Pre-Qualification of Suppliers

INSTRUCTIONS: Supplier shall complete this questionnaire in its entirety, unless otherwise directed by Company, and include all attachments requested.

Pre-Qualification entity applied for:

    Pre-Qualification entity applied for:

    Mandatory Attachments:

    • Trade License:

    • VAT Certificate:

    • Bank Details:

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    GENERAL INFORMATION

    Category applied for:

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    NUMBER OF STAFF EMPLOYED

    Please provide the organization chart/employee list from immigration or any other relevant document.

    MANAGEMENT STRUCTURE

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    SPECIFIC REQUIREMENTS

    All firms must provide (Tick appropriate box)




    FINANCIAL POSITION

    All firms must provide (Tick appropriate box):




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    PAST EXPERIENCE

    Provide a list of 5 current clients/customers that you have transacted business with and value (for the past 5 years) and attach the document proof i.e., Awarding letter, purchase order, agreement etc.

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    HEALTH & SAFETY

    You must provide details of your health and safety staff, process and policies implemented in your organization.




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    BANK DETAILS

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    APPENDIX 1 – DECLARATION

    Having studied the tender information for pre-qualification we/I hereby state:

    • a) The information furnished in our application is accurate to the best of my/our knowledge.

    • b) Have read and understood the terms and condition.

    • c) That in case of being qualified we acknowledge that this grants me/us the right to participate in due time in the submission of a tender or quotation on the basis of provisions in the tender or quotation documents to follow.

    • d) If the legal, technical, financial conditions or the contractual capacity of the firm changes when the call for Tenders/Quotations is issued, we commit ourselves to inform you and acknowledge your right to review the tender made.

    • e) We enclose all the required documents and information required for the prequalification evaluation.





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    Optional Attachment:

    If provided, will get points accordingly and will be registered as pre-qualified supplier for all future RFQ’s and tenders.

    • Bank Statement (Last 3 Months):

    • Organization chart/employee list from Immigration:

    • Health and Safety Policy and ISO certificate:

    • Financial Statement (Last Audited):

    • 5 Projects (Awarding Letter/PO/Contract/agreement):[file 5-projects]

    • Professional certificate for applied category:

    • ICV (In-Country Value) Certificate:

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    Conflict of Interest Declaration Form

    Are you aware of any conflict of interest, which might have an impact on your ability to offer / deliver the services in question to National Security Institute?

    If Yes, please provide details:

    I hereby declare that the above is an accurate and complete Declaration of all Conflicts of Interest on the part of my (company/organization) in relation to this framework of which I am aware. I undertake to inform NSI of any changes to this declaration or of any other conflicts of interest which may arise during the lifetime of the framework.

    I accept that NSI may take appropriate action in relation to conflicts of interest, and that my (company/organization) may be excluded for tendering for a specific contract where the effect of the conflict of interest has not been dealt with to the satisfaction of NSI.

    This acknowledgment aims at supporting transparency, meeting the public interest, safeguarding NSI reputation, and protecting NSI employees and contractors from any differences that may arise.

    Name (Block Capitals):

    Signature: [signature sgnature-last* color:#000000 background:#ffffff]

    Date:

    Position:

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