Long Term Grazing Permit EOI Response Form

Part C – Response Form

Expression of Interest (EOI)

PART C – Response Form

Name: / 2015-16 Murray Region TSR LongTermGrazing Permits EOI
Applicant Name:
Applicant Address:
ABN:
PIC:
Reserve Name:
Reserve Number:

1.General Information for Respondents

This Part C – Response Form must be completed and forms part of the EOIresponse.

Please ensure all sections in PartCare fully addressed and all details are provided.Provide attachments where necessary, clearly labelled and cross-referenced.

2.Respondent/contact person:

Name:
Position:
Telephone no:
Mobile no:
Facsimile no:
e-mail address:

3.Respondent’s current insurance details:

The Respondent must maintain Public Liability Insurance of $20million for the duration of the LTGP. A copy of the relevant Insurance Policy or Certificate of Currency is to be submitted with acceptance.

Insurer / Policy type / Policy No. / Limit / Expiry Date

4.Has the Respondent read, understood and accepted the terms of allEOI documents including?

Part A – Information about this EOI:

Yes
No / [Please provide details where there are genuine reasons why not]

Part B – Long Term Grazing Permit including terms and conditions:

Yes
No / [Please provide details where there are genuine reasons why not]

Part D – Eastern TSR list including site maps:

Yes
No

5.Is the Respondent aware of any real or perceived conflicts of interest that may exist?

Yes / [Please provide details]
No

6.Response to the evaluation criteria

The Respondent must respond to each of the evaluation criteria. (As stated in Part A, this list is not exhaustive and Murray Local Land Services may take into account other considerations when evaluating Responses.)

Note: A separate individual Expression of Interest form (Part C – Response Form) must be submitted for each TSR.

Evaluation criterion (i) / The nominated amount being the annual dollar value for a grazing permit over the nominated TSR.
NOTE:
A $100 minimum price must be tendered for a reserve (ex GST)
All tendered prices are subject to an annual Consumer Price Index (CPI) increase.
Tendered annual price - $ (Exclusive of GST)
Evaluation criterion (ii) / Proposed approach to managing the TSR.
Past record of TSR management will be considered if you have previously held a permit OR describe past experience of any other Crown land management/permits held on public land (fill out field below).
1.
a)Relevant livestock production and land management experience. (Any records available to LLS on livestock or land/invasive species management will be considered)
Circle below
Relevant livestock and land management experience (Yrs) / 0-5 / 5-10 / 10-20 / >20
Fence maintenance/ construction experience (Yrs) / 0-5 / 5-10 / 10-20 / >20
Weed management experience (Yrs) / 0-5 / 5-10 / 10-20 / >20
b)Capacity to manage the TSR (ie resources/ materials to undertake management)
Circle below
Weed management resources / Hand tools / Pump spray / Quad mounted spray unit / Ute/ tractor mounted unit
Fencing maintenance/ construction equipment / Y / N
Evaluation criterion (iii) / Locality:
Are you a direct neighbour to this TSR?
2. / Yes Circle: Share a fence Across the road Across the watercourse
Distance to TSR (km) / 1 - 10 / 10-30 / 30-50 / >50
No

7.Does the Respondent certify that the information contained in this Response is true and correct, and submitted in good faith?

Yes
No

8.Signed by the Tenderer or Respondent’s authorised representative who warrants that he or she has authority to submit this Response on behalf of the Respondent:

Applicant’s Signature:
Name:
Position:
Date:

Murray Local Land ServicesPage 1

Version Approved 021215