THIS REQUEST FOR PROPOSAL (THE “RFP”) IS TO INVITE BIDDERS TO SUBMIT A FIRM, FIXED PRICE PROPOSAL FOR THE LEASE OF APPROXIMATELY 240M² TO 270M² HEALTH FACILITY (CLINIC) AND 5 TO 10 ONSITE, UNDERCOVER PARKING SPACES OR WITHIN THE CLOSE PROXIMITY OF THE PROPOSED HEALTH FACILITY (CLINIC) IN SPRINGFONTEIN, XHARIEP DISTRICT MUNICIPALITY IN THE FREE STATE PROVINCE.
BID NUMBER : DPWFS RFP 036/2016

ADVERT DATE:

31 MARCH2017

CLOSING DATE AND TIME:

05 MAY 2017 AT 11:00 AM

COMPULSORY CLARIFICATION MEETING:

A COMPULSORY CLARIFICATION MEETING WILL TAKE PLACE AT CNR ST. ANDREW AND MARKGRAAF STREET, O.R TAMBO HOUSE (OLD LEBOHANG BUILDING), 8TH FLOOR AUDITORIUM ON FRIDAY, 21 APRIL 2017 STARTING AT 09H00

VALIDITY PERIOD OF THE PROPOSAL:

90 DAYS

ENQUIRIES

BIDDING PROCESS: MR. LETSHEGO TAU – OR051 492 3887

TECHNICAL: MR. MAKHORO SEETSI – OR 051410 7540

PUBLIC NOTICE

INVITATION TO TENDER

BID NUMBER: DPWFS RFP 036/2016

THIS REQUEST FOR PROPOSAL (THE “RFP”) IS TO INVITE BIDDERS TO SUBMIT A FIRM, FIXED PRICE PROPOSAL FOR THE LEASE OF APPROXIMATELY 240M² TO 270M² HEALTH FACILITY (CLINIC) AND 5 TO 10 ONSITE, UNDERCOVER PARKING SPACES OR WITHIN THE CLOSE PROXIMITY OF THE PROPOSED HEALTH FACILITY (CLINIC) IN SPRINGFONTEIN, XHARIEP DISTRICT MUNICIPALITY IN THE FREE STATE PROVINCE.

(THE LETTABLE SPACE OF THE PROPOSED BUILDING SHOULD NOT BE LESS THAN OR MORE THAN THE REQUIRED SPACE AS STATED ON THIS RFP)

Tenders must be deposited in the tender box situated on the Ground floor(Main Entrance Foyer), O.R Tambo House (Old Lebohang Building); Cnr. St Andrew and Markgraaf Street; Bloemfontein. Tender document(s) must be submitted by no later than 11:00 am on 05May2017.

Please note that tenders, which are not submitted in a properly sealed and marked envelope and / or are not deposited in the relevant tender box and / or are deposited after the closing date and time, will not be considered. Faxed tenders will not be considered.

Clarification Meeting:

A compulsory clarification meeting will take place as follows:

Date: Friday, 21 April 2017

Time:09h00

Venue:Cnr. St. Andrew and Markgraaf Street, O.R Tambo House (Old Lebohang Building), 8th Floor Auditorium, Bloemfontein

Failure to attend this clarification meeting will lead to disqualification.

NOTE:

Bid documents are obtainable free of charge from the e-tender portal at from Friday, 21 May 2017. OR

Bid Documents will be available at the Department of Public Works and Infrastructure, Charlotte Maxeke Street, Syfrets Building, 1st Floor, Room 104. However, a non-refundable tender / bid deposit of R 267.00 per set payable in cash is required on collection of the bid document. [Payments to be made at the O.R Tambo House, 1st floor, Room 123]

The Department is not bound to accept any tender and reserves the right to accept any tender in whole or in part.

CONTENTS

SECTION 1: ______RETURNABLE DOCUMENTS

SECTION 2: ______TERMS OF REFERENCE

SECTION 3: ______BID OFFER

SECTION 1: RETURNABLE DOCUMENTS

Responsiveness Criteria

Mandatory documents:

  • A valid Tax Clearance Certificate, or a unique security Personal Identification number (PIN) issued by the South African Revenue Services (where Consortium / Joint Venture / Sub-contractors are involved, each party to the association must submit a separate Valid Tax Clearance Certificate or a unique security personal Identification number)
  • Municipal services (water, sanitation, rates and electricity) clearance certificate or Lease Agreement with a Current Bill of Account not owing more than Ninety (30) days.
  • Valid Proof of Registration on the National Treasury`s Central Supplier`s Database must be accompany this bid
  • A Valid original or certified proof of property ownership registration (Deeds Registration) or Sales Agreement of the building which is exchanging hands and Certified copies of Directors’ Identity Documents.
  • The building must be within the geographic boundaries specified in the bid documents in Springfontein, Xhariep District Municipality.
  • The size of accommodation offered may not be less than the minimum lettable area specified in the bid documentation.
  • Attendance of the Mandatory clarification meeting the details of which are listed in the tender notice and invitation.
  • Proof that the proposed building is zoned as a Community and Institutional use zones (e.g. schools, clinics or places of worship) as per the provisions of the Spatial Planning and Land Use Management Act No. 16 of 2013 (Zone Certificate Issued by Mangaung Metropolitan Municipality).

Returnable Documents

Returnable Documents will be used for tender evaluation purposes and be incorporated into the contract

The tenderer must return the following returnable documents legibly completed and signed in FULL.

1.Resolution of Board of Directors

2.Resolution of Board of Directors to enter into Consortia Or Joint Ventures (in case of Joint Venture or Consortia)

3.Special Resolution of Consortia or Joint Ventures.

4.Certified B-BBEE Certificate issued by a South African National Accreditation System (SANAS) or Auditors approved and registered by the Independent Regulatory Board of Auditors (IRBA), where Consortium / Joint Venture are involved Bidders are to hand in their consolidated B-BBEE certificates.

5.Standard Bidding Document 1 (SBD 1) – Invitation to Bid

6.Standard Bidding Document 2 (SBD 2) – Application for Tax Clearance Certificate

7.Standard Bidding Document 4 (SBD 4) – Declaration of Interest

8.Standard Bidding a Document 6.1 (SBD 6.1) – Preference points claim form in terms of the Preferential Procurement Regulations 2011.

9.Standard Bidding Document 8 (SBD 8) – Declaration of Bidder’s Past Supply Chain Management Practices.

10.Standard Bidding Document 9 (SBD 9) - Certificate of Independent Bid Determination

LIST OF RETURNABLE DOCUMENTS

1.THE BIDDER MUST COMPLETE THE FOLLOWING RETURNABLE DOCUMENTS:

Bid Document Name: / Number of Pages: / Returnable document:
Resolution of Board of Directors / 1 Pages
Resolution of Board of Directors to enter into Consortia or JV / 2 Pages
Special Resolution of Consortia or Joint Venture / 3 Pages
SBD 1: Invitation to Bid / 1Pages
SDB 2: Application for Tax Clearance Certificate / 2 Pages
SBD 4: Declaration of Interest / 4 Pages
SBD 6.1: Preference Points Claim Form in terms of the PPR 2011 / 6 Pages
SBD8: Declaration of Bidder’s Past Supply Chain Management Practice / 2 Pages
SBD 9: Certificate of Independent Bid Documentation / 4 Pages
Pages
Pages
Pages
Pages
Pages
Name of Bidder / Signature / Date

RESOLUTION OF BOARD OF DIRECTORS

RESOLUTIONof ameetingof theBoardof *Directors/Members/Partnersof:

(legallycorrectfullnameandregistrationnumber,ifapplicable,ofthe Enterprise)

Heldat (place)

on (date)

RESOLVEDthat:

1TheEnterprisesubmitsaTendertotheDepartmentof Public Works and Infrastructure, Free State Province inrespectof thefollowingproject:

(projectdescription asper Tender Document)

TenderNumber: (TenderNumberas perTenderDocument)

2*Mr/Mrs/Ms:

in*his/herCapacityas: (PositionintheEnterprise)

andwhowillsignasfollows:

be,andishereby,authorised tosigntheTender,andany andallotherdocumentsand/or correspondence inconnectionwithandrelatingtotheTender,aswellastosignanyContract,andany andalldocumentation,resultingfrom theawardof theTendertotheEnterprisementionedabove.

Name / Capacity / Signature
1
2
3
4
5
6
7
8

Note:ENTERPRISESTAMP

1.*Delete which isnotapplicable.

2.NB.Thisresolutionmustbesignedbyall theDirectors/Members/Partnersof the Tendering Enterprise.

1

RESOLUTION OF BOARD OF DIRECTORSTOENTER INTO CONSORTIAOR JOINT VENTURES

RESOLUTIONof ameetingof theBoardof *Directors/Members/Partnersof:

(Legallycorrectfullnameandregistrationnumber,ifapplicable,ofthe Enterprise)

heldat (place) on (date) RESOLVEDthat:

1 TheEnterprisesubmitsaTender,inconsortium/jointventurewiththefollowingEnterprises:

(Listallthelegallycorrectfullnamesandregistration numbers,ifapplicable,ofthe Enterprisesforming theconsortium/joint venture)

totheDepartmentof Public Works and Infrastructure, Free State Province inrespectof thefollowingproject:

(Projectdescriptionasper TenderDocument)

TenderNumber: (Tender Number asper Tender Document)

2 *Mr/Mrs/Ms:

in*his/herCapacityas: (Positionin the Enterprise)

andwhowillsignasfollows:

be,andishereby,authorisedtosignaconsortium/joint ventureagreementwiththepartieslistedunder item1above,andany andallotherdocuments and/orcorrespondenceinconnectionwithandrelatingto theconsortium/jointventure,inrespectof theprojectdescribedunderitem 1above.

3 TheEnterpriseacceptjointandseveralliabilitywiththepartieslistedunderitem1aboveforthedue fulfilmentoftheobligationsofthe jointventurederivingfrom, andin anywayconnectedwith,theContractto beenteredintowiththeDepartmentinrespectoftheprojectdescribedunderitem1above.

4 TheEnterprisechoose asitsdomiciliumcitandi etexecutandiforallpurposes arising fromthisjointventure agreementandtheContractwiththeDepartmentinrespectoftheprojectunderitem1above:

Physicaladdress:

(code)

PostalAddress:

(code)

Telephonenumber: ______code)

Faxnumber:

(code)

Name / Capacity / Signature
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Note:ENTERPRISESTAMP

1.* Delete whichisnotapplicable.

2.NB.Thisresolutionmustbesignedbyall theDirectors/Members/Partnersof the Tendering Enterprise.

3.Should the number of Directors / Members/Partnersexceed the space available above, additional names, capacityand signaturesmustbe supplied ona separatepage.

SPECIAL RESOLUTION OF CONSORTIAOR JOINT VENTURES

RESOLUTIONofameetingofthedulyauthorisedrepresentatives ofthefollowinglegalentitieswhohave entered intoaconsortium/jointventuretojointlytenderfortheprojectmentionedbelow:(legallycorrectfullnames andregistrationnumbers,ifapplicable,ofthe Enterprisesforminga consortium/jointventure)

1

2

3

4

5

6

7

8

Heldat (place)

on (date)

RESOLVEDthat:

A. Theabove-mentionedEnterprisessubmitatender inconsortium/jointventuretotheDepartmentofPublic and Infrastructure Works, Free State Province inrespectof thefollowingproject:

(Projectdescriptionasper TenderDocument)

TenderNumber: (Tender Number asper Tender Document)

B. Mr/Mrs/Ms:

in*his/herCapacityas: (Positionin the Enterprise)

andwhowillsignasfollows:

be,and ishereby,authorisedto signthetender,andanyandallotherdocumentsand/orcorrespondence inconnectionwithandrelatingtothetender,aswellastosignany Contract,andany andall documentation,resultingfromtheawardofthetendertotheEnterprisesinconsortium/jointventure mentionedabove.

C. TheEnterprisesconstitutingtheconsortium/jointventure,notwithstandingitscomposition,shallconduct allbusinessunderthenameandstyleof:

D. TheEnterprisestotheconsortium/jointventureacceptjointandseveralliabilityfortheduefulfilmentof theobligationsofthe consortium/jointventurederivingfrom,andinanywayconnectedwith,theContract enteredintowiththeDepartmentinrespectof theprojectdescribedunderitem Aabove.

E. AnyoftheEnterprises totheconsortium/jointventureintendingtoterminatetheconsortium/jointventure agreement, forwhateverreason,shallgivetheDepartment 30dayswrittennoticeofsuchintention. Notwithstandingsuchdecisiontoterminate,theEnterprisesshallremainjointlyand severallyliabletothe Departmentfortheduefulfilmentoftheobligationsoftheconsortium/joint ventureasmentionedunder item Dabove.

F. NoEnterprisetotheconsortium/joint ventureshall,withoutthepriorwrittenconsentoftheother Enterprisestotheconsortium/jointventureandoftheDepartment,cedeanyofitsrightsorassign anyof itsobligationsundertheconsortium/joint ventureagreementinrelationtotheContractwiththe Departmentreferredtoherein.

G. TheEnterpriseschooseasthedomiciliumcitandietexecutandioftheconsortium/jointventureforall purposesarisingfromtheconsortium/joint ventureagreementandtheContractwiththeDepartmentin respectof theprojectunderitem Aabove:

Physicaladdress:

(code)

PostalAddress:

(code)

Telephonenumber: (code)

SBD 1

INVITATION TO BID

YOU ARE HEREBY INVITED TO BID FOR REQUIREMENTS OF THE (NAME OF DEPARTMENT/PUBLIC ENTITY)

BID NUMBER: DPWFS RFP 036/2016CLOSING DATE: 05 MAY 2017CLOSING TIME: 11:00

DESCRIPTION:THIS REQUEST FOR PROPOSAL (THE “RFP”) IS TO INVITE BIDDERS TO SUBMIT A FIRM, FIXED PRICE PROPOSAL FOR THE LEASE OF APPROXIMATELY 240M² TO 270M² HEALTH FACILITY (CLINIC) AND 5 TO 10 ONSITE, UNDERCOVER PARKING SPACES OR WITHIN THE CLOSE PROXIMITY OF THE PROPOSED HEALTH FACILITY (CLINIC) IN SPRINGFONTEIN, XHARIEP DISTRICT MUNICIPALITY IN THE FREE STATE PROVINCE.

The successful bidder will be required to fill in and sign a written Contract Form (SBD 7).

DEPOSITED IN THE BID BOX SITUATED AT (STREET ADDRESS)

Cnr. St’ Andrews and Markgraaf Street

O.R Tambo House (Old Lebohang Building)

Ground Floor (Main Entrance Foyer)

Bloemfontein

Bidders should ensure that bids are delivered timeously to the correct address. If the bid is late, it will not be accepted for consideration.

The bid box is generally open 24 hours a day, 7 days a week.

ALL BIDS MUST BE SUBMITTED ON THE OFFICIAL FORMS – (NOT TO BE RE-TYPED)

THIS BID IS SUBJECT TO THE PREFERENTIAL PROCUREMENT POLICY FRAMEWORK ACT AND THE PREFERENTIAL PROCUREMENT REGULATIONS, 2011, THE GENERAL CONDITIONS OF CONTRACT (GCC) AND, IF APPLICABLE, ANY OTHER SPECIAL CONDITIONS OF CONTRACT

THE FOLLOWING PARTICULARS MUST BE FURNISHED
(FAILURE TO DO SO MAY RESULT IN YOUR BID BEING DISQUALIFIED)

NAME OF BIDDER………………………………………………………………………………………………………………………

POSTAL ADDRESS………………………………………………………………………………………………………………….

STREET ADDRESS…………………………………………………………………………………………………………………

TELEPHONE NUMBERCODE……………NUMBER………………………………………………………………………………..

CELLPHONE NUMBER…………………………………………………………………………………………………………………

FACSIMILE NUMBERCODE ………… .NUMBER…………………………………………………………………………………

E-MAIL ADDRESS………………………………………………………………………………………………………………….

VAT REGISTRATION NUMBER……………………………………………………………………………………………

HAS AN ORIGINAL AND VALID TAX CLEARANCE CERTIFICATE BEEN SUBMITTED? (SBD 2)YES or NO

HAS A B-BBEE STATUS LEVEL VERIFICATION CERTIFICATE BEEN SUBMITTED? (SBD 6.1) YES or NO

IF YES, WHO WAS THE CERTIFICATE ISSUED BY?

AN ACCOUNTING OFICER AS CONTEMPLATED IN THE CLOSE CORPORATION ACT (CCA)…….…………….………………...

A VERIFICATION AGENCY ACCREDITED BY THE SOUTH AFRICAN ACCREDITATION SYSTEM (SANAS); R………………….

A REGISTERED AUDITOR ………………………………...…………………………………………………………………………………..

[TICK APPLICABLE BOX]

(A B-BBEE STATUS LEVEL VERIFICATION CERTIFICATE MUST BE SUBMITTED IN ORDER TO QUALIFY FOR PREFERENCE POINTS FOR B-BBEE)

ARE YOU THE ACCREDITED REPRESENTATIVE

IN SOUTH AFRICA FOR THE GOODS / SERVICES / WORKS OFFERED?YES or NO

[IF YES ENCLOSE PROOF]

SIGNATURE OF BIDDER ………………………………………………………………………………………………

DATE………………………………………………………………………………………………

CAPACITY UNDER WHICH THIS BID IS SIGNED………………………………………………………………………………………………

TOTAL BID PRICE………………………………………………………………….IN WORDS…………………......

………………………………………………………………………………………………………… (VAT INCLUSIVE)

______

ANY ENQUIRIES REGARDING THE BIDDING PROCEDURE MAY BE DIRECTED TO:

Department: Public Works and Infrastructure

Contact Person: Mr. Letshego Tau

Tel: 051 492 3887

E-mail address:

ANY ENQUIRIES REGARDING TECHNICAL INFORMATION MAY BE DIRECTED TO:

Contact Person:Mr. Makhoro Seetsi

Tel: 051410 7540

E-mail address:

SBD 2

TAX CLEARANCE REQUIREMENTS

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

  1. In order to meet his requirement bidders are required to complete in full the attached 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.
  1. 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.
  1. 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.
  1. In bids where Consortia / Joint Venture / Sub-contractors are involved, each party must submit a separate Tax Clearance Certificate.
  1. Copies of the TCC 001 “Application for a Tax Clearance Certificate” form are available from any SARS branch office nationally or on the website
  1. Applications for the 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

SBD 2

-2-

  1. 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: ………………………………………………

(1)Adress……………………………………………………………………………………………………………………………….……………………………….……………………………………………………………………………….…………………………………………………….…………………..

DATE: 20……/……./………

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 UNDER PAYMENT OF TAXES, DUTIES OR LEVIES OR THE RENDITION RETURNS BY ANY PERSON AS A RESULT OF ANY SYSTEM NOT BEING YEAR 2000 COMPLIANT

SBD 4

DECLARATION OF INTEREST

1.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 this 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 positionin relation to the evaluating/adjudicating authority where-

-the bidder is employed by the state; and/or

-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.

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

2.2Identity Number: …………………………………………………………………………………………………

2.3Position occupied in the Company (director, trustee, shareholder²): ……………………………………..

2.4Company Registration Number: ………………………………………………………………………..…….

2.5Tax Reference Number: ………………………………………………………………………………….………

2.6VAT Registration Number: ………………………………………………………………………………....

2.6.1The names of all directors / trustees / shareholders / members, their individual identity numbers, tax reference numbers and, if applicable, employee / persal numbers must be indicated in paragraph 3 below.

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; or

(e)Parliament.

²”Shareholder” means a person who owns shares in the company and is actively involved in the management of the enterprise or business and exercises control over the enterprise.

2.7 Are you or any person connected with the bidder YES / NO

presently employed by the state?

2.7.1If so, furnish the following particulars:

Name of person / director / trustee / shareholder/ member: ……....………………………………

Name of state institution at which you or the person connected to the bidder is employed : ………………………………………

Position occupied in the state institution: ………………………………………

Any other particulars:

………………………………………………………………

………………………………………………………………

………………………………………………………………

2.7.2If you are presently employed by the state, did you obtainYES / NO

the appropriate authority to undertake remunerative

work outside employment in the public sector?

2.7.2.1If yes, did you attached proof of such authority to the bidYES / NO

document?

(Note: Failure to submit proof of such authority, where

applicable, may result in the disqualification of the bid.

2.7.2.2If no, furnish reasons for non-submission of such proof:

…………………………………………………………………….

…………………………………………………………………….

…………………………………………………………………….

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

trustees / shareholders / members or their spouses conduct

business with the state in the previous twelve months?

2.8.1If so, furnish particulars:

…………………………………………………………………..

…………………………………………………………………..

…………………………………………………………………...

2.9Do you, or any person connected with the bidder, haveYES / NO

any relationship (family, friend, other) with a person

employed by thestate and who may be involved with

the evaluation and or adjudication of this bid?

2.9.1 If so, furnish particulars.

……………………………………………………………...

…………………………………………………………..….

………………………………………………………………

2.10 Are you, or any person connected with the bidder,YES/NO

aware of any relationship (family, friend, other) between

any other bidder and any person employed by the state

who may be involved with the evaluation and or adjudication

of this bid?

2.10.1If so, furnish particulars.

………………………………………………………………

………………………………………………………………

………………………………………………………………

2.11Do you or any of the directors / trustees / shareholders / members YES/NO

of the company have any interest in any other related companies

whether or not they are bidding for this contract?

2.11.1If so, furnish particulars:

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….

3Full details of directors / trustees / members / shareholders.

Full Name / Identity Number / Personal Tax Reference Number / State Employee Number / Persal Number

DECLARATION

I, THE UNDERSIGNED (NAME)…………………………………………………………………… CERTIFY THAT THE INFORMATION FURNISHED IN PARAGRAPHS 2 and 3 ABOVE IS CORRECT. I ACCEPT THAT THE STATE MAY REJECT THE BID OR 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

SBD 6.1

PREFERENCE POINTS CLAIM FORM IN TERMS OF THE PREFERENTIAL PROCUREMENT REGULATIONS 2011

This preference form must form part of all bids invited. It contains general information and serves as a claim form for preference points for Broad-Based Black Economic Empowerment (B-BBEE) Status Level of Contribution

NB:BEFORE COMPLETING THIS FORM, BIDDERS MUST STUDY THE GENERAL CONDITIONS, DEFINITIONS AND DIRECTIVES APPLICABLE IN RESPECT OF B-BBEE, AS PRESCRIBED IN THE PREFERENTIAL PROCUREMENT REGULATIONS, 2011.

  1. GENERAL CONDITIONS

1.1The following preference point systems are applicable to all bids:

-the 80/20 system for requirements with a Rand value of up to R1 000 000 (all applicable taxes included); and

-the 90/10 system for requirements with a Rand value above R1 000 000 (all applicable taxes included).

1.2The value of this bid is estimated to exceed/not exceed R1 000 000 (all applicable taxes included) and therefore the……………………system shall be applicable.

1.3Preference points for this bid shall be awarded for: