Tender for the scanning & data capture of archive microfilms Supplier Background Questionnaire

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1 Tender for the scanning & data capture of archive microfilms Supplier Background Questionnaire 1 of 15

2 INTRODUCTION This document must be completed in addition to the main tender submission and proposals submitted without this questionnaire will be rejected. 1. Guidance tes 1.1. Please note the term "applicant" refers to sole proprietor, partnership, Limited Company, Co-operative or as appropriate. The undertaking should be signed by the applicant, a partner or authorised representative in her/his own name and on behalf of the applicant Please answer the questions specifically for your Company and not for the Group where your Company is part of a group of Companies Applicants must complete the whole Questionnaire. Failure to do so may result in your exclusion from the Select list of Tenderers Applicants should include, where appropriate, any supporting documents marking clearly on all enclosures the applicant's name and the number of the question to which they refer Where a question is not applicable, the applicant should write "NOT APPLICABLE" Procedures for the letting and regulation of the Contract will be in accordance with the Council's current Standing Orders and any appropriate Domestic and European Legislation and Directives. 2. Information Relating to Applicant 2.1. Full name of applicant (if a partnership, the full name of each partner must be given) 2.2. Business address (for correspondence) 2.3. In the case of a Limited Company, Registered Office (if different from above) 2 of 15

3 2.4. Person signing application on behalf of the Firm 2.5. Designation of person named in Telephone number of applicant 2.7. Is the applicant a sole trader, partnership, Private or Public Limited Company or other (please specify) 2.8. Have any of the Directors, Partners or Associates been in any Organisation which has been liquidated or gone into receivership? (If so, give details) 2.9. Has any Director, Partner or Associate ever been employed by this Council? (If so, give details) Please state if any Director, Partner or Associate has a relative(s) who is or was employed by this Council as an Officer or is or was a District Councillor If a Limited Company state the applicant's date of registration and registration number DATE REGISTRATION NUMBER 3 of 15

4 2.12. Please enclose a copy of the Certificate of Incorporation of the Applicant under Section 13 of the Companies Act 1948/1985 and any Certificate of Change of Names (if applicable). Please tick if enclosed If the applicant is a member of a group of companies, give the names and addresses of the ultimate holding company and all other subsidiaries. Please also provide a Structure Diagram to illustrate the relationships. 4 of 15

5 2.14. If your Company is a member of a Group / Joint Venture, has another Group/Joint Venture member applied for this Contract? If yes please provide details Would the group or the ultimate holding company be prepared to guarantee the applicant's contract performance as its subsidiary? (Tick as appropriate) Please confirm that the objects of the Applicant, as set out in the Memorandum of Association provide for it to carry out contracts of the type applied for. 3. Financial Information, including Insurance 3.1. Who in the applicant s organisation is responsible for financial matters? Name Position Tel Address 3.2. Copies of audited accounts for the last 12 months should be enclosed, to include:- Balance sheets Full notes to the Accounts Profit and Loss Accounts Director's Report/Auditor's Report Please tick if enclosed 3.3. Details of any outstanding claims or litigations against the applicant, if any. If none state NONE 5 of 15

6 3.4 Please list details (Policy number, company, value, expiry date) of relevant insurance policies (e.g. public liability, professional indemnity, motor) held: 4. Previous Experience 4.1 Please give details of all previous contracts/projects undertaken relevant to your proposals that have been completed in the last 3 years. (by using the table below please extend the table if required) We reserve the right to contact any of these clients for reference purposes. Contract Name and Brief Description Period Approx Annual Value Name Contact Details Contract Name and Brief Description Period Approx Annual Value Name Contact Details Contract Name and Brief Description Period Approx Annual Value Name Contact Details 6 of 15

7 5. Technical and Management Resources 5.1. State the address from which the Contract with the Council would be controlled: State the address from which the Contract with the Council would operate (if different from above):- 6. Equal Opportunities 6.1. Do you as an employer comply with your statutory obligations under the Race Relations Act 1976? 6.2. Accordingly, is it your practice not to treat one person less favourably than another because of colour, race, nationality, ethnic origin, sex, age, religious and political beliefs, in relation to decisions to recruit, train or promote employees? 6.3. In the last 3 years, has any finding of unlawful discrimination been made against the applicant by any Court or Industrial Tribunal? If YES, give details 6.4 In the last 3 years, has the applicant been subject to any formal investigation by the Commission for Racial Equality on the grounds of alleged unlawful discrimination? If YES, give details. 7 of 15

8 6.5 Do you undertake to provide information and access to such documents as the Council may require to enable it to satisfy itself that your company complies and will continue to comply with the Race Relations Act 1976? 8 of 15

9 7. Declaration Please ensure that when you return the Questionnaire that all information that has been asked of the Applicant in support of this application has also been enclosed. Any supporting documents should be marked clearly with the Applicant s Name and the number of the Question to which they refer. NO part of this Application form or details supplied to the Authority can be returned to the Applicant. The Applicant agrees that the statements contained within the application are accurate and that any entry therein which is falsely made shall be justification for my/our exclusion from the selected Tender List. The Applicant agrees that in the event of there being any uncertainty as to the intention of any portion of this document, particulars of such uncertainty shall be referred to the Council, in writing, for clarification. The Council may take up some or all s. In certain instances it may be necessary for the Applicant to provide additional Referees should the Council decide it is appropriate to do so. The Applicant will be advised in writing. The Applicant agrees to provide further information as to Referees where necessary to aid in the analysis of this Questionnaire. The Applicant certifies that s/he has read the whole of the foregoing and that the answers to the Questionnaire and accompanying information are a true and accurate response. Applicant Name: Signature*: For and on behalf of:. Date: 2004 Witness I hereby witness the signature of the Applicant and that the signature is his usual signature and to the best of my knowledge is authorised on behalf of the Company to complete this Questionnaire. Witness: Designation: 9 of 15

10 * To be signed by the Applicant of a Company or Incorporated Company, by a Partner of authorised representative respectively in his own name, and on behalf of such Company or Incorporated Company in presence of a witness. A witness must countersign this document. 10 of 15

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