download RFQ Submission Document for completion and ... - Tender

Private Bag X20 Hatfield, 0028,
Tel: (012) 420 2433
Email: schalk claasen@up.ac.za
www.up.ac.za
DEPARTMENT OF FACILITIES MANAGEMENT SERVICES
RFQ NO.: FM/FEN/2013/87
Closing Date and Time: 09 August 2013 at 12:00
ENGINEERING 2 - FUME CUPBOARDS
CHEMICAL LABORATORIES
KINDLY PROVIDE ALL THE INFORMATION REQUESTED IN THE SPACES
PROVIDED AND INSERT SUPPLEMENTARY PAGES IF REQUIRED FOR
ADDITIONAL INFORMATION REQUESTED IN MAIN TENDER DOCUMENT.
(Failure to provide all the requested information will compromise the RFQ and
may lead to disqualification from the tender process)
COMPANY DETAILS/PROFILE OF MAIN CONTRACTOR
Name of Tenderer
Date established
Company Registration no
VAT registration no
Name of Applicant/CEO/Director
Primary/core business service
offering:
Annual turnover (mark with an
X): Large Business (R35m +)
Qualifying Small Enterprise (R5m to
R35m)
Exempt Micro Enterprise (less than
R5m)
1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / Noncompliant
BBBEE Status (Level):

CONTACT INFORMATION
Landline: ( )
Fax no: ( )
Mobile number:
E-mail address:
Website (n/a if no website):
Physical Address:
Postal Address:
Private Company
Public Company
Partnership
Other Specify:
FORM OF ORGANISATION
Mark Appropriate with an X
Sole Proprietor
Trust
Closed Corporation
DETAILS OF MAJOR CONTRACTS THAT ALLIGN CLOSEST WITH THE ONE
ON OFFER, EXECUTED IN THE PAST 5 YEARS
1
2
3
4
Client, Project & Year Description Monetary Value
5
PRESENT ASSIGNMENTS AT HAND (max. 5 - related or unrelated to the
one on offer)
1
2
3
4
5
Project Description Monetary Value

1
2
3
CONTACT DETAILS OF THREE MAJOR CLIENTS
Client Email Address Telephone Contact Person
THE FOLLOWING DOCUMENTS MUST ACCOMPANY THIS SUBMISSION
Kindly confirm its inclusion by placing an X in the column adjacent to it.
Please ensure that the documents are in order as described below.
No. DOCUMENT (X)
Proof of insurance and current limits for both public liability
1 and contractor’s all risk insurance
2 VAT registration certificate
Proof of banking details by means of: cancelled cheque (or
certified copy thereof) or written confirmation of account
3 details from the bank concerned
4 Tax clearance certificate from SARS
5 Registration document (CK1/CK2) of the enterprise
Verified certificate, issued by a SANAS accredited
verification agency, disclosing the B-BBEE status of the
enterprise in terms of the codes of Good Practice, B-BBEE of
6 2007
7 Company Profile
Proof of previous experience in Fume Cupboards
installations in laboratory construction projects with chilled
8 water HVAC
Proof of previous experience in construction projects where
the work was required to be interphased with the continued
9 occupation of the works by the client.
Are any of the directors, members or proprietors or any of their family
members employed at the University of Pretoria? (Mark with an X)
Yes
If yes, please provide details:
No
NO LATE SUBMISSIONS WILL BE CONSIDERED.
I hereby certify that the information
submitted is correct and that all copies of
original documents submitted are authentic.
I am authorised to sign on behalf of the
applicant.
Name:
Capacity:
Signature:
________________________
________________________
________________________