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CONTRACT TITLE
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TIMETABLE
Return of questionnaire [ date]
(Questionnaires received by [Authority Name] after this date may not be considered)
Issue of Tender Documents [ date]
Return of Tender Documents [ date] |
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OVERVIEW OF THE REQUIREMENT
[Introduction
Details of awarding Authority
Brief description of scope of project
Details of contract duration including options to extend] |
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CONTACT DETAILS
[Include, name, address, telephone, fax number and e-mail address]
NAME |
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ADDRESS |
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POST CODE |
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TELEPHONE NUMBER |
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FAX NUMBER |
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E-MAIL ADDRESS |
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Any questions relating to this document should be addressed to the above contact.
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PART A - BACKGROUND INFORMATION |
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Name of Organisation |
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Address for all correspondence
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Contact Name |
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Contact Position |
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Telephone Number |
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Fax Number |
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E-mail address |
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Website address (if applicable) |
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Address of Registered Office (If applicable)
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Nature of Organisation
(E.g. Plc, Partnership etc). |
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Number of Employees |
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Names of the Directors or Partners |
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Group
If the Organisation is a Member of a Group of Companies, please give the name and address of the ultimate parent company. |
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Company Registration Number
(or alternative EU registration number). |
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VAT Registration Number
(or alternative EU registration number). |
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Consortia Details (if applicable)
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1 |
Name and address
Identify which part of the service this consortia member will deliver |
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2 |
Name and address
Identify which part of the service this consortia member will deliver |
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3 |
Name and address
Identify which part of the service this consortia member will deliver |
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Sub Contractor Details (if applicable)
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a |
Name and address
Identify which part of the service this sub contractor will deliver |
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b |
Name and address
Identify which part of the service this sub contractor will deliver |
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c |
Name and address
Identify which part of the service this sub contractor will deliver |
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PART B - FINANCIAL STATUS |
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BANK DETAILS |
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Name of Bank:
(from which a financial reference may be sought). |
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Address: |
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Telephone Number: |
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Suitable contact name: |
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Telephone Number:
(if different) |
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Provide details of the Annual Turnover (in £ Sterling) for: |
Latest Year |
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One year previous |
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Please attach one copy of your organisation’s audited accounts (or equivalent) and the accounts of your group (if any) for the last 2 years in English and in UK Sterling together with details of any significant changes since the last year end. Copies of the accounts should be signed and dated by Directors and auditors (preferably scanned, if being submitted electronically) or marked as draft. |
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PART C - BUSINESS PROBITY |
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Please confirm whether any of the following criteria applies to your organisation: |
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Is the organisation bankrupt or being wound up, having its affairs administered by the court, or have you entered into an arrangement with creditors, suspended business activities or any analogous situation arising from similar proceedings under national laws or regulations? |
YES
NO |
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Is the organisation the subject of proceedings for a declaration of bankruptcy, for compulsory winding-up or administration by the court or for an arrangement with creditors or of any other similar proceedings under national laws or regulations? |
YES
NO |
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Has any employee whom you would propose to use to deliver this service been convicted of an offence concerning his professional conduct by a judgement which has the force of res judicata? |
YES
NO |
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Has any employee whom you would propose to use to deliver this service been guilty of misrepresentation in supplying or failing to supply the information that may be required in this Section? |
YES
NO |
A matter already settled in court
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Has any employee whom you would propose to use to deliver this service been guilty of grave professional misconduct? |
YES
NO |
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Has the organisation failed to fulfil obligations relating to the payment of social security contributions in accordance with the legal provisions of the United Kingdom or the country in which it is established? |
YES
NO |
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Has the organisation failed to fulfil obligations relating to the payment of taxes in accordance with the legal provisions of the United Kingdom or the country in which it is established? |
YES
NO |
Note: Failure to disclose information relevant to this section may result in your exclusion from this and/or other competitions. |
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PART D – SERVICE OPERATION AND QUALITY |
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What are the principal business activities of your organisation? |
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State your organisation’s experience in delivering the same or similar service to that described under [Subject Details] |
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Provide contact details for 2 referees for work within the last two years that is similar or the same to that required by this requirement. Note that contact will be made with referees without further reference to you. |
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a. Referee Organisation
Contact Name
Title
Address
Service Provided
Period of Contract
Approximate Vale |
Referee Organisation
Contact Name
Title
Address
Service Provided
Period of Contract
Approximate value |
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b. Referee Organisation
Contact Name
Title
Address
Service Provided
Period of Contract
Approximate Vale
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Referee Organisation
Contact Name
Title
Address
Service Provided
Period of Contract
Approximate value |
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OPTIONAL INFORMATION REQUIREMENTS |
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TECHNICAL CAPACITY |
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Provide management/project leader experience, education and professional qualifications for those leading the management of the provision of the goods/services required |
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Provide details of human resources, plant and technical equipment available for providing this service |
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Particular contracts may require specific information including, but not limited to:
Insurances
Employer’s Liability Compulsory Insurance (ECLI)
Public Liability Insurance
Professional Indemnity Insurance
Standards and Policies
Health and Safety
Quality Assurance
Equal Opportunities
Environmental Management |
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EXPRESSION OF INTEREST |
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Name of organisation/lead organisation wish to register interest and apply to be considered for short listing to receive Invitation to Tender documentation for provision of [contract title ]. I confirm that the answers given on this questionnaire are true, complete, accurate and not misleading. |
Signed: |
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Print Name: |
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Title: |
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Date: |
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