Appointment of an occupational health therapist for functional capacity evaluation (kwazulu-natal sharks board)

• The SBD4 form includes a signature block that must be completed by an authorised signatory.
• Provide the signatory’s full name, position, and the name of the bidding entity.
• Sign and date the form to confirm acceptance of all declarations in paragraphs 1–3.

• Procuring entity: Supply Chain Management, Natal Sharks Board.
• No specific contact names, email addresses, telephone numbers or submission address are provided in this annexure. Refer to the main tender advertisement or covering letter for those details.

• Complete and sign the SBD4 Bidder’s Disclosure form (Annexure A) in full.
• Declare whether the bidder or any director/trustee/shareholder/member/partner or person with a controlling interest is employed by the state (YES/NO). If YES, provide full name, ID number and the name of the state institution.
• Declare any relationship with persons employed by the procuring institution (YES/NO). If YES, furnish the required particulars.
• Declare any interest in other related enterprises (YES/NO). If YES, furnish the required particulars.
• Certify that the bid was prepared independently, without collusion or sharing of information with competitors.
• Attach the signed SBD4 form to your quotation. Failure to complete the form truthfully will result in disqualification and possible reporting to the Competition Commission and the National Prosecuting Authority.
• Ensure that any other returnable documents listed in the main tender package (not shown in this annexure) are also submitted.

• Mandatory returnable: the SBD4 Bidder’s Disclosure form.
• Complete all sections:

1. Purpose – acknowledge transparency, accountability and ethics requirements; note automatic disqualification if listed on the Register for Tender Defaulters or List of Restricted Suppliers.
2. Bidder’s Declaration:

• 2.1 State employment of directors/trustees/shareholders/members/partners or persons with controlling interest (YES/NO). If YES, provide full names, ID numbers and state institution names.
• 2.2 Relationship with employees of the procuring institution (YES/NO). If YES, furnish particulars.
• 2.3 Interest in other related enterprises (YES/NO). If YES, furnish particulars.

3. Declaration (paragraphs 3.1–3.7) – certify understanding, truthfulness, independent preparation, no collusion, no disclosure to competitors, no improper contact with officials, and awareness of penalties for false declarations.

• Sign and date the form; include the signatory’s position and the bidder’s name.
• Submit the completed form together with your quotation package.

• Disqualification triggers:

• Appearance on the Register for Tender Defaulters or the List of Restricted Suppliers.

• Incomplete, false or misleading information on the SBD4 disclosure form.

• Evidence of collusive behaviour or prior involvement in drafting the specifications for this bid.

• Compliance requirement: All bidders must comply with South African procurement legislation, including PFMA SCM Instruction 22 and the Prevention and Combating of Corrupt Activities Act.
• Collusion prohibition: No consultations, communications, agreements or arrangements with competitors regarding quality, quantity, specifications, pricing methods/formulas, market allocation, bid‑submission intentions or delivery particulars. Breach leads to disqualification and possible reporting to the Competition Commission (section 59 of the Competition Act) and the National Prosecuting Authority.
• Exception: Communication between partners in a joint‑venture or consortium is permitted.

• Scope: Provide an Occupational Health Therapist to conduct a Functional Capacity Evaluation for one employee.
• Deliverable: A completed functional capacity assessment report for the employee.
• Standards: Services must be performed in accordance with relevant occupational health and safety regulations and professional guidelines (e.g., HPCSA standards).
• No further technical specifications, service levels or capacity requirements are detailed in this annexure; consult the full Terms of Reference or specification document for additional requirements.

• Do not appear on the National Treasury’s Register for Tender Defaulters or List of Restricted Suppliers.
• Complete the SBD4 disclosures on:

• State employment of directors, trustees, shareholders, members, partners or controlling interests.

• Relationships with employees of the procuring institution.

• Interests in other related enterprises.

• Certify independent bid preparation, absence of collusion, and no unauthorised communication with competitors or officials.
• Acknowledge penalties for false declarations: bid rejection, action under PFMA SCM Instruction 22, possible reporting to the Competition Commission, referral to the National Prosecuting Authority, and a potential ten‑year ban from public‑sector contracts under the Prevention and Combating of Corrupt Activities Act.
• Although not mentioned in this annexure, typical compliance documents for health‑service contracts include CSD registration, tax clearance certificate, B‑BBEE certificate and professional registration with the HPCSA.

• Bidders must not engage in any consultations, communications, agreements or arrangements with competitors regarding quality, quantity, specifications, pricing methods/formulas, market allocation, bid‑submission intentions or delivery particulars.
• Such conduct is considered collusive bidding and will result in disqualification, with possible reporting to the Competition Commission (section 59 of the Competition Act) and the National Prosecuting Authority.
• Communication between joint‑venture or consortium partners is permitted.

Address: Not specified in the provided document. The contact address field in the form is blank.

Returnable Documents: SBD 6.1 Preference Points Claim Form must be included with your tender. Failure to submit required proof/documentation for specific goals will be interpreted as not claiming those preference points. Study the General Conditions, Definitions and Directives applicable to the tender and Preferential Procurement Regulations, 2022 before completing the form.

SBD 6.1 Preference Points Claim Form must be completed and submitted with your tender. Study the General Conditions, Definitions and Directives applicable to the tender and Preferential Procurement Regulations, 2022 before completing the form.

Points are awarded for Price and Specific Goals. Maximum points: Price 80 points, Specific Goals (CSD&CIPC) 20 points, total 100 points. The applicable preference point system will be either 80/20 (for contracts up to R50 million) or 90/10 (for contracts above R50 million). The tender document states one of the following will apply: a) 90/10 system applies; b) 80/20 system applies; c) Either system applies, to be determined after tenders are received using the lowest/highest acceptable tender. Price points are calculated using a formula comparing your price to the lowest (or highest for income-generating contracts) acceptable tender. Specific Goals points are based on B-BBEE status as per Table 1 in the SBD 6.1 form.

The tender is for the appointment of an occupational health therapist to conduct a functional capacity evaluation for one employee. Definitions provided clarify terms: 'tender', 'price', 'rand value', 'tender for income-generating contracts', and 'the Act' (Preferential Procurement Policy Framework Act, 2000).

You must complete and submit the SBD 6.1 Preference Points Claim Form. Points for Specific Goals (CSD&CIPC) are awarded based on your B-BBEE status: 80-100% Black Owned (F/M/HDP): 20 points; 60-79% Black Owned (F/M/HDP): 18 points; Less than 60% Black Owned (F/M/HDP): 16 points; White Owned: 14 points; Non-Compliant: 0 points. You must declare your company/firm name, registration number, and type (e.g., Pty Ltd, Close Corporation). You must certify that the information and points claimed are true and correct. The organ of state may require documentary proof to substantiate claims at any time. Fraudulent claims can lead to disqualification, contract cancellation, cost recovery, restriction from state business for up to 10 years, and criminal prosecution.

Points for Specific Goals (CSD&CIPC) are awarded based on your B-BBEE status: 80-100% Black Owned (F/M/HDP): 20 points; 60-79% Black Owned (F/M/HDP): 18 points; Less than 60% Black Owned (F/M/HDP): 16 points; White Owned: 14 points; Non-Compliant: 0 points. You must indicate how you claim points for each preference point system (80/20 or 90/10).

You must declare your company/firm name, registration number, and type (e.g., Pty Ltd, Close Corporation). You must certify that the information and points claimed are true and correct. The organ of state may require documentary proof to substantiate claims at any time. Fraudulent claims can lead to: disqualification from the tendering process; recovery of costs, losses, or damages by the organ of state; contract cancellation and claim for damages; recommendation for restriction from obtaining business from any organ of state for up to 10 years; criminal prosecution.