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PROSPECTIVE PROVIDER LIST APPLICATIONThis page to be completed for each submission

APPLICATION DETAILS

Reference Number: FAS/12/13/PPL1

Close: Date: Tuesday: 21 February 2012 Time: 11:00

Description: Invitation to apply for registration on the Fasset list of prospective providers

RESPONDENT DETAILS

Organisation/ individual:Contact person:Date:Email address:Telephone Number:Cellular Number:Fax Number:

PLEASE INDICATE IF THIS IS THE ORIGINALOR THE COPYOriginal Copy

Procurement process administered by

Reference no: FAS/12/13/PPL1 Fasset Prospective Provider List Application

Contents

DOCUMENTS IN THIS APPLICATION DOCUMENT PACK

Please note that “bid/bidder” in this document includes respondent.

Respondents are to ensure that they have received all pages of this document, which consists of the following sections:

SECTION 1

Note: Documents in this section are for information to/instruction of respondents and must not be returned with applications.

Background

Special Conditions of Registration (Division 1)

Evaluation process/criteria

SECTION 2

Note: Documents in this section must be completed and returned or supplied with applications.

Special conditions of registration (Division 2)

Tax Clearance Certificate Requirements

Declaration of interest

Declaration of bidder’s past SCM practices

SECTION 3

Note: Documents in this section must be completed and returned or supplied with applications.

Invitation to register

Prospective provider information form

Category list

Curriculum vitae guideline template (for professional services and training providers)

B-BBEE status level certificate - certified copy


Section 1: Background

BACKGROUND

In order to comply with the regulations of the Public Finance Management Act and to ensure a competitive procurement process, the Finance, Accounting, Management Consulting and other Financial Services Seta (Fasset) invites prospective providers of the services/goods as indicated in the categories list, to apply for a listing on Fasset's Prospective Provider List.

Fasset intends to utilise this Prospective Provider List to obtain quotations for possible discrete elements of work and where appropriate the supply of products that may become necessary from time to time. Fasset also intends to use this prospective provider list for petty cash purchases where feasible.

It is important to note that should an applicant be successful in their application to be added to the prospective provider list, Fasset is under no obligation to utilise their services. Successful applicants are not in any way guaranteed future business.

Whilst Fasset is issuing this application in good faith, it reserves the right to cancel or delay the selection process.


Section 1: Special conditions of registration (Division 1)

SPECIAL CONDITIONS OF REGISTRATIONDIVISION 1

1 FRAUD AND CORRUPTION

1.1 All providers are to take note of the implications of contravening the Prevention and Combating of Corrupt Activities Act, Act No 12 of 2004 and any other Act applicable.

2 NOTES TO ALL PROVIDERS SEEKING REGISTRATION ON THE LIST OF PROSPECTIVE PROVIDERS OF FASSET

2.1 The purpose of this list is to give all prospective providers an equal opportunity to submit quotations to Fasset.

2.2 Preference will be given to registered providers but it does not necessarily follow that providers who are not yet registered will be totally excluded from quoting for the supplying of goods or services to the Fasset. It is envisaged however, that this list will contribute to efficient administration and compliance with the PFMA.

2.3 Attached please find, inter alia, an official prospective provider application form to assist in compiling the list according to legislation. It is imperative that applicants read the prospective provider application document carefully, complete it in full and sign where appropriate.

2.4 The list will be valid until Fasset decides to re-establish the list.

2.5 Providers will be notified whether their applications were accepted or not.

3 LATE SUBMISSIONS

3.1 Late submissions may not be considered for registration on the list until the next update, provided that all the information and documentation as set out in this document pack are satisfactory, or after the publishing of the next advertisement.

3.2 A submission will be considered late if it arrives only one second after 11:00 or any time thereafter. The tender (bid) box shall be locked at exactly 11:00 and submissions arriving late will only be considered as per par 3.1 above. Respondents are therefore strongly advised to ensure that submissions be despatched timely, allowing enough time for any unforeseen events that may delay the delivery of the submission.

3.3 Submissions sent via normal post or any other mechanism shall be deemed to

be received at the date and time of arrival at the Deloitte premises (tender/bid box or reception). Submissions received at the physical address after the closing date and time of the submission, shall therefore be deemed to be received late.

4 CLARIFICATIONS/QUERIES

4.1 Any clarification, required by a provider regarding the meaning or interpretation of the prospective provider application document, or any other aspect concerning



the application, is to be requested in writing (letter, facsimile or e-mail) from Mary Morudu by Friday, 15 October 2011 The reference number (FAS/11/12/PPL1) should be mentioned in all correspondence. Telephonic requests for clarification will not be accepted. If appropriate, the clarifying information will be made available to all providers by e-mail only.

5 SUBMITTING PROSPECTIVE PROVIDER LIST APPLICATION DOCUMENTS

5.1 An original plus (1) one hard copy of the application document pack (two documents in total), should be handed in/delivered to:

The Procurement ManagerDeloitteDeloitte Brooklyn House315 Veale StreetBrooklyn0181

5.2 All documentation and responses will be supplied and exchanged electronically utilising Microsoft Office (Word, Excel) products.

5.3 Prospective provider application documents should be submitted in a sealed envelope, marked with:

Reference Number (FAS/12/13/PPL1)

Closing date and time (21 February 2012 at 11:00)

The name and address of the applicant.

5.4 Documents submitted on time by providers shall not be returned.

5.5 Documents received late will only be considered for the next quarter update.

6 DIRECTIONS TO DELOITTE OFFICES FOR DELIVERY OF APPLICATIONS

Physical Address

DeloitteDeloitte Brooklyn House315 Veale StreetBrooklyn0181

(Refer attached map for directions)



7 REASONS FOR REJECTION

7.1 Fasset shall reject an application to be registered if the provider has committed a proven corrupt or fraudulent act in applying to register.

7.2 Any attempt to gain information in a manner deemed to be unfair or disadvantageous to other respondents or any attempt to influence the outcome of the response evaluation will result in immediate disqualification from the application process.

7.3 Fasset may disregard the application of any provider if that provider, or any of its directors:

Have abused the SCM system of Fasset.

Have committed proven fraud or any other improper conduct in relation to such system.

Have failed to perform on any previous contract and the proof exists.

7.4 Such actions shall be communicated to the National Treasury.

7.5 No faxed or e-mailed applications will be accepted.

8 GENERAL CONDITIONS OF CONTRACT

8.1 The General Conditions of Contract, which are available on request or on the Fasset website, will only guide the quotations to be invited from the list of prospective providers.


Section 1: Evaluation process/criteria

EVALUATION PROCESS/CRITERIA

ALL PROVIDERS MUST TAKE NOTE OF THE EVALUATION PROCESS THAT WILL BE FOLLOWED

1. EVALUATION PROCESS 1.1 Evaluation of the responses will be done in the phases noted hereunder.

1.2 RESPONSIVENESS CHECK

1.2.1 An original plus (1) one hard copy (2 documents in total) of the application document pack submitted.

1.2.2 Original Tax Clearance Certificate submitted.

1.2.3 Business (company) registration certificate submitted, if applicable.

1.2.4 IRP 30A submitted in case of a Labour Broker.

1.2.5 A valid VAT registration certificate (VAT103) submitted, if applicable.

1.2.6 Declaration of interest completed, signed and submitted.

1.2.7 Declaration of bidder’s past SCM practices completed, signed and submitted.

1.2.8 Invitation to register completed, signed and submitted.

1.2.9 Prospective provider information form completed, signed and submitted.

1.2.10 Categories form completed and submitted.

1.2.11 Curriculum/curricula vitae completed and submitted (for professional services and training).

1.2.12 Organisational/Individual profile submitted.

1.2.13 Reference letters from at least two providers for services rendered for the categories applied for.

1.2.14 B-BBEE status level certificate – certified copy.

1.3 EVALUATION

1.3.1 Providers who are regarded as responsive, as determined through 1.2 above will be evaluated further. Information will be presented to the Fasset PPL Evaluation Committee to be assessed on the following:


Section 1: Evaluation process/criteria

1.3.2 Assessment Criteria

Assessment Criteria

Yes No

Display knowledge and experience in categories applied for as a provider through the CVs.

Display knowledge and experience in categories applied for as a provider through the organisational/individual profile.

Reference letters from at least two providers for services rendered for the categories applied for.

1.4 PPL ADJUDICATION COMMITTEE

1.4.1 The recommendations for registration will be submitted to the Bid Adjudication Committee for consideration and final approval of the list of prospective providers of Fasset.


Section 2: Special Conditions of Registration (Division 2)

SPECIAL CONDITIONS OF REGISTRATION: DIVISION 2

SPECIAL CONDITIONS COMPLETE CONFIRMATIONYes No If no, indicate

deviation1 ADDITIONAL INFORMATION REQUIREMENTS

1.1 During evaluation of the provider application forms, additional information may be requested in writing. Replies to such request must be submitted, within 5 (Five) working days. Failure to comply, may lead to your provider application being disregarded.

2 FORMAT OF APPLICATION DOCUMENT

2.1 Applicants must complete all the necessary documents and undertakings requirements in this prospective provider application documents. Applicants are to set out their applications in the format prescribed hereunder.

2.2 Part 1: Front page of this document

2.2.1 The front page of this document must be completed and attached to each submission.

2.3 Part 2: SARS Tax Clearance Certificate(s)

2.3.1 An original, valid tax clearance certificate must accompany the application. The certificate requirements page should not be returned as part of the application.

2.4 Part 3: Additional Registration Certificates

2.4.1 A valid Business (company) registration certificate must be submitted, if applicable.

2.4.2 A valid IRP 30A must be submitted in the case of a Labour Broker.

2.4.3 A valid VAT registration certificate (VAT103) must be submitted, if applicable.

2.5 Part 4: Declaration of Interest

2.5.1 Each party to the application must complete, sign and return the “Declaration of Interest” form.

2.6 Part 5: Declaration of bidder’s past SCM




deviationpractices

2.6.1 Each party to the application must complete, sign and return the “Declaration of bidder’s past SCM practices”.

2.7 Part 6: BEE Status

2.7.1 B-BBEE status level certificate – certified copy (if applicable).

2.8 Part 6: Invitation To Register

2.8.1 Applicants must complete, sign and return the full “Invitation to register” document.

2.9 Part 7: Prospective Provider Information Form

2.9.1 Applicants must complete and return the full information form.

2.10 Part 8: Categories Form

2.10.1 Applicants must complete and return the categories form.

2.11 Part 9: Proposed Curricula Vitae

2.11.1 A maximum of 2 representative CV’s per professional service and training categories must be provided in order to demonstrate skill and capacity in the specific category. A CV format is provided as a guide and each CV may not exceed 2 pages.

2.12 Part 10: Organisational/Individual Profile

2.12.1 It is expected that prospective providers will provide sufficient details of their knowledge and experience in the relevant categories only and in line with the category description requirements in their response to enable Fasset to effectively evaluate the response.

2.12.2 In the case of individuals, only provide relevant information pertaining to an individual.

2.12.3 Not more than three (3) pages, and must at least contain information below:




deviation Highlight core business of the organisation. When was the organisation established? Profile of the management of the organisation

(People without voting rights, Women, Disability).

Profile of the employees of the organisation (People without voting rights, Women, Disability).

What is the role of the organisation in the empowerment of employees with regards to training (bursaries, in-house training etc)?

Details of contracts for similar work within the last 3 years.

Two (2) reference letters for whom work was done in the specified categories

2.12.4 Samples of work done are not required at this stage.

3 CONSIDERATION FOR REGISTRATION

3.8 Only providers who hand in all the correct documentation will be considered for registration on the list.

3.9 An organisation will not be considered for registration unless the required number of copies is submitted.

4 UPDATE OF INFORMATION ON SUCCESSFUL PLACEMENT

4.1Successful providers that are placed on the list are responsible to provide updated information in the event of any changes to the e-mail address.Failure to do so will result in removal from the list if a request for quote is sent to the e-mail noted on the database and is then returned undelivered due to address not being valid/ not existing, etc.


Section 2: Tax Clearance Certificate Requirements

TAX CLEARANCE CERTIFICATE REQUIREMENTS

It is a condition of bid (tender) that the taxes of the successful bidder must be in order, or that satisfactory arrangements have been made with South African revenue Services (SARS) to meet the bidder’s tax obligations.

1. In order to meet this requirement, bidders are required to complete in full the form TCC 001 “Application for a Tax Clearance Certificate” and submit it to any SARS branch office nationally. The Tax Clearance Certificate Requirements are also applicable to foreign bidders/ individuals who wish to submit bids.

2. SARS will then furnish the bidder with a Tax Clearance Certificate that will be valid for a period of 1 (one) year from the date of approval.

3. The original Tax Clearance Certificate must be submitted together with the bid. Failure to submit the original and valid Tax Clearance Certificate will result in the invalidation of the bid. Certified copies of the Tax Clearance Certificate will not be acceptable.

4. In bids where Consortia / Joint ventures / Sub-contractors are involved, each party must submit a separate Tax Clearance Certificate.

5. Copies of the TCC 001 “Application for a Tax Clearance Certificate” form are available from any SARS branch office nationally or on the website www.sars.gov.za.

6. Applications for Tax Clearance Certificates may also be made via eFiling. In order to use this provision, taxpayers will need to register with SARS as eFilers through the website www.sars.gov.za.

http://www.sars.gov.za/

http://www.sars.gov.za/


Section 2: Declaration of Interest

DECLARATION OF INTEREST1. Any legal person, including persons employed by the State1, or persons having a kinship with

persons employed by the State, including a blood relationship, may make an offer or offers in terms of the invitation to bid (includes a price quotation, advertised competitive bid, limited bid or proposal). In view of possible allegations of favouritism, should the resulting bid, or part thereof, be awarded to persons employed by the State, or to persons connected with or related to them, it is required that the bidder or his/her authorised representative declare his/her take an oath declaring his/her interest, where –

1.1. The bidder is employed by the State; and/or

1.2. The bidder is a Management Board member of Fasset and/or

1.3. The legal person on whose behalf the bidding document is signed, has a relationship with persons/a person who are/is involved in the evaluation and or adjudication of the bid(s), or where it is known that such a relationship exists between the person or persons for or on whose behalf the declarant acts and persons who are involved with the evaluation and or adjudication of the bid.

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

2.1. Full Name of bidder or his or her representative:

2.2. Identity Number:

2.3. Position occupied in the Company (director, shareholder, etc):

2.4. Company Registration Number:

2.5. Tax Reference Number:

2.6. VAT Registration Number:

2.7. Are you or any person connected with the bidder presently employed by the State? YES / NO

2.7.1. If so, furnish the following particulars

Name of person/ director/ shareholder/member:

Name of State institution to which the person is connected:

Position occupied in the State institution:

Any other particulars:

2.8. Did you or your spouse, or any of the company’s directors/shareholders/members YES / NO

1 “State” means(a) Any national or provincial department, national or provincial public entity or constitutional institution within the

meaning of the Public Finance Management Act, 1999 (Act No 1 of 1999);(b) Any municipality or municipal entity;(c) Provincial legislature;(d) National Assembly or the National Council of Provinces;(e) Parliament.


Section 2: Declaration of Interest

or their spouses conduct business with the State in the previous twelve (12) months?

2.8.1. If so, furnish the following particulars.

2.9. Do you, or any person connected with the bidder, have any relationship (family, friend, other) with a person employed by the State or Deloitte Consulting2 (Pty) Ltd and who may be involved with the evaluation and or adjudication of this bid?

YES / NO


2.10. Are you, or any person connected with the bidder, aware of any relationship (family, friend, other) between the bidder and any person employed by the State or Deloitte Consulting (Pty) Ltd who may be involved with the evaluation and or adjudication of this bid?

YES / NO


2.11. Do you or any of the directors/shareholders/members of the company have any interest in any other related companies whether or not they are bidding for this contract?

YES / NO


DECLARATION

I, THE UNDERSIGNED (NAME)

CERTIFY THAT THE INFORMATION FURNISHED IN PARAGRAPHS 2.1 TO 2.11.1 ABOVE IS CORRECT. I ACCEPT THAT THE STATE MAY ACT AGAINST ME IN TERMS OF PARAGRAPH 23 OF THE GENERAL CONDITIONS OF CONTRACT SHOULD THIS DECLARATION PROVE TO BE FALSE.

Signature Date

Position Name of bidder

2 Deloitte Consulting (Pty) Ltd is the Procurement Administrator


Section 2: Declaration of Bidders’s Past Supply Chain Management Practices

DECLARATION OF BIDDER'S PAST SUPPLY CHAIN MANAGEMENT PRACTICES

1 This declaration will be used by institutions to ensure that when goods and services are being procured, all reasonable steps are taken to combat the abuse of the supply chain management system.

2 The bid of any bidder may be disregarded if that bidder, or any of its directors have:

a. abused the institution's supply chain management system;b. committed fraud or any other improper conduct in relation to such system; orc. failed to perform on any previous contract.

3 In order to give effect to the above, the following questionnaire must be completed and submitted with the bid.Item Question Yes No3.1 Is the bidder or any of its directors listed on the National Treasury’s

prospective provider list as companies or persons prohibited from doing business with the public sector?(Companies or persons who are listed on this prospective provider list were informed in writing of this restriction by the National Treasury after the audi alteram partem rule was applied).

Yes

No

3.1.1 If so, furnish particulars:

3.2 Is the bidder or any of its directors listed on the Register for Tender Defaulters in terms of section 29 of the Prevention and Combating of Corrupt Activities Act (No 12 of 2004)?To access the Register enter the National Treasury’s website, www.treasury.gov.za click on the icon “Register for Tender Defaulters” or submit your written request for a hard copy of the Register to facsimile number 012-3265445.

Yes

No


3.3 Was the bidder or any of its directors convicted by a court of law (including a court outside of the Republic of South Africa) for fraud or corruption during the past five years?

Yes

No


3.4 Was any contract between the bidder and any organ of state terminated during the past five years on account of failure to perform on or comply with the contract?

Yes

No


CERTIFICATION

I, THE UNDERSIGNED (FULL NAME) ………………………………………………………………………………………….CERTIFY THAT THE INFORMATION FURNISHED ON THIS DECLARATION FORM IS 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 Respondent

http://www.treasury.gov.za/


Section 2: Preference Points Claim Form In Terms of the Preferential Procurement Regulations, 2001 (Purchases)

PREFERENCE POINTS CLAIM FORM IN TERMS OF THE PREFERENTIAL PROCUREMENT REGULATIONS, 2001

(PURCHASES)This preference form must form part of all applications. It contains general information and serves as a claim form for Historically Disadvantaged Individual (HDI) preference points as well as a summary for preference points claimed for attainment of other specified goals.

NB: BEFORE COMPLETING THIS FORM, ORGANISATION MUST STUDY THE GENERAL CONDITIONS, DEFINITIONS AND DIRECTIVES APPLICABLE IN RESPECT OF EQUITY OWNERSHIP BY HISTORICALLY DISADVANTAGED INDIVIDUALS (HDIs), AS PRESCRIBED IN THE PREFERENTIAL PROCUREMENT REGULATIONS, 2001

1. GENERAL CONDITIONS

1.1 Failure on the part of an applicant to fill in and/or sign this form may be interpreted to mean that the preference points are not claimed.

1.2 The purchaser reserves the right to require of an applicant, either before a application is accepted or at any time subsequently, to substantiate any claim in regard to preferences, in any manner required by the purchaser.

2. GENERAL DEFINITIONS

2.1 “Acceptable bid” means any bid, which in all respects, complies with the specifications and conditions of bid as set out in the bid document. For this application “bid” also includes application.

2.2 “Bid” means a written offer in a prescribed or stipulated form in response to an invitation by an organ of state for the provision of goods, works or services. For this application “bid” also includes application.

2.3 “Comparative price” means the price after the factors of a non-firm price and all unconditional discounts that can be utilised have been taken into consideration.

2.4 “Consortium or joint venture” means an association of persons for the purpose of combining their expertise, property, capital, efforts, skills and knowledge in an activity for the execution of a contract.

2.5 “Contract” means the agreement that results from the acceptance of a bid by an organ of state.

2.6 “Specific contract participation goals” means the goals as stipulated in the Preferential Procurement Regulations, 2001.

2.6.1 In addition to the abovementioned goals, the Regulations [12(1)] also make provision for organs of state to give particular consideration to procuring locally manufactured products.

2.7 “Control” means the possession and exercise of legal authority and power to manage the assets, goodwill and daily operations of a business and the active and continuous exercise of appropriate managerial authority and power in determining the policies and directing the operations of the business.

2.8 “Disability” means in respect of a person, a permanent impairment of a physical, intellectual, or sensory function, which results in restricted, or lack of, ability to perform an activity in the manner, or within the range, considered normal for a human being.

2.9 “Equity ownership” means the percentage ownership and control, exercised by individuals within an enterprise.

2.10 “Historically Disadvantaged Individuals (HDI’s)” means a South African citizen

(1) Who, due to the apartheid policy that had been in place, had no franchise in national elections prior to the introduction of the Constitution of the Republic of South Africa, 1983 (Act No 110 of 1983) or the Constitution of the Republic of South Africa, 1993 (Act No 200 of 1993) (“the interim Constitution”); and or



(2) Who is a female; and/or

(3) Who has a disability.

Provided that a person who obtained South African citizenship on or after the coming to effect of the Interim Constitution, is deemed not to be a HDI.

2.11 “Management” means an activity inclusive of control and performed on a daily basis, by any person who is a principal executive officer of the company, by whatever name that person may be designated, and whether or not that person is a director.

2.12 “Owned” means having all the customary elements of ownership, including the right of decision-making and sharing all the risks and profits commensurate with the degree of ownership interests as demonstrated by an examination of the substance, rather than the form of ownership arrangements.

2.13 “Person” includes reference to a juristic person.

2.14 “Rand value” means the total estimated value of a contract in Rand denomination that is calculated at the time of invitations and includes all applicable taxes and excise duties.

2.15 “Small, Medium and Micro Enterprises (SMMEs)” bears the same meaning assigned to this expression in the National Small Enterprise Act, 1996 (Act No 102 of 1996).

2.16 “Subcontracting” means the primary contractor’s assigning or leasing or making out work to, or employing another person to support such primary contractor in the execution or part of a project in terms of the contract.

2.17 “Trust” means the arrangement through which the property of one person is made over or bequeathed to a trustee to administer such property for the benefit of another person.

2.18 “Trustee” means any person, including the founder of a trust, to whom property is bequeathed in order for such property to be administered for the benefit of another person.

3. ESTABLISHMENT OF HDI EQUITY OWNERSHIP IN AN ENTERPRISE

3.1 Equity ownership shall be equated to the percentage of an enterprise which is owned by individual classified as HDIs, or in the case of a company, the percentage shares that are owned by individual classified as HDIs, who are actively involved in the management and daily business operations of the enterprise and exercise control over the enterprise, commensurate with their degree of ownership.

3.2 Where individuals are not actively involved in the management and daily business operations and do not exercise control over the enterprise commensurate with their degree of ownership, equity ownership may not be claimed.

4. POINTS AWARDED FOR HISTORICALLY DISADVANTAGED INDIVUDUALS

4.1 In terms of Regulation 13(2) preference points for HDI’s are calculated on their percentage shareholding in a business, provided that they are actively involved in and exercise control over the enterprise. The following formula is prescribed in Regulation 13(5)(c).

Where

NEP = Points awarded for equity ownership by an HDI

NOP = The maximum number of points awarded for equity ownership by an HDI in

that specific category

EP = The percentage of equity ownership by an HDI within the enterprise or



business, determined in accordance with the definition of HDI’s

4.2 Equity claims for a trust will only be allowed in respect of those persons who are both trustees and beneficiaries and who are actively involved in the management of the trust.

4.3 Documentation to substantiate the validity of the credentials of the trustees contemplated above must be submitted.

4.4 Listed companies and tertiary institutions do not qualify for HDI preference points.

4.5 A consortium or joint venture may, based on the percentage of the contract value managed or executed by their HDI-members, be entitled to preference points in respect of an HDI.

4.6 A person awarded a contract as a result of preference for contracting with, or providing equity ownership to an HDI, may not subcontract more than 25% of the value of the contract to a person who is not an HDI or does not qualify for the same number or more preference for equity ownership.

5. DECLARATION

5.1 Applicants who claim points in respect of equity ownership must complete the Declaration at the end of this form.

6. EQUITY OWNERSHIP CLAIMED IN TERMS OF PARAGRAPH 2.10 ABOVE. POINTS TO BE CALCULATED FROM INFORMATION FURNISHED IN PARAGRAPH 7.5

Ownership Percentage owned

6.1 Equity ownership by persons who had no franchise in the national elections %

6.2 Equity ownership by women %

6.3 Equity ownership by disabled persons* %

*If points are claimed for disabled persons, indicate nature of impairment (see paragraph 2.8 above)

………………………………………………………………………………………………………

7. DECLARATION WITH REGARD TO EQUITY

7.1 Name of firm:

7.2 VAT registration number:

7.3 Company registration number:

7.4 Type of firm

Partnership One person business/sole trader Close corporation Company (Pty) Limited

Tick applicable box


Section 2: Preference Points Claim Form in term of the Preferential Procurement Regulations, 2001 (Purchases)

7.5 List all shareholders by Name, Position, Identity Number, Citizenship, HDI status and ownership, as relevant. Information to be used to calculate the points claimed in paragraph 8

Name Date/Position occupied in enterprise

ID number Date RSA citizenship obtained

*HDI Status *Non-HDI status

% of business/ enterprise

ownedNo franchise

prior to elections

Women Disabled

* Indicate Yes or No


Section 2: Preference Points Claim Form in term of the Preferential Procurement Regulations, 2001 (Purchases)

7.6 I/We, the undersigned who warrants that he/she is duly authorised to do so on behalf of the firm certify that points claimed, based on the equity ownership, indicated in paragraph 8 of the foregoing certificate, qualifies the firm for the preference(s) shown and I/we acknowledge that:

7.6.1 The information furnished is true and correct.

7.6.2 The equity ownership claimed is in accordance with the General Conditions as indicated in paragraph 1 of this form.

7.6.3 In the event of a contract being awarded as a result of points claimed as shown in paragraph 8, the contractor may be required to furnish documentary proof to the satisfaction of the seller that the claims are correct.

7.6.4 If the claims are found to be incorrect, the seller may, in addition to any other remedy it may have:

Recover costs, losses or damages it has incurred or suffered as a result of that person’s conduct.

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.

Impose a financial penalty more severe than the theoretical financial preference associated with the claim which was made.

WITNESSES

1. …………………………………………

2. ………………………………………… DATE: …………………………………………

ADDRESS: ………………………………………

……………………………………………………..

……………………………………………………..

……………………………………………………..

…………………………………….SIGNATURE(S) OF BIDDER(S)


Section 2: Preference points claim form in terms of the Preferential Procurement Regulation 2001 (Promotion of Small Enterprises))

PREFERENCE POINTS CLAIM FORM IN TERMS OF THE PREFERENTAIL PROCUREMENT REGULATIONS, 2001

(PROMOTION OF SMALL ENTERPRISES)

NB: BEFORE COMPLETING THIS FORM, BIDDERS MUST STUDY THE GENERAL CONDITIONS, DEFINITIONS AND DIRECTIONS SPECIFIED IN THE PREFERENCE POINTS CLAIM FORM (PURCHASES) IN TERMS OF THE PREFERENTIAL PROCUREMENT REGULATIONS, 2001

1. INTRODUCTION

1.1 In terms of regulation 17 of the Preferential Procurement Regulations pertaining to the Preferential Procurement Policy Framework Act, 2000 (Act No 5 of 2000), it is the Government’s intention to promote small businesses (now referred to as small enterprises) by using the preference point system as a mechanism to award points to bidders.

2. CLAIM WITH REGARD TO BEING A SMALL ENTERPRISE

2.1 Bidders who regard themselves as a micro, very small or medium enterprise (SMME) as defined by the National Small Enterprise Act, 1996 (Act No 102 of 1996) as amended by the National Small Business Amendment Act (Act 26 of 2003) and the National Small Business Amendment Act (Act 29 of 2004) may claim preference points.

2.2 Do you regard yourself as a SMME in terms of the Act? YES / NO

2.3 Should bidders wish to claim points for being a SMME, then bidders must complete the following table.

First select and tick in column (A) the relevant sector or sub-sector you are operating in. Within the chosen sector, select and tick the relevant block in columns (B), (C) and (D) indicating your organisation’s position pertaining to employees (B), turnover (C) and asset value (D).

See the example in 2.4 below:



Annex 1: Schedule National Small Enterprise Act

Sector or sub-sector in

accordance with the Standard

Industrial Classification

A Size or class Total full time equivalent of

paid employees

B Total annual turnover

C Total gross asset value

(fixed property excluded)

D

Less than Less than

AgricultureMedium 100 R5.00 m R5.00 mSmall 50 R3.00 m R3.00 mVery small 10 R0.50 m R0.50 mMicro 5 R0.20 m R0.10 m

Mining and quarrying

Medium 200 R39.00 m R23.00 mSmall 50 R10.00 m R6.00 mVery small 20 R4.00 m R2.00 mMicro 5 R0.20 m R0.10 m

Manufacturing Medium 200 R51.00 m R19.00 mSmall 50 R13.00 m R5.00 mVery small 20 R5.00 m R2.00 mMicro 5 R0.20 m R0.10 m

Electricity, gas and water


Construction Medium 200 R26.00 m R5.00 mSmall 50 R6.00 m R1.00 mVery small 20 R3.00 m R0.50 mMicro 5 R0.20 m R0.10 m

Retail and motor trade and repair service


Wholesale trade, commercial agents and allied services


Catering, accommodation and other trade


Transport, storage and communications


Finance and business services


Community, social and personal services


PLEASE TICK THE APPROPRIATE BLOCK AS INDICATED IN THE EXAMPLE BELOW



2.4 Bidders are to claim preference points based on the size or class of enterprise indicated above:

Example

Sector or sub-sector in accordance

with the Standard Industrial

Classification

A Size or class Total full time equivalent of

paid employees

B Total annual turnover

C Total gross asset value

(fixed property

excluded)

D

Less than Less than

AgricultureMedium 100 R5.00 m R5.00 m

ü Small 50 R3.00 m ü R3.00 mVery small 10 R0.50 m R0.50 m üMicro 5 ü R0.20 m R0.10 m

The annual turnover shall be the factor determining the ultimate classification and hence the points claimable. The company in this example would be classified as a “small” enterprise because of the turnover in lieu of the fact that according to the other parameters, the company could be classified as a “micro” or “very small” enterprise.

2.5 Insert your claim in the table below based on the information contained in paragraph 2.3.

2.6 If required, the information supplied above must be substantiated by an internal auditor’s certificate and the relevant documentation.

Classification Tick correct classificationMicro

Very Small

Small

Medium

3. DECLARATION

3.1 I/we, the undersigned, who warrants that he/she is duly authorised to do so on behalf of the firm declare that points claimed, based on promotion of small, medium or micro enterprises, qualifies the firm for the point(s) shown and I/we acknowledge that:

3.1.1 The information is true and correct.

3.1.2 In the event of a contract being awarded as a result of points claimed, the contractor may be required to furnish documentary proof substantiating the external auditor’s certificate, that the claims are correct.

3.1.3 If the claims are found to be incorrect, the Fasset may, in addition to any other remedy it may have:

Recover all costs, losses or damages it has incurred or suffered as a result of that person’s conduct.

Cancel the contract and claim any damages which it has suffered as a result of having to make a less favourable arrangement due to such cancellation.



Impose a financial penalty more severe than the theoretical financial preference associated with the claim which was made in the bid.

Restrict the contractor, its shareholders and directors from obtaining business from the Fasset for a period determined by the Fasset.

WITNESSES

1. …………………………………………

2. ………………………………………… DATE: ……………………………………

…………………………………….SIGNATURE(S) OF BIDDER(S)


Section 3: Invitation to Register

INVITATION TO REGISTER

PROVIDERS ARE HEREBY INVITED TO REGISTER ON THE LIST OF PROSPECTIVE PROVIDERS OF FASSET

REFERENCE NUMBER FAS/12/13/PPL1 CLOSING DATE 21 February 2011 CLOSING TIME 11:00

DESCRIPTION Invitation to suppliers and service providers to apply for registration on the Fasset list of prospective providers

The successful applicants will be registered on the prospective provider list

APPLICATION DOCUMENTS MAY BE:

DEPOSITED IN THE BID/TENDER BOX SITUATED AT(Street address)

The Foyer, Deloitte Brooklyn House, 315 Veale Street, Brooklyn, Pretoria

OR

POSTED TO: Deloitte, P O Box 11007, Hatfield, Pretoria, 0028

ORHANDED IN AT RECEPTION SITUATED AT(Street address)

Deloitte Brooklyn House, 315 Veale Street, Brooklyn, Pretoria

No faxed or e-mailed applications will be accepted

Respondents should ensure that submissions are delivered to Deloitte before the closing date and time to the correct physical address.

* Refer to Paragraph 3 of the “Special Conditions to Register: Division 1”.

Application forms can be delivered and deposited into the bid/tender box between 08:00 and 16:30, Mondays to Thursdays and 08:00 to 16:00 on Fridays, prior to the closing date, and between 08:00 and 11:00 on the closing date.

All application documents must be submitted on the official forms (not to be re-typed).

This application is subject to the Special Conditions of Registration.

Application forms submitted that do not comply with the following may not be considered for evaluation:

An application that is not in the format prescribed. An application without some or all of the required documents. Applications without the required number of copies.



Any queries regarding the registration procedures and technical information may be directed to:

Name: Sibongiseni Radebe

Tel.: 012-482 0038

Fax: 012-349 8997

e-Mail [email protected]

All applicants must furnish the following particulars and include it in their submission(Failure to do so may result in your application being disqualified)

Name of bidder:

Contact details of responsible person who will act on behalf of the entity in terms of the bid.

Name and Surname

Telephone number: Code Number

Cellular number:

Facsimile number: Code Number

e-Mail address:

Contact details of alternative responsible person who will act on behalf of the person above should he/she not be available

Name and Surname


Cellular number:

Facsimile number: Code Number

e-Mail address:



Confirmation

Are you an accredited representative in South Africa for the goods/services offered by you:

YES / NO / NA

Declaration

We have examined the information provided in your application documents and offer to undertake the work prescribed in accordance with the requirements as set out in the application document. We confirm that this application will remain binding upon us and may be accepted by you at any time before the expiry date.

Signature of bidder:

Date:

Are you duly authorised to commit the bidder: YES / NO

Capacity under which this bid is signed

TOTAL NUMBER OF CATEGORIES APPLIED FOR


Section 3: Prospective Provider Information Form

PROSPECTIVE PROVIDER INFORMATION FORM

All applicants must furnish the following particulars and include it in their submission

(Failure to do so may result in your application being disqualified)

(This form only needs to be completed once, irrespective of the number of categories being applied for)

Name of Business

Business Service(Tick the appropriate block)

Supplier Service Provider

Provider grouping detail/Type of firm(Tick the appropriate block)

1. Public Company (Ltd)2. Private Company (Pty) Ltd3. Close Corporation registered in terms of the SA

Companies Act (cc)4. Other (specify)5. Partnership6. One person business/Sole Proprietor7. Foreign Company8. Trust9. Section 21 Company

Where business service can be rendered(Tick the appropriate block)

International National

If none of the above are applicable, please specify the Province/s

Please indicate where the Organisation’s Head Office is:

Postal Address:

Code

Physical Address:

Code

Company Contact Number:

Code Number

Contact person:




Fax Number: Code Number

Cellular number: Number

e-Mail address:

Annual Turnover(Average over last 3 years)

R

Business (Company) Registration Number:

VAT Registration number:

Income Tax Reference Number:

Company PAYE number:

Company UIF number:

Skills Development Levy Registration number

Tax clearance (Tick the appropriate block)

Yes No

Arrangements made (proof in part 2)

Not applicable (attach proof)

Number of Fulltime Employees

HDI Equity Ownership People without voting rights %

Women equity %Disabled individuals %

SMME status MediumSmallVery SmallMicroOther



BEE statusPlease submit details of your BEE status in terms of the latest Codes of Good Practice issued in terms of the Broad Based Black Economic Empowerment Act, where possible and attach the required proof where available.

BEE status where available

7.7 I, the undersigned certify that the information provided is true and correct.

DATE: ………………………

…………………………………….SIGNATURE OF RESPONDENT


Section 3: Category List

CATEGORY LIST

Category Sub-category Comment Indicate with X

Professional Services Employee Placement Quality Assurance Skills Planning Learnership Related Services, eg development of material, ability to implement, assessments etc.

Accreditation is a minimum requirement. Proof must be submitted.

General Services Mailing ServicesHandymanPest Controllers

Office equipment and supplies

General Office equipment Must be able to deliver in Blackheath, JHB

Office furniture Must be able to deliver in Blackheath

Stationery Must be able to deliver in Blackheath

Information Technology Equipment & Goods

Consumables Must be able to deliver in Blackheath

Hardware Must be able to deliver in Blackheath

Software Must be able to deliver in Blackheath

Training Management and LeadershipSkills DevelopmentTechnical financial skills and legislative and other changes in the financial services sector


Section 3: Curriculum Vitae Guideline Template

CURRICULUM VITAE GUIDELINE TEMPLATE(This template to be duplicated for each CV)

Proposed skills area (linked to category/categories applied for):

1. Surname

2. First name:

3. Date of birth:

4. Nationality

5. Education

Institution(Date from - Date to)

Degree(s) or Diploma(s) obtained

6. Membership of professional bodies

7. Other skills (e.g. computer literacy, email & internet, etc.)

8. Present position:

9. Years within the organisation:

10. Key qualifications (relevant to the categories)

11. Professional experience

Date(From – To) (mm/yy)OrganisationLocationPositionDescription of duties

Date(From – To) (mm/yy)OrganisationLocationPositionDescription of duties

12. Other relevant information (e.g. Publications)


Directions to Deloitte

DIRECTIONS TO DELOITTE

N1 North N1 South

Lynnwood R

oad

Duncan Street

Fehrsen StreetM

iddle StreetG

eorge Storrar

Fountain

Circle

Brooklyn

Circle

Veale Street

R21 toOR TamboInternational

DeloitteWaterkloof House

Eeufees Road (off ramp)

Nelson Mandela Ave (R21) to Pretoria

Dey Street

Queen Wilhelmina Ave

BankForum

Brooklyn Mall

Brooklyn Square

Deloitte Brooklyn House

Charles Street

AtterburyRoad

Veale Street

R28

Waterkloof Road

SARS

BronkhorstStreet