PROSPECTIVE SUPPLIER DATABASE APPLICATION FOR GAUTENG DATABASE

Transcription

1 PROSPECTIVE SUPPLIER DATABASE APPLICATION FOR GAUTENG DATABASE APPLICATION DETAILS Description: Invitation for prospective suppliers and professional service providers to register on the Insika Foundation CWP supplier database Reference: INSIKA/PSD-GP/ RESPONDENT DETAILS This page must be completed and submitted with each sealed application Organisation: Province: District: Municipality: Contact person: Contact number: address:

2 DOCUMENTS IN THIS APPLICATION PACK Respondents are to ensure that they have received all pages of this document, which consists of the following sections: SECTION 1 Documents in this section are for information /instruction to respondents and must not be returned with applications. A. Background B. Application submission conditions and instructions C. Application evaluation process/criteria SECTION 2 Documents in this section must be completed and returned or supplied with applications. A. Prospective supplier information form B. Commodity list (Goods & Services) SECTION 3 Documents in this section must be completed and returned or supplied with applications. A. Compliance checklist B. Signed SBD Forms: o o o o o SBD 4 Declaration of interest SBD 6.1 PPPFA Regulations claim form SBD 6.2 Declaration Certificate for Local Production and Content (PPE suppliers only) SBD 8 Declaration of Bidder's Past SCM Practices SBD 9 Certificate of independent Bid Determination Page 2

3 SECTION 1: A. BACKGROUND This section is for information only, do not return with the application The Community Work Programme (CWP) is a government programme based in the Department of Coorporative Governance. The primary purpose of the programme is to create an employment safety net (basic minimum income) for the unemployed especially in the rural communities. The programme supplements livelihood strategies by providing a basic level of income security. Each site employs or more participants. The programme/ participants need the following goods and services: 1. Goods Protective Wear, Tools, Agricultural inputs etc 2. Services Various Training The sites are managed by Implementing Agents (IA s). Insika Foundation is an Implementing Agent for: Gauteng a) Merafong Local Municipality b) City of Johannesburg District Region E In order to comply with the regulations of the Public Finance Management Act and to ensure a competitive procurement process, Insika Foundation invites prospective suppliers of the goods/ services as indicated above, to apply for a listing on Insika Foundation s prospective supplier database. Insika intends to utilise this prospective supplier database to obtain quotations and where appropriate the supply of goods/ services that may become necessary for CWP. It is important to note that should an applicant/ supplier be successful in their application to be added to the prospective supplier database, Insika Foundation is under no obligation to utilise their services. Successful applicants are not in any way guaranteed future business. Page 3

4 SECTION 1: B. APPLICATION SUBMISSION CONDITIONS AND INSTRUCTIONS This section is for information only, do not return with the application 1 FRAUD AND CORRUPTION 1.1 All suppliers are to take note of the implications of contravening the Prevention and Combating of Corrupt Activities Act, Act No 12 of 2004 and any other Act applicable. 2 NOTES TO ALL SUPPLIERS SEEKING REGISTRATION ON THE DATABASE OF PROSPECTIVE SUPPLIERS OF INSIKA FOUNDATION 2.1 The purpose of this database is to give all prospective suppliers an equal opportunity to submit quotations to Insika Foundation. 2.2 Attached please find, inter alia, an official prospective supplier application form to assist in compiling the list according to legislation. It is imperative that applicants read the prospective supplier application document carefully, complete it in full and sign where appropriate. 2.3 The database will remain valid until Insika Foundation decides to re-establish the database. 2.4 Insika Foundation will regularly update the Supplier database. 3 REQUEST FOR CLARIFICATIONS/ QUERIES 3.1 Any clarification required by a supplier regarding the meaning or interpretation of the prospective supplier application document, or any other aspect concerning the application is to be requested by letter, fax or or telephone to the following contact details: Insika SCM Officer scm@insikafoundation.co.za Fax: Postal Address: Insika Foundation - Insika SCM Officer P.O Box 3840 Halfway House 1685 OR Insika Foundation - Insika SCM Officer Elethu House, Suite G4/Block 27 Thornhill Office Park 94 Bekker Road Midrand 1685 Page 4

5 OR alternatively contact the following project co-ordinator: Name & Surname Cell Number Sites Hangwi Masakona Merafong Local Municipality, City of Johannesburg District Region E 4 SUBMITTING THE APPLICATION DOCUMENT PACK 4.1 All applications must be in a sealed envelope with the Reference number prominently displayed. 4.2 The application document pack can be returned to the Insika SCM Officer at Insika Foundation via post or courier. 4.3 Alternatively the application document pack can be hand delivered to the following address: Insika Foundation - Insika SCM Officer Elethu House, Suite G4/Block 27 Thornhill Office Park 94 Bekker Road Midrand Prospective supplier application document packs should be submitted in a sealed envelope, marked with: Reference Number INSIKA/PSD-GP/ The name and address of the applicant. 5 CLOSING OF APPLICATIONS Please note that the closing date is 31 March Page 5

6 SECTION1: C. APPLICATION EVALUATION PROCESS This section is for information only, do not return with the application ALL SUPPLIERS MUST TAKE NOTE OF THE EVALUATION PROCESS THAT WILL BE FOLLOWED FOR THIS APPLICATION PROCESS 1. EVALUATION PROCESS 1.1 Evaluation of the responses will be completed in the phases noted hereunder. 1.2 STAGE 1: RESPONSIVENESS CHECK (COMPULSORY) Please note: Applications without the completed/ submitted documents mentioned below will be regarded as non-responsive and disqualified immediately The completed application form, An original valid tax clearance certificate submitted, Company registration certificate submitted, Certified ID copies of Director/s of the company Proof of Banking Details of the company A valid VAT registration certificate (VAT103) submitted if applicable, SBD 4 - Declaration of interest completed, signed and submitted, SBD Preference points claim form in terms of the Preferential Procurement Regulation, 2001 submitted SBD 6.2 Declaration Certificate for Local Production and Content completed, signed and submitted (PPE suppliers only) SBD 8 - Declaration of bidder s past SCM practices completed, signed and submitted SBD 9 Certificate of independent Bid Determination B-BBEE Certificate of a supplier in terms of the Codes of Good Practice issued by the DTI in terms of the B-BBEE Act, if in possession of such a certificate Company profile of the entity (training service providers only) Proof of accreditation where applicable (training service providers only) Page 6

7 1.3 STAGE 2: EVALUATION CRITERIA Suppliers who are regarded as responsive, as determined through paragraph 1.2 above will be evaluated further. If complete information is not submitted the supplier will be regarded as non-responsive and the application will not be evaluated further Points will be awarded for B-BBEE Status Level of Contribution in terms of Regulation 5 (2) and 6 (2) of the Preferential Procurement Regulations, preference points must be awarded to a bidder for attaining the B-BBEE status level of contribution in accordance with the table below: B-BBEE Status Level of Contributor Number of points (80/20 system) Non-compliant contributor Assessment Criteria CRITERIA 1. Compliance documents all submitted and signed 2. BEE status Yes No The Insika SCM Officer will evaluate all applications from suppliers and compile the supplier database for approval by the Accounting Authority. Page 7

8 1.4 STAGE 3: OTHER REASONS FOR DISQUALIFICATION In addition to the above evaluation, Insika Foundation will reject an application to be registered if the supplier has: Committed a proven corrupt or fraudulent act in applying to register. Made an attempt to gain information in a manner deemed to be unfair or disadvantageous to other respondents or any attempt to influence the outcome of the response evaluation will result in immediate disqualification from the application process Insika Foundation will also disregard the application of any supplier if that supplier, or any of its directors: Have abused the SCM processes of Insika Foundation in the past; Have committed fraud or any other improper conduct; Have failed to perform or deliver on any previous contract with Insika Foundation in the past; Such actions will also be communicated to the National Treasury to incorporate such suppliers on their supplier blacklist. Page 8

9 SECTION 2: A. PROSPECTIVE SUPPLIER INFORMATION FORM All applicants must furnish the following particulars and include it in their submission (Failure to do so will result in your application being disqualified) 2.1 IMPORTANT NOTES Applicants will be contacted via and must therefore submit an operating and valid address; failure to comply will result in excluding the supplier from the database; It should be noted that Insika Foundation reserves the right to accept or reject any application without being obliged to give any reasons in this respect; 2.2 SUPPLIER DETAILS Supplier Name: Company / CC Registration Number: VAT Registration Number (if applicable): Income Tax Reference Number (compulsory): Web Address (if applicable): Address (compulsory): Landline Contact Number: Cell Number: Number of Full Time Employees: Number of years in business: Postal Address: (compulsory) Code Physical Address: (compulsory) 2.3 SUPPLIER CLASSIFICATION: (PLEASE TICK THE RELEVANT BOX / BOXES) ISO Listed Importer Services Manufacturer Repairer Black Owned Distributor Exporter Sales Page 9

10 2.4 MAIN CONTACT PERSON IN YOUR ORGANIZATION: Name: Organization Position: Landline Number: Cell Number: Address: 2.5 ACCOUNTS CONTACT PERSON IN YOUR ORGANIZATION: Name: Organization Position: Landline Number: Cell Number: Address: 2.6 COMMODITY LIST (PRODUCTS & SERVICES): Suppliers of the following products/services are required to register on the database. Please mark the main services your organization supplies: Item # Description Tick applicable goods/ services 100 PPE Conti Suits 65/35 Poly Cotton Branded in full colour Size: 36, 100 Size 38, 100 Size 40, 150 Size 44, 200 Size 46, 150 Size 48, 200 Size 50, Dust Coats Poly Cotton Branded in Full Colour Safety googles Sun Hats Poly Cotton branded in full colour Safety Boots and safety shoes. Bata, Bronx, Bova, Le Maitre, or Frams. Sizes: Size 4, 100 Size 5, 100 Size 6, 200 Size 7, 100 Size 8, 100 Size 9, 100 Size 10, Gumboots- Bata Disposable Gloves Industrial Leather Gloves HBC Work Suits T Shirts 100% cotton Branded in Full colour. Sizes 280 small, 200 medium 200 large, 200 Xtra large 200 XX large, 120 XXX large Page 10

11 Item # Description Tick applicable goods/ services Dust Masks 200 TOOLS AND MATERIAL Mops Refuse Bags (100 Pack ) Window Washer Paint Brushes Hand Fork Two-Stroke (Oil) 10L Grass Cutting Machines Paint 20L Paint Roller Tray Sets Sanding Paper X 5 Sheets Thinners 20L Mutton Cloth HBC Kits Liquid Soap (Cleaning) 20L Handy Andy 20L Floor Polish 20L Seedlings Pesticides First Aid Kits Beads = Different Colour Raffia = Different Colour Fleure Wools = Different Colours Scissors Sewing Machines Curtain Material Unpick Measuring Tape Box Of Pins Machine Needle Size 14 & Shoe Soles All Sizes Inner Soles Page 11

12 Item # Description Tick applicable goods/ services Leather Aprons Crochette Needles Shoe Needles Contact Glue Sewing Cloth Zips, Buttons And Thread Welding Mask Welding Gloves Electrode Holder Welding Rods Steel Bars - Square Bar Steel Bars - Square Tubing River Sand Building Accessories Cement Brick Making Machines Jerry Cans 300 AGRICULTURAL INPUTS Cabbage seedlings Beetroot seedlings Spinach seedlings Mustard Spinach seedlings Green Pepper seedlings Carrots seedlings Kale seedlings Cabbage seeds Beetroot seeds Spinach seeds Mustard Spinach seeds Green Pepper seeds Carrots seeds Kale seeds Fruit Trees Page 12

13 Item # Description Tick applicable goods/ services Shade Tress 400 OFFICE EQUIPMENTS Laptops Printers/scanners/Fax/Photocopier Office Desks Office Chairs Extension Cables Steel Filing Cabinets Modems 500 TRAINING COURSES Home Based Care HIV/ AIDS Health & safety Early Childhood Development Cooking Sewing/ Knitting Welding Painting Plumbing Brick making Plant Production/ Agriculture First Aid 2.7 TRACK RECORD List three largest contracts/projects completed by your organisation in the last three years: WORK PERFORMED FOR WHOM CONTACT PERSON AND TELEPHONE NUMBERS CONTRACT FEE Page 13

14 I/we the undersigned acknowledge(s) that: The information furnished is true and correct; The Equity Ownership claimed is in accordance with the general conditions; Any conflict of interest has been declared. Signature of Owner or Authorised Representative Date Witness Date Page 14

15 SECTION 3: SUPPLIER COMPLIANCE CHECKLIST Documents in this section must be completed and returned with the application Please mark the documents that you have included/ submitted in the application pack. # SUPPLIER RESPONSE CHECKLIST YES NO 1. The application form (completed and signed) 2. An original valid tax clearance certificate 3. Company registration certificate 4. Certified ID copies of Director/s of the company 5. Proof of Banking Details of the company 6. A valid VAT registration certificate (VAT103) submitted if applicable 7. SBD 4 - Declaration of interest completed, signed and submitted 8. SBD Preference points claim form in terms of the Preferential Procurement Regulation, SBD 6.2 Declaration Certificate for Local Production and Content 10. SBD 8 - Declaration of bidder s past SCM practices 11. SBD 9 Certificate of independent Bid Determination 12. B-BBEE Certificate of the supplier in terms of the Codes of Good Practice issued by the DTI in terms of the B-BBEE Act, if in possession of such a certificate. 13. Company profile of the entity (training service providers only) 14. Proof of accreditation where applicable (training service providers only) Page 15