Install Vending Machines - Eastern Cape

Returnable Documents:

The Department of Public Works and Infrastructure (DPWI) hereby issues the following request calling Bidder(s) for the purpose of leasing space for the installation of vending machines in the state-owned facilities within the Eastern Cape province. The Department of Public Works and Infrastructure (DPWI), as a Custodian of immovable assets of the Eastern Provincial Government, is responsible for ensuring the effective and efficient management of these assets, in order to meet the required levels of service delivery. This must be done in the most cost-effective way and in line with the provisions of the Government Immovable Asset Management Act, (GIAMA, Act ). The Department of Public Works & Infrastructure invites Bidder(s) from qualified and experienced young entrepreneurs for the leasing of space within state-owned facilities across the Eastern Cape Province for the purpose of installing and operating vending machines offering snacks, non-alcoholic beverages, and/or other approved items. The objective of this bidder is to: 1. Provide convenient access to food and beverages to staff and visitors. 2. Enhance service delivery in government facilities. 3. Generate revenue through leasing arrangements. 4. Promote local entrepreneurship and economic development. 5. Promote youth and disability empowerment by encouraging participation of youth-owned and disability-inclusive enterprises in vending opportunities. Applicants are requested to state the type of products to be sold in the vending machine. EQUIPMENT REQUIREMENTS It will be the responsibility of the Service Provider to make the necessary site visits to confirm the availability of space for installation and related requirements. The successful Service Provider shall provide new or like new equipment which is approved in terms of Departmental requirements, Occupational Health and Safety standards, and in terms of quality specifications of the South African Bureau of Standards (SABS). PURPOSE OF THE BIDDER The Department presents to the bidder(s) opportunities for availing space for the installation of vending machines in the state-owned facilities within the Eastern Cape Province. The DPWI issues this bidder(s) in accordance with the provisions of its approved Revenue Management Strategy. This strategy broadly guides the DPWI to continuously identify, review its immovable property portfolio on a regular basis, and to identify properties that can be utilized to enhance revenue through property portfolio. The DPWI requests that the Expression includes amongst other things: • Confirmation of the inspection of the facility • Type of products to be sold, or made available for purchase • The extent of the space required • Number of vending machines to be installed per building of 40 Please note that the DPWI will decide, after concluding the bidder(s) Process, to proceed with the procurement process, and that such process will only formally commence with the requests specified by the Supply Chain Management Section of the Department in compliance with its processes of handling Bidder(s) and other proposals. DELIVERY AND INSTALLATION Equipment shall be delivered, installed and operational at all awarded locations within a period of sixty (60) calendar days from the signature date of the lease agreement. Equipment shall be installed so as to present an attractive, professional and uniform configuration which is in line with national approved advertising standards. Equipment shall be secured to provide for safe, secure operation and to prevent tipping/shifting or falling. All delivery and installation costs shall be the responsibility of the Service Provider. MAINTENANCE, REPAIRS AND SCHEDULING The Department shall expect prompt service from the Service Provider in response to vending machine equipment that is not operational and problems related to damaged equipment failure or product complaints. Service calls shall be responded to within twenty-four (24) hours from Department notification to Service Provider. If equipment repairs cannot be made on site, and downtime is determined by the Department to be excessive, the Service Provider may be requested to replace the equipment with a loaner/ replacement unit until such time as repairs can be completed or the Service Provider provides a permanent replacement. Lost, stolen or damaged equipment shall be replaced or repaired (as applicable) at no cost to the Department MONTHLY PAYMENTS Upon award of contract, the successful Service Provider shall adhere to the remittance/ payment procedure below. Reports and revenue checks should be received no more than twenty-five (25) days after the end of a monthly cycle. The monthly statement shall include the following: A. Vending machine number and description B. Erf number and physical address where available C. Amount due to the Department Losses of revenue as a result of vandalism, and natural factors etc., shall not be deducted from proceeds to be paid to the Department. No tobacco or alcohol products shall be advertised/sold by the Service Provider on Department property. DEFAULT IN PAYMENT The monthly report of gross receipts and the monthly payments due to the Department must be submitted no later than twenty-five (25) calendar days after the last day of preceding month. OTHER SERVICE PROVIDER RESPONSIBILITIES a) This bidder (which includes all other information, written or oral, made available during the bidding Process) is made available by the DPWI to prospective respondents on condition that it is used solely for the purpose of responding to this bidder. b) This bidder is provided solely for the purpose set out in the bidder. Each Prospective Respondent to whom this bidder is made available must make their own independent assessment of the opportunity after making such investigation and taking such professional advice as they deem necessary. c) Neither the receipt of this bidder or any related document by any person, nor any information contained in the documents or distributed with them or previously or subsequently communicated to of 40 any Prospective Respondent or its advisors, is to be taken as constituting the giving of any advice (investment, legal or otherwise) by the DPWI. d) While the DPWI has taken reasonable care to present correct information in this bidder, errors and omissions may occur. The DPWI and any of its officials will not accept any liability or responsibility for the adequacy, accuracy or completeness of any of the information or opinions stated in this bidder or any other document issued by the DPWI, regardless of use and regardless of any losses that the intended or unintended recipients of this bidder may incur. e) No guarantees, representations or warranties, whether express or implied, are made by DPWI or any of their employees with respect to the information or opinions contained in any document. The Prospective Respondent expressly waives any claim(s) it has or may have in respect of such guarantees, representations or warranties, howsoever arising. f) The DPWI reserves the right to suspend, modify or withdraw this bidder at any time without prior notice and without liability to compensate or reimburse any person. g) The DPWI is not obliged to perform any action or take any further steps upon conclusion of the bidding Process. h) All responses to this bidder are compiled and submitted at the Prospective Respondent’s sole risk and cost and the DPWI is not liable to compensate any person for any costs or losses incurred in connection therewith i) By its participation in the bidder Process, the Prospective Respondent is deemed to acknowledge and consent to the terms and conditions of this bidder, including the contents of this Important Notice. j) The list of facilities is attached as Annexure C.1, which is batched according to the district offices in the Province where these properties are situated. THE DEPARTMENT WILL PROVIDE: A. Space for installation of vending machine. CONDITIONS OF BID The successful bidder will be required to enter into a written agreement with the Department of Public Works and Infrastructure (DPWI) subject to the general and specific conditions listed below and any other conditions that may be required, but mutually agreeable to either party. Should the DPWI consider that at any time the Bidder is not fulfilling his/her obligations in terms of the contract, and if after due notice to do so the Bidder is still in default, the DPWI may terminate the Bidder whereupon the service provider must remove the vending machine and make good all state property to the satisfaction of the Accounting Officer of the Department. Failure to do this, the Department may itself remove the vending machine and recover the expense of doing so from the Bidder. OWNERSHIP OF THE VENDING MACHINE The vending machine shall remain the property of the Bidder on termination of the contract and shall be removed within sixty (60) days from termination of the contract. Should the Bidder fail to remove the vending machine within the stipulated time period, the Department shall have it removed at the cost of the Bidder. of 40 ANNEXURE C.1 LIST OF FACILITIES IDENTIFIED FOR VENDING MACHINES DISTRICT FACILITY SIZE NO. FACILITY TYPE PROPERTY NAME OFFICE TYPE m2 1 Erf 206 Maluti Maluti Office Complex Alfred Nzo Office 4m2 2 Erf 816 Maluti DSD Offices Alfred Nzo Office 4m2 3 Erf 3649 Mt Frere DOE Offices Alfred Nzo Office 4m2 4 Erf 2478 Mt Frere Mt Frere Complex Alfred Nzo Office 4m2 5 Erf 179 – 184 Matatiele Social Development Alfred Nzo Office 4m2 6 Erf 6 Matatiele Tylor Bouquet Hospital Alfred Nzo Office 4m2 7 Erf 9361 Butterworth Old Butterworth Collage Amathole Cluster Office 2.5m2 8 Erf 79 Elliotdale Elliotdale Cluster Office Amathole Cluster Office 2.5m2 9 Erf 2314 Fort Beautfort Cape Collage Amathole Office 2.5m2 Farm 1924, King DPWI (Maintenance Unit) 2.5m2 10 William’s Town RD Hanker BCMM Office Erf 68614, East Amathole& BCMM District 2.5m2 11 London office BCMM Office 12 Erf 304 Dimbaza Social Development BCMM Office 2.5m2 ERF 27306 East 2.5m2 13 London Stirling Teachers Centre BCMM Office 14 ERF 4047 Zwelitsha Steve Tshwethe Building BCMM Office 2.5m2 House of Traditional 2.5m2 15 Erf 5760 Bhisho Leaders BCMM Office 16 Erf 657 Bhisho Office of the Premier BCMM Office 2.5m2 17 Erf 19009 East London Government Garage BCMM Office 2.5m2 DPWI (Old Covenant 2.5m2 18 Erf 5556 Cala Building) Chris Hani Office 19 Erf 124 Lady Frere Department Of Education Chris Hani Office 2.5m2 Farm 328, Herschel 2.5m2 20 RD Bensonvale College Joe Gqabi Office 21 Erf 3102 Aliwal North Themba Kojana Building Joe Gqabi Office 2.5m2 22 Erf 1608 Aliwal North DPWI Office Joe Gqabi Cluster Office 2.5m2 Erf 2968 Albany Road, 2.5m2 23 P. E Old Ford House NMBM Office Walton Building 2.5m2 (Department of Health 24 Erf 1651 Mount Road District office) NMBM Office Dept of Education District 2.5m2 25 Erf 213 Korsten Office NMBM Office Erf 3966 Port Elizabeth 2.5m2 26 Central Old Ford House NMBM Office 27 Erf 1635, Port St Johns PSJ Deport OR Tambo Office 2.5m2 28 Erf 308 Umtata KSD Building OR Tambo Office 2.5m2 29 Erf 2178 Umtata Botha Sigcau Building OR Tambo Cluster Office 2.5m2 Erven 2023-2025 Sarah 2.5m2 30 Grahamstown Old SABC Building Bartman Office Sarah 2.5m2 31 Erf 6272 Grahamstown Regional Library Bartman Office of 40 BID EVALUATION This bid will be evaluated in three (03) phases as follows (a) Phase One: Compliance, responsiveness to the bid rules and conditions (b) Phase Two: Bidders passing stage 1 above will thereafter be evaluated on functionality (c) Phase Three: Bidders passing all stages above will thereafter be evaluated on Price PHASE ONE: COMPLIANCE, RESPONSIVENESS TO THE BID RULES AND CONDITIONS Bids which are late, incomplete, unsigned or submitted by facsimile or electronically, will not be accepted. Bidders’ proposals must meet the following minimum requirements and supporting documents must be submitted with the completed bid document in a sealed envelope in the bid box at the closing date and time. Failure to comply will automatically eliminate the bid for further consideration: 1. Bids must be submitted on the original documents and bids which are late, incomplete, unsigned or submitted by facsimile or electronically, will not be accepted. 2. The following Declarations must be duly completed and signed: (SBD4). Does the bidder or any of its Directors / Trustees / Shareholder / Members / Partners or any person having a controlling interest in the enterprise have any other related enterprise whether or not they are bidding for this contract such interest must be disclosed on question 2.3.1 of SBD 4. 3. The Form SBD1 “Part A” should be completed and “Part B” must be fully completed (date, signature, amount) 4. SBD 3.1 – Pricing Schedule – Firm Prices – must be completed 5. Annexure A - Resolution to sign must be completed and signed (if applicable): 6. Bidders must be a legal entity. In the event of a subservice provider or joint ventures or consortiums a signed agreement by all parties must be submitted with the bid. Also see notes to the “Authority to Sign”. Failure to submit a compliant agreement with the bid will automatically eliminate the bid for further consideration. PHASE TWO: EVALUATION OF FUNCTIONALITY The functionality criteria and maximum score in respect of each of the criteria are as follows: FUNCTIONALITY CRITERIA MAXIMUM MAXIMUM POINTS SCORE POINTS SCORE A. Project Development Proposal 80 90 B. Local Economic Development 20 10 TOTAL SCORE 100 100 Bidder should score a minimum of 50 points for further evaluation. of 40 Table 1: FUNCTIONALITY EVALUATION CRITERIA: MINIMUM POINTS TO BE SCORED ON THE FUNCTIONALITY IS 50 POINTS FOR FURTHER EVALUATION. Table 1: Functionality and Evaluation Criteria Point Max s Point Score s d Project Implementation Proposal: 60 - Availability of Vending Machine (Ownership/Rental) or 30 Intent of (ownership/rental) 25 Project - Maintenance (availability Implementation of resources/ response 10 Project Proposal 1 Approach & time for faulty machine) Understanding of and technical support plan the brief - Product Management (e.g. Asset Management plan) & 20 quality assurance plan No Submission 0 Age from 35 years and below 20 100% black youth 20 51% to 99% black youth ownership 10 1 Youth 30% to 50% black youth ownership 5 Below 30% black youth ownership 0 Local Economic Development No Submission 0 Person living with disability 20 100% living with disability 20 2 Disability 51% to 99% with disability 10 30% to 50% with disability 5 No Submission 0 Total Points 100 of 40 PHASE THREE EVALUATION ON NEW PPPFA and SPECIFIC GOALS THE PREFERENTIAL PROCUREMENT POLICY FRAMEWORK ACT WILL BE APPLIED AND THE 80/20 OR 90/10 PREFERENCE POINTS SYSTEM WILL BE APPLICABLE. FUNCTIONALITY CRITERIA MAXIMUM MAXIMUM POINTS POINTS SCORE SCORE POINTS FOR PRICE 80 90 SPECIFIC GOALS 20 10 TOTAL POINTS 100 100 Please note: 1. Bidders need to complete and sign SBD 6.1 to claim points for specific goals. Failure will lead in non-awarding of points for specific goals 2. The Department intends to award this to the highest point scorer as per item (erf), unless circumstances justifies otherwise 3. All information will be verified through CSD (if applicable) 4. SBD 6.1 is attached 5. A medical certificate from a medical practitioner with a practise number must be attached to claim points for disability 6. A Cipro certificate (CK) and certified ID copy/s must be attached as proof of ownership to claim points for specific goals. Despite any delays, the service provider will be granted 60 days, and the rental will commence at expiry of 60 months, unless the department agrees otherwise with the party. NB: All Information provided will be subject to risk assessment. of 40 PRICING SCHEDULE – FIRM PRICES SBD 3.1 NOTE: ONLY FIRM PRICES WILL BE ACCEPTED. NON-FIRM PRICES (INCLUDING PRICES SUBJECT TO RATES OF EXCHANGE VARIATIONS) WILL NOT BE CONSIDERED Name of bidder.......................................... Bid number: SCMU5-25/26-0068 Closing Time 11:00 Closing date: 10 February 2026 OFFER TO BE VALID FOR PERIOD UP UNTIL AWARD FROM THE CLOSING DATE OF BID. BID FOR APPOINTMENT OF SERVICE PROVIDER TO INSTALL VENDING MACHINES IN STATE- OWNED FACILITIES THROUGH LEASING OF SPACE WITHIN THE EASTERN CAPE PROVINCE. NO. OF AMOUNT PAYABLE TO AMOUNT PAYABLE TO THE VENDING THE DEPARTMENT FOR DEPARTMENT FOR VEDING MACHINE ALL VENDING MACHINE MACHINES FOR 12 DISTRICT TO BE PER MONTH (EXCL.VAT) MONTHS (EXCL.VAT) NO. FACILITY TYPE PROPERTY NAME OFFICE INSTALLED 1 Erf 206 Maluti Maluti Office Complex Alfred Nzo 2 Erf 111 Maluti DPWI Depot Alfred Nzo 3 Erf 3017 Mount Ayliff DPWI Office Alfred Nzo 4 Erf 212 Mount Frere DPWI Office Alfred Nzo 5 Erf 349 Mount Frere DPWI Office Alfred Nzo 6 Erf 179 – 184 Matatiele Social Development Alfred Nzo 7 Erf 6 Matatiele Tylor Bouquet Hospital Alfred Nzo 8 Erf 87 Bizana Education Alfred Nzo 9 Erf 9361 Butterworth Old Butterworth Collage Amathole 10 Erf 79 Elliotdale Elliotdale Cluster Office Amathole 11 Erf 2314 Fort Beautfort Cape Collage Amathole Farm 1924, King William’s DPWI (Maintenance Unit) 12 Town RD Hanker BCMM Amathole& BCMM District 13 Erf 68614, East London office BCMM 14 Erf 304 Dimbaza Social Development BCMM 15 ERF 27306 East London Stirling Teachers Centre BCMM of 40 NO. OF AMOUNT PAYABLE TO AMOUNT PAYABLE TO THE VENDING THE DEPARTMENT FOR DEPARTMENT FOR VEDING MACHINE ALL VENDING MACHINE MACHINES FOR 12 DISTRICT TO BE PER MONTH (EXCL.VAT) MONTHS (EXCL.VAT) NO. FACILITY TYPE PROPERTY NAME OFFICE INSTALLED 16 ERF 4047 Zwelitsha Steve Tshwethe Building BCMM 17 Erf 5760 Bhisho House of Traditional Leaders BCMM 18 Erf 657 Bhisho Office of the Premier BCMM 19 Erf 19009 East London Government Garage BCMM DPWI (Old Covenant 20 Erf 5556 Cala Building) Chris Hani 21 Erf 124 Lady Frere Department Of Education Chris Hani 22 Farm 328, Herschel RD Bensonvale College Joe Gqabi 23 Erf 3102 Aliwal North Themba Kojana Building Joe Gqabi 24 Erf 1608 Aliwal North DPWI Office Joe Gqabi 25 Erf 2968 Albany Road, P. E Old Ford House NMBM Dept of Education District 27 Erf 213 Korsten Office NMBM 28 Erf 3966 Port Elizabeth Central Old Ford House NMBM 29 Erf 1635, Port St Johns PSJ Deport OR Tambo 30 Erf 308 Umtata KSD Building OR Tambo 31 Erf 2178 Umtata Botha Sigcau Building OR Tambo 32 Erven 2023-2025 Grahamstown Old SABC Building Sarah Bartman 33 Erf 6272 Grahamstown Regional Library Sarah Bartman A SUB TOTAL - YEAR 1 B SUB TOTAL - YEAR 2 (YEAR 1 PLUS 8% ESCALATION B = A + 1,05) C SUB TOTAL - YEAR 3 (YEAR 2 PLUS 8% ESCALATION C = B + 1,05) D SUB TOTAL FOR THREE YEARS (D = A + B + C) E ADD VAT @ 15% (IF APPLICABLE) E = D x 0,15 F GRAND TOTAL FOR THREE YEARS (F = D + E) This amount must be carried over to The total amount for the 3-year lease should include a minimum escalation of 5% per annum. of 40 SBD 6.1 PREFERENCE POINTS CLAIM FORM IN TERMS OF THE PREFERENTIAL PROCUREMENT REGULATIONS 2022 This preference form must form part of all tenders invited. It contains general information and serves as a claim form for preference points for specific goals. NB: BEFORE COMPLETING THIS FORM, TENDERERS MUST STUDY THE GENERAL CONDITIONS, DEFINITIONS AND DIRECTIVES APPLICABLE IN RESPECT OF THE TENDER AND PREFERENTIAL PROCUREMENT REGULATIONS, 2022 1. GENERAL CONDITIONS 1.1 The following preference point systems are applicable to invitations to tender: - the 80/20 system for requirements with a Rand value of up to R50 000 000 (all applicable taxes included); and - the 90/10 system for requirements with a Rand value above R50 000 000 (all applicable taxes included). 1.2 To be completed by the organ of state (delete whichever is not applicable for this tender). a) The applicable preference point system for this tender is the 90/10 preference point system. b) The applicable preference point system for this tender is the 80/20 preference point system. c) Either the 90/10 or 80/20 preference point system will be applicable in this tender. The lowest/ highest acceptable tender will be used to determine the accurate system once tenders are received. 1.3 Points for this tender (even in the case of a tender for income-generating contracts) shall be awarded for: (a) Price; and (b) Specific Goals. 1.4 To be completed by the organ of state: The maximum points for this tender are allocated as follows: POINTS POINTS PRICE 80 90 SPECIFIC GOALS 20 10 Total points for Price and SPECIFIC 100 100 GOALS of 40 1.5 Failure on the part of a tenderer to submit proof or documentation required in terms of this tender to claim points for specific goals with the tender, will be interpreted to mean that preference points for specific goals are not claimed. 1.6 The organ of state reserves the right to require of a tenderer, either before a tender is adjudicated or at any time subsequently, to substantiate any claim in regard to preferences, in any manner required by the organ of state. 2. DEFINITIONS (a) “tender” means a written offer in the form determined by an organ of state in response to an invitation to provide goods or services through price quotations, competitive tendering process or any other method envisaged in legislation; (b) “price” means an amount of money tendered for goods or services, and includes all applicable taxes less all unconditional discounts; (c) “rand value” means the total estimated value of a contract in Rand, calculated at the time of bid invitation, and includes all applicable taxes; (d) “tender for income-generating contracts” means a written offer in the form determined by an organ of state in response to an invitation for the origination of income-generating contracts through any method envisaged in legislation that will result in a legal agreement between the organ of state and a third party that produces revenue for the organ of state, and includes, but is not limited to, leasing and disposal of assets and concession contracts, excluding direct sales and disposal of assets through public auctions; and (e) “the Act” means the Preferential Procurement Policy Framework Act, 2000 (Act No. ). 3. FORMULAE FOR PROCUREMENT OF GOODS AND SERVICES 3.1. POINTS AWARDED FOR PRICE 3.1.1 THE 80/20 OR 90/10 PREFERENCE POINT SYSTEMS A maximum of 80 or 90 points is allocated for price on the following basis: 80/20 or 90/10 Pt−Pmin Pt−Pmin Ps= 80(1− ) or Ps= 90(1− ) Pmin Pmin Where Ps = Points scored for price of tender under consideration Pt = Price of tender under consideration Pmin = Price of lowest acceptable tender 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: of 40 80/20 or 90/10 Pt−Pmax Pt−Pmax Ps= 80(1+ ) or Ps= 90(1+ ) Pmax Pmax Where Ps = Points scored for price of tender under consideration Pt = Price of tender under consideration Pmax = Price of highest acceptable tender 4. POINTS AWARDED FOR SPECIFIC GOALS 4.1. In terms of Regulation 4(2); 5(2); 6(2) and 7(2) of the Preferential Procurement Regulations, preference points must be awarded for specific goals stated in the tender. For the purposes of this tender the tenderer will be allocated points based on the goals stated in table 1 below as may be supported by proof/ documentation stated in the conditions of this tender: 4.2. In cases where organs of state intend to use Regulation 3(2) of the Regulations, which states that, if it is unclear whether the 80/20 or 90/10 preference point system applies, an organ of state must, in the tender documents, stipulate in the case of— (a) an invitation for tender for income-generating contracts, that either the 80/20 or 90/10 preference point system will apply and that the highest acceptable tender will be used to determine the applicable preference point system; or (b) any other invitation for tender, that either the 80/20 or 90/10 preference point system will apply and that the lowest acceptable tender will be used to determine the applicable preference point system, then the organ of state must indicate the points allocated for specific goals for both the 90/10 and 80/20 preference point system. of 40 Table 1: Specific goals for the tender and points claimed are indicated per the table below. (Note to organs of state: Where either the 90/10 or 80/20 preference point system is applicable, corresponding points must also be indicated as such. Note to tenderers: The tenderer must indicate how they claim points for each preference point system.) Number of Number of Number of Number of points points points points claimed allocated claimed allocated (80/20 (90/10 (90/10 The specific goals allocated (80/20 system) system) system) system) points in terms of this tender (To be (To be (To be (To be completed by completed by completed completed the organ of the tenderer) by the organ by the state) of state) tenderer) Historically Disadvantaged Individual: - (a) 100% black ownership 10 5 (b) 51% to 99% black ownership 5 2.5 (c) Less than 51% black 0 0 ownership Black women ownership:- (a) 100% black women 6 3 ownership (b) 30% to 99% black women 4 2 ownership (c) Less than 30% black women 0 0 ownership Locality:- (a) Within the Eastern Cape 4 2 (b) Outside the Eastern Cape 0 0 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 of 40 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 service provider 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 service provider, 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: ............................................................... ............................................................... ............................................................... ............................................................... of 40 SBD 4 BIDDER’S DISCLOSURE 1. PURPOSE OF THE FORM Any person (natural or juristic) may make an offer or offers in terms of this invitation to bid. In line with the principles of transparency, accountability, impartiality, and ethics as enshrined in the Constitution of the Republic of South Africa and further expressed in various pieces of legislation, it is required for the bidder to make this declaration in respect of the details required hereunder. Where a person/s are listed in the Register for Tender Defaulters and / or the List of Restricted Suppliers, that person will automatically be disqualified from the bid process. 2. Bidder’s declaration 2.1 Is the bidder, or any of its directors / trustees / shareholders / members / partners or any person having a controlling interest1 in the enterprise, employed by the state? YES/NO 2.1.1 If so, furnish particulars of the names, individual identity numbers, and, if applicable, state employee numbers of sole proprietor/ directors / trustees / shareholders / members/ partners or any person having a controlling interest in the enterprise, in table below. Full Name Identity Number Name of State institution 2.2 Do you, or any person connected with the bidder, have a relationship with any person who is employed by the procuring institution? YES/NO 2.2.1 If so, furnish particulars: ................................................................................................ ......................................................................................................... 1 the power, by one person or a group of persons holding the majority of the equity of an enterprise, alternatively, the person/s having the deciding vote or power to influence or to direct the course and decisions of the enterprise. of 40 SBD 4 Does the bidder or any of its directors / trustees / shareholders / members / partners or any person having a controlling interest in the enterprise have any interest in any other related enterprise whether or not they are bidding for this contract? YES/NO 2.3.1 If so, furnish particulars: ........................................................................................ ........................................................................................

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