A-4 FormPromotional gifts for Slovenian EU presidencyApplication

APPLICATION

Promotional gifts for Slovenia's presidency of the EU

Procurement of backpacks, towels, caps and scarves, and USB keys with integrated software

(In the case of a joint bid, each partner is required to complete a separate application form)

1GENERAL INFORMATION ABOUT THE BIDDER

1.1BIDDER

Name and head office / Country of the head office
Candidate

1.2CONTACT PERSON

First name(s) and surname
Telephone
Fax
E-mail

1.3BUSINESS AND FINANCIAL DATA (in EUR)

Financial data / Year before last / Last year / This year
/ Next year / Average
Annual revenues, excluding this contract
Short-term coefficient (Current assets/ Short-term obligations)

Integral part of EPRO system©.

A-4 FormPromotional gifts for Slovenian EU presidencyApplication

1.4 REFERENCES

Ref. <No.> / Project title
Legal entity / Country / Overall project value / Proportion carried out by legal entity [%] / Client / Dates
(start/end of project) / Names of partners
(if any)
Detailed description of the project, containing the references and areas relevant to the project.

Integral part of EPRO system©.

A-4 FormPromotional gifts for Slovenian EU presidency Application

1.5REGISTRATION AND ACTIVITIES

Registration data
Name registered
Number / Date / Registration authority
First registration
Last modification
Modification(s) of registration data not yet included in register
Description
Activities
NACE nomenclature / Description

2STATEMENT

I, the undersigned, being the authorised signatory of the above bidder applying for the tender procedure referred to above, hereby declare that we are aware of all the terms, award criteria and other contents of the contract papers and bid documentation. If our bid is accepted:

we fully intend to submit all insurance documents.

We are fully aware that our bid will be excluded if:

we submit information which is untrue;

we do not submit in time all the required verification and insurance documents when the contracting authority so requests; or if we in any other way prevent the contracting authority from entering into the contract with us as a result of this tender procedure;

we break the provisions of the contract awarded to us on the basis of this bid.

I hereby declare that:

  • we are not participating in any other application for the same contract, neither as individual candidates, nor as partners in a consortium;
  • all the information we have provided in the bid are true, and we assume full responsibility for the information and truthfulness thereof;
  • we are not in any situation excluding us from participating in contracts listed in the Public Procurement Act of Slovenia in GTC or in other contract papers for this award procedure;
  • we have listed only references of successfully concluded projects;
  • we will inform the contracting authority immediately if there is any change in the above circumstances at any stage during the implementation of the contract.

By signing this statement, the bidder confirms the fulfilment of the following conditions:

-the bidder and all his/her legal representatives, if the bidder is a legal entity, has not been convicted by a final judgement for any of the offences laid down in Article 42, Paragraph 1, of the Public Procurement Act ZJN-2;

-the bidder has paid all taxes and contributions;

-the bidder has settled all arrears to his/her subcontractors from previous award procedures;

Signed on behalf of the bidder:

First name(s) and surname
Signature
Date

Integral part of EPRO system©.

A-4 FormPromotional gifts for Slovenian EU presidency Application

INSTRUCTIONS FOR COMPLETING THE FORM[*]: Application (A-4 Form)

The bidder completes the application form only with information relating to business entities applying for the tender.

The Application form consists of:

  1. General information about the bidder;
  2. The statement – the last part of application, which must be signed by the authorised signatory of the bidder.

Part 1: GENERAL INFORMATION ABOUT THE BIDDER

1.1 – BIDDER:

Provide the name and the address of the head office of the business entity applying for the tender, and the country where the head office is located.

1.2 – CONTACT PERSON:

Provide all the required information about the person whom the contracting authority can contact with regard to this tender procedure.

If the contracting authority has published an electronic auction, the invitation for tenders with all supporting documents is sent to the e-mail address provided under this heading.

1.3 – BUSINESS AND FINANCIAL DATA:

The bidder completes the form with financial data. These must be based on verified annual financial statements, and latest company reports. Provisional figures (e.g. those not based on official balance sheets) should be entered in italics. Figures in all columns must have the same basis in order to facilitate direct comparison of individual years. If from some reason this is not possible (e.g. if the basis has changed), the business entity must provide an explanation (a note below the table).

Data must be entered in individual columns.

Annual revenues (excluding this contract) – revenues generated through the entity’s normal operations (e.g. sales of goods, provision of services, interest, dividends) accumulated over the entire year (the item is indicated in the profit and loss account under AOP 102 – gross operating income).

Current ratio (current assets/current liabilities) – the data is taken from the forecast balance sheet. Current assets are indicated under item AOP 022, and are divided by current liabilities indicated under AOP 075. For the current year, the amount of the current ratio is forecast on the basis of the previous period by considering the projected short-term liabilities of the company in the current year.

1.4 – REFERENCES

The bidder provides an overview of their most important projects from the last 3 years that are relevant to the tender procedure (public contract) he/she is applying for, and in such a way as to demonstrate the fulfilment of the conditions of the contract and supporting documentation. Each reference should be entered into a separate table (by copy-pasting the table as necessary). The bidder must number the references by entering the consecutive number for each reference in the place of <No.> in the Ref. <No.> field. The country field refers to the country in which the project was carried out.

1.5 – REGISTRATION AND ACTIVITIES

Registration data – provide the full registered name of the business entity, the number, date, and the registration authority that recorded the latest change in the register. Complete the lower part of the table with information on any modifications that have occurred, but have not yet been entered in the register.

Activities – the bidder states the main business activities he/she is actually involved in using the NACE nomenclature.

Part 2: STATEMENT

The bidder must carefully read the statement and sign it. The statement must be signed by a representative or assignee who is also the authorised signatory of the bid.

NOTE: IN THE CASE OF A JOINT BID (CONSORTIUM), EACH PARTNER IS REQUIRED TO COMPLETE A SEPARATE APPLICATION FORM (A-4 FORM)

Integral part of EPRO system©.

[*] These instructions need not be enclosed with the application.