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
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