RfP - IRS for managing the EEA/Norway Grants 09-14 A ANNEX - ADMINISTRATIVE TABLE OF ANSWER Where a tender involves several service providers, they shall make a proposal in the name of only one candidate, who is then the sole candidate if the proposal is successful, the other service providers being considered as subcontractors. The candidate(s) must stipulate the role, qualifications and experience of each service provider and, where relevant, the monitoring arrangements that exist between them. A.1 Legal Entity Form The legal entity form shall be filled in by a representative of the candidate authorised to sign contracts with third parties. The Legal Entity File must be supported by the following documents relating to each candidate in order to show its name, address and official registration number: - - - - - A legible copy of the instrument of incorporation or constitution, and a copy of the statutes, if they are contained in a separate instrument, or a copy of the notices of such constitution or incorporation published in the national or other official journal, if the legislation which applies to the candidate requires such publication; A legible copy of the most recent amendment to the instruments mentioned in the previous indent, including that involving any transfer of the registered office of the legal entity, or a copy of the notice published in the relevant national or other official journal of such amendment, if the legislation which applies to the candidate requires such publication. If the instruments mentioned in the previous paragraph have not been amended since incorporation and the candidate 's registered office has not been transferred since then, a written confirmation, signed by an authorised representative of the candidate, that there has been no such amendment or transfer; A legible copy of the notice of appointment of the persons authorised to represent the candidate in dealings with third parties and in legal proceedings, or a copy of the publication of such appointment if the legislation which applies to the legal entity concerned requires such publication. If the above documents doesn’t show the registration number, a proof of registration, as prescribed in their country of establishment, on one of the professional or trade registers or any other official document showing the registration number. If the above documents does not show the VAT number, a copy of the VAT registration document, where applicable. All candidates shall provide their Legal Entities File as well as the evidence mentioned above. Subcontractors shall only provide the legal entity file, without the above mentioned evidence. The legal entity form is available at the following link: http://ec.europa.eu/budget/info_contract/legal_entities_en.htm 1/6 RfP - IRS for managing the EEA/Norway Grants 09-14 A.2 Financial Identification Form The “Financial Identification Form” must be completed for the bank account opened in the country of domicile of the Candidate and: - stamped and signed by the representative of the candidate’s Bank, and - countersigned by the Account Holder, representing [1] the Contractor. The Financial Identification Form can be downloaded from the EUROPA website: http://ec.europa.eu/budget/info_contract/ftiers_en.htm 1 The declared Account Holder must be a person duly authorised to act legally on behalf of the Contractor for financial matters related to the present Contract. 2/6 RfP - IRS for managing the EEA/Norway Grants 09-14 A.2.1 Candidate Identification Form Please complete the information below: REPLY 1. Name of the candidate party 2. Legal status of the candidate party 3. Candidate party’s address 4. Person(s) authorised to sign contracts on behalf of the candidate party a) SURNAME and first name b) POSITION / ROLE (Director, etc.) c) d) 5. COPY of an official document issued by the National Authority for confirmation, with a specimen signature PROOF OF AUTHORISATION to sign contracts on behalf of the candidate party Contact person for this call for tender: a) SURNAME and first name d) Position/Role (Director, etc.) e) Direct telephone number f) Direct fax number g) Direct electronic mail address h) Postal address 3/6 RfP - IRS for managing the EEA/Norway Grants 09-14 A.3 Exclusion criteria form DECLARATION OF HONOUR with respect to THE EXCLUSION CRITERIA The undersigned [name of the signatory of this form, to be completed]: in his/her own name (if the economic operator is a natural person (i.e an individual) or in case of own declaration of a director or person with powers of representation, decision making or control over the economic operator) or representing (if the economic operator is a legal person) Official name in full (only for legal person): Official legal form (only for legal person): Official address in full: VAT registration number: declares that the company or organisation that he/she represents / he/she: a) Is not bankrupt or being wound up, is not having its affairs administered by the courts, has not entered into an arrangement with creditors, has not suspended business activities, is not the subject of proceedings concerning those matters, and is not in any analogous situation arising from a similar procedure provided for in national legislation or regulations; b) Has not been convicted of an offence concerning professional conduct by a judgment which has the force of res judicata; c) Has not been guilty of grave professional misconduct proven by any means which the contracting authorities can justify; d) Has fulfilled its obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the country in which it is established, or with those of the country of the contracting authority or those of the country where the contract is to be carried out; e) Has not been the subject of a judgement which has the force of res judicata for fraud, corruption, involvement in a criminal organisation or any other illegal activity. f) Is not a subject of the administrative penalty for being guilty of misrepresentation in supplying the information required by the contracting authority as a condition of participation in the procurement procedure or failing to supply an information, or being declared to be in serious breach of his obligation under contract covered by the budget; g) That in case of award of contract, he/she shall provide the evidence that they are not in any of the situations described in points a, b, d, e above. For situations described in (a), (b) and (e), production of a recent extract from the judicial record is required or, failing that, a recent equivalent document issued by a judicial or administrative authority in the country of origin or provenance showing that those requirements are satisfied. Where the Candidate is a legal person and the national legislation of the country in which the Candidate is established does not allow the provision of such documents for legal persons, the documents should be provided for natural persons, such as the company directors or any person with powers of representation, decision making or control in relation to the Candidate. For the situation described in point (d) above, recent certificates or letters issued by the competent authorities of the State concerned are required. These documents must provide evidence covering all taxes and social security contributions for which the Candidate is liable, including for example, VAT, income tax (natural persons only), company tax (legal persons only) and social security contributions. 4/6 RfP - IRS for managing the EEA/Norway Grants 09-14 For any of the situations (a), (b), (d) or (e), where any document described in two paragraphs above is not issued in the country concerned, it may be replaced by a sworn or, failing that, a solemn statement made by the interested party before a judicial or administrative authority, a notary or a qualified professional body in his country of origin or provenance. By signing this form, the undersigned acknowledges and agrees that if any of the declarations or information provided in the context of the present tender proves to be false, or has made substantial errors or committed irregularities or fraud he/she may be excluded from the tender procedure at any moment without any right for compensation. He she also undertakes that EFTA/FMO shall determine a financial penalty proportional to the seriousness of the offence committed. Full name: Date: Signature: 5/6 RfP - IRS for managing the EEA/Norway Grants 09-14 A.3.1 Absence of conflict of interests form DECLARATION OF HONOUR with respect to ABSENCE OF CONFLICT OF INTERESTS The undersigned [name of the signatory of this form, to be completed]: in his/her own name (if the economic operator is a natural person (i.e an individual) or in case of own declaration of a director or person with powers of representation, decision making or control over the economic operator) or representing (if the economic operator is a legal person) Official name in full (only for legal person): Official legal form (only for legal person): Official address in full: VAT registration number: declares on their honour: • They have no conflict of interest in connection with the contract; a conflict of interest could arise in particular as a result of economic interests, political or national affinities, family or emotional ties, or any other relevant connection or shared interest; • They will inform the FMO, without delay, of any situation constituting a conflict of interest or which could give rise to a conflict of interest; • They have not made and will not make any offer of any type whatsoever from which an advantage can be derived under the contract; • They have not granted and will not grant, have not sought and will not seek, have not attempted and will not attempt to obtain, and have not accepted and will not accept, any advantage, financial or in kind, to or from any party whatsoever, constituting an illegal practice or involving corruption, either directly or indirectly, as an incentive or reward relating to the award of the contract; • That the information provided, within the context of this invitation to tender, is accurate, sincere and complete. By signing this form, the undersigned acknowledges and agrees that if any of the declarations or information provided in the context of the present tender proves to be false, or has made substantial errors or committed irregularities or fraud he/she may be excluded from the tender procedure at any moment without any right for compensation. He she also undertakes that EFTA/FMO shall determine a financial penalty proportional to the seriousness of the offence committed. Full name: Date: Signature: 6/6