All Sections Marked with an Asterisk * Are Compulsory to Complete

All sections marked with an asterisk “*” are compulsory to complete.

Section A: Company information 1.1 Company Name* Date* Company Type* 1.2 (e.g. Sole proprietor, Partnership, Joint Venture, (Pty) Ltd, etc.) Company registration number* (DTI) (if 1.3. applicable) Value Added Tax (VAT) registration 1.4 number* (SARS) What do you Product 1.5 Services? Other? supply*? s?

Briefly describe your 1.6 company’s core business:

1.7 Experience in the particular Industry* Years Months Region al 1.8 Offices/ Presen ce

Section B: References: Tel & Cell Company/Client Contact person/s 2. number/s of E-mail Address* Name* Name* reference* 2.1 2.2 2.3 2.4 2.5 Section C: Contact Details Position in Company 3.1 Contact Name 1* E-mail Address 1* 1* 3.2 Tel Fax 3.3 Cell 1* 1* 1* Position in Company 3.4 Contact Name 2* E-mail Address 2* 2* 3.5 Tel Fax 3.6 Cell 2* 2* 2* Position in Company 3 3.7 Management Name 3* E-mail Address 3* * 3.8 Tel Fax 3.9 Cell 3* 3* 3* Physical Postal Address * (Head 3.1 Office/ 0 Tender Office)

3.1 Postal 1 Code Company Website 3.1 Address 2 (if available)

Section D: Additional Information Less than N$10m Complete the appropriate BEE “tic More than N$10m turnover but “tick 4.1 turnover questionnaire. k” less than N$35m ”

4.2 If evaluated by an independent BEE-rating agency, please provide copy of certificate.

4.3 Please supply a copy of your Company Profile (add softcopy [CD/USB]

4.4 Employment Equity Certificate

4.5 Value-Added Tax Registration Certificate

4.6 Financial Proposal

4.7 Proof of Contactors All Risk Insurance Cover (Subcontractors Only)

4.9 Company Registration Certificate

4.10 Letter of Good Standing from Social Security Commission

4.11 Good Standing Certificate from Inland Revenue

4.12 SME Certificate

NB The documents outlined above are mandatory in order to be eligible to participate. The SSC reserves the right to disqualify proposals if the requirements are not adhered to and may request for clarifications of evaluating company profiles. Section E: Declaration

I/we, the undersigned (Print name/s) ______;

Certify that the information as finished in this document is correct.

______Signature/s Date

______Designation (Please initial all other pages of this document)

Please submit your application in a sealed envelope addressed to and marked:

EXPRESSION OF INTEREST FOR GOODS AND SERVICES 2017

SOCIAL SECURITY COMMISSION

Fleet, Procurement & Property Department

Cnr A. Kloppers & J Haupt Str, Khomasdal, Windhoek

Submission of proposals to be placed in the TENDER BOX at the Reception of SOCIAL SECURITY COMMISSION, Cnr A. Kloppers & J Haupt Str, Khomasdal, Windhoek

No faxed or emailed proposals will be accepted. No document will be returned to unsuccessful companies. Only short listed companies will be contacted.

Enquiries: Mr. Walter Cloete Tel: 061 280 7002 Product Offerings Please tick the goods and services you intend to provide below, in terms of this invitation to register. Tic Tic Tic k k k Category Cat "X" Category Cat "X" Category Cat "X" Advertising & Promotion Building & Construction Computer Services (IT) C00 C04 Supply and Delivery of ICT Advertising 1 Environmental Impact Assmt. 7 Equipment: C00 C04 C27 Calendar Manufacturers 2 Architects 8 Hardware (IBM) 4 C27 Hardware (HP) 5 C00 C04 C27 Corporate Gifts 3 Builders Hardware 9 Hardware (Sun) 6 C00 C05 C27 Display Design 4 Building Renovators 0 Hardware (Other) 7 C00 C05 C10 Event Management 5 Ceilings & Ceiling Products 1 Equipment Rental 1 C00 C05 C10 Exhibition Organisers 6 Central Heating 2 UPS 2 C00 C05 C11 Flags 7 Civil Engineering 3 Printer Cartridges 0 C00 C05 C11 Graphic Design 8 Contractors 4 SSC blank cards 1 C00 C05 Supply and Delivery of ICT Marketing Services 9 Demolition 5 Systems Software C01 C05 Data Storage Systems (EMC & C27 Network Marketing 0 Drilling/Directional Boring 6 IBM) 0 C01 C05 C27 Newsprint/ Add Placements 1 Ducting & Ventilation 7 Software (Other) 1 C01 C05 C27 Outdoor Advertising 2 Earthmoving 8 Software (Oracle) 2 C01 C05 C27 Pamphlet Distributors 3 Engineers 9 Software (Samantyc) 3 C01 C06 C11 Promotional Items 4 Equipment 0 Software (Microsoft) 2 C01 C06 C27 Public Relations 5 Insulating Materials 1 Data Auditing Tools 9 C01 C06 C28 Signs & Banners 6 Insulation 2 Data Archiving Tools 0 C01 C06 Trade-Fares 7 Ladders 3 C01 C06 Provision of ICT Consulting TV Production & Design 8 Lifts 4 Services C06 C27 Air & Water Products Light Fittings & Fixtures 5 IT Consulting Services 8 C01 C06 C11 Air Conditioners 9 Locks 6 Web Page Design 3 C02 C06 C10 Dam Linings & Water Proofing 0 Paving & Walling 7 IT & Project Management 6 C02 C06 C09 Dust & Fume Control 1 Portable Toilets 8 Directory Portal 8 C02 C06 C09 Filters & Pumps 2 Pre-Fabrications 9 Directory Service 9 C02 C07 C10 Hoses & Clamps 3 Project Management 0 Ecommerce Online 0 C02 C07 C10 Tanks & Containers 4 Quantity Surveying 1 Hosting 3 C07 C10 Audio & Visual Roofing 2 Internet Cafes 4 C02 C07 Amplifiers 5 Scaffolding 3 C02 C07 Antennas & Aerials 6 Shopfittings 4 Provision of ICT Training C02 C07 C10 Editing 7 Structural Steelwork 5 PC Software Training 9 C02 C26 Education 8 Surge & Lightning Protection 8 C02 C26 Provision of ICT Maintenance Frames 9 Space Planning Interior Design 9 and Support Services C03 C10 HiFi Equipment 0 Business Services Maintenance 7 C03 C07 C10 Instruments 1 Business Management Services 6 Internet Support 5 C03 C07 Projectors 2 Construction & Interior Design 7 Recording Studios C03 Courier Services C07 Provision of ICT Network and 3 8 Security Services C03 C07 C10 Video Conferencing 4 Fire Control Systems 9 Networking 8 C08 C09 First aid Supplies 0 Advanced Connectivity Systems 7 C08 Automotive Office Furniture 1 Domestic Services C03 C08 C11 Breakdown Services 5 Office plants 2 Appliance repair 4 C03 C08 C11 Exhausts & Fitment 6 Photographers 3 Blinds 5 C03 C11 Fibreglass Products 7 Protective Clothing C084 6 C03 C08 C11 Fleet Maintenance 8 Recyclers 5 Cleaning Services & Products 7 C03 C08 C11 Parts & Accessories 9 Scrap & Waste Products 6 Construction & Interior Design 8 C04 C08 C11 Rental & Hiring 0 Secretarial Services 7 Drain Cleaning 9 C04 C08 C12 Repairs & Services 1 Storage & Filing 8 Electrical Appliances 0 C04 C09 C12 Trailers 3 Translation Services 0 Fences 2 C04 C09 C12 Trucks 4 Typing Service 1 Fire Alarms & Extinguishers 3 C04 C09 C12 Tyres & Wheels 5 Uniforms 2 Florists & Flowers 4 C04 C09 C12 Valet & Wash 6 Workwear 3 Glass 5 C26 C12 Chemicals & Plastics Market Intelligence 6 Gutters & Downpiping 6 C09 Risk Auditing & Consultancy C26 C12 Gasses 4 Services 7 Handyman Services 7 C09 C12 Resins 5 Indoor Plants 8 C09 C12 Sealants 6 Irrigation 9 C13 Kitchenware 0 C13 Landscaping & Garden Maint. 1 C13 Lightning Protection 2 C13 Locksmiths 3 C13 Paint Contractors 4 C13 Pest Control 5 C13 Plumbers 6 C13 Tree Felling/Bush Clearing 7

Tic Tic Tic k k k Category Cat "X" Category Cat "X" Category Cat "X" Education & Training Legal Telecommunication C13 C18 C21 Driving Instruction 8 Attorneys 1 Billing Systems 7 C13 C18 C21 Equipment 9 Immigration 2 Call centre equipment 8 C14 C18 C21 Training Support 0 Labour Relations 3 Call centre services 9 C18 C22 Employment & Labour Private Investigations 4 CPE Cabling (Data/Voice) 0 C14 C22 Agencies 1 Plant & Machinery CPE Voice & Data 1 C14 C18 C22 Arbitration & Mediation 2 Compressors & Pumps 5 Engineering Services 2 C14 C18 C22 Secretarial Services 3 Forklifts 6 FAX Equipment and Repairs 3 C18 C22 Personnel Recruitment Generators 7 Mast & antenna construction 4 Engineering Lifting Equipment C18 Mast & antenna engineering & C22 8 design 5 C14 C18 C22 Air-conditioning 4 Plant Hire 9 Mobile Phones 6 C14 C25 Monitoring equipment & C22 Electrical 5 Crane Hire 8 accessories 7 C14 C25 C22 Galvanising 6 Rigging Services 9 Operational support systems 8 C14 C26 C22 General Engineering 7 Container lifting 5 Optical fiber accessories 9 C14 C23 Powder Coating 8 Printing & Stationary Optical fiber cable supply 0 C14 C19 C23 Scrap Metal Merchants 9 Binding Equipment 0 Optical fiber Splicing 1 C15 C19 C23 Solar Equipment 0 Books 1 Optical fiber terminal equipment 2 C15 C19 C23 Structural 1 Business Forms 2 Optical fiber test equipment 3 C19 C23 Finance Comics 3 Overhead cable accessories 4 C15 C19 Overhead infrastructure C23 Acceptance 2 Editing 4 construction 5 C15 C19 C23 Accountants & Auditors 3 Labels 5 Overhead planning & surveying 6 C15 C19 C23 Assessors 4 Lamination 6 PABX Systems 7 C15 C19 C23 Associations 5 Machinery & Equipment 7 Radio Communications 8 C15 C19 C23 Bookkeepers 6 Printing 8 RF CPE 9 C15 C19 C24 Consultants 7 Publishers/Publications 9 RF Equipment & accessories 0 C15 C20 C24 Debtors Management 8 Reproduction & Binding Services 0 RF Installation 1 C15 C20 C24 Equipment 9 Rubber Stamps 1 RF Planning & Surveying 2 C16 C20 C24 Merchant 0 Stationery 2 Routing equipment & accessories 3 C16 C20 C24 Pension Funds 1 Warehousing & Distribution 3 Satellite CPE 4 C16 C24 Stock & Share brokers 2 Property Satellite Equipment 5 C16 C20 Switching equipment & C24 Systems 3 Agencies 4 accessories 6 C20 C24 Food & Beverage Services 5 Telephone Cards 7 C16 C20 C24 Catering Services 4 Valuations & Appraisers 6 Test & Measuring Equipment 8 C16 C24 Conference Centres 5 Security Timber Poles 9 C16 C20 Transmission equipment & C25 Conference co-ordination 6 Access Control & Time Mgmt. 7 accessories 0 C16 C20 C25 Hire 7 Alarms 8 Underground civil construction 1 C16 C20 Underground infrastructure C25 Mineral Water 8 Armed response 9 construction 2 C16 C21 Underground planning & C25 Vending Machines 9 Automation 0 surveying 3 C17 C21 C26 Water Coolers 0 Burglar Proofing 1 Cable Monitoring Services 0 C21 C26 Freight, Courier & Logistics CCTV 2 Site Acquisitions 1 C17 C21 C26 Air Cargo 1 Fences & Gates 3 Masts 2 C17 C21 C28 Boxes 2 Locks & Locksmiths 4 GPS Equipment 1 C17 C21 Cargo Equipment 3 Safes & Strongrooms 5 Travel & Tourism C17 C21 C25 Contractors 4 Suppliers 6 Agents 4 C17 C26 C25 Courier Services 5 Guards 4 Car Hire 5 C17 C25 Customs Clearing & Shipping 6 Charters 6 C17 C25 Distribution 7 Heliport Services 7 C17 C26 Equipment 8 Accommodation 3 C17 Furniture Removal 9 C18 Warehousing 0