Supplier Database Documentation Supplier Name: ______

PREFERRED SUPPLIER DATABASE SUBMISION

Province: (Only one province may be indicated per submission)
Organisation Registered Name / Name of individual
Organisation Trading name:
Contact Person:
Telephone Number:
Fax Number:
e-mail address:

Contents:

Service Providers are to ensure that they have received all pages of this document, which consist of the following documents: The checklist must also be completed as a guideline for the Service Provider as to compliance with W&RSETA requirements for submission. Please note that non-compliance to any of these conditions may lead to your submission not being evaluated.

No / Description / Special Instruction
1 / Instructions for completion / To be completed in full
2 / Vendor Information Form / To be completed in full
3 / Bid commitment an declaration of interest / To be completed in full
4 / Tax clearance requirements / Valid original tax clearance certificate must be submitted
5 / Preference point claim form / To be completed in full
6 / General conditions of contract / Each page must be initialled

1INSTRUCTIONS FOR COMPLETION

  • In order to comply with the Supply Chain Framework Regulations (in terms of the PFMA), Service Providers are requested to please complete the bid forms included in this document.
  • Failure to complete these forms fully and return these forms may lead to disqualification of the Service Provider.
  • Please return original documents to the W&RSETA Head office :

W&RSETA House

224 Witch-Hazel Street

Highveld Technopark

Centurion

0046

  • Please clearly mark envelopes with the title “Supplier Database submission”, Service Provider name and contact information.Please make use of courier services if needed. Only originally signed submissions will be evaluated
  • All queries must be in writing and addressed to Tertia van der Merwe at :
  • No telephonic queries will be responded to.
  • All queries will be collated and the responses published on the W&RSETA Website (
  • All responses must be in the standard format as contained in this document. Responses which are not in this format will be disregarded.
  • The service/s for which the organisation would like to be registered must be marked by putting a cross (x) in the “applicable” column in the list of services hereunder.
  • Where there is a special requirement listed for a service, proof of compliance to such special requirement should be attached to the submission and marked “Special Requirement”. Should no such proof be attached, the assumption will be non-compliance to such special requirement and the submission will not be considered for that service.

Products and Services and Product and Service Codes

Code / Service Description / Criteria / Submission Requirement / Applicable?
SME016 / Assisting small organisations with their Completion of WSPs & ATRs / Previous experience in the completion of WSP/ATRs
Must have knowledge of seta processes and skills development. / CV with contactable references
Knowledge of the W&R sector would be an advantage
SME017 / Monitoring and Verification of learning / Previous experience in conducting site visits and progress reporting / C.V.
Knowledge of the W&R sector would be an advantage
SME018 / Project Management / Must have experience in project management. / CV with contactable references
Knowledge of seta processes and the NSDS Landscape
SME019 / Conducting workplace readiness assessments / Previous exposure to Learnership implementation / CV with contactable references
Knowledge of the W&R sector would be an advantage
SME020 / Sector Specialist services / Previous experience in skills development
Knowledge of the W&R sector would be an advantage / CV with contactable references
Knowledge of seta processes and the NSDS Landscape
SME021 / External Moderation / Competence in the Moderator Unit standard essential / Proof of competence
Knowledge of the W&R sector would be an advantage / C.V with contactable references
SME022 / Consulting services / Knowledge of the W&R sector would be an advantage / C.V with contactable references
Previous experience and expertise in the skills development environment
SME023 / Conducting strategic planning workshops for board members and managers / Previous experience and expertise in facilitating strategic planning sessions / C.V with contactable references
Knowledge of the W&R sector would be an advantage
Knowledge of seta processes and the NSDS Landscape

2. Vendor Information Form

You are kindly requested to complete this document accurately as the information contained herein is required for the following purposes:

  • To enable W&RSETA to compile a database of registered suppliers;
  • To support W&RSETA in the implementation of a system of preferences as required by the Preferential Procurement Policy Framework Act (No 5 of 2000).
  • Failure to complete the form in full may result in the supplier not being considered for the awarding of any orders or contracts by the W&RSETA.

PLEASE COMPLETE ALL PAGES.

Name of Company
Postal Address
Physical Address
Telephone No / Mobile Telephone No
Fax No / E-mail address
Company
Registration No / Tax Clearance
Certificate *
VAT RegistrationNo** / Tax registration No

*Are you registered in terms of sections 23(1) or 23(3) of the Value-added Tax Act, 1991 (Act No. 89 of 1991)? YES / NO

**An original Tax Clearance Certificate must be attached to this form –. Failure to do so can disqualify the bid.

For office use
Database reference / Master List number

1.Participation capacity (tick one box)

Prime contractor / Supplier
Sub-contractor / Professional services
Manufacturer / Joint Venture partner
Other, specify ………………………………………………………………………….

2.Type of firm (tickone box)

Partnership / One person business/sole trader
Close corporation / Company
Pty Ltd.
Other, specify ………………………………………………………………………….

3.Principal business activities (tick one box)

Security / Construction
Catering / Consulting
Manufacturer / Retailer/Distributor
Other, specify ………………………………………………………………………….

4.Business sector (tick one box)

Agriculture / Mining and Quarrying
Manufacturing / Electricity, Gas and Water
Retail and motor trade repair services / Construction
Wholesale trade, commercial agents & allied services / Community, social and personal services
Commercial Agents and other trade / Transport, storage and communication
Finance and business services / Commercial Agents and other trade
Other, specify ………………………………………………………………………….

5.Company classification (tick one box)

Contractor who generates more than 75% of turnover as a prime contractor / Contractor who generates less than 75% of turnover as a prime contractor
Labour – only sub-contractor / Manufacturer
Supplier / Professional service provider
Other, specify ………………………………………………………………………….

6.Products or services to offer to W&RSETA (fill in)

7.Total number of years the firm has been in business: ______

8.Total number of employees

Full time: ______Part time: ______

  1. Street address of all facilities used by the Firm (e.g. Warehouse, storage space, offices, etc.)

______

  1. Do you share any facilities? YES/NO

If yes, which facilities are shared? ______

With whom do you share facilities? (Name of firm/individuals).

______

______

  1. Is the firm registered or does it have a business license(s)?

YES/NO (if yes, give details and quote relevant reference numbers and dates)

______

  1. Detail all trade associations in which you have a membership:

______

______

  1. Did the firm exist under a previous name? YES / NO

If yes, what was its previous name? ______

Who were the owners/partners/directors? ______

  1. Identify any owner or management officer who has an interest in another firm

Name / Duties as employee in other firm / Name and address of other firm / Type of business of other firm
  1. What is the enterprise’s average annual turnover (excl. VAT) during the lesser of the period for which the business has been operating or the previous three financial years?

R ______

  1. The financial manager/ external auditor/ CEO/Accounting Officer (whichever is relevant to your type of business) needs to confirm the following:

The business/entity is:

A Going Concern Yes / No

In a Sound Financial Condition Yes / No

Have the financial & operational capacity to fulfil the contract requirements Yes / No

Signature______

Capacity______

  1. Identify by name, HDI status and length of service, those individuals in the firm (including owners and non-owners) responsible for the day-to-day management and business decisions

ACTIVITY / NAME / RACE / GENDER
M / F / DISABLED?
YES / NO * / LENGTH OF SERVICE (YEARS)
FINANCING DECISIONS
Cheque Signing
Acquisition of lines of credit
Sureties
Major Purchase or Acquisitions
Signing Contracts
ACTIVITY / NAME / RACE / GENDER
M / F / DISABLED?
YES / NO * / LENGTH
OF SERVICE
(YEARS)
MANAGEMENT DECISIONS
Estimating
Marketing and Sales Operation
Hiring & Firing of Management Personnel
Supervision of office personnel
Supervision of Field/
Production Activities
  1. List the four largest contracts/assignments completed by your firm in the last three years.

Work performed / For whom / Contact person and telephone number / Contract fee/amount

* Payment transactions:

Alternative payee
(This field is only to be filled in if payments are not to be made directly to the vendor to whom the payable is owed)

* Contact person: (Sales person)

Name / Telephone number

Bank Details:

Country
(Where bank is located)
Name of bank
Bank key
(Branch Number)
Bank account
(Account Number)
Account holder (Only to be filled in if the name of the account holder is not the same as the name oftheof the vendor)
Name of account
(Type of account)

Initials and Surname (Bank official): ______

Signature (Bank official): ______

Telephone Number (Bank Official): ______

Signature ______duly authorised to sign on behalf of

______(Name of organisation) address ______

Telephone no. ______

Date ______

COMMISSIONER OF OATHS:

Signature: ______Date: ______

STAMP

MUST BE DATE STAMPED AND SIGNED

BY A COMMISSIONER OF OATHS

Page 1 of 28

Supplier Database Documentation Supplier Name: ______

3. BID COMMITMENT AND DECLARATION OF INTEREST

PART A: BID COMMITMENT

  1. I/We hereby bid to supply all or any of the supplies and/or to render all or any of the services described in the proposal documents to the W&RSETA, on the terms and conditions and in accordance with the specifications stipulated in the bid documents (and which shall be taken as part of, and incorporated into, this bid) at the prices and on the terms regarding time for delivery and/or execution inserted therein.
  1. I/We agree that -

(a)the offer herein shall remain binding upon me/us and open for acceptance by the W&RSETA during the validity period indicated and calculated from the closing time of the bid;

(b)this bid and its acceptance shall be subject to the terms and conditions contained in the W&RSETA General Conditions of Contract (form VEND 01) and Preference Points Claim Forms – General Conditions and Definitions of the Preferential Procurement Policy Framework Act - PPPFA (PREF 01) with which I am/we are fully acquainted;

(c)if I/we withdraw my/our bid within the period for which I/we have agreed that the bid shall remain open for acceptance, or fail to fulfil the contract when called upon to do so, the W&RSETA may, without prejudice to its other rights, agree to the withdrawal of my/our bid or cancel the contract that may have been entered into between me/us and the W&RSETA and I/we will then pay to the W&RSETA any additional expense incurred by the W&RSETA having either to accept any less favourable bid or, if fresh bids have to be invited, the additional expenditure incurred by the invitation of fresh bids and by the subsequent acceptance of any less favourable bid; the W&RSETA shall also have the right to recover such additional expenditure by set-of against moneys which may be due or become due to me/us under this or any other bid or contract or against any guarantee or deposit that my have been furnished by me/us or on my/our behalf for the due fulfilment of this or any other bid or contract and pending the ascertainment of the amount of such additional expenditure to retain such moneys, guarantee or deposit as security for any loss the W&RSETA may sustain by reason of my/our default;

(d)if my/our bid is accepted the acceptance may be communicated to me/us by letter or order by ordinary post or registered post and that SA Post Office Ltd shall be regarded as my/our agent, and delivery of such acceptance to SA Post Office Ltd shall be treated as delivery to me/us;

(e)the law of the Republic of South Africa shall govern the contract created by the acceptance of my/our bid and that I/we choose citandi et executandi in the Republic at (full address of this place);

......

  1. I/We furthermore confirm that I/we have satisfied myself/ourselves as to the correctness and validity of my/our bid; that the price(s) and rate(s) quoted cover all the work/item(s) specified in the bid documents and that the price(s) and rate(s) cover all my/our obligations under a resulting contract and that I/we accept that any mistakes regarding price(s) and calculations will be at my/our risk.
  1. I/We hereby accept full responsibility for the proper execution and fulfilment of all obligations and conditions devolving on me/us under this agreement as the Principal(s) liable for the due fulfilment of any contract, which might be awarded based on this offer.
  1. I/We agree that any action arising from this contract may in all respects be instituted against me/us and I/we hereby undertake to satisfy fully any sentence or judgement which may be pronounced against me/us as a result of such action.
  1. I/We declare that I/we have participation/no participation* in the submission of any other offer for the supplies/services described in this RFP document. If in the affirmative, state names(s) of Service Provider(s) involved

......

* Delete whichever is not applicable.

  1. Are you duly authorised to sign the bid? *YES / NO
  1. Has the Declaration of Interest (part B of this form:) been duly completed? *YES / NO

PART B: DECLARATION OF INTEREST

1.Any legal person, including persons employed by the principal, or persons having a kinship with persons employed by the principal, 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 employed by the principal, or to persons connected with or related to them, it is required that the Service Provider or his/her authorised representative declare his/her position in relation to the evaluating/adjudicating authority and/or take an oath declaring his/her interest, where:

the Service Provider is employed by the principal; and/or

the Service Provider is a board member

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 declarantdeclaring 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 / Are you or any person connected with the Service Provider, employed by the principal? / Yes / No
2.1.2 / If so, state particulars:
2.2 / Do you, or any person connected with the Service Provider, have any relationship (family, friend, other) with a person employed by the principal and who may be involved with the evaluation and or adjudication of this bid? / Yes / No
2.2.1 / If so, state particulars
2.3 / Are you, or any person connected with the Service Provider, aware of any relationship (family, friend, other) between the Service Provider and any person employed by the principal who may be involved with the evaluation and or adjudication of this bid? / Yes / No
2.3.1 / If so, state particulars

DECLARATION

I, The undersigned (Name)

Hereby certify that the information furnished in paragraph 2.1 to 2.3.1 above is correct. I accept that the W&RSETA may act against me in terms of Paragraph 23 of the General Conditions of Contracts should this declaration prove to be false..

Signature / Date
Position / Name of Service Provider

Page 1 of 28

Supplier Database Documentation Supplier Name: ______

4. TAX CLEARANCE REQUIREMENTS

IT IS A CONDITION OF BIDDING THAT -

1.The taxes of the providermust be in order, or that satisfactory arrangements have been made with the Receiver of Revenue to meet his / her tax obligations.

2.The attached form “Application for Tax Clearance Certificate (in respect of bidders)” must be completed in all respects and submitted to the Receiver of Revenue where the Service Provider is registered for tax purposes.

The Receiver of Revenue will then furnish the Service Provider with a Tax Clearance Certificate that will be valid for a period of six (6) months from date of issue. This Tax Clearance Certificate must be submitted in the original together with the bid. Failure to submit the original and valid Tax Clearance Certificate may invalidate the bid.

3.In bids where Consortia / Joint Ventures / Sub-contractors are involved each party must submit a separate Tax Clearance Certificate. Copies of the Application for Tax Clearance Certificates are available at any Receiver’s Office.

APPLICATION FOR TAX CLEARANCE CERTIFICATE

(IN RESPECT OF BIDDERS)

1.Name of taxpayer / bidder: ......

2.Trade name: ...... ……......

3.Identification number:

4.Company / Close Corporation registration number:

5.Income tax reference number:

6.VAT registration number (if applicable):

7.PAYE employer’s registration number (if applicable):

Signature of contact person requiring Tax Clearance Certificate: ......

Name: ......

Telephone number: Code:………………… Number: ......

Address: ......

DATE: 20_____ / ______/ ______

PLEASE NOTE THAT THE COMMISSIONER FOR THE SOUTH AFRICAN REVENUE SERVICE (SARS) WILL NOT EXERCISE HIS DISCRETIONARY POWERS IN FAVOUR OF ANY PERSON WITH REGARD TO ANY INTEREST, PENALTIES AND / OR ADDITIONAL TAX LEVIABLE DUE TO THE LATE- OR UNDERPAYMENT OF TAXES, DUTIES OR LEVIES OR THE RENDITION RETURNS BY ANY PERSON AS A RESULT OF ANY SYSTEM NOT BEING YEAR 2000 COMPLIANT.

Page 1 of 28

Supplier Database Documentation Supplier Name: ______

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

GENERAL CONDITIONS AND DEFINITIONS

80/20 RULE: Estimated Value Less Than R 500 000 Per Incident