Supplier Database Submission Form ppt

Supplier Database Submission Form
Page 1 of 17








“FEEL THE BEAT AT AFRICA’S FEET”




Name of Supplier: _________________________________



PREFERRED SUPPLIER DATABASE SUBMISSION


Province: (Only one province may be indicated
per submission)


Organisation Registered Name / Name of
individual

Organisation Trading name:


Contact Person:


Telephone Number:


Fax Number:


E-mail address:

Supplier Database Submission Form
Page 2 of 17
Contents:
Suppliers must ensure that they have received all pages of this document, which consist of the
following:












The checklist
must be
completed as a
guideline for the
Supplier to comply with AFCON 2013 LOC requirements for submission and registration thereof.
Please note that non-compliant submissions to any of these conditions will not be evaluated.

No
Description
Special Instruction
1
Instructions for completion
To be completed in full
2
Vendor Information Form

To be completed in full
3
Supplier Database Registration
Commitment and Declaration of Interest
To be completed in full
4
Tax Clearance Requirements
Valid original tax clearance
certificate must be
submitted
5
Preference Points Claim Form
To be completed in full
6
General Conditions of Contract
Each page must be
initialled
7
Company Profile
Company Profile must be
submitted
8
Certified Copy of the owner/member,
director’s Identification Document
Certified copy of the
owner/member, director’s
identification document
must be submitted
9
Company Registration Documents

Company registration
documents must be
submitted


Supplier Database Submission Form
Page 3 of 17
1 INSTRUCTIONS FOR COMPLETION
 In order to comply with the Supply Chain Framework Regulations , Suppliers are requested to
please complete the Supplier Database registration forms included in this document.
 Failure to complete these forms fully and return these forms may lead to disqualification of the
Supplier.
 Please return original documents to the AFCON 2013 LOC Head Office at
SAFA House
76 Nasrec Road
Nasrec
Johannesburg

 Please clearly mark envelopes with the title “Supplier Database Submission”, Supplier name,
contact information. Please make use of courier services if needed. Only originally signed
submissions will be evaluated
 All queries must be in writing and addressed to Mncedisi Khumalo:
 No telephonic queries will be responded to.
 All responses must be in the standard format as contained in this document. Responses which
are not in this format will be disregarded.
 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.
 Where there is a special requirement listed for a service, proof of compliance to such special
requirement should be attached to the submission and marked “Special Requirement”. Should
no such proof be attached, the assumption will be non-compliance to such special requirement

and the submission will not be considered for that service.






















Supplier Database Submission Form
Page 4 of 17
Products and Services

1.1 indicate (X) the business sector in which your company is involved /operating.
1.2 Indicate (X) the preferred City of conducting business or mark all for National.

Business Sector

Johannesburg
Durban
Mbombela
Nelson
Mandela
Bay
Rustenburg
Advertising (Print, TV, Radio, Outdoor Media)






Aircraft / Charter Flight Services






Architects and Project Management

Brand Management Services






Catering






Chauffer and Driver Managed Services






Cleaning Consumables






Cleaning Contractor Services

Clothing Designers and Suppliers (Formal
Uniform, Sports Apparel)






Clothing Suppliers (Safety Apparel)






Corporate Gifts and Marketing Promotional
Items






Courier and Postal Services

Event Management Services






Exhibition Services






Facilities Management Services






Filing, Archiving, and Document Management
Systems Services

Florist






Hygiene and Sanitary Services






Indoor Plant Services






Information Technology (Support, Software,
Hardware, Consumables)

Interior Decoration






Irrigation System Suppliers






Language Translation, Training and
Interpretation Services






Laundry and Dry Cleaning Services

Legal Services






Marketing Service Providers






Marquee, Tent, and Portable Restroom Hire






Media Analysis, Monitors, Photographers

Medical Service Providers (Emergency, Travel,
Event, Hospitals)






Network and Data Cabling (Supply, Install and
Maintain)






Pitch Protection Services






Printing Services

Programme and Project Management Services






Public and International Relations Services






Publications






Removals and Storage Facilities

Supplier Database Submission Form
Page 5 of 17
Risk Management Services






Security Services (Guards, Stewards, VIP
Protection, Fence, Surveillance, Access Control,
Radios)






Signage Design and Erection






Sound, Audio Visual, Stage, Lighting, Video
Production, Supplies, Installation)

Sports Hospitality & Entertainment






Telecommunication Supplies and Services






Training Service Providers – Stewards and
Volunteers (SETA Accredited)






Transportation

Waste Disposal and Management






Logistics Management Services

Supplier Database Submission Form
Page 6 of 17
2. VENDOR INFORMATION FORM

Please complete this document accurately as the information contained herein is required for the
following purposes:
 To support AFCON 2013 LOC 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 AFCON 2013 LOC.
PLEASE COMPLETE ALL PAGES.

ORGANISATIONAL DETAIL
Organisation Registered Name

Organisation Trading Name

Postal Address



Physical Address

Telephone Number

E-mail Address

Fax Number

Cellphone Number

Company Registration Number

Tax Clearance Certificate Number

VAT Registration Number

Participation Capacity (please tick one)
Sub Contractor

Supplier

Consortium Partner

Joint Venture
Partner

Other (please specify)



Type of Organisation (please tick one)
Sole Trader

Partnership

Close Corporation

(Pty) Ltd

Ltd

S(21) company

Public entity



Organisational Classification Detail
Principal Business activities


Business Sector

Number of years the organisation has
been in business

Total Number of Employees

Is the organisation registered or does it
have a business license

List all trade associations in which the
organisation has membership

Did the organisation exist under a
previous name?

If so, list previous name

List the directors / members of the
organisation under the previous name





Supplier Database Submission Form
Page 7 of 17


Identify any owner or management officer which has an interest in other firm(s):
Name of owner/manager:

Other firm(s)

Duties in other firm

Name:

Other firm:

Duties in other firm

Organisation’s average annual turnover

(excl. VAT) for the previous 3 financial
years



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 the following. Failure to do so may invalidate your
Supplier Database Registration)
Yes
No
A going concern


In a sound financial condition


Has the financial and operational capacity to fulfil the contract requirements




Full Names: ___________________________________________________

Signature: _____________________________________________________

Capacity: ______________________________________________________

Supplier Database Submission Form
Page 8 of 17
Identify by name, HDI status and length of service, those individuals in the firm (including
owners and non-owners) responsible for the day-to-day management and business
decisions

Activity

Full Names
I.D. Number
Race
(B/C/A/W)
Gender
(M/F)
Disability(Y
/N)
Length
of
service
(Years)
Financing Decisions
Cheque Signing






Acquisition of lines
of credit






Sureties

Major purchase or
Acquisitions






Contract Signing






Management Decisions
Estimating






Marketing and
Sales

Hiring and Firing of
Staff






Supervision of
Office Staff






Supervision of Field
Staff

List the three largest contracts/assignments completed by your firm in the last three years.

Work performed
Purchaser
Contact person and
telephone number
Contract fee/amount


















This application must be stamped and signed by a Commissioner of Oaths:

Stamp and signature of Commissioner of Oaths:

Supplier Database Submission Form
Page 9 of 17
3. SUPPLIER DATABASE REGISTRATION COMMITMENT AND DECLARATION OF
INTEREST

PART A: SUPPLIER DATABASE REGISTRATION COMMITMENT

1. I/We hereby submit the Supplier Database application for registration to supply all or any of the
supplies and/or to render all or any of the services described in the proposal documents to the
AFCON 2013 LOC, on the terms and conditions and in accordance with the specifications
stipulated in the Supplier Database Registration Documents (and which shall be taken as part
of, and incorporated into, this Supplier Database Register) at the prices and on the terms
regarding time for delivery and/or execution inserted therein.
2. I/We agree that -


(a) this Supplier Database Registration and its acceptance shall be subject to the terms and
conditions contained in the AFCON 2013 LOC General Conditions of Contract and
Preference Points Claim Forms – General Conditions and Definitions of the Preferential
Procurement Policy Framework Act - PPPFA with which I am/we are fully aware of;

(b) if I/we withdraw my/our Supplier Database registration within the period for which I/we have
agreed that the Supplier Database registration shall remain open for acceptance, or fail to
fulfil the contract when called upon to do so, the AFCON 2013 LOC may, without prejudice

to its other rights, agree to the withdrawal of my/our Supplier Database registration or cancel
the contract that may have been entered into between me/us and the AFCON 2013 LOC
and I/we will then pay to the AFCON 2013 LOC any additional expense incurred by the
AFCON 2013 LOC having either to accept any less favourable Supplier Database
registration or, if new Supplier Database registrations have to be invited, the additional
expenditure incurred by the invitation of new Supplier Database registrations and by the
subsequent acceptance of any less favourable Supplier Database registration; the AFCON
2013 LOC shall also have the right to recover such additional expenditure by set-of against
moneys which may be due or become due to me/us under this or any other Supplier
Database registration or contract or against any guarantee or deposit that my have been
furnished by me/us or on my/our behalf for the due fulfilment of this or any other Supplier
Database registration or contract and pending the ascertainment of the amount of such
additional expenditure to retain such moneys, guarantee or deposit as security for any loss
the AFCON 2013 LOC may sustain by reason of my/our default;

(c) if my/our Supplier Database registration is accepted the acceptance may be communicated
to me/us by e-mail, letter or order by ordinary post or registered post and that SA Post Office
Ltd shall be regarded as my/our agent, and delivery of such acceptance to SA Post Office
Ltd shall be treated as delivery to me/us;

(d) the law of the Republic of South Africa shall govern the contract created by the acceptance
of my/our Supplier Database registration and that I/we choose citandi et executandi in the
Republic at (full address of this place);




3. I/We furthermore confirm that I/we have satisfied myself/ourselves as to the correctness and
validity of my/our Supplier Database registration; that the price(s) and rate(s) quoted cover all
the work/item(s) specified in the Supplier Database registration documents and that the

price(s) and rate(s) cover all my/our obligations under a resulting contract and that I/we
accept that any mistakes regarding price(s) and calculations will be at my/our risk.



Supplier Database Submission Form
Page 10 of 17
4. I/We hereby accept full responsibility for the proper execution and fulfilment of all obligations
and conditions devolving on me/us under this agreement as the Principal(s) liable for the due
fulfilment of any contract, which might be awarded based on this offer.

5. I/We agree that any action arising from this contract may in all respects be instituted against
me/us and I/we hereby undertake to satisfy fully any sentence or judgement which may be
pronounced against me/us as a result of such action.



* Delete whichever is not applicable.

6. Are you duly authorised to sign the Supplier Database registration?
*YES / NO


7. Has the Declaration of Interest (part B of this form :) been duly completed? *YES / NO



Supplier Database Submission Form
Page 11 of 17
PART B: DECLARATION OF INTEREST

1. 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:

 the Supplier is employed by the principal; and/or
 the Supplier is a board member
 the legal person on whose behalf the Supplier Database registration 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,
employed by the principal?
Yes

No

2.1.2
If so, state particulars:

2.2
Do you, or any person connected with the Supplier, have
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?
Yes

No



2.2.1
If so, state particulars


2.3
Are you, or any person connected with the Supplier, aware
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?
Yes

No

2.3.1
If so, state particulars


DECLARATION
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 AFCON 2013 LOC may act against me in terms of Paragraph 23 of the General
Conditions of Contracts should this declaration prove to be false



Signature

Date



Position

Name of Supplier


Supplier Database Submission Form
Page 12 of 17
4. TAX CLEARANCE REQUIREMENTS
IT IS A CONDITION OF THE AFCON 2013 LOC SUPPLIER DATABASE REGISTRATION
THAT

1. The taxes of the provider must be in order, or that satisfactory arrangements have been made
with the Receiver of Revenue to meet his / her tax obligations.

2. An original valid Tax Clearance Certificate must be submitted together with the Supplier
Database registration form. Failure to submit the original and valid Tax Clearance Certificate
SHALL invalidate the Supplier Database registration.

3. In Supplier Database registrations where Consortia / Joint Ventures / Sub-contractors are
involved each party/member must submit a separate Tax Clearance Certificate.

Supplier Database Submission Form
Page 13 of 17
4. 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 AFCON 2013 LOC reserves the right to require of a supplier, that he/she should substantiate any claim, in any manner
required by AFCON 2013 LOC.

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 AFCON 2013 LOC and incur
obligations binding the principal in favour of AFCON 2013 LOC.

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 AFCON 2013 LOC.

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.


Supplier Database Submission Form
Page 14 of 17

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.

PREFERENCE 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 Points allocated

1.1 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)
(“the Interim Constitution”) and/or
1.2 who is a female; and/or
1.3 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 non-
executive directors.

3. In the event that the percentage of ownership contemplated above changes after the closing date of the tender, the
SUPPLIER must notify AFCON 2013 LOC 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:


Supplier Database Submission Form
Page 15 of 17


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.

Supplier Database Submission Form
Page 16 of 17
DECLARATION WITH REGARD TO EQUITY OWNERSHIP:
NAME
POSITION
OCCUPIED IN
ENTERPRISE
IDENTITY NUMBER
Date RSA or
TBVC citizen-
ship obtained
Percentage
owned by
HDI’s
Percentage
owned by
Women
Percentage
owned by
disabled
people
Percentage
owned by
others

Supplier Database Submission Form
Page 17 of 17


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 AFCON 2013 LOC
that the claims are correct.

2.5 If the claims are found to be incorrect, AFCON 2013 LOC 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. ………………………………………. DATE: ……………………………….

………………………………………….
SIGNATURE(S)
OF SUPPLIER(S)