either the stamp of the municipality or the landlord, which is in the name of

the company, not older than three (3) months or

• An official letter which is in the name of the company from the local tribal authority, not older than three (3)

months; or

• A valid signed lease agreement which is in the name of the company, that clearly shows the business address (not

expired at closing date), accompanied by tax invoice/statement of account from the estate agent / landlord not older

than three (3) months); or

• If the municipal rates and taxes statement is in the Landlord’s or Director’s name an affidavit certified by the

commissioner of oaths must be attached indicating that the company/enterprise is operating from the stated

addressed, accompanied by their municipal rates and taxes statement (not older than three (3) months).

Goal 2: - Women Ownership. Tenderers should complete one relevant row for points claimed.

• Certified Copy of ID.
• Certified Copy of CK certificate (issued by CIPC).

Goal 3: Youth Ownership. Tenderers should complete one relevant row for points claimed.

• A tenderer must submit a copy of their CIPC company registration and /or shareholder certificate as proof, which

shows ownership or share certificate documents and ID of owners. The youth owners should be less than 35 years

at the time of submission of tender to claim these points.

NB: If no proof is attached the tenderer will not be awarded the points claimed.

4.3 Declaration with regard to company/firm

Name of firm:

VAT Registration number:

Company / CC / Trust registration number:

Type of firm (tick one): ☐ Partnership

☐ Sole proprietor / One-person business

☐ Close Corporation

☐ Listed company

☐ Private company (Pty) Ltd

☐ Trust

Principal business activity:

Municipal Information Municipality where

business is situated:

Registered Account

Number:

Stand Number:

4.4 Total number of years the company/firm has been in business: ............................................................

4.5 I/We, 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

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acknowledge that:

i. The information furnished is true and correct;

ii. The preference points claimed are in accordance with the General Conditions as indicated in paragraph 1 of

this form;

iii. In the event of a contract being awarded as a result of points claimed as shown in paragraphs 1.4 and 4.2, the

contractor may be required to furnish documentary proof to the satisfaction of the organ of state that the

claims are correct;

iv. If the specific goals have been claimed or obtained on a fraudulent basis or any of the conditions of contract

have not been fulfilled, the organ of state may, in addition to any other remedy it may have –

(a) disqualify the person from the tendering process;

(b) recover costs, losses or damages it has incurred or suffered as a result of that person’s

conduct;

(c) cancel the contract and claim any damages which it has suffered as a result of having to

make less favourable arrangements due to such cancellation;

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

shareholders and directors who acted on a fraudulent basis, be restricted from obtaining

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

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

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

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

Signature(s) of tenderer(s)

Surname and name: ................................................................

Date: ...............................................................

Address: ...............................................................

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

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

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Mbd 8 - declaration of bidder’s past supply chain

Management practices

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. willfully 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 Database of Yes No

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 audi alteram partem rule was applied).

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

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

bottom of the home page.

4.1.1 If so, furnish particulars:

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

of section 29 of the Prevention and Combating of Corrupt Activities Act (No 12 of ☐ ☐

2004)?

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

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

4.2.1 If so, furnish particulars:

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

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

years?

4.3.1 If so, furnish particulars:

4.4 Does the bidder or any of its directors owe any municipal rates and taxes or municipal Yes No

charges to the municipality / municipal entity, or to any other municipality / municipal ☐ ☐

entity, that is in arrears for more than three months?

4.4.1 If so, furnish particulars:

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4.5 Was any contract between the bidder and the municipality / municipal entity or any other Yes No

organ of state terminated during the past five years on account of failure to perform on or ☐ ☐

comply with the contract?

4.5.1 If so, furnish particulars:

Certification mbd 8

I, the undersigned (full name)

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

Certify that the information furnished on this declaration form

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

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Mbd 9 - certificate of independent bid determination

Certificate of independent bid determination

1 This Municipal Bidding Document (MBD) must form part of all bids1 invited.

2 Section 4 (1) (b) (iii) of the Competition Act No. , as amended, prohibits an agreement between,

or concerted practice by, firms, or a decision by an association of firms, if it is between parties in a

horizontal relationship and if it involves collusive bidding (or bid rigging). 2 Collusive bidding is a pe se

prohibition meaning that it cannot be justified under any grounds.

3 Municipal Supply Regulation 38 (1) prescribes that a supply chain management policy must provide

measures for the combating of abuse of the supply chain management system, and must enable the

accounting officer, among others, to:

a. takes all reasonable steps to prevent such abuse;

b. reject the bid of any bidder if that bidder or any of its directors has abused the supply chain management

system of the municipality or municipal entity or has committed any improper conduct in relation to

such system; and

c. cancel a contract awarded to a person if the person committed any corrupt or fraudulent act during the

bidding process or the execution of the contract.

5. This MBD serves as a certificate of declaration that would be used by institutions to ensure that, when bids are

considered, reasonable steps are taken to prevent any form of bid-rigging.

6. In order to give effect to the above, the attached Certificate of Bid Determination (MBD 9) must be completed

and submitted with the bid:

1 Includes price quotations, advertised competitive bids, limited bids and proposals.

2 Bid rigging (or collusive bidding) occurs when businesses, that would otherwise be expected to compete,

secretly conspire to raise prices or lower the quality of goods and / or services for purchasers who wish to

acquire goods and / or services through a bidding process. Bid rigging is, therefore, an agreement between

competitors not to compete

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the acceptance or rejection of a tender. The municipality reserves the right to appoint or not to appoint to lowest

bidder in an event the bidder is below the market related rates.

This tender is drawn up in line with the Municipality’s Supply Chain Management Policy.

(CSD Report) showing MAAA number (NT Instruction 4A of 2016/17)

12 Valid SARS Tax Compliance Status (TCS) PIN — will be verified electronically MANDATORY

by the Municipality on the SARS eFiling system

13 Municipal Rates & Taxes account (company and directors) not older than 3 MANDATORY

months, or signed lease stating rates are included, or tribal-authority letter if rural

— must not be in arrears for more than 3 months at award stage

Goal 1: Locality of supplier. Tenderers should complete one relevant row for points claimed.

• The municipal rates and taxes statement, which is in the name of the company, not older than three (3) months;

or

• The Clearance Certificate issued by the bidding companies’ local municipality, which is in the name of the

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company, not older than three (3) months; or

• The completed Municipal Form with either the stamp of the municipality or the landlord, which is in the name of

the company, not older than three (3) months or

• An official letter which is in the name of the company from the local tribal authority, not older than three (3)

months; or

• A valid signed lease agreement which is in the name of the company, that clearly shows the business address (not

expired at closing date), accompanied by tax invoice/statement of account from the estate agent / landlord not older

than three (3) months); or

• If the municipal rates and taxes statement is in the Landlord’s or Director’s name an affidavit certified by the

commissioner of oaths must be attached indicating that the company/enterprise is operating from the stated

addressed, accompanied by their municipal rates and taxes statement (not older than three (3) months).

Goal 2: - Women Ownership. Tenderers should complete one relevant row for points claimed.

• Certified Copy of ID.
• Certified Copy of CK certificate (issued by CIPC).

Goal 3: Youth Ownership. Tenderers should complete one relevant row for points claimed.

• A tenderer must submit a copy of their CIPC company registration and /or shareholder certificate as proof, which

shows ownership or share certificate documents and ID of owners. The youth owners should be less than 35 years

at the time of submission of tender to claim these points.

NB: If no proof is attached the tenderer will not be awarded the points claimed.

4.3 Declaration with regard to company/firm

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

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 audi alteram partem rule was applied).

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

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

bottom of the home page.

4.1.1 If so, furnish particulars:

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

of section 29 of the Prevention and Combating of Corrupt Activities Act (No 12 of ☐ ☐

2004)?

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

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

4.2.1 If so, furnish particulars:

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

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

years?

4.3.1 If so, furnish particulars:

4.4 Does the bidder or any of its directors owe any municipal rates and taxes or municipal Yes No

charges to the municipality / municipal entity, or to any other municipality / municipal ☐ ☐

entity, that is in arrears for more than three months?

4.4.1 If so, furnish particulars:

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4.5 Was any contract between the bidder and the municipality / municipal entity or any other Yes No

organ of state terminated during the past five years on account of failure to perform on or ☐ ☐

comply with the contract?

4.5.1 If so, furnish particulars:

Certification mbd 8

I, the undersigned (full name)

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

Tax Compliance Status (TCS) PIN — will be verified electronically MANDATORY

TAX COMPLIANCE STATUS TCS PIN: AND CSD No

Tax compliance requirements

Tax compliance status (tcs) certificate or pin may also be made via e-filing

Tax compliance status system pin code from the south african revenue service (SARS) and

Tax compliance status

Tax Compliance Status (TCS) PIN from SARS eFiling

Tax compliance status (tcs) pin

TCS PIN: AND CSD No

TCS PIN, or a finding of non-compliance on verification, will result in the bid being

CSD Report) showing MAAA number (NT Instruction 4A of 2016/17)

Csd number

Csd number must be provided

Central Supplier Database MANDATORY

Central supplier database (csd),

Only the documents in SECTION A are treated as grounds for immediate disqualification (non-responsive bids) in terms of

SECTION A: MANDATORY (non-submission will result in disqualification)

1 Signed and completed Form of Offer and Acceptance MANDATORY

2 Completed and signed Pricing Schedule — all pricing fields completed in non- MANDATORY

3 Completed and signed MBD 1 — Invitation to Bid MANDATORY

4 Completed and signed MBD 4 — Declaration of Interest MANDATORY

5 Completed and signed MBD 6.1 — Preference Point Claim Form (PPR 2022) MANDATORY

6 Completed and signed MBD 8 — Declaration of Bidder's Past SCM Practices MANDATORY

Pricing schedule for services

If “YES”, please provide VAT number

Form of offer and acceptance

Qualifications and Certified copies of 30

qualifications in the

CVs and experience of

key personnel = 10

Points Allocation: 80 points

B-BBEE Details: RNABLE DOCUMENTS CHECKLIST

The table below lists all documents required with this bid. Bidders are advised to tick each row and verify submission

before depositing the bid.

Only the documents in SECTION A are treated as grounds for immediate disqualification (non-responsive bids) in terms of

the Municipal Finance Management Act, No. (MFMA), the Municipal Supply Chain Management Regulations

(GN ), Phokwane Local Municipality's SCM Policy, and National Treasury prescripts.

Documents in SECTION B are required to score functionality and/or claim preference points. A bidder who fails to submit a

B-BBEE certificate will NOT be disqualified but will receive zero (0) preference points for that specific goal. Documents in

SECTION C may be requested/verified after closing and before award in line with MFMA SCM Regulation 21(c) and

National Treasury Circular MFMA No. 104.

No. Required Document / Requirement Status Tick (X)

SECTION A: MANDATORY (non-submission will result in disqualification)

1 Signed and completed Form of Offer and Acceptance MANDATORY

2 Completed and signed Pricing Schedule — all pricing fields completed in non- MANDATORY

erasable black ink

3 Completed and signed MBD 1 — Invitation to Bid MANDATORY

4 Completed and signed MBD 4 — Declaration of Interest MANDATORY

5 Completed and signed MBD 6.1 — Preference Point Claim Form (PPR 2022) MANDATORY

6 Completed and signed MBD 8 — Declaration of Bidder's Past SCM Practices MANDATORY

7 Completed and signed MBD 9 — Certificate of Independent Bid Determination MANDATORY

8 Completed Schedule 1A — Authority of Signatory (company resolution / power MANDATORY

of attorney for JV / sole-proprietor certificate)

9 Completed Schedule 1B — Compulsory Enterprise Questionnaire MANDATORY

10 Proof of registrat

HDI Requirement: 50%

this, we are seeking the service of a medical assessment provider to conduct comprehensive evaluations this

assessment will help identity potential health risks, determine fitness for work, and inform health and wellness

initiatives. By investing in the health of our employees, we aim to promote productivity, safety, and overall quality

of life.

exposed to hazardous environments, to:

• Detect occupational diseases at an early stage
• Monitor the effects of exposure to health risks in the workplace
• Biological monitoring
• Ensuring employees are medically fit for specific tasks
• Reduce absenteeism and long-term illness through early interventions
• Support legal compliance with the Occupational Health and Safety

enhancing overall workplace safety.

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Employee’s who working in sewer. Water Treatment, and Refuse Operations are exposed to respiratory

hazards. Detecting early signs of respiratory issues and ensuring workplace safety and compliance.

The municipality needs to conduct an incapacity investigation to assess the employee’s ability to perform their

duties. This evaluation requires fitness for accurate role. It needs to support for workplace safety and

productivity.

they utilize chemicals daily, to ensure medical fitness for work and to verify if employees are fit for the specific

work, also for occupational health evaluation.

to emergency and provide basic care, assist colleague and the public in need and to enhance workplace safety

and reduce the risk, providing immediate care until medical professional arrive.

assess risk and implement controls to mitigate or eliminate them. This helps prevent injuries, illness and

damages to property and the environment. This proactive approach will enhance public safety, employee’s wellbeing and resilience.

organogram detailing

project members and

their roles= 10 points

Qualifications and Certified copies of 30

Expertise of key staff practitioners’

qualifications in the

relevant field (e.g

Occupational Health) =

10 points

4.4 Total number of years the company/firm has been in business: ............................................................

4.5 I/We, 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

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acknowledge that:

i. The information furnished is true and correct;

ii. The preference points claimed are in accordance with the General Conditions as indicated in paragraph 1 of

this form;

iii. In the event of a contract being awarded as a result of points claimed as shown in paragraphs 1.4 and 4.2, the

contractor may be required to furnish documentary proof to the satisfaction of the organ of state that the

claims are correct;

iv. If the specific goals have been claimed or obtained on a fraudulent basis or any of the conditions of contract

have not been fulfilled, the organ of state may, in addition to any other remedy it may have –

(a) disqualify the person from the tendering process;

(b) recover costs, losses or damages it has incurred or suffered as a result of that person’s

conduct;

(c) cancel the contract and claim any damages which it has suffered as a result of having to

make less favourable arrangements due to such cancellation;

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

shareholders and directors who acted on a fraudulent basis, be restricted from obtaining

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

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

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

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

Signature(s) of tenderer(s)

Surname and name: ................................................................

Date: ...............................................................

Address: ...............................................................

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

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

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Mbd 8 - declaration of bidder’s past supply chain

2 Completed and signed Pricing Schedule — all pricing fields completed in non- MANDATORY

erasable black ink

3 Completed and signed MBD 1 — Invitation to Bid MANDATORY

4 Completed and signed MBD 4 — Declaration of Interest MANDATORY

5 Completed and signed MBD 6.1 — Preference Point Claim Form (PPR 2022) MANDATORY

6 Completed and signed MBD 8 — Declaration of Bidder's Past SCM Practices MANDATORY

7 Completed and signed MBD 9 — Certificate of Independent Bid Determination MANDATORY

8 Completed Schedule 1A — Authority of Signatory (company resolution / power MANDATORY

of attorney for JV / sole-proprietor certificate)

9 Completed Schedule 1B — Compulsory Enterprise Questionnaire MANDATORY

demonstrate their commitment to employee safety, reduce liability and promote a culture of safety awareness,

ultimately enhancing productivity and compliance with regulatory requirements.

Specifications

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The Tenderer shall, within two (2) weeks after receiving a completed copy of this Agreement (including the Schedule of

Deviations, if any), contact the Employer's agent (whose details are given in the Contract Data) to arrange the delivery of any

bonds, guarantees, proof of insurance and other documentation to be provided in terms thereof.

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financial statements for a period of 36 months.

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Mbd 9 - certificate of independent bid determination

considered, reasonable steps are taken to prevent any form of bid-rigging.

6. In order to give effect to the above, the attached Certificate of Bid Determination (MBD 9) must be completed

and submitted with the bid: