INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS OF KENYA
PRE-QUALIFICATION OF SUPPLIERS FOR GOODS, WORKS & SERVICES FOR
THE YEAR 2015– 2016
CLOSING DATE: TUESDAY, 18 TH NOVEMBER 2014 AT 4.30 P.M.
Please indicate the item applied for as follows:
CATEGORY NO. :……………………………
CATEGORY NAME:…………………………….................................................................
Name
of Merchant ………………………………………….……
Postal
Physical
Address ………………………………………………
Address ………………………………………………
Telephone
No. ………………………………………………
TABLE OF CONTENTS
PAGE NUMBER
TENDER NOTICE .............................................................................................................................. 6
1. PRE-QUALIFICATION INSTRUCTIONS .............................................................................. 8
1
2. BRIEF CONTRACT REGULATIONS/GUIDELINES ....................................................... 10
3. PRE-QUALIFICATION DATA INSTRUCTIONS ............................................................. 11
4. PRE-QUALIFICATION EVALUATION CRITERIA .......................................................... 13
PART I: PRE-QUALIFICATION REGISTRATION DOCUMENTATION ........................... 15
PART ll: SUPPLIER DETAILS................................................................................................... 16
PART III : COMPANY DETAILS .............................................................................................. 16
PART VII: PERFORMANCE STANDARDS & FACILITIES ................................................ 19
PART VIII: MANPOWER ........................................................................................................... 20
PART IX: GENERAL INFORMATION .................................................................................... 20
PART X: BUSINESS PROBITY AND LITIGATION HISTORY ........................................... 22
PART XI: DECLARATION ........................................................................................................ 23
2
TENDER NOTICE
Pre-Qualification of Suppliers for Goods and Services for the Calendar Years 2015 and 2016
ICPAK invites applications for pre-qualification from interested, eligible and competent bidders
for supply of the under listed Goods and Services for the Year starting January 2015 to
December 2016.
Item No
Ref. Number
Item Description
Eligible Group
CATEGORY A – SUPPLY AND DELIVERY OF GOODS.
Supply of General Office Stationery.
Special Groups
Special Groups
1
ICPAK/PROC/1/2015
2
ICPAK/PROC/2/2015
Supply of fresh flowers.
ICPAK/PROC/3/2015
Design, Supply and delivery of
stationery e.g. notebooks etc.
ICPAK/PROC/4/2015
Design, Supply and delivery of branded Open
promotional materials e.g. T-Shirts, caps,
umbrellas, banners, bags, etc.
3
4
printed Special Groups
ICPAK/PROC5/2015
Supply of Computers, Computer accessories Open
and consumables.
ICPAK /PROC/6/2015
Supply of general office equipment and Open
Furniture i.e. Office executive chairs, cabinets,
safes etc.
ICPAK /PROC/7/2015
Supply of general Hardware i.e.
Electrical and plumbing items.
8
ICPAK /PROC/8/2015
Supply of Printers.
Open
9
KCAU/PROC/9/2015
Provision of Fumigation Services.
Special groups
5
6
Building, Open
7
3
Item No
Ref. Number
Item Description
Eligible Group
ICPAK /PROC/10/2015
Supply of Telephone and Telecommunication Open
Equipment i.e. headsets, PABX and accessories.
11
ICPAK /PROC/11/2015
Supply of Internet Security/Antivirus software.
Open
12
ICPAK /PROC/12/2015
Supply of fresh milk.
Special groups
ICPAK /PROC/13/2015
Supply and delivery of Mineral water and Open
Dispensers.
ICPAK /PROC/14/2015
Supply of Newspapers & Other Periodicals.
10
13
14
Special groups
CATEGORY B – PROVISION OF SERVICES
15
ICPAK /PROC/15/2015
Provision of security services
ICPAK /PROC/16/2015
Provision of printing services i.e. printing of the Open
official publications of the Institute, Journal,
brochures, flyers, booklets ,Desktop calendars
etc.
ICPAK /PROC/17/2015
Facilitation-rappoteuring/report
editorial services.
ICPAK /PROC/18/2015
Provision of production of documentaries, TV Open
and Radio infomercials.
ICPAK /PROC/19/2015
Provision of training and education content Open
development
services
for
Continuous
Professional Development (CPD)
ICPAK /PROC/20/2015
Provision of maintenance services for Open
computers, printers, ups, anti-virus/IT security
solutions, local/wide Area Network and wireless
Network etc.
ICPAK /PROC/21/2015
Provision of hosting, ISP, internet services and Open
maintenance services.
22
ICPAK /PROC/22/2015
Provision of Courier and Postage Services.
Special Groups
23
ICPAK /PROC/23/2015
Provision of Cleaning Services.
Special Groups
24
ICPAK /PROC/24/2015 Provision of sanitary disposal services.
16
17
18
19
20
21
4
Open
writing
and Open
Open
Item No
Ref. Number
Item Description
ICPAK /PROC/25/2015
Provision of creative design production services Special groups
(including cartoons, animators, publication of
layout design.)
ICPAK /PROC/26/2015
Provision of signage and outdoor branding Open
services.
ICPAK /PROC/27/2015
Provision of media monitoring and liaison Open
services.
ICPAK /PROC/28/2015
Provision of garbage collection services.
ICPAK /PROC/29/2015
Provision of travel agency services, air ticketing Open
and travel arrangements (IATA Registered
only).
25
26
27
28
Eligible Group
29
ICPAK /PROC/30/2015
30
Open
Provision of small building works, renovation,
partitioning, plumbing and related services.
Open
ICPAK /PROC/31/2015
Provision of transport and taxi services i.e. Open
small cars, vans and buses etc.
32
ICPAK /PROC/32/2015
Provision of Legal services.
Open
33
ICPAK /PROC/33/2015
Repair, maintenance and servicing of lift.
Open
34
ICPAK /PROC/34/2015
Provision of Website design and development.
Open
31
ICPAK /PROC/35/2015
35
Provision of Consultancy services, training and
team building.
Open
36
ICPAK /PROC/36/2015
Provision of systems audit services.
Open
37
ICPAK/PROC/37/2015
Provision of external audit services
Open
ICPAK /PROC/38/2015
Provision of hotel & conferencing facilities-All Open
counties.
ICPAK /PROC/39/2015
Provision and Supply of clean water tanker Open
services.
ICPAK /PROC/40/2015
Provision of fire extinguisher, maintenance and Open
services.
38
39
40
5
Item No
Ref. Number
Item Description
ICPAK /PROC/41/2015
Provision of Event Management Services i.e. Special groups
renting of tents, PA system, chairs etc.
ICPAK /PROC/42/2015
Provision of job evaluation services.
ICPAK /PROC/43/2015
Provision of General Insurance, all risks, Open
burglary, money, public liability, professional
indemnity.
ICPAK/PROC/44/2015
Human Resources Consultancy.
41
42
43
44
Eligible Group
ICPAK/PROC/45/2015
45
Open
Open
Provision of staff surveys e.g. work
environment survey, employee satisfaction etc.
Open
46
ICPAK/PROC/46/2015
Repairs and Maintenance of generators.
Open
47
ICPAK/PROC/47/2015
Provision of photography and videography
Special groups
ICPAK/PROC/48/2015
Staff Medical Insurance Cover (in-out patient) Open
(Open to Insurers and Brokerage firms).
49
ICPAK/PROC/49/2015
Provision of Assets Valuation Services.
Open
50
ICPAK/PROC/50/2015
Provision of Catering Services.
Open
48
Pre-qualification Tender documents can be obtained during working hours (8.00am-5.00pm)
from the Procurement Office located at ICPAK Offices Ground floor, Ruaraka,Thika Road, upon
production of receipt for payment of a non-refundable fee of Kshs. 1,000 per set of documents
payable to Standard Chartered Bank of Kenya Ltd, A/C No 0102093120900 Ruaraka Branch. An
acknowledgement receipt for the payment shall then be obtained from the cash office, after
which the prospective supplier will be issued with the pre-qualification documents from the
Procurement office.
Eligible applicants may also obtain tender documents from the ICPAK Website www.icpak.com
and submit a duly filled prequalification document with evidence of having paid a non
refundable fee of Kshs. 1,000/-.
Dully completed pre-qualification documents in a plain sealed envelopes and clearly marked the
pre-qualification Category, Pre Qualification Reference Number and Name should be addressed
to:
6
Chief Executive Officer
ICPAK
P.O Box 59963 00200, NAIROBI.
The document is to be deposited in the Tender Box provided at the ICPAK Secretariat by
Tuesday, 18th November 2014.
Mandatory Requirements
Each application for pre-qualification should be accompanied by:
1.
2.
3.
4.
5.
6.
Copy of Certificate of Registration.
Copy of VAT Registration Certificate
Tax Compliance Certificate from Kenya Revenue Authority
Copies of PIN Certificates of firm/company/individual.
Copy of current Trade License
Registration certificate from National Treasury for registered Youth Groups, women
and persons with disabilities
The submitted pre-qualification documents shall be opened immediately thereafter in the
boardroom in the presence of bidders or their representatives who may wish to attend.
The Management of the Institute reserves the right to accept or reject any application either in
part or in whole without assigning reasons thereof. Late submissions will be rejected.
The special groups are Youth (Up to 35 years), Women and Persons with Disabilities who
have registered with the National Treasury (Directorate of Procurement)
Open means: All eligible bidders can apply for these categories.
PROCUREMENT OFFICER
For: THE CHIEF EXECUTIVE OFFICER
7
GENERAL INSTRUCTIONS
1)
You are requested to provide particulars as indicated in part II, III, IV, V, VI of this form
as accurately as possible and where space provided is not sufficient, please use a separate
sheet of paper and attach to this form.
2)
ICPAK attaches great importance to correct information given. If the information given is
found to be incorrect in any respect, the applicant shall be rendered ineligible for
registration/deregistered.
3)
ICPAK reserves the right to visit and inspect business premises of all the applicants to
verify information provided.
4)
All the information provided would be treated as confidential.
5)
This Prequalification Document is eligible for one Item Code which should be clearly
written at the top of the form.
6)
Your prequalification documents should be submitted properly bound, filled and page
numbered. ICPAK shall not be responsible for Loss of documents not bound (loose).
8
1. PRE-QUALIFICATION INSTRUCTIONS
1.1
Introduction
The Institute of Certified Public Accountants of Kenya (ICPAK) would like to invite
interested candidates who must qualify by meeting the set criteria as provided by the
ICPAK to perform the contract of supply and delivery or provision of goods, services and
works to ICPAK.
1.2
Pre-qualification Objective
The main objective is to supply and deliver assorted items and also provide services
under relevant tenders/quotations to ICPAK on as and when required during the stated
period.
1.3
Invitation of Pre-qualification
Suppliers registered with Registrar of Companies under the Laws of Kenya in respective
merchandise or services are invited to submit their Pre-Qualification documents to The
Chief Executive Officer, Institute of Certified Public Accountants of Kenya so that they
may be pre-qualified for submission of quotations. Bids will be submitted in complete
lots singly or in combination. The prospective suppliers are required to supply mandatory
information for pre-qualification.
1.4
Experience
Prospective suppliers and contractors must have carried out successful supply and
delivery of similar items/services to Government/Corporation/ institutions of similar size.
Potential suppliers/contractors must demonstrate the willingness and commitment to meet
the pre-qualification criteria.
Note:
1. ICPAK may waiver some of the conditions in this document in line with the
Public Procurement and Disposal rules and Regulations.
9
2. Special Group firms (registered with Special Groups/AGPO) will be treated in
accordance with the Public Procurement and Disposal (Preference and
Reservation) Regulations, 2013
1.5
Pre-qualification Document
This document includes questionnaire forms and documents required of prospective suppliers.
1.6
In order to be considered for pre-qualification, prospective suppliers must submit all the
information herein requested.
1.7
Distribution of Pre-qualification Documents
A copy of the completed pre-qualification data and other requested information shall
be submitted to reach:
Chief Executive Officer
ICPAK
P.O Box 59963 00200, NAIROBI.
www.icpak.com
The document is to be deposited in the Tender Box provided at the ICPAK Secretariat by
Tuesday, 18th November 2014.
1.8
Questions Arising from Documents
Questions that may arise from the pre-qualification documents should be directed to the
following address:
Procurement Officer,
ICPAK
P.O Box 59963 00200,
NAIROBI.
Email: [email protected]
1.9
Additional Information
Institute of Certified Public Accountants of Kenya reserves the right to request
submission of additional information from prospective bidders.
10
1.10
Request for quotations will be made available only to those bidders whose
qualifications are accepted by Institute of Certified Public Accountants of Kenya after
scoring a minimum of 70% after the completion of the pre – qualification process.
11
2. BRIEF CONTRACT REGULATIONS/GUIDELINES
2.1
Taxes on Imported Materials
The Supplier shall pay custom duty, VAT and all other taxes as required by the law.
2.2
Customs Clearance
The contractors shall be responsible for custom clearance of their imported goods and
materials.
2.3
Contract Price
The contract shall be of unit price type or cumulative of computed unit price and
quantities required. Quantities may increase or decrease as determined by demand on the
authority of the Chief Executive Officer or Tender Committee. Prices quoted should be
inclusive of all delivery charges.
2.4
Payments
All local purchase shall be on credit of a minimum of thirty (30) days or as may be
stipulated in the Contract Agreement.
12
3. PRE-QUALIFICATION DATA INSTRUCTIONS
3.1
Pre-qualification data forms
The attached questionnaire forms described as part II, III, IV, V, VI, VII, are to be
completed by prospective suppliers/contractors who wish to be pre-qualified for
submission of tender for the specific tender.
3.1.1
The pre-qualified application forms which are not filled out completely and submitted in
the prescribed manner will not be considered. All the documents that form part of the
proposal must be written in English and indelible ink.
3.2
Qualification
3.2.1
It is understood and agreed that the pre-qualification data on prospective bidders is to be
used by Institute of Certified Public Accountants of Kenya in determining, according to
its sole judgment and discretion, the qualifications of prospective bidders to perform in
respect to each tender item/category as described by the client.
3.2.2
Prospective bidders will not be considered qualified unless in the judgment of Institute of
Certified Public Accountants of Kenya they posses capability, experience, qualified
personnel available and suitability of equipment and net current assets or working capital
sufficient to satisfactorily execute the contract for goods/services.
3.3
Essential Criteria for Pre-qualification (exempted for Special groups/AGPO
registered firms)
(a) Experience: Prospective bidders shall have at least 2 years experience in the supply of
goods, and 5 years in the case of Consultancy services and allied items in case of
potential supplier/contractor should show competence, willingness and capacity to
13
service the contract. Professional consultants shall be required to have indemnity cover
with reputable insurance Company.
(b)
Prospective supplier requires special experience and capability to organize supply
and delivery of items, or services at short notice.
(c)
ICPAK reserves to request for additional qualification information as the
tender/quotation stage to suit particular procurement.
3.3.2
Personnel
The Suppliers/Contractors/Consultants shall provide pertinent information to demonstrate
that they have qualified staff to carry out the assignment. CVs’ of the key personnel for
individual or group to execute the contract must be indicated in part VIII.
3.3.3
Financial Condition (Exempted for Special groups/ AGPO registered firms)
The Supplier’s financial condition will be determined by latest financial statement
submitted with the prequalification documents as well as letters of reference from their
bankers regarding suppliers/contractors credit position. Potential suppliers/contractors
will be pre-qualified on the satisfactory information given.
3.3.4Special consideration will be given to the financial resources available as working capital,
taking into account the amount of uncompleted orders on contract and now in progress.
Data to be filled/ provided on Part II. However, potential bidders should provide evidence
of financial capability to execute the contract.
3.3.5 Past Performance (exempted for Special Groups/ AGPO registered firms)
Past performance will be given due consideration in pre-qualifying bidders. Letter of
reference from past customers should be included in part V.
3.4
Statement
Application must include a sworn statement on part VII by the Tenderer ensuring the
accuracy of the information given.
14
3.5
Withdrawal of Prequalification.
Should a condition arise between the time the firm is pre-qualified to bid and the bid
opening date which could substantially change the performance and qualification of the
bidder or the ability to perform such as but not limited to bankruptcy, change in
ownership or new commitments, the ICPAK reserves the right to reject the tender from
such a bidder even though they have been initially pre-qualified.
3.6
The firm must have a fixed Business Premise and must be registered in Kenya, with
certificate of Registration, Incorporation/Memorandum and Articles of Association,
copies of which must be attached.
3.6.1
The firm must show proof that it has paid all its statutory obligations and have Valid Tax
Compliance Certificate from the Kenya Revenue Authority.
15
PRE-QUALIFICATION EVALUATION CRITERIA
A: MANDATORY REQUIREMENTS
1
Requirements
Certified copy of Certificate of Registration/Incorporation
Certified copy of Valid Tax Compliance Certificate
2
3
4
5
7
8
Score
Mandatory
Mandatory
Air Travel firms must be registered with IATA and any other
relevant
Bodies
Transport Hire firms must attach evidence of having taken all the
necessary Insurance covers.
Outside Catering Services – bidders to avail a certificate of health for
food handling from CCN/County/Municipal council
Single Business Permit from CCN/ County/Municipal Council or
certificate/letter of exemption for professional services from the
municipal authorities ( AGPO (Special groups) registered firms
are exempted).
Evidence of physical registered office – Attach utility bill e.g.
Electricity/water bill etc or tenancy agreements( AGPO/Special
Groups registered
16
Mandatory
Mandatory
Mandatory
Mandatory
Mandatory
firms are exempted)
B: TECHNICAL EVALUATION
Requirements (submit evidence)
1
2
3
4
5
6
PART No.
Registration Documentation
Supplier Pre-qualification Data
Financial Position
Manpower/Key personnel
Past Performance & Experience
Litigation History
Total
I
II
III
V
VI
VII
Score
(%)
25
5
20
20
25
5
100
Note:
3. The minimum score to qualify for prequalification shall be 70%. Applicants who
will not meet this minimum score shall be disqualified at this stage.
4. AGPO/Special groups registered firms shall be evaluated separately.
PART I: PRE-QUALIFICATION REGISTRATION DOCUMENTATION
All firms must provide copies of the following: 1. Copies of Certificate of Incorporation/Partnership deed/business registration
2. Valid Tax Compliance Certificate from Kenya Revenue Authority
3. Copy of current Single Business Permit from CCN/County/Municipal Council or exemption
where applicable
4. Copies of relevant registration certificates/permits/licenses specific to your line of business
from applicable bodies’ e.g. Ministry of Public Works, IATA, ICPAK, CAK, PRSK, AAK,
MISK, CCK, LSK, ACPAK, ACPSK, ISPAK, Pest Control Board etc.
5. Current letters of recommendation from previous organizations served (provide at least
two) where applicable.
6. Copies of current practicing Certificates for all professionals where applicable from
relevant/ applicable bodies.
17
7. Where registration for service provision is mandatory, the firm must attach evidence of
valid registration certificate with relevant Professional bodies/Authorities.
8.
CVs for Senior Staff for Consultancy Services
9. Evidence of physical registered office where applicable– Attach utility bill e.g.
Electricity/water bill etc or tenancy agreements
PART ll:
1. SUPPLIER PREQUALIFICATION DATA
A.
Business Name
………………………………………………………………………………………………
……………………………………
Pin No.
……………………………………………………
……………………………………………
VAT
Reg.
No
(Attach copy registration certificate)
B.
Address
P.O.
Box…………………….....Postal
Code..................................City/Town……………………………………
……….
Telephone
Nos………………………………………………………………………
…………………….
Mobile
Nos………………………………………………………………………………………….
Fax
No……………………………………………………………
…………………………………………..
Email
Address:………………………………………………………
18
……………….
Website
address
any)………………………………………………………………………….
C.
(If
Physical Address
Business
Location……………………………………………………………………………………
……………………...
Name of building …………………………………………………….
………………………………
Plot
No.
Road/Street
Name
……………………………………………….............................................................
Floor No. ………………………………………………… Room
………………………………………..
No.
______________________________________________________________________
2. COMPANY DETAILS
A Sole Proprietor
Your
name
in
full……………………………………….……………........................ Age………
........................................
….…….
Nationality……………………………….
Country
of
.................................
origin……………………………….
*Citizenship details…………………………………………………….……………….….
B Partnership
Given details of partners as follows:
Name
Nationality
Citizenship Details
Shares
………………………………………………………………………………………............
....................................................................
………………………………………………………………………………………............
.....................................................................
19
C Registered Company:
Private
Public……………………………………………………………………………..................
or
State the nominal and issued capital of companyNominal Kshs.………………………………..
Issued Kshs.…………………………………..
Given details of all directors as follows:Name
Nationality
Citizenship Details
Shares
1. …………………………………………………………………………………………................
...............................................................
2. …………………………………………………………………………………………..............
...............................................................
3. …………………………………………………………………………………………..............
...............................................................
4. …………………………………………………………………………………………..............
...............................................................
*If Kenya Citizen, indicate under “Citizenship Details” whether by Birth,
Naturalization or Registration
D. Registration with Registrar of Companies
1)
Date of Registration
…………………………
……………………………………
Registration No.
(Attach copy/copies of registration certificate)
2)
Registration with Ministry of Public Works
Date of Registration ………………………………………
……………………………
Registration No.
Present
Category
………………………………………………………………………
…………………………………
(Attach copy/copies of current registration certificate)
20
3)
Registration with any other bodies/authority relevant to your line of business
e.g. AAK, MISK, CCK, LSK, ICPAK, ACPAK, ACPSK, ISPAK, PRSK etc
Date of Registration ………………………………………… Registration No.
……………………………
Present
Category
………………………………………………………………………………………
…………………
(Attach a copy/copies of registration certificates)
4.
3.
Current Practising Certificates ((Attach copy)
TRADE LICENCES
Single Business Permit held - City Council of Nairobi /County/Municipality Councils
1)
Licence No. ………………………………. Expiry Date ………………………………..
Licensed
for.......................................................................................................................................
Current Trade Licence – Ministry/Statutory Commissions/Regulatory Commissions etc
1)
2)
3)
Licence
No.
……………………………
…
Licence
No.
……………………………
..
Licence
No.
……………………………
..
Expiry
Date
…………………………
……..
Expiry
Date
…………………………
……..
Expiry
Date……………………
…………….
(Attach copy/copies of registration certificate)
21
4. NATURE OF BUSINESS
A.
Please list the goods or services you provide specific to item Code, Item Description
applied for:
1)
………………………………………………………………………………………………
………………………………......
B.
For Contractors, state your area of specialisation specific to item Code, Item Description
applied for: 1)
………………………………………………………………………………………………
…………………………………
2)
………………………………………………………………………………………………
……………………………………
3)
………………………………………………………………………………………………
……………………………………
PART III: FINANCIAL POSITION / INVESTMENT
A.
B.
Company’s Capital
1)
Authorised Shares Ksh ……………………………………
2)
Issued Shares Ksh. ……………………………………
Partnership & Sole Proprietorship:
Total Investment: Kshs. ……………………………………………………
NB: Provide and attach certified audited financial statements for the previous
(latest) two years and/or bank statements for the last one year certified by the
issuing bank as proof of ability to execute the items applied for.
C.
Maximum value of business which you
…………………………………………………..
22
can
handle
at
any
time
D.
State terms of payment in preference order
i)
………………………………………………………………………
ii)
………………………………………………………………………
iii)
………………………………………………………………………
Note: ICPAK prefers payment to be made within 30 days after delivery of goods/services.
______________________________________________________________________________
PART IV: PERFORMANCE STANDARDS & FACILITIES
A.
Space
1)
2)
3)
B.
…………………
Owned or rented
…………………
Owned or rented
…………………
Office Owned or rented
Factor
y
Godo
wn
Sq.ft. ……………………………………
…………………………
Sq.ft. ……………………………………
…………………………
Sq.ft. ……………………………………
…………………………
Machinery
1)
You own or lease …………………………………………………
2)
Approximate value Ksh……………………………………………
(Provide and attach a list of key plant/equipment for the execution of the works)
3)
State
extent
to
which
you
would
have
work……………………………………………………
to
sub-contract
………………………………………………………………………………………
………………………………
………………………………………………………………………………………
…………………………………
4)
Are you certified by any Quality Assurance Body? If so, give the standard and
name
………………………………………………………………………………………
…………………………………
………………………………………………………………………………………
23
…………………………………
(Attach copies of the accreditation)
______________________________________________________________________________
PART V: MANPOWER
a)
Name
of
Chief
Executive
Officer/Principal
………………………………………………………………………………
b)
How many staff does your organization have?.…………………
c)
Indicate the number in each category:
Officer
(i) Technical (Permanent……….. Temporary………….)
(ii) Semi Skilled (
d)
Permanent………… Temporary………)
Please describe generally the experience and expertise your organisation posses that will
generally enable you to effectively and efficiently undertake the Consultancy services
that you are applying for as required by ICPAK.
Attach CV's of key professional/technical personnel in the following format.
Name
……………………………………………………………………………………………
Age
……………………………………………………………………………………………
Academic
………………………………………………………………………
Under graduate…………………………………………………………
Post
graduate……………………………………………………………………
…… Diploma………………………………………………………… High
School…………………………………............………………………
Professional Qualification ………………………………......………..
………………………………………...………………………………
24
Qualification
(Attach Certificates if any)
Length of service with the
firm
Position
held
……………………......
______________________________________________________________________________
PART VI: PAST PERFORMANCE & EXPERIENCE
a) Please provide at least four (4) major supplies/projects/assignments you have undertaken
relevant to the job you are bidding for performed over the last three (3) years,
1.
Name of 1 st Client (Organization)
i)
Name
of
Client
…………………………………………………………
(organization)
ii)
Address
of
Client
………………………………………………………
(organization)
iii)
Name of Contact Person at the client (organization) …………………………..
iv)
Telephone
No.
of
……………………………………………………………………
v)
Value
of
…………………………………………………………………………
vi)
Duration
of
Contract
……………………………………………………………..
Client
Contract
(date)
(Attach documental evidence of existence of contract)
Name of 2 nd Client (organization)
2.
i)
Name
of
Client
…………………………………………………………
(organization)
ii)
Address
of
Client
………………………………………………………
(organization)
iii)
Name of Contact Person at the client (organization) …………………………..
iv)
Telephone
No.
of
……………………………………………………………………
Client
v)
Value
of
……………………………………………………………………
Contract
vi)
Duration
of
Contract
……………………………………………………………..
25
(date)
(Attach documental evidence of existence of contract)
3.
Name of 3rd Client (organization)
i)
Name
of
Client
…………………………………………………………
(organization)
ii)
Address
of
Client
………………………………………………………
(organization)
iii)
Name of Contact Person at the client (organization) …………………………..
iv)
Telephone
No.
of
……………………………………………………………………
v)
Value
of
…………………………………………………………………………
vi)
Duration
of
Contract
……………………………………………………………..
Client
Contract
(date)
(Attach documental evidence of existence of contract)
4.
Name of 4th Client (organization)
i)
Name
of
Client
…………………………………………………………
(organization)
ii)
Address
of
Client
………………………………………………………
(organization)
iii)
Name of Contact Person at the client (organization) …………………………..
iv)
Telephone
No.
of
……………………………………………………………………
v)
Value
of
………………………………………………………………………
vi)
Duration
of
Contract
……………………………………………………………..
Client
Contract
(date)
(Attach documentary evidence of existence of contract)
b) Trade References
Attach at least four (4) current letters of recommendation from reputable organisations that
you have supplied goods, works/service for the last three years.
c) Name and address of your Bankers
………………………………………………………………………………………………
26
………………………….......................................................…………………………
………………………………………………………………………………………………
……………………………………………….........................................................……
d) Have you ever had an order/contract issued and cancelled in whole or part by ICPAK?
Yes/No ……………………
If
yes
give
reasons
for
cancellation
………………………………………………………………………………………………
………………………………………………………………………………………………
……………………………….............................................................................……
e) Do you have any objection in ICPAK obtaining a confidential financial report
from
your
bankers?…………………………………………………………………………
…………………………………………
f) Has your company ever been involved in litigation/arbitration with clients/consultants?
If
yes,
give
details
………………………………………………………………………………………………
…………………………
………………………………………………………………………………………………
……………………………………..
27
PART VII: BUSINESS PROBITY AND LITIGATION HISTORY
Please confirm whether any of the following criteria applies to your organization: Note that
failure to disclose information relevant to this section may result in your exclusion as a potential
ICPAK supplier.
No.
PARTICULARS
RESPONSE
1.
2.
3.
4
Is the organization bankrupt or being
wound
up, having
its
affairs
administered by the court, or have
entered into an arrangement with
creditors, suspended business activities
or any analogous situation arising from
similar proceedings in Kenya or the
country in which it is established?
Please provide a statement of any material
pending or threatened litigation or other legal
proceedings where the claim is of a value in
excess of Kshs 500,000/=
Has any partner, director or shareholder been
the subject of corruption or fraud investigations
by the police, Kenya Anti-Corruption
Commission or similar authority in the country in
which your organization is established?
Has the organization not fulfilled obligations
relating to the payment of any statutory
deductions or contributions including income tax
as required under Kenyan
law?
PART VIII: SWORN STATEMENT
I declare that to the best of my knowledge the answers submitted in this pre-qualification
questionnaires (and any supporting documentation) are correct. I understand that any
misrepresentation will render my organization ineligible to participate in any future business
activities with Institute of Certified Public Accountants of Kenya (ICPAK).
Having studied the pre-qualification information for the above provision of goods, works or
28
services applied for I hereby state:
1. The information and answers furnished in this pre-qualification questionnaire form
(and any supporting documentation) are correct to the best of our knowledge and I
understand that any misrepresentation will render my organization ineligible to
participate in any future business activities with Institute of Certified Public
Accountants of Kenya.
2. That in case of being pre-qualified we acknowledge that this grants 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.
3. We enclose all the required documents and information required for the pre-qualification
evaluation.
4. We will not engage in corrupt practices with the Commission/Members of Staff.
5. We have not been debarred from participating in Public Procurement Proceedings.
FORM COMPLETED BY
Date:
Name:
Signature:
Stamp or seal
(Full name and designation of the person signing and stamp or seal)
29
30