EDMS N°: XXXX 1

MS-XXXX/DEPT/PROJECT

MS-4069/GS
Market Survey
Technical Questionnaire
Provision of goods transport services

Firms interested shall return a completed questionnaire in duplicate.

In case of a combination of firms, the questionnaire shall be completed individually by each member of the combination of firms and returned in duplicate to CERN in the same envelope.

Firm compiling the questionnaire

Name:

Should you be qualified, are you interested in receiving the invitation to tender following this market survey?

Yes / No

If not, are you interested in being kept in CERN’s database?

Yes / No

If yes, please state your main activities which could be of interest to CERN with the name of the person to be contacted.

Main activities / Person to be contacted

11 MS-4069/GS

Table des Matières

1. general information about the firm compiling the questionnaire 4

1.1 Persons to Be Contacted for Technical Matters: 4

1.2 Persons to Be Contacted for Commercial Matters: 4

2. TYPE OF FIRM 4

2.1 Country of Origin of the Firm Compiling the Questionnaire 4

2.2 Country of Origin in Case of a Combination of Firms 5

2.3 Subcontracting 6

3. ADMINISTRATIVE SITUATION 6

4. COMPETENCE AND EXPERIENCE 7

4.1 Competence 7

4.2 Electronic Business 11

4.3 References 14

5. sIZE 14

6. QUALITY ASSURANCE 14

6.1 ISO 9001 14

6.2 ISO 14001 15

7. COMMUNICATION 15

8. COMPLIANCE WITH THE QUALIFICATION CRITERIA 16

9. GENERAL COMMENTS 16

1.  general information about the firm compiling the questionnaire

1.1  Persons to Be Contacted for Technical Matters:

Name / Tel-Fax / Email
Mr. Mrs.
/ Tel:
Fax:
In case of absence:
Mr. Mrs.
/ Tel:
Fax:

1.2  Persons to Be Contacted for Commercial Matters:

Name / Tel-Fax / Email
Mr. Mrs.
/ Tel:
Fax:
In case of absence:
Mr. Mrs.
/ Tel:
Fax:

2.  TYPE OF FIRM

2.1  Country of Origin of the Firm Compiling the Questionnaire

The term «country of origin» shall mean the country in which the firm compiling the questionnaire is established. This should be within one of the CERN Member States or, under certain conditions as stipulated in the Qualification Criteria, from an Associate Member State or Candidate for Accession.

The firm compiling this questionnaire shall indicate its country of origin in the table below.

Name/address of the firm compiling the questionnaire / Country of Origin

2.2  Country of Origin in Case of a Combination of Firms

In case of a combination of firms, please indicate below the organisation of the combination of firms, providing the information requested for each member of the combination of firms and explaining how the services will be distributed among the members of the combination of firms.

Name and address / Core activity / Country of Origin
Lead Firm (…. %)
Member of Combination of Firms (…. %)

2.3  Subcontracting

Would the firm subcontract any part of the services?

Yes / No

If yes, please specify which part of the services would be sub-contracted, and indicate the name and address of the potential sub-contractors if known at this time. Please provide the information requested below for each proposed sub-contractor.

Name and address / Services to be sub-contracted

3.  ADMINISTRATIVE SITUATION

Is the firm or any members of the combination of firms involved in bankruptcy proceedings, prosecution for debt, sequestration or any analogous situation arising from a similar procedure provided for in law?

Yes / No

Has the firm or any member(s) of the combination of firms made arrangements of any kind with creditors for their benefit?

Yes / No

Has the firm or any member(s) of the combination of firms been subject of a judgement for fraud, corruption or any other illegal activity?

Yes / No

Has the firm or any member(s) of the combination of firms been declared to be in serious breach of a CERN contract for failure to comply with its contractual obligations?

Yes / No

4.  COMPETENCE AND EXPERIENCE

4.1  Competence

Do you have the proven experience in the field(s) of provisioning of goods transport services?

Yes / No

If yes, please demonstrate specifically which aspects of your experience would be most relevant to the future contract:

Which type of Transport Company are you?

4.1.1 / What is your main business? [1] / ¨ Freight Forwarder
¨ Transporter
¨ Courier express[2]
4.1.2 / Do you provide door to door services? / ¨ Yes ¨ No
4.1.3 / Span
If domestic, which country? / ¨ Domestic ¨ International
……………….
4.1.4 / Which of the following transport modes do you offer? 1 / ¨ Road ¨ Air ¨ Sea ¨ Rail
4.1.5 / Can you transport dangerous material?
If yes, which class (es)? / ¨ Yes ¨ No
………………
4.1.6 / Do you offer a daily pickup or delivery?
If No, how many deliveries/pickups per week / ¨ Yes ¨ No
………………

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Which of the following services would you propose to provide to CERN?

/ Inbound goods transport / Weight / Freight Forwarder / Transporter / Courier Express[3] / Mode(s)[4] / Typical delivery time[5] / Class of service[6] /
4.1.7 / to CERN Meyrin, CH from Switzerland / < 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.8 / 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.9 / to CERN Prevessin, FR from France / < 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.10 / 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.11 / to CERN Prevessin, FR from the European Union / < 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Sea ¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.12 / 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Sea ¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.13 / to CERN Meyrin, CH from other countries / < 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Sea ¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.14 / 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Sea ¨ Rail / … days / ¨ Unique ¨ Multiple
Outbound goods transport / Weight / Freight Forwarder / Transporter / Courier Express[7] / Mode(s)[8] / Typical delivery time[9] / Class of service[10]
4.1.15 / from CERN Meyrin, CH to Switzerland / < 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.16 / 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.17 / from CERN Prevessin, FR to France / < 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.18 / 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.19 / from CERN Prevessin, FR to the European Union / < 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Sea ¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.20 / 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Sea ¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.21 / from CERN Meyrin, CH to other countries / < 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Sea ¨ Rail / … days / ¨ Unique ¨ Multiple
4.1.22 / 30 kgs / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Yes ¨ No / ¨ Road ¨ Air
¨ Sea ¨ Rail / … days / ¨ Unique ¨ Multiple

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4.2  Electronic Business

Completion of the following table will help CERN in evaluating your e-procurement capabilities. Please answer the following questions:

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/ Question / Since When? / Forecasted when? / Nothing planned / Software Package(s)/Product(s) used, and/or exchange protocols and/or standard[11] / Comments /
4.2.1 / Do you offer an electronic service providing an offer for a given transport request?
4.2.2 / Have you implemented an on-line ordering process?
4.2.3 / Have you implemented electronic ordering via xml?
4.2.4 / Have you implemented an electronic parcel tracking system?
4.2.5 / Have you implemented an electronic parcel tracking via xml?
4.2.6 / Have you implemented Advanced Shipment Notification (ASN)?
4.2.7 / Have you implemented an electronic invoicing?
4.2.8 / Do you invoice on a monthly basis (in case you are not using electronic invoicing)?
4.2.9 / Do you invoice on a monthly basis (in case you are using electronic invoicing)?

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4.3  References

Please provide at least three references of similar services by completing the forms provided in annex A. References should be related to recent European contracts comparable in size and complexity to those services required at CERN during the last five years.

CERN reserves the right to verify the references provided. In addition, the firm or each member (in the case of a combination of firms) shall be prepared to arrange a visit by CERN to any of their references.

5.  sIZE

2012 / 2013 / 2014
Number of employees
In all activities in Europe
In the field of goods transport services in Europe
Turnover
In all activities in Europe
In the field of goods transport services in Europe

6.  QUALITY ASSURANCE

6.1  ISO 9001

Are you ISO 9001:2008 certified in the field of goods transport services?

Yes / No

If yes, please attach a copy of the relevant certificate which clearly shows the certification authority and date of certification.

If no, please indicate details of your internal quality assurance system and how you would set up an equivalent quality assurance procedure. Use a separate page if necessary.

6.2  ISO 14001

Are you ISO 14001 certified in the field of goods transport services?

Yes / No

If yes, please attach a copy of the relevant certificate which clearly shows the certification authority and date of certification.

If no, please indicate details of your internal quality assurance system and how you would set up an equivalent quality assurance procedure. Use a separate page if necessary.

7.  COMMUNICATION

Will you make at least one commercial contact person and one technical contact person available for the entire duration of the contract?

Yes / No

If not, please explain the exceptions:

Are the contact persons concerned able to communicate in English or French?

Yes / No

8.  COMPLIANCE WITH THE QUALIFICATION CRITERIA

Do you comply with all the qualification criteria as stipulated in this market survey?

Yes / No

If no, please explain which criteria are not fulfilled.

9.  GENERAL COMMENTS

Indicate any other information that may be relevant to this market survey.

Date / Authorized Signature and stamp of firm
(To be signed by each member in case of a combination of firms)

ANNEXE A: References

REFERENCE 1
Name of the client
Full address
Name of the person to be contacted in customer organisation
Telephone
E-mail
Scope of the contract
Level of responsibility taken over by the firm
Duration and annual turnover
Number and qualifications of personnel performing the contract
Organisational structure (e.g. single contractor, role in the case of a combination of firms, organisational flow chart)
Way of performance and methodology (e.g. service level agreement, performance measurements and-indicators, space and incentives for improvements, reporting, payment method, interface with the client)
Quality and safety management
You are/were acting as… / Freight Forwarder / Transporter / Courier Express
Was this for Domestic or International transport (or both)?
Which mode(s) did you use? / Road / Air / Sea / Rail
Did you transport dangerous material, and if so, which class(es)
Electronic Business solutions in place
Other relevant details

Continue on separate sheet if necessary.

REFERENCE 2
Name of the client
Full address
Name of the person to be contacted in customer organisation
Telephone
E-mail
Scope of the contract
Level of responsibility taken over by the firm
Duration and annual turnover
Number and qualifications of personnel performing the contract
Organisational structure (e.g. single contractor, role in the case of a combination of firms, organisational flow chart)
Way of performance and methodology (e.g. service level agreement, performance measurements and-indicators, space and incentives for improvements, reporting, payment method, interface with the client)
Quality and safety management
You are/were acting as… / Freight Forwarder / Transporter / Courier Express
Was this for Domestic or International transport (or both)?
Which mode(s) did you use? / Road / Air / Sea / Rail
Did you transport dangerous material, and if so, which class(es)
Electronic Business solutions in place
Other relevant details

Continue on separate sheet if necessary.

REFERENCE 3
Name of the client
Full address
Name of the person to be contacted in customer organisation
Telephone
E-mail
Scope of the contract
Level of responsibility taken over by the firm
Duration and annual turnover
Number and qualifications of personnel performing the contract
Organisational structure (e.g. single contractor, role in the case of a combination of firms, organisational flow chart)
Way of performance and methodology (e.g. service level agreement, performance measurements and-indicators, space and incentives for improvements, reporting, payment method, interface with the client)
Quality and safety management
You are/were acting as… / Freight Forwarder / Transporter / Courier Express
Was this for Domestic or International transport (or both)?
Which mode(s) did you use? / Road / Air / Sea / Rail
Did you transport dangerous material, and if so, which class(es)
Electronic Business solutions in place
Other relevant details

Continue on separate sheet if necessary.