request for quotation for goods and services for the …

City of uMhlathuze | Supply Chain Management Unit 1

Supplier Name: …………………………………………………………………………………………………………

REQUEST FOR QUOTATION FOR GOODS AND SERVICES FOR THE CITY OF UMHLATHUZE

Procurement Less than R200 000 (including vat)

(For publication in the City of uMhlathuze Notice Boards and website)

The City of uMhlathuze request your quotation on the goods and/or services listed hereunder and/or on the available RFQ

forms. Please furnish all information as requested and return your quotation on the date stipulated. Late and incomplete

submissions will invalidate the quotation submitted.

ADVERTISEMENT DATE

03 November 2021

CLOSING DATE

09 November 2021

PROCUREMENT OFFICER

Nondumiso Mbuyazi

TEL.NO.

035 907 5799

RFQ NO. RFX7000005557

DESCRIPTION OF GOODS AND SERVICES

REPAIR ON THE BOILER AT NSD ABLUTIONS

RFQ SPECIFICATION FORMS/DOCUMENTS ARE OPTAINABLE FROM:

http://www.umhlathuze.gov.za/wp-content/uploads/2014/09/MBD-AND-DECLARATION-FORMS.pdf

TIME 12h00

CUMPULSORY SITE MEETING N/A

SITE MEETING DATE AND TIME

SITE MEETING VENUE

TECHNICAL ENQUIRIES FOR ADDITIONAL INFORMATION:

Mondli Ngongoma / Tebogo Moamosi 035 907 5716 / 035 907 5149

Quotation above R30 000 will be evaluated on the basis of the 80:20 point system as stipulated in the Preferential Procurement

Policy Framework ( Act number 5 of 2000) and City’s Supply Chain Management Policy and Procedure





SIGNATURE OF BIDDER

CAPACITY

PLEASE NOTE THAT NO PRICE INCREASE WILL BE APPROVED AFTER SUBMISSION OF QUOTATION.

REQUEST FOR QUOTATION (RFQ) NUMBER:

Delivery Address: STORES AND PROCUREMENT, BETASTRAAL, ALTON, RICHARDS BAY

ITEM NO.

DESCRIPTION Quantity Required

Delivery Period/ Lead Time

Price per Unit (Excluding VAT)

Total (Excluding Vat)

1.

REPAIR ON THE BOILER AT NSD ABLUTIONS

1

NB: ANY AND ALL ALTERATIONS MUST BE SIGNED FOR BY THE BIDDER CONFIRMING THAT ALL ALTERATION WAS MADE BY THE BIDDER. PLEASE NOTE THAT PRICE CHANGES WITHOUT A SIGNATURE WILL BE DISQUALIFIED.

Sub-Total

Vat

Grand Total

Conditions

1. All prices quoted must be exclusive of Value Added Tax (VAT). 2. Prices quoted must include delivery and offloading charges and goods must be delivered to the address indicated. 3. All prices submitted must be firm. “Firm” prices are deemed to be fixed prices, which are only subject to the following

statutory changes, namely VAT and any levy related to customs and excise. 4. Quantities are given in good faith and without commitment to the City of uMhlathuze. 5. Vendors not registered for Value Added Tax with SARS will be treated as Non VAT vendors. 6. Suppliers submitting quotation should be registered with Central Suppliers Database, CSD number must be supplied.

If supplier is not registered they cannot be considered for evaluation. If supplier wants to be registered with CSD they must go to www.csd.gov.za and get themselves registered.

7. Letter of Good standing must be provided.

SCOPE OF WORK

http://www.csd.gov.za/


NORTHERN SERVICES BOILER ROOM REPAIRS

PROJECT SPECIFICATION

1. SCOPE OF WORK

This work covers the appointment of a Specialist with a 1SO PE only CIDB

Grading Northern Services Boiler Room Repairs

2. CONTRACT PERIOD AND COMPLETION DATE

The contract is valid for 2 weeks, which period shall include any statutory and builders’

holidays falling within this period.

3. PENALTIES FOR LATE COMPLETION

A penalty of R500,00 per day shall be raised for every day or part thereof that the

work remains incomplete after the date specified in clause 2 above.

4. HOURS OF WORK

Normal hours of work shall be defined as:

Mon day to Friday: 07H00 to 16H30.

The undertaking of work outside normal working hours should be subject to the approval of

the Project Leader.

5. PROGRAMME AND METHOD OF WORK

The Contractor’s method of work and programme of work shall be submitted to the

Project Leader. For the purpose of this contract, the site is where the Contractor is

working at any given time.

6. OCCUPATIONAL INJURIES AND DISEASES ACT:

OCCUPATIONAL HEALTH AND SAFETY ACT

6.1 The Contractor shall comply with the Compensation for Occupational Injuries and Diseases

Act 1993 (Act 130 of 1993), and any amendment thereof.

6.2 The Contractor undertakes to carry out its obligations in accordance with the requirements

of the Occupational Health and Safety Act, 1993 (Act 85 of 1993) and Regulations and

comply with all requirements of the Act.


6.3 Compliance with Asbestos Regulations 20 and 21.

7. CLEARING OF SITE

All excess and discarded material shall be totally removed from the area. The works

will not be deemed to be complete unless the site is cleared to the satisfaction of the

Project Leader. Burying of discarded material will not be permitted.

8. INFORMATION TO BE OBTAINED ON SITE

The tenderer must visit the site of the proposed work and acquaint himself with the nature of

the work, the condition under which the work is to be performed, the means of access to the

site, any limitations or restrictions that may be imposed by City of uMhlathuze or other

authorities and in general with all matters that may influence or affect the contract and shall be

deemed to have allowed in his tender for any additional cost involved due to the foregoing, an

no claims for any extras in connection with the position or nature of the work will be

entertained.

9. GENERAL

9.1 The Contractor must verify all levels and dimensions on site before any work commences

and any discrepancies must be discussed with the Project Leader.

9.2 All workmanship and materials must comply with the latest relevant SANS codes and

specification.

10 MEASUREMENT AND PAYMENT

10.1 Invoice to be submitted on completion of work.

10.2 All tendered rates to be inclusive of VAT.

11 WORK PREVIOUSLY PERFORMED

The tenderers should provide proof of competence. The list and/or references of

the similar work previously executed listed. Work previously performed will form

part of an evaluation criteria.

EMPLOYER –

CONTACT

DETAILS

NATURE

OF WORK

VALUE

OF

WORK


Northern Services Boiler Room Repairs

SCHEDULE OF QUANTITIES

SCHEDULE 1: PRELIMINARY AND GENERAL

ITEM DESCRIPTION UNIT QTY RATE AMOUNT

NO R c

1. PRELIMINARY AND GENERAL

1.1 FIXED CHARGE ITEMS

1.1.1

Contractual requirements Sum 1

1.1.2

Facilities required by Engineer Sum 1

1.1.3

Facilities required by Contractor Sum 1

1.1.4

General responsibilities and other fixed charge obligations. Sum

1

1.1.5

Name board No 1

1.1.6

Removal of site establishment Sum 1

Other value related items

1.1.7

Quality assessor / community liaison co-ordinator Weeks 2

1.2 TIME RELATED ITEMS

1.2.1

Contractual requirements Weeks 2

Operation and Maintenance of facilities on site

1.2.2

Facilities for contractor for duration of the contract Weeks 2

1.2.3

Facilities for engineer for duration of contract Weeks 2

Health & Safety

1.2.4

Preparation of Health & Safety Plan Sum 1

1.2.5 Implement and maintenance of Health and Safety on-site Training Sum 1

1.2.6

Personal Protective clothing and Equipment Sum 1

1.2.7

Other Health and Safety time related obligations Sum 1

1.2.8

Supervision for the duration of the contract Weeks 2

TOTAL CARRIED FORWARD TO SUMMARY SHEET


SCHEDULE 2: SUMS

ITEM

No.

DESCRIPTION UNITS QTY RATE AMOUNT

R

C

SUMS

PREAMBLES For preambles refer to "Specification of Materials and Methods to be used", PW 371

NOTE All prices/rates to be net, excluding Value Added Tax

All work as detailed in this bill is within existing buildings

TRADE NAMES For trade names refer to item B1.8 of Section No 1, Preliminaries

BOILERS

1. Repairs/Replacement of Boilers Sum 1

STEEL DOORS AND BURGLARS

2. Supply and install steel double door and burglar guards Sum 1

TOTAL CARRIED FORWARD TO SUMMARY SHEET


SUMMARY OF SCHEDULES

Schedule No. Description Amount ( R )

1 Preliminary and General

2 Sums

SUB TOTAL 1

5 % Contingencies

SUB TOTAL 2

TOTAL CONSTRUCTION COST

Value Added Tax at 15%

TOTAL AMOUNT OF TENDER CARRIED FORWARD TO FORM OF OFFER AND ACCEPTANCE

WITNESSES

1. ………………………………… CONTRACTOR: ………………………….

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

WITNESSES

1. ……………………………………. ………………………………………..…..

PROJECT MANAGER

2. ……………………………………. DATE: ……………………………


C3.2 GENERAL INFORMATION

The Works will be executed according to the construction programme (Gantt Chart)

showing the critical path. As the major building works will take place within existing

covered building, it is not anticipated that there will be any delays due to inclement

weather conditions.

1. SPECIFICATIONS

2.1. Work Procedure: 2.1.1. All work to be done according to SANS relevant specifications. See relevant section

below. 2.1.2. Install all safety warning signs, cones, danger tape, delineators and pedestrian route

indicators on site and maintain for the duration of the construction work.

PART A : THE WORKS

PS 1 : GENERAL DESCRIPTION

Components consist of:

Site Establishment

De-establishment and maintenance of the works during the defects liability

All appurtenant works not specifically mentioned here but as described in the project specifications and Bill of Quantities.

It is the responsibility of the contract that labour –intensive methods of construction be applied wherever possible .The construction shall be planned in such a way that as many operations as possible shall be done by means of hand labour. The labour to be employed in the contract shall be recruited from the local community and maximum use shall be made of local skilled labour and subcontractors from the community.


PS 2: DETAILS OF CONTRACT

The contractor will be responsible for carrying out all work under the contract in accordance with specifications and schedule of quantities. The specifications and schedule of quantities define the scope of this contract and indicate all work to be done. They may be supplemented by additional drawings to supply information regarding details of construction and exact lines, levels and depths. The contractor is to co –ordinate all his operations and activities with the Employer/Engineer.

PS 3: CONSTRUCTION PROGRAMME Submission of Programme

The programme of the work as required in terms of the General Conditions of Contract shall be submitted to the Engineer for approval not later than 07 days after the Order to Commence Work has been given to the contractor. The programme shall take into account the constraints.

PS 4: MONITORING OF CONSTRUCTION

The Engineer will use the programme or revised programme to monitor the progress, and shall take appropriate steps, as provided for in the in the General Conditions of Contract should the Contractor not perform in accordance with the programme.

PS 5: WATER FOR WORKS

The contractor shall make his own arrangement for the water he requires for the execution of the work under his contract and must allow in rates for all costs of obtaining water for the contract.

The water shall be clean and free from injurious amount of acids ‘alkalis ‘organic and other substances that may impair the strength or durability of concrete.

PS 6: APPROVED DUMP SITE

Waste materials must be dumped at UThungulu dumpsite. PS 7: SITE PREPARATION Prior to the commencement of any work all the wasted material shall be removed from the site and disposed of at a dumpsite.


PS 8: EXISTING SERVICES: Although the plans may show the position of existing underground services, neither the Employer nor the Engineer will accept the responsibility for the accuracy or for any omission that may have been made. The contractor shall take all reasonable steps to protect any existing works against damage, which may arise as a result of his operations on site. The contractor shall be held responsible for damage to any existing works and any damage caused, including any claims which may arise as a result there from, shall be borne by the contractor, unless it is established by the engineer that the contractor exercised reasonable care and damage was unavoidable and that the notices were served timeously.

2. CONDITIONS OF CONTRACT

3.1. Conditions of Contract: 3.1.1. All quotations to be sealed in an envelope and must be deposited in the

quotation box at the Municipal Stores at no.22 Betastraal in Alton. Clearly marked with the following: - For Manager: Supply Chain Management Unit: City of

uMHLATHUZE - Stores Representative:

- Quotation description:

Northern Services Boiler Room Repairs

3.1.2. All quotations to be inclusive of VAT or as indicated or qualified as a

“Non Vendor”. 3.1.3. No quotation shall be accepted after 12:00 on the closing date as specified. 3.1.4. NB!! Compulsory Documentation to be attached to Quotation: Failure to

submit valid documents as specified below will invalidate the offer.

No DESCRIPTION OF CERTIFICATES REQUIRED

YES NO

1 Workmans compensation commissioner x 2 CIDB certificate rating as 1 SO PE only x 3 BBBEE SANAS Rating certificate from verified Agency according

to Section 9(1) - Act 53 of 2003 x


4 TAX Clearance certificate x 5 Previous experience in construction, building and civil works (

please attach completion letters) x

3.1.5. There will be a compulsory site inspection 3.1.6. Enquiries relating to this Quotation must be directed to Mondli Ngongoma, (Mon

to Fri) (Phone. 035 907 5716) 3.1.7. Closing date: Proposals/Quotations must be deposited in the Municipal Quotation

Box, Stores and Procurement, Dead end Betastraal Street, Alton, Richards Bay, on the closing date as indicated in the Advert. Any offers received at any other venue or handed directly to Municipal officials will be disqualified.

3.1.8. Vendors Registration: Prospective Vendors, who are not yet registered on Councils Vendors Database, must submit a completed Vendors application form to Council’s Supply Chain Unit on, or before the Quotation closing date. No Orders may be issued if a Vendor is not registered on Council’s Vendors Database.

3.1.9. NB!! No quotations will be considered from persons in the Service of the State*. The attached declaration FORM 1 must be completed and submitted with your quote.

3.2. Evaluation Procedure & Award of Quotation: 3.2.1. The quotation (<R500 000) will be evaluated using the 80/20 method. This request

for quotations is subjected to the terms of the uMhlathuze Municipality Preferential Procurement Policy. It is solely the responsibility of aspirant vendors who desire to avail themselves of the preferences available under this policy to familiarize themselves of its contents and to make such claims for preference. Copies of the uMhlathuze Municipality Preferential Procurement Policy may be obtained from the office of the Chief Financial officer.

3.2.2. If a list of relevant previous experience with references and working telephone numbers are not included, the quotation cannot be accepted.

3.2.3. Price will make out 80 points. 3.2.4. Preferentiality: To claim BBBEE points, add a certificate issued by an accredited

SANAS Verification Agency. This will make out 20 Points. 3.2.5. The Tenderer / Contractor with the highest Contender score will be awarded the

contract. 3.2.6. NOTE: “Council may not necessarily accept the lowest or any other offer, and

reserves the right to select in its favour any, all, or no portion of any offer made.” Preferentiality: To claim BBBEE points, add a certificate issued by an accredited SANAS

Verification Agency. This will make out 20 Points. The Tenderer / Contractor with the highest Contender score will be awarded the contract. NOTE: “Council may not necessarily accept the lowest or any other offer, and reserves

the right to select in its favour any, all, or no portion of any offer made.


3.4. Special Conditions of Contract: 3.4.1. Ref. / Requisition number: - 3.4.2. Works order No: - N/A 3.4.3. Vote No: - 3.4.5. Contingencies: - 5% 3.4.6. Completion period - 2 weeks, excluding public holidays and time to get

test results. (Completion period proposed by contractor: ____________weeks) 3.4.7. Previous Experience - Add a list of relevant previous experience with

references working telephone numbers. If not relevant your quotation may not be accepted.

3.4.7. Penalties per day - No payment, if work is not done to specifications. Quotation can be cancelled if work is not done with in the completion period. R500/day for poor performance and if extension of time is not granted.

3.5. Successful Tenderer: 3.5.1. Should you be successful, please ensure that the following information appears on

your invoice,

- Council’s VAT registration number: 4690193521

- The words “TAX INVOICE” for VENDORS and “INVOICE” for Non- Vendors in a prominent place;

- Name, address and VAT and company registration number of the supplier; - Name, address and VAT registration number of the Municipality; - Invoice number and date of issue; - Accurate description of goods and/or services; - Quantity or volume of goods or services supplied; and - Price & VAT 3.5.2. In addition to the above requirements, the following requirements must also be

met: - Valid Order number or Tender no. - Supplier banking details 3.5.3. Complete and Sign the attached FORM 2 - FORM OF OFFER AND

ACCEPTANCE. 3.5.4. Take note of FORM 3 - Memorandum of agreement – ITO S37 of the Occupational

Health and Safety act 85 of 1993

]


CHECKLIST

PLEASE USE THE CHECKLIST TO CONFIRM THAT ALL COMPULSARY DOCUMENTS HAVE BEEN ATTACHED TO YOUR QUOTATION.

No. Details √

1. Certified Copy of Company Registration Document

2. MBD 4: Declaration of Interest (attached)

3. MBD 8: Declaration Of Bidder’s Past Supply Chain Management Practices

4. MBD 9: Certificate of Independent Bid Determination

5. BBBEE Certificate/ Sworn Affidavit

6. Tax Compliance Certificate

7. Training Suppliers to be Accredited with SITA(If applicable)

8. Catering Suppliers to submit a Health Certificate

9. SHE Risk Management: Contractor SHE FILE (Attached) uMH Q5(During induction)

10. Letter of Good Standing with Compensation Fund for (Principal Contractor and Sub-Contractor) / Tender Letter (Dept. of Labour)

11. Rate & Tax Invoice for Company OR Certified Copy of Lease Agreement OR Affidavit Certified by the SAPS

12. Rate & Tax Invoice for all the Directors of the Company OR Certified of Lease Agreement OR Affidavit Certified by the SAPS

13. All alterations have been signed.

14. Quotation is signed.

FOR OFFICE USE

15. Verification of other interest against CSD

16. Tax compliance verification

17. Verification of supplier restriction against CSD

18. Service provide not in service of the State


COMPULSORY REQUIREMENTS

1. Tax Compliance Certificate.

2. The quotation page must be signed. If you are using your own format on your Company’s letterhead to quote please ensure the quotation is signed.

3. The attached MBD 4 form (Declaration of interest) must be completed and submitted with the quotation. If the MBD 4 if incomplete or not attached the quotation will be disqualified.

4. The attached MBD 8 form (Declaration of interest) must be completed and submitted with the quotation. If the MBD 8 if incomplete or not attached the quotation will be disqualified.

5. The attached MBD 9 form (Certificate of independent Bid Determination) must be completed and submitted with the quotation. If the MBD 9 is incomplete or not attached the quotation will be disqualified.

6. A copy of B-BBEE Status Level Verification certificate must be attached. If not attached no point for B-BBEE will be awarded.

7. All price alterations must be signed for by the Bidder confirming that such changes were made by the Bidder.

PLEASE NOTE THAT PRICE CHANGES WITHOUT A SIGNATURE WILL LEAD TO THE DISQUALIFICATION OF THE QOUTATION SUBMITTED.

I HEREWITH CONFIRM THAT HAVE READ AND UNDERSTOOD THE ABOVEMENTIONED REQUIREMENTS.

Signature: …………………………… NAME:………………………………………………


uMH Q4

DECLARATION OF INTEREST MBD 4

1. No bid will be accepted from persons in the service of the state¹.

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 favouritism, should the resulting bid, or part thereof, be

awarded to persons connected with or related to persons in 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 or her representative: ……………………………………………………………………………………

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

3.3 Position occupied in the Company (director, trustee, hareholder²): ……………………………………………………………………

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

must be indicated in paragraph 4 below.

3.8 Are you presently in the service of the state? Yes No

(Mark appropriate block with “X”)

3.8.1 If yes, furnish particulars

………………………………………………………………………

………………………………………………………………………

¹MSCM 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;

(c) an official of 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.1 of 1999);

(e) a member of the accounting authority of any national or provincial public 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 exercises control over the company.

3.9 Have you been in the service of the state for the past twelve months? Yes No



………………………………………………………………………

………………………………………………………………………

3.10 Do you have any relationship (family, friend, other) with persons in the service of the state and who may be involved with the

evaluation and or adjudication of this bid? Yes No



………………………………………………………………….

………………………………………………………………….

3.11 Are you, aware of any relationship (family, friend, other) between any other bidder and any persons in the service of the state

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

Yes No



………………………………………………………………….

………………………………………………………………….


3.12 Are any of the company’s directors, trustees, managers, principle shareholders or stakeholders in service of the state.

Yes No



………………………………………………………………….

………………………………………………………………….

3.13 Are any spouse, child or parent of the company’s directors trustees, managers, principle shareholders or stakeholders in

service of the state?

Yes No


3.13.1 If yes, furnish particulars.

………………………………………………………………….

………………………………………………………………….

3.14 Do you or any of the directors, trustees, managers, principle shareholders, or stakeholders of this company

have any interest in any other related companies or business whether or not they are bidding for this contract .

Yes No



3.14.1 If yes, furnish particulars.

………………………………………………………………….

………………………………………………………………….

4. Full details of directors / trustees / members / shareholders.

Full Name Identity Number State Employee Number


CERTIFICATION OF CORRECTNESS OF INFORMATION SUPPLIED IN THIS DOCUMENT

I/ WE, THE UNDERSIGNED, WHO WARRANT THAT I AM DULY AUTHORISED TO DO SO ON BEHALF OF THE TENDERER,

CERTIFY THAT THE INFORMATION SUPPLIED IN TERMS OF THIS DOCUMENT IS CORRECT AND TRUE, THAT THE

SIGNATORY TO THIS DOCUMENT IS DULY AUTHORISED AND ACKNOWLEDGE THAT:

(1) The tenderer will furnish documentary proof regarding any tendering issue to the satisfaction of uMhlathuze Municipality, if

requested to do so.

(2) If the information supplied is found to be incorrect and/or false then uMhlathuze Municipality, in addition to any remedies it

may have, may:

(a) Recover from the contractor all costs, losses or damages incurred or sustained by uMhlathuze Municipality as a result of the

award of the contract, and/or

(b) Cancel the contract and claim any damages which uMhlathuze Municipality may suffer by having to make less favourable

arrangements after such cancellation.

DATE : ……………………………………………… SIGNATURE : …………………………………………

CAPACITY : ……………………………………………… NAME OF BIDDER : …………………………………………

MBD 8

DECLARATION OF BIDDER’S PAST SUPPLY CHAIN MANAGEMENT PRACTICES


Item Question Yes No

4.1 Is the bidder or any of its directors listed on the National Treasury’s Database of Restricted Suppliers as companies or

persons prohibited from doing business with the public sector?

(Companies or persons who are listed on this Database were informed in writing of this

restriction by the Accounting Officer/Authority of the institution that imposed the restriction after

the 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.

Yes

No

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 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.

Yes

No


4.3 Was the bidder or any of its directors convicted by a court of law (including a court of law

outside the Republic of South Africa) for fraud or corruption during the past five years?

Yes

No

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

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



Item Question Yes No

4.4 Does the bidder or any of its directors owe any municipal rates and taxes or municipal charges

to the municipality / municipal entity, or to any other municipality / municipal entity, that is in

arrears for more than three months?

Yes

No


4.5 Was any contract between the bidder and the municipality / municipal entity or any other organ

of state terminated during the past five years on account of failure to perform on or comply with

the contract?

Yes

No


CERTIFICATION


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


MBD 9

CERTIFICATE OF INDEPENDENT BID DETERMINATION

I, the undersigned, in submitting the accompanying bid:

________________________________________________________________________

(Bid Number and Description)

in response to the invitation for the bid made by:

______________________________________________________________________________

(Name of Municipality / Municipal Entity)

do hereby make the following statements that I certify to be true and complete in every respect:

I certify, on behalf of:_______________________________________________________that:

(Name of Bidder)

1. I have read and I understand the contents of this Certificate;


2. I understand that the accompanying bid will be disqualified if this Certificate is found not to be true and complete

in every respect;

3. I am authorized by the bidder to sign this Certificate, and to submit the accompanying bid, on behalf of the bidder;

4. Each person whose signature appears on the accompanying bid has been authorized by the bidder to determine

the terms of, and to sign, the bid, on behalf of the bidder;

5. For the purposes of this Certificate and the accompanying bid, I understand that the word “competitor” shall include

any individual or organization, other than the bidder, whether or not affiliated with the bidder, who:

(a) has been requested to submit a bid in response to this bid invitation;

(b) could potentially submit a bid in response to this bid invitation, based on their qualifications,

abilities or experience; and

(c) provides the same goods and services as the bidder and/or is in the same line of business as

the bidder

6. The bidder has arrived at the accompanying bid independently from, and without consultation, communication,

agreement or arrangement with any competitor. However communication between partners in a joint venture or

consortium³ will not be construed as collusive bidding.

³ Joint venture or Consortium means an association of persons for the purpose of combining their expertise, property, capital, efforts, skill and knowledge

in an activity for the execution of a contract.

7. In particular, without limiting the generality of paragraphs 6 above, there has been no consultation,

communication, agreement or arrangement with any competitor regarding:

(a) prices;

(b) geographical area where product or service will be rendered (market allocation)

(c) methods, factors or formulas used to calculate prices;

(d) the intention or decision to submit or not to submit, a bid;

(e) the submission of a bid which does not meet the specifications and conditions of the bid; or

(f) bidding with the intention not to win the bid.

8. In addition, there have been no consultations, communications, agreements or arrangements with any competitor

regarding the quality, quantity, specifications and conditions or delivery particulars of the products or services to

which this bid invitation relates.


9. The terms of the accompanying bid have not been, and will not be, disclosed by the bidder, directly or indirectly,

to any competitor, prior to the date and time of the official bid opening or of the awarding of the contract.

10. I am aware that, in addition and without prejudice to any other remedy provided to combat any restrictive practices

related to bids and contracts, bids that are suspicious will be reported to the Competition Commission for

investigation and possible imposition of administrative penalties in terms of Section 59 of the Competition Act No

89 of 1998 and or may be reported to the National Prosecuting Authority (NPA) for criminal investigation and or

may be restricted from conducting business with the public sector for a period not exceeding ten (10) years in

terms of the Prevention and Combating of Corrupt Activities Act No 12 of 2004 or any other applicable legislation.

………………………………………... …………………………..

SIGNATURE DATE

………………………………………. …………………………..

POSITION NAME OF BIDDER

request for quotation for goods and services for the …

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