Any person, including persons in the employ of the State; or persons acting on behalf of the State, performing business as a sole proprietor or in partnership; or persons acting in the capacity of a trustee/s of a trust; or any legal entity, including legal entities and trusts, of which the members, directors, shareholders, trustees and/or beneficiaries are in the employ of the State or act on behalf of the State, may make an offer or offers in terms of this tender / bid invitation.
In view of the possible allegations of favouritism, should the resulting tender / bid, or part thereof, be awarded to persons employed by the State; or to persons who act on behalf of the State; or to persons connected or related to them, the bidder / tenderer or the bidder / tenderer's duly authorized representative shall disclose herein any relationship and/or kinship, including blood relation, which he/she; his/her employer; the bidder / tenderer's management; members; directors; partners; shareholders; trustees; and/or beneficiaries may have with any person or persons in the employ of the State and/or with any person or persons acting on behalf of the State and who may directly or indirectly be involved in, and/or may be in a position to influence the adjudication and/or evaluation and/or award of this bid / tender.
In order to give effect to the above, the following questionnaire shall be completed and submitted with the tender / bid. Failure to furnish the information requested in the questionnaire below may render the tender / bid submission not to be considered at all.
Is the bidder / tenderer and/or the duly authorized representative in the employ of the State?
If yes, state the full particulars of such person/s, together with their current position held as an employee of the State.
Is the bidder / tenderer and/or the duly authorized representative in the employ of the person/s or legal entity acting on behalf of the State, and who may directly or indirectly be involved in, and/or may be in a position to influence the adjudication and/or evaluation and/or award of this tender / bid YES N?
If yes, state the full particulars of such person/s, together with their current position held as an employee of such person/s or legal entity acting on behalf of the State.
Does the bidder / tenderer, the bidder's / tenderer's duly authorised representative, and/or any of the bidder's / tenderer's employees, management, partners, members, directors, shareholders, trustees and/or beneficiaries have any relationship (family, friend, business- or financial interest) with a person, or persons in the employ of the State and/or in the employ of the person/s or legal entity acting on behalf of the State, and who may directly or indirectly be involved in, and/or may be in a position to influence, the adjudication and/or evaluation and/or award of this tender / bid YES N?
If yes, state the full particulars of the persons between whom the relationship exists, the nature of the relationship and the current position/status of such employee/s of the State and/or of the person/s and/or legal entity acting on behalf of the State herein.
Does the bidder / tenderer have access or potential access to information on a Bid emanating from the business unit who will be directly contracted to management information by virtue of their appointment in the South African Social Security Agency YES N?
If yes, state full particulars for your current position.
Does the bidder / tenderer share premises with any service provider contracted to the South African Social Security Agency YES N?
If yes, state particulars on premises.
Does the bidder / tenderer have any previous involvement in the execution of this project?
If yes, state details of previous involvement in this project.
Does the bidder / tenderer have any subcontracting relationship with any service provider that is rending a service to the South African Social Security Agency in any capacity YES N?
If yes, state the relationship.
(name of the person duly authorised to sign the bid / tender documents on behalf of the bidder / tenderer) hereby certify that the information, furnished above, is correct in all respects. I accept and understand the South African Social Security Agency , as representative of the Government of the Republic of South Africa in this bid / tender, may act against me and the bidder / tenderer, jointly and severally, should this declaration prove to be false.