APPLICATION FORM FOR REGISTRATION ON THE W&RSE TA SUPPLIER D ATABASE

W&RSETA Standard Supplier Database Registration Documents
APPLICATION FORM FOR REGIS TRATION ON THE W&RSE TA
SUPPLIER D ATABASE
COVER SHEET
Province (Only one province may be indicated per submission)
Name of Province:
Company / Entity Details
Organisation Registered Name
/ Name of individual
Organisation Trading name:
Main Contact Details
Name and Surname:
Telephone Number:
Cellular Phone Number:
Fax Number:
e-mail address:
Sales Contact Details
Name and Surname:
Telephone Number:
Cellular Phone Number:
Fax Number:
e-mail address:
Page 1 of 22
W&RSETA Standard Supplier Database Registration Documents
SUPPLIER DATABASE SUBMISION
In order to comply with the requirements of the Public Finance Management Act of 1999 (PFMA)
and to ensure compliance with the Preferential Procurement Policy Framework Act of 2000
(PPPFA) and its regulations, the W&RSETA invites prospective service providers to be added to
their Supplier Database. It is envisaged, that this database will contribute to efficient administration
and compliance with the PFMA.
The purpose of this database is to give all prospective suppliers an equal opportunity to
submit quotations to the W&RSETA.
Procurement of all goods and services are centralised and managed by the Supply Chain
Management (SCM) Division based at our head office in Centurion.
W&RSETA Head Office and Regional Office details:
Head Office
224 Witch-Hazel Avenue
Highveld Techno Park
Centurion
Tel : 012 676 9000
Eastern Cape
Kings Entertainment Centre
No. 1 Aquarium Road
Beach Front, East London
Tel : 043 722 3010
Mpumalanga
202 Parkmed Centre
64 Mandela Street
Emalahleni
Tel : 031 690 1214
Gauteng Province (North)
Ground Floor, Block B
1267 Pretorius Street
Hatfield Office Park, Hatfield
Tel : 012 430 4930
Western Cape
Old Warehouse Building
Black River Park, Fir Road
Observatory
Tel : 021 442 6700
Free State
Ground Floor, Justitia Building
133 St Andrew Street
Bloemfontein
Tel : 051 447 8443
Gauteng Province (South)
Building 18
Woodlands Office Park
Western Service Road
Woodmead
Kwa-Zulu Natal
Office 102B, 1st Floor
Clifton Place
19 Hurst Grove, Durban
Tel : 031 333 8800
N.B: The Supplier Database registration schedule for 2010/2011
Submission date
Closing date
1st Submission
2rd Submission
07 June 2010
30 September 2010
25 October 2010
31 March 2011
All submission are to reach the W&RSETA Head Office before closure of business on the
stipulated closing date . W&RSETA official hours are between 8:00 am and 17:00 pm
Page 2 of 22
W&RSETA Standard Supplier Database Registration Documents
REQUIRED DOCU MENTATION AND EVALUATION CRITERIA:
No
1
2
Description
Instructions for completion
Products and services
3
4
5
Vendor Information Form
Declaration of interest
Tax clearance requirements
6
7
8
Preference point claim form
General conditions of contract
Company profile and shareholding
certificate
Individual/partners/shareholders/members
ID copies
For Consultancy/professional Services:
Updated copies of CV’s
Updated Registration with the relevant
applicable professional bodies/
certification
Banking details, copy of last 3 month
bank statement, proof of business
physical address and copy of ID
document
Price list (all product and services listed)
9
10
11
12
13
Special Instruction
To be completed in full
Select applicable services that can be
supplied or rendered
To be completed in full
To be completed in full
Valid original tax clearance certificate must be
submitted. where partnerships, Consortia /
Joint Ventures / Sub-contractors are involved
each party must submit a separate Tax
Clearance Certificate.
To be completed in full
Each page must be initialled
Attached to registration document
Attached to registration document
Attached to registration document
Attached to registration document
Attached to registration document
Attached to registration document
§ Failure to comply with all of the above criteria and completion of the forms as required, as well
as submission of supporting documentation will result in the application being disqualified.
§
Kindly note, for each service selected a list of three (3) contactable references and the
value of past three services rendered must be submitted. Please use the following format:
Product
/ Name
Service Type organisation
services
rendered
or Contact
that Person
were
Contact Numbers
Value of Service
§ Service Providers will only have an opportunity to apply for registration of a maximum of 5
commodity categories.
§ Company profiles, leaflets and brochures are also welcomed.
Page 3 of 22
W&RSETA Standard Supplier Database Registration Documents
INSTRUCTIONS FOR COMPLETION (Please read carefully)
§ All the forms should be completed either electronically (but Signature should be in the original)
or by hand (legibly and with a black pen).
clearly mark envelopes with the title “2010/2011Supplier Database
Registration”, addressed to "The Executive Manager SCM” at: W&RSETA House,
224 Witch - Hazel Avenue, Highveld Technopark, Centurion, 0046
§ Please
§ The front cover of the submission must clearly state the specific province for which the
registration is applicable to.
§ The service/s for which the organisation would like to be registered must be marked by putting
a cross (x) in the “applicable” column in the list of services hereunder.
§ The next Supplier Database publication will only occur in the Government Tender Bulletin.
Queries
§ All queries must be in writing and addressed to the Executive Manager SCM at
[email protected] or Faxed
PSD 2010/2011.
to 086 506 7017 with the subject heading:
§ No telephonic queries will be responded to.
PRODUCTS AND SERVICES LIST
Code
COM001
COM002
COM003
COM004
COM005
COM006
COM007
COM008
COM009
Product / Service
Advertising and advertising related
services
Corporate Clothing
Corporate Gifts (including promotional
items)
Framing
Design and layout of publications
Editorial Services
Event Management
COM020
Media Services
Multimedia and related products and
services
Printing
Sound and Lighting control
Web Design and Update
CopyWriting
Translation services
Media Monitoring
DVD Production
Filming and production related services
Communication and public relations
services
Branding and corporate identity
COM021
Photographic services
COM010
COM011
COM012
COM013
COM014
COM015
COM017
COM018
COM019
Special Requirement
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Page 4 of 22
Applicable
W&RSETA Standard Supplier Database Registration Documents
Code
ETD001
ETD002
ETD003
ETD004
ETD005
ETD006
ETD007
ETD008
ETD009
ETD010
ETD011
ETD012
ETD013
ETD014
Product / Service
Management Development Training
Office Admin Training
Assessor Training
Moderator Training
SDF Training
Mentoring Training
SCM Training
First Aid Training
MS Office Training
Policy Development Training
Soft Skills Training
Performance Management Training
Workplace Forum Training
Customer Service Training
Special Requirement
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
ETD015
ETD016
ETD017
ETD018
ETQ001
Project Management Training
Managing of ETD intervention Training
Qualification Development Training
General Training
Assessment
ETQ002
Certification partners
ETQ003
ETQ004
ETQ005
ETQ006
ETQ007
Learning material evaluators
Moderation (organisation)
Moderation (individual)
Monitoring and evaluation of programmes
Verification*
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Accreditation with an ETQA
Competence in the relevant unit standard/s
and registration with ETDPSETA
Prior experience in SAQA regulated
certification processes
Accreditation with an ETQA
Competence in the relevant unit standard
Competence in the relevant unit standard
Competence in the relevant unit standard
Competence in the relevant unit standard ;
Prior experience
FIN001
Long Term and Short term insurance
services
Travel Related Services
· Flights
· Car Hire
· Accommodation
· Venue Hire
· Visa applications
Job Evaluation Consultants
Labour Evaluation Consultants
Organisational Development Specialists
Recruitment and Placement
Credit Record checking
Business process specialists
Payroll Outsourcing
Response Handling
Employee Assistance Program services
Debt Counseling Services
Catering for less than 5 people with less
than 24 hours notice
FIN002
HRO001
HRO002
HRO003
HRO004
HRO005
HRO006
HRO007
HRO008
HRO009
HRO010
CAT001
Portfolio of clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Catering for various dietary
requirements(e.g. Halaal, vegetarian, vegan
& kosher )
CAT002
Catering for more than 5 people
OPS002
Crockery & appliances
Catering for various dietary requirements
(e.g. Halaal, vegetarian, vegan and kosher)
N/A
OPS003
Document Archives / Corporate Offsite
Electronic storage facilities (e.g. scanned
Page 5 of 22
Applicable
W&RSETA Standard Supplier Database Registration Documents
Code
OPS004
OPS005
OPS006
OPS007
OPS008
OPS009
OPS010
Product / Service
Storage facilities
Flowers and flower delivery services
Office Deco Services
Special Requirement
documents)
Office Furniture
Office Maintenance
Security Services
· Alarm systems
· Access Control Systems
· CCTV Systems
· Arm Response
Electrical Services
Portfolio of services and clients
Portfolio of services and clients
Registration with the relevant national body
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Registration with the relevant national body
N/A
OPS011
Maintenance contract for existing water
purifying dispensers
Pest Control Services
OPS012
OPS013
OPS014
Recording Services
Transcription Services
Renovations and Restoration services
N/A
N/A
Portfolio of services and clients
OPS015
OPS016
OPS017
Portfolio of services and clients
OPS018
Driver (Casual & Part time)
Messenger or Delivery Services
Courier Services
· National
· International
Fire Systems
QUA001
Development of learning material
RES001
RES002
Research Services
Economic Research
RES003
Social Research
RES004
Sector Specific Research
RES005
Impact Evaluation
RES006
Research Project Management
RES007
Career Guides
RES008
SCM001
SCM002
ISO 9001:2008 auditing
Dispute resolution experts
General Legal services
SCM003
Litigation
SCM004
Conciliation, mitigation and arbitration
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Portfolio of services and clients
Registration with the relevant national body
Experience and expertise in the
development of learning material
N/A
Knowledge and experience of conducting
projects in Sector Skills Planning, Labour
Market Analysis and Skills Forecasting
Knowledge and experience of conducting
research projects in Skills Devevelopment
arena minimum 3 yeaers experience
Knowledge and experience of conducting
projects in the W&RSector, minimum 2
years experience
Knowledge and experience in development,
execution and reporting of impact
evaluations minimum number of impact
evaluations 3.
Submit proof of have experience in
managing research projects
Knowledge and Experince in developing
Career guides for various audiences using
various forms of media
Registered SABS ISO 9001:2008 auditors
Portfolio of services and clients
SETA knowledge, minimum 3 years
experience in public sector legal services,
labour law expertise
SETA knowledge, minimum 3 years
experience in public sector legal services,
labour law expertise
SETA knowledge, minimum 3 years
experience in public sector legal services,
Page 6 of 22
Applicable
W&RSETA Standard Supplier Database Registration Documents
Code
Product / Service
SCM005
Contract drafting
SCM006
Stationery (including photocopy paper;
excluding computer consumables)
Groceries (including cleaning products)
Computer Consumables (including toners,
printer cartridges ,drum kits etc)
Mentors for small businesses
SCM007
SCM008
SME015
ITS001
Special Requirement
ITS005
ITS006
ITS007
ITS008
IT Hardware / Software maintenance and
repair
IT Hardware distributors (PC's, Notebooks,
Printer, servers, backup devices)
IT Software: Microsoft software packages:
software (Office, Visio, Project, etc) ,
licenses
Software packages (Commercial Of The
Shelve Software, antivirus)
Network cabling (IT, data and voice)
UPS vendors and maintenance
Data Backup Services
Telephony (including fax related service*s)
ITS009
STR001
STR002
Software development
Strategic Planning
Teambuilding
ITS002
ITS003
ITS004
Applicable
labour law expertise
SETA knowledge, minimum 3 years
experience in public sector legal services,
labour law expertise
N/A
Delivery to the relevant W&RSETA offices
N/A
Experience and expertise in mentorship and
small business development
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Portfolio of services and clients
Portfolio of services and clients
CONSULTANCY/PROFESSIONAL SERVICES
Code
Description
Special Requirement
CON001
Independent Skills Development Facilitator
Proof of experience and contactable
references
CON002
Monitoring of implementation of learning
programmes
Proof of experience and contactable
references
CON003
Verification of
programmes
learning
Proof of experience and contactable
references
CON004
Quality Assurance of learning programmes
Proof of experience and contactable
references
CON005
Project Management
Proof of experience and contactable
references
CON006
External
Moderation
Programmes
CON007
Monitoring,
verification
and
Quality
assurance of learning programmes
learners
on
of
learning
Competence in the specific unit standard
Proof of experience and contactable
references
Page 7 of 22
Select
W&RSETA Standard Supplier Database Registration Documents
3. VENDOR INFORMATION FORM
Please complete this document accurately as the information contained herein is required for the following
purposes:
· To support W&RSETA in the implementation of a system of preferences as required by the
Preferential Procurement Policy Framework Act (No 5 of 2000).
· Failure to complete the form in full may result in the supplier not being considered for the awarding
of any orders or contracts by the W&RSETA.
PLEASE COMPLETE ALL PAGES.
ORGANISATIONAL DETAIL
Organisation Registered Name
Organisation Trading Name
Postal Address
Physical Address
Telephone no
E-mail address
Fax number
Company registration number
Company practice number
Company professional number
Tax clearance certificate number
VAT registration number
Participation Capacity (please tick one)
Consultancy
Consortium Partner
Supplier
Joint Venture
Partner
Other (please specify)
Type of Organisation (please tick one)
Sole Trader
Close Corporation
Ltd
Public entity
Organisational Classification Detail
Principal Business activities
Partnership
(Pty) Ltd
S(21) company
Business Sector
Number of years the organisation has
been in business
Total number of employees
Page 8 of 22
W&RSETA Standard Supplier Database Registration Documents
The financial manager/ external auditor/ CEO/Accounting Officer (whichever is relevant to
your type of business) needs to confirm the following:
The business/entity is:
(Please indicate on each of these. Failure to do so may invalidate your Supplier
Yes No
Database registration)
A going concern
In a sound financial condition
Have the financial and operational capacity to fulfill the contract requirements
Full Names: ___________________________________________________
Signature: _____________________________________________________
Capacity: ______________________________________________________
Page 9 of 22
W&RSETA Standard Supplier Database Registration Documents
4.
1.
DECLARATION OF INTEREST
Any legal person, including persons employed by the principal, or persons having a
kinship with persons employed by the principal, including a blood relationship, may make
an offer or offers in terms of this invitation to Supplier Database registration. In view of
possible allegations of favouritism, should the resulting Supplier Database registration, or
part thereof, be awarded to persons employed by the principal, or to persons connected
with or related to them, it is required that the Supplier or his/her authorised representative
declare his/her position in relation to the evaluating/adjudicating authority and/or take an
oath declaring his/her interest, where:
r the Supplier is employed by the principal; and/or
r the Supplier is a board member
r the legal person on whose behalf the Supplier Database registrationding document is
signed, has a relationship with persons/a person who are/is involved in the evaluation
and or adjudication of the Supplier Database registration(s), or where it is known that
such a relationship exists between the person or persons for or on whose behalf the
declarant acts and persons who are involved with the evaluation and or adjudication
of the Supplier Database registration.
2.
In order to give effect to the above, the following questionnaire must be completed and
submitted with the Supplier Database registration.
2.1
Are you or any person connected with the Supplier, Yes
No
employed by the principal?
2.1.2 If so, state particulars:
2.2
Do you, or any person connected with the Supplier, have Yes
any relationship (family, friend, other) with a person
employed by the principal and who may be involved with
the evaluation and or adjudication of this Supplier
Database registration?
2.2.1 If so, state particulars
No
2.3
No
Are you, or any person connected with the Supplier, aware Yes
of any relationship (family, friend, other) between the
Supplier and any person employed by the principal who
may be involved with the evaluation and or adjudication of
this Supplier Database registration?
2.3.1 If so, state particulars
I, The undersigned (Name)
Hereby certify that the information furnished in paragraph 2.1 to 2.3.1 above is correct. I accept
that the W&RSETA may act against me in terms of Paragraph 23 of the General Conditions of
Contracts should this declaration prove to be false..
Signature and Capacity
Date
Page 10 of 22
W&RSETA Standard Supplier Database Registration Documents
6. PREFERENCE POINTS CLAIM FORM IN TERMS OF THE PREFERENTIAL
PROCUREMENT REGULATIONS 2001
GENERAL CONDITIONS AND DEFINITIONS
80/20 RULE: Estimated Value Less Than R 500 000 Per Incident
NB: BEFORE COMPLETING RELEVANT CLAIM FORMS, SUPPLIERS MUST
CAREFULLY STUDY THE GENERAL CONDITIONS AND DEFINITIONS
1.
GENERAL CONDITIONS
1.1
The preference point system is applicable to all Supplier Database registrations.
1.2
Failure on the part of a supplier to complete and sign a claim form may be interpreted to mean that preference points are
not claimed.
1.3
W&RSETA reserves the right to require of a supplier, that he/she should substantiate any claim, in any manner required by
W&RSETA.
2.
GENERAL DEFINITIONS
The defined works and expressions commencing with capital letters, shall have the meanings hereby assigned to them
unless such meanings are inconsistent with the context of a particular tender or contract:
2.1
“Act” means the Preferential Procurement Framework Act, 2000 (Act No 5 of 2000)
2.2
“Agent” means a person mandated by another person (“the principal”) to do business for an on behalf of, or to represent in
a business transaction, the principal, and thereby acquire rights for the principal against W &RSETA and incur obligations
binding the principal in favour of W &RSETA.
2.3
“Comparative price” means the price after the factors of a non-firm price and all unconditional discounts that can be
utilised have been taken into consideration.
2.4
“Consortium or Joint Venture” means an association of persons for the purpose of combining their expertise, property,
capital, efforts, skill and knowledge in an activity for the execution of a contract.
2.5
“Contract” means the agreement that results from the acceptance of a tender by W &RSETA.
2.6
“Disability” means, in respect of a person, a permanent impairment of a physical intellectual, or sensory function, which
results in restricted, or lack of, ability to perform an activity in the manner, or within the range, considered normal for a
human being.
2.7
“Firm price” is the price that is only subject to adjustments in accordance with the actual increase or decrease resulting
from the change, imposition, or abolition of customs or excise duty and other duty, levy, or tax which, in terms of a law or
regulation is binding on the contractor and demonstrably has an influence on the price of any supplies, or the rendering
costs of any service, for the execution of the contract.
2.8
“Historically Disadvantaged Individual (HDI)” means a South African citizen –
2.8.1
who has no franchise in national elections prior to the introduction of the Constitution of the Republic of South Africa, 1983
(Act No 110 of 1983) or the Constitution of the Republic of South Africa, 1993 (Act No 200 of 1993)(“the Interim
Constitution”) and/or
2.8.2
who is a female; and/or
2.8.3
who has a disability.
Provided that a person who obtained South African citizenship on or after the coming to effect of the Interim Constitution, is
deemed not to be an HDI.
2.9
“Management” in relation to an enterprise or business, means an activity inclusive of control and performed on a daily
basis, by any person who is a principal executive officer of the company, by whatever name the person may be designated.
Page 11 of 22
W&RSETA Standard Supplier Database Registration Documents
2.10
“Non firm prices” means all prices other than “firm” prices.
2.11
“Person” includes reference to a juristic person.
2.12
“Rand value” means the total estimated value of a contract in Rand denomination which is calculated at the time of tender
invitations and includes all applicable taxes and excise duties.
2.13
“Small, Medium and Micro Enterprises (SMME’s)” bears the same meaning assigned to this expression in the National
Small Business Act, 1996 (Act No 102 of 1996).
2.14
“Sub-contracting” means the primary contractor’s assigning or leasing or making out work to, or employing, another
person to support such primary contractor in the execution of part of a project in terms of the contract.
2.15
“Tender” means a written offer or Supplier Database registration in a prescribed or stipulated form in response to an
invitation by an organ of state for the provision of services or goods.
2.16
“Trust” means the arrangement through which the property of one person is made over or bequeathed to a trustee to
administer such property for the benefit of another person.
2.17
“Trustee” means any person, including the founder of a trust, to whom property is bequeathed in order for such property to
be administered for the benefit of another person.
PREFEREN CE POINTS CLAIM FORM
EQUITY OWNERSHIP BY HISTORICALLY DISADVANTAGED INDIVIDUALS
1.
In terms of regulation 13 of the preferential procurement regulations pertaining to the Preferential Procurement Policy
Framework Act, 2000 (Act No 5 of 2000) the preference points system must include preference points of equity ownership
by historically disadvantaged individuals as defined by the Act.
Equity Ownership
1.1
Points allocated
Preference points for equity ownership by historically disadvantaged individuals who, due to the apartheid policy that had
been in place had no franchise in
national elections prior to the introduction of the Constitution of the RSA, 1983 (Act 110 of 1983) or the Constitution of the
RSA, 1993 (Act 200 of 1993)
1.2
1.3
(“the Interim Constitution”) and/or
who is a female; and/or
who is a person with a disability
2.
The equity ownership contemplated above must be equated to the percentage of an enterprise or business owned by
individuals or, in respect of a company, the percentage of a company’s shares that are owned by individuals, who are
actively involved in the management of the enterprise or business and exercise control over the enterprise, commensurate
with their degree of ownership at the closing date of the tender.
2.1
Where an organisation is classified as a non-governmental organisation (NGO), the ownership criterion is replaced by the
percentage of HDI directors on the Board of Directors of the NGO, irrespective of whether they are executive or nonexecutive directors.
3.
In the event that the percentage of ownership contemplated above changes after the closing date of the tender, the
SUPPLIER must notify W &RSETA and such tender will not be eligible for any preference points.
4.
Preference points should not be claimed in respect of individuals who are not actively involved in the management
of an enterprise or business and who do not exercise control over an enterprise or business commensurate with
their degree of ownership.
5.
All claims made for equity ownership by an HDI will be considered according to the following criteria:
5.1
Equity within private companies will be based on the percentage of equity ownership.
5.2
Preference points will not be awarded to public companies and tertiary institutions.
5.3
The following formula will be applied to calculate the number of points for equity ownership by an HDI:
Page 12 of 22
W&RSETA Standard Supplier Database Registration Documents
NEP= NOP X EP
100
Where
NEP = Points awarded for equity ownership by an HDI.
NOP = The maximum number of points awarded for equity ownership by an HDI in the specific category.
EP = The percentage of equity ownership by an HDI within the enterprise of business.
6.
Equity claims for a Trust will only be allowed in respect of those persons who are both trustees and beneficiaries and who
are actively involved in the management of the Trust.
7.
Documentation to substantiate the validity of the credentials of the trustees contemplated above must be submitted.
7.1
Documentation to substantiate the validity of the credentials of the board of directors who are actively involved in the
management of the NGO as contemplated in 2.1 above must be submitted.
8.
A Consortium or Joint Venture may, based on the percentage of the contract value managed or executed by their HDI
members, be entitled to equity ownership in respect of an HDI.
9.
The points scored for equity ownership will be added to the points scored for price and functionality.
10.
A person awarded a contract as a result of preference for contracting with, or providing equity ownership to an HDI, may
not subcontract more than 25% of the value of the contract to a person who is not an HDI or does not qualify for such
preference.
Page 13 of 22
W&RSETA Standard Supplier Database Registration Documents
Page 14 of 22
Date RSA or
TBVC citizenship obtained
Percentag
e owned
by others
IDENTITY NUMBER
Percentag
e owned
by
disabled
people
POSITION
OCCUPIED IN
ENTERPRISE
Percentag
e owned
by
Women
NAME
Percentag
e owned
by HDI’s
DECLARATION WITH REGARD TO EQUITY OWNERSHIP:
W&RSETA Standard Supplier Database Registration Documents
1.
HOW MANY PERMANENT STAFF MEMBERS ARE EMPLOYED BY THE SUPPLIER?
…………………………………………… ..
2.
I/we, the undersigned, who warrants that he/she is duly authorised to do so on behalf of
the firm certify that points claimed, based on owners/shareholders who are actively
involved in the day to day management of the enterprise equity ownership, qualifies the
firm for the points shown and I/we acknowledge that:
2.1
The information furnished is true and correct.
2.2
The Equity Ownership claimed is in accordance with the conditions.
2.3
A person awarded a contract as a result of preference for contracting with, or providing
equity ownership to an HDI, may not subcontract more than 25% of the value of the
contract to a person who is not an HDI or does not qualify for such preferences.
2.4
In the event of a contract being awarded as a result of points claimed, the contractor may
be required to furnish documentary proof to the satisfaction of W&RSETA that the claims
are correct.
2.5
If the claims are found to be incorrect, W&RSETA may, in addition to any other remedy it
may have
2.5.1
Recover all costs, losses or damages it has incurred or suffered as a result of that
person’s conduct;
2.5.2
Cancel the contract and claim any damages which it has suffered as a result of having to
make less favourable arrangements due to such cancellation.
WITNESSES:
1.
……………………………………… .
2.
……………………………………… .
………………………………………….
SIGNATURE(S)
OF SUPPLIER(S)
DATE:
7. GENERAL CONDITIONS OF CONTRACT
……………………………… .
(Continued on following page)
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W&RSETA Standard Supplier Database Registration Documents
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