Cape Winelands District Municipality

Q 2012/869 CALL FOR PROPOSAL – APPOINTMENT OF A SUITABLY QUALIFIED AND EXPERIENCED SERVICE PROVIDER TO UNDERTAKE TAXI RANK SURVEYS IN BREEDE VALLEY MUNICIPAL AREA (DE DOORNS, RAWSONVILLE, TOUWSRIVER, WORCESTER) AND UPDATE THE CURRENT PUBLIC TRANSPORT RECORD AND OPERATING LICENCE STRATEGY REPORTS

COMPANY NAME: ………………..………………………………………………………………

POSTAL ADDRESS: ……………………………………..……..…………………………………..

…………………………………………..……………………………………

………………………………….

ANY ENQUIRIES REGARDING THE BIDDING PROCEDURE MAY BE DIRECTED TO: Department: Financial Management Services Supply Chain Management Tel: 086 126 5263 Fax: 086 688 4173

NOTE: Revised Preferential Procurement Regulations became effective on 7 December 2011.

Bidders wishing to be awarded points in terms of the Broad-Based Black Economic Empowerment Act must submit a certified copy of their Balanced Broad-Based Black Economic Empowerment Score Card. Failure to submit the abovementioned B-BBEE Score Card will result in the bidder only receiving the applicable points for price.

For more information please visit:

The Department of Trade and Industry: http://bee.thedti.gov.za/ South African National Accreditation System: http://www.sanas.co.za/directory.php Independent Regulatory Board of Auditors: http://irba.co.za/index.php

1 CAPE WINELANDS DISTRICT MUNICIPALITY

DOCUMENT PAGE

A. Notice...... 3

B. Conditions of Quotations...... 4-7

C. Contract Data…………………………………………………….…………………… 8-11

D. Form of Offer and Acceptance……………………………………………………… 12-13

E. Questionnaire – (List of partners/members/directors & B-BBEE Act)………… 14

F. Declaration by Supplier …..………………………………………………….……… 16-17

G. Certificate of Independent Bid Determination ……………………………………. 18-19

H. Credit Order Instruction……………………………………………………….……... 20

2 A. QUOTATION NOTICE

Formal Written Price Quotations are hereby invited from potential service providers to undertake taxi rank surveys in the Breede Valley Municipal area and update the Current Public Transport Record (CPTR) and Operating Licence Strategy (OLS) reports.

Documents are obtainable from the Supply Chain Management Unit of the Cape Winelands District Municipality at 29 Du Toit Street, Stellenbosch - Tel no 0861 265 263. Alternatively documents may be downloaded from the website: www.capewinelands.gov.za. → Supply Chain → View tenders and Quotes → Quotation open.

Technical enquiries should be directed to Mr BB Kurtz at Tel. 021-888 5210 or Fax: 021-882 9931.

Duly completed documents shall be enclosed in a sealed envelope endorsed “Q 2012/ 869: CALL FOR PROPOSAL – APPOINTMENT OF A SUITABLY QUALIFIED AND EXPERIENCED SERVICE PROVIDER TO UNDERTAKE TAXI RANK SURVEYS IN BREEDE VALLEY MUNICIPAL AREA (DE DOORNS, RAWSONVILLE, TOUWSRIVER, WORCESTER) AND UPDATE THE CURRENT PUBLIC TRANSPORT RECORD AND OPERATING LICENCE STRATEGY REPORTS)”. The sealed document shall be placed in the official tender box of the District Municipality’s offices at 29 Du Toit Street, Stellenbosch, before 11h00 on Wednesday, 19 September 2012.

M MGAJO MUNICIPAL MANAGER

3 B. GENERAL CONDITIONS OF QUOTATION Unless otherwise stipulated, the Government Procurement: General Conditions of Contract, July 2010, will apply to this quotation and;

1. The prospective Bidder’s attention is drawn to the following list of forms, attached to this document, and other documents that shall be completed and submitted with his/her bid documents:

a) Official Quotation Form (Form E) b) Questionnaire – (List of partners/members/directors & B-BBEE Act) (Form F) c) Declaration by Supplier (Form G) d) Certificate of Independent Bid Determination - MBD 9 (Form H) e) A valid and originally certified B-BBEE Score Card (not a photo-copy of another certified copy) f) An original Tax Clearance Certificate issued by the South African Revenue Service g) Proof of registration for VAT (if applicable) 2. In terms of Section 112(1) (l) of the Local Government: Municipal Finance Act, 2003 (Act No 56 of 2003), persons who were convicted for fraud or corruption or who wilfully neglected, reneged on or failed to comply with a government tender during the past 5 years, or whose tax matters are not cleared by the South African Revenue Services may not participate in the bidding process and the bidder shall submit a sworn statement to this effect.

3. The official quotation form must be completed in BLACK ink and any corrections to the official quotation form must also be made in BLACK ink and signed by the bidder. Any Formal Written Price Quotation received with correction fluid (Tippex) corrections shall be disqualified.

4. Quotations that are not clearly endorsed, or which are received after the closing time and date will not be considered.

5. Telexed, faxed or e-mailed quotations will not be accepted.

6. The forms should be carefully completed and no errors will be condoned after bids have been opened.

7. The fact and action of handing in a quotation to the Council is accepted as a contract between the Council and the Bidder whereby such a quotation remains valid and available for a period of ninety (90) days, calculated from the closing date as advertised for the quotation, for acceptance, or non-acceptance by the Council. The bidder undertakes not to withdraw, or alter, the tender during this period.

Notice of acceptance of the quotation by the Municipal Manager will be considered as a binding contract with effect from the date of such notice.

8. The bidder will be liable to take out forward cover to barricade him/her against fluctuation of the exchange rate in the event of importing any component, related to the quotation, from a country dealing in currency other than that of South Africa.

9. The Council does not bind itself to accept the lowest or any, quotation and reserves the right to accept any quotation in whole or part.

4 10. No prospective contractor will be allowed to sub-contract more than 25% of the contract value (excluding materials) to another enterprise. Any such offers will be rejected.

11. Please note that no bids will be considered from persons in the service of the State.

12. Any person, having a kinship with persons in the service of the state, including a blood relationship, may make an offer in terms of this invitation to bid. In view of possible allegations of favouritism, should the resulting bid, or part thereof, be awarded to persons connected with or related to persons in service of the state, it is required that the bidder or their authorised representative declare their position in relation to the evaluating/adjudicating authority and/or take an oath declaring his/her interest.

13. The bid of any person who canvasses or solicits, or causes to be canvassed or solicited, the support of any person employed by or in the service of the Employer or of the Consulting Engineer in favour of his offer, will not be considered.

14. The applicable 80/20 preferential points system as set out in the Revised Preferential Procurement Regulations will be used to evaluate individual tenders. h) Bidders wishing to benefit from it must submit a valid and originally certified copy (not a photo-copy of another certified copy) of their Balanced Broad-Based Black Economic Empowerment Score Card. Failure to submit the abovementioned B-BBEE Score Card will result in the bidder only receiving the applicable points for price.

Regulation R502 of 8 June 2011 provides for a preference points system

80/20 Points System for tenders with a 90/10 Points System for tenders with a value of >R30,000 to R1,000,000 value of >R1,000,000 The points are awarded as follows: The points are awarded as follows:

 80 points is awarded for the lowest price if it  90 points is awarded for the lowest price if it complies with the tender conditions. complies with the tender conditions.

 additional points is awarded for attaining the B-  additional points is awarded for attaining the B- BBEE status level of contributor in accor-dance BBEE status level of contributor in accor-dance with the table below: with the table below:

B-BBEE Status Level of Number of B-BBEE Status Level of Number of Contributor Points Contributor Points 1 20 1 10 2 18 2 9 3 16 3 8 4 12 4 5 5 8 5 4 6 6 6 3 7 4 7 2 8 2 8 1 Non-compliant contributor 0 Non-compliant contributor 0

IN TERMS OF LEGISLATION AN ORIGINAL TAX CLEARANCE CERTIFICATE MUST ACCOMPANY THIS TENDER.

5 QUOTATION SUBMITION

In accordance with procurement guidelines, a two-envelope tender system will be followed and your proposal shall be sealed in one outer and two inner envelopes, as detailed below:

a. The outer envelope shall be addressed to the Cape Winelands District Municipality and clearly indicate the quotation number, quotation description, closing date and time of submission. b. Both inside envelopes shall indicate your firm's name and address. The first inner envelope shall be marked "Technical Proposal" and contain the Technical Component of your proposal. The second inner envelope shall be marked "Price Proposal" and include your financial cover letter and Cost Component, as well as all the tender documentation required by Cape Winelands District Municipality as part of any tendering process.

B1. QUOTATION EVALUATION PROCESS

Responsive quotations will be evaluated based on the 80/20 preference points system for quotations with a value of

The description of the functionality (quality) criteria and the maximum number of quotation evaluation points allocated to each is shown in the table below. The score for functionality (quality) will be the sum of the scores for the individual criteria.

Description of functionality (quality) criteria Maximum number of evaluation points a. Expertise and experience of key personnel : [60] criteria applied to CPTR and OLS projects Poor =15; Average =30; Good = 45; previously successfully completed at Excellent = 60 municipal- or provincial levels b. Proposed work plan. (Approach and

methodology). An organogram linking the [40] key personnel as per criteria (a) to the Poor =10; Average =20; Good = 30; various aspects within the proposed work Excellent = 40 plan to be submitted. Total evaluation points for functionality (quality) 100 (Ms)

The minimum score for functionality is 75. Bid offers which score less than the minimum score of 75 for functionality will be rejected.

B1.1. Functionality (Quality) evaluation

This submission is the first round of evaluation and the evaluation of the functionality component will be completed prior to any cost component being considered and compared. The functionality component, which has a total possible score of 100, will be evaluated using the following criteria: a. Expertise and experience of key personnel [60 points] Clearly stipulate the processes to be followed, functioning of monitoring structures, project plan related activities and programme schedule. Aforementioned criteria to be demonstrated against previously completed CPTR and OLS projects successfully completed at Local Municipal levels. A maximum of 60 points can be awarded

6 b. Proposed work plan (Approach and methodology) [40 points] Provide an organogram indicating monitoring and reporting lines - indicate the appropriate skills and experience of personnel to undertake the various aspects within the project. Skilled personnel shall only be replaced with a person with similar or more experience upon approval by the client. A maximum number of 40 points can be awarded.

The Client reserves the right to request the bidders who have equalled or bettered the minimum requirement to do a presentation of their proposal. The individual presentations shall be evaluated against criteria (b), being proposed Work Plan (approach and methodology).

The Cost Component will be opened only for those firms/institutions whose Functionality Component meets the minimum requirements (a score of 75) for the assignment.

B1.2. Evaluation of price

The points allocated to the lowest responsive quotation price are 80. All other responsive quotation price proposals will be allocated points proportional to that of the lowest responsive quotation price.

Please note that the Cape Winelands District Municipality is not bound to select any of the firms/institutions submitting quotations. Furthermore, since a contract will be awarded in respect of the quotation, which is considered most responsive to the needs of the project concerned, Cape Winelands District Municipality does not bind itself in any way to select the firm/institution offering the lowest price.

B1.3. Final points scored

Final score for responsive quotations shall be calculated as follows: sum of points scored for price plus preferential points scored.

7 C. CONTRACT DATA

The Conditions of Contract are the “Standard Professional Services Contract” – September 2005 – Second Edition of CIDB document 1015 as published by the Construction Industry Development Board.

PART 1: DATA PROVIDED BY EMPLOYER

1. Clause 1 Employer: Cape Winelands District Municipality PO Box 100 Stellenbosch 7599 Employer’s Telephone Number: 0861265263 Employer’s VAT Registration Number: 4700193459

2. Clause 3.3 and 4.3.2 The designated contact person of the Employer:

Name: Mr. B B Kurtz Telephone: (021) 888 5210 Facsimile: (021) 882 9931 E-mail: [email protected]

3. Clause 1 The Project: CALL FOR PROPOSALS – APPOINTMENT OF A SUITABLY QUALIFIED AND EXPERIENCED SERVICE PROVIDER TO UNDERTAKE TAXI RANK SURVEYS IN THE BREEDE VALLEY MUNICIPAL AREA (WORCESTER, DE DOORNS AND TOUWSRIVER) AND UPDATE THE CURRENT PUBLIC TRANSPORT RECORD AND OPERATING LICENCE REPORTS.

4. Clause 1 The Period of Performance shall be defined by the Service Provider subject to negotiation and approval by the Client. Interim payments shall be based on attainment of listed deliverables up to a maximum of 80% of the contract amount with the balance, 20%, payable on submission of the close-out report.

5. Clause 3.5 The location of the performance of the Project is in the whole of the Breede Valley Local Municipal Area as determined in the Terms of Reference.

6. Clause 3.6 The Service Provider may not release public or media statements or publish material related to the Services or Project under any circumstances.

7. Clause 3.11 The penalty payable is R200-00 per day subject to a maximum amount of R 6.000-00.

8. Clause 4.3.1(d) The Service Provider is required to assist in obtaining approvals, licences and permits from the state, regional and municipal authorities having jurisdiction over the Project.

8 TERMS OF REFERENCE

1. BACKGROUND

The Cape Winelands District Municipality (CWDM) recently (first half of 2012) commenced a process of updating the Current Public Transport Record (CPTR) and Operating Licence Strategy (OLS) for the CWDM. The final draft versions of the reports have been prepared and will be submitted to the various Local Municipal Councils shortly for approval.

During the survey period for the Breede Valley Municipal area, the taxi associations expressed some concerns over the impact of the surveys on current internal processes in the region and requested that the surveys be terminated immediately. This resulted in only pedestrian counts and cordon surveys being undertaken. The Breede Valley Municipal CPTR and OLS was thus prepared based on the aforementioned 2012 survey results and the CPTR and OLS information in the 2010 Integrated Transport Plan.

The CWDM is therefore seeking professional service providers to undertake the required taxi rank surveys to update the current Breede Valley CPTR and OLS reports.

2. OBJECTIVE OF THE PROJECT

The objective of this project is to undertake the required taxi rank surveys and to update the current Breede Valley CPTR and OLS reports.

3. SCOPE OF SERVICES

The scope of services required is as follows:

3.1 Taxi rank surveys

• Undertake taxi rank surveys at the various taxi ranks in Breede Valley Municipality. 13 Ranks (informal and formal) have been identified in the various towns within the Breede Valley Municipal area which have to be surveyed as shown in the table below.

Table 1: Number of facilities by town

No of sites TOWN Ranks Major boarding/ alighting points De Doorns 1 0 Rawsonville 0 1 Touwsriver 0 1 Worcester 1 (holding area) 9 TOTAL 2 11

The number of mini-bus routes operating in the various towns, as registered at the Provincial Regulating Entity (PRE), is shown in the Table below.

9 Table 2: Number of routes per town

TOWN PRE ROUTES DE DOORNS 11 RAWSONVILLE 4 TOUWSRIVER 3 WORCESTER 19 TOTAL 37

• The taxi rank surveys have to be undertaken in compliance with the tables and formats stipulated in TPR2: Transitional Information Requirements for Public Transport – 1997 as published by the Government Gazette 1998.

3.2 Updating the current CPTR [weekday & week-end]

The following tables will have to be updated in the CPTR report: • Route descriptions (all day) • Routes as identified by facility • Rank/termini utilisation of loading/holding facilities (specified peak hour or off-peak hour) • Service capacity and capacity (specified peak hour) utilisation of routes (Bus and minibus-taxi type) • Description of facilities (Bus and minibus-taxi only) • Passenger and vehicle waiting times (Specified peak hour)

3.3 Updating the current OLS

Based on the taxi rank survey results, as well as the analyses undertaken as part of the CPTR process, the OLS report must be updated. In this report the following items must be updated. • Chapter 2: Analyses of the public transport system • Chapter 4: Operating Licence Strategy • Chapter 6: Stakeholder Consultation

4. DELIVERABLES

The deliverables will be the provision of a draft and final report containing the results of the taxi rank surveys in the required CPTR format, as well as the updated chapters of the OLS.

☼ Inception report - including agreed scope, budget, programme and deliverables;

☼ List in tabular format all vehicle registration numbers surveyed per route indicating status of vehicle.

☼ Current Public Transport record (CPTR) and Operating Licence Strategies (OLS’s) based on the table formats stipulated in TPR2: Transitional Information Requirements for Public Transport – 1997 as published by the Government Gazette 1998, are met.

☼ 2 colour hard copies of all documentation is required, as well as an electronic copy (CD) of all documentation and maps. The report should be provided in MSWord format with all plans and maps in ArcGIS and ARCVIEW shapefiles with attribute data or links to excel files, UTM 34 SOUTH, WGS 84.

10 5. KEY PERSONNEL REQUIRED

Below is a recommended list of key personnel for the completion of this contract:

☼ Project leader(s) who is a registered professional Transport / Traffic Engineer/Planner with at least 10 (ten) years of verifiable post graduate experience in project facilitation and management of transport planning related projects.

☼ Transport planners who are professional transport engineers with at least 5 (five) years of verifiable post graduate experience in transportation planning.

☼ GIS support with verifiable experience in transport engineering

The abovementioned key personnel to be clearly indicated on the organisational organogram which must be linked to the flow diagram as required in terms of the “Approach and methodology” criteria.

PART 2: DATA PROVIDED BY THE SERVICE PROVIDER

1. Clause 1

The Service provider:………......

Address:......

Telephone: ......

Facsimile: ......

Service Provider’s Company Registration Number: ………………………………...... ….…..

Service Provider’s Income Tax Reference Number: .…………………………………...……..

Service Provider’s VAT Reference Number: …………..………….………………..…………..

2. Clause 5.3

The authorized and designated representative of the Service provider:

Name: ......

Contact details for receipt of communication:

Telephone: ......

Facsimile: ......

Address: ......

E-mail: ……….…………………………………..…………………………………………….. 3. Clause 5.5 & 7.2

The Key Persons and their jobs / functions in relation to the services are:

Name Specific Duties

Attach an organisational organogram clearly defining flow of responsibility for various activities.

12 D. FORM OF OFFER AND ACCEPTANCE

OFFER

The Employer, identified in the acceptance signature block, has solicited offers to enter into a Contract in respect of the following works:

Q 2012/869: CALL FOR PROPOSALS – APPOINTMENT OF A SUITABLY QUALIFIED AND EXPERIENCED SERVICE PROVIDER TO UNDERTAKE TAXI RANK SURVEYS IN THE BREEDE VALLEY MUNICIPAL AREA (DE DOORNS, RAWSONVILE, TOUWSRIVER AND WORCESTER) AND UPDATE THE CURRENT PUBLIC TRANSPORT RECORD AND OPERATING LICENCE REPORTS

The bidder, identified in the offer signature block, has examined the documents listed in the contract data and addenda thereto as listed in the quotation schedules, and by submitting this offer has accepted the Conditions of Quotation.

By the representative of the bidder, deemed to be duly authorized, signing this part of this form of offer and acceptance, the bidder offers to perform all of the obligations and liabilities of the Service Provider under the contract including compliance with all its terms and conditions according to their true intent and meaning for an amount of be determined in accordance with the conditions of contract identified in the Conditions of Contract.

THE OFFERED SUM, INCLUSIVE OF ALL DISBURSEMENTS AND MAN-DAYS TO EXECUTE THIS WORK IS

Offer in Rand: R …………………………………………………………(INCLUSIVE OF VAT at 14%)

Value of tender to be sub-contracted, excluding materials: ………..…. %

(…….………………………………………………………………………………………….………………)

With reference to (B. General Conditions of Tender Par.11) above, the bidder declares that (tick one box as applicable): It intends sub-contracting more than 25% of the value of the contract to subcontractors

It DOES NOT intend sub-contracting more than 25% of the Value of the contract to subcontractors

This offer may be accepted by the Employer by signing the Acceptance part of this form of offer and acceptance and returning one copy of this document to the Bidder before the end of the period of validity stated in the Conditions of Quotation, whereupon the Bidder becomes the party named as the Service Provider in the Conditions of Contract.

Signature(s): ......

Name(s): ......

Capacity for the Bidder: ………………………………......

Name of organization………………………………………………………………………...……………..

Name and Signature of

Witness: ...... Date: ......

13 ACCEPTANCE

By signing this part of this form of offer and acceptance, the Employer identified below accepts the Bidders offer. In consideration thereof, the Employer shall pay the Service Provider the amount due in accordance with the Conditions of Contract identified in the contract that is the subject of this agreement.

Deviations from and amendments to the documents listed in the contract data and any addenda thereto as listed in the quotation schedules as well as any changes to the terms of the offer agreed by the bidder and the Employer during this process of offer and acceptance, are contained in the schedule of deviations attached to, and forming part of this agreement. No amendments to or deviations from said documents are valid unless contained in this schedule, which must be signed by the authorized representative(s) of both parties.

The bidder shall within two weeks after receiving a completed copy of this agreement, including the schedule of deviations (if any), contact the Employer’s agent (whose details are given in the contract data) to arrange the delivery of any bonds, guarantees, proof of insurance and any other documentation to be provided in terms of the conditions of contract identified in the Contract Data at, or just after, the date this agreement comes into effect. Failure to fulfil any of these obligations in accordance with those terms shall constitute a repudiation of this agreement.

Notwithstanding anything contained herein, this agreement comes into effect on the date when the bidder receives one fully completed original copy of this document, including the schedule of deviations (if any). Unless the bidder (now Service Provider), within five days of the date of such receipt, notifies the Employer in writing of any reason why he cannot accept the contents of this agreement, this agreement shall constitute a binding contract between the parties.

ACCEPTANCE (to be completed by the Cape Winelands District Municipality)

Name and address: Cape Winelands District Municipality, PO Box 100, Stellenbosch, 7599

Name: ……………………………………………..………………………….…

Executive Director for the Employer: ……………………..……..……..…………………….

Signature: ……………………………………………………….……………….....

Name of Witness: ………………………………………………………..……………….…

Signature: …………………………………………………….….………………….

14 E. QUESTIONNAIRE

List all partners / members / directors of this enterprise Van / Surname / Ifani Voornaam / First name / Amagama ID Nr./No. Inombolo

BROAD-BASED BLACK ECONOMIC EMPOWERMENT (Act 53 of 2003)

LW! Om Voorkeurpunte te eis NB! To claim Preference points a QAPHELA! Ukuba ufuna ukwenza moet 'n gesertifiseerde afskrif certified copy of your Balanced ibango lamanqaku akhethekileyo, van u Gebalanseerde Breë Broad-Based Black Economic kufuneka ukuba isicelo sakho Basis Swart Ekonomiese Empowerment Score Card must be sihambe kunye nekopi ye Balanced Bemag-tigingstelkaart voorgelê submitted. Broad-Based Black Economic

word. Empowerment Score Card eqinisekisiweyo.

Vir meer inligting besoek: / For more information please visit: / Inkcukach ezithe vetshe uzakuzifumana aph:

The Department of Trade and Industry: http://bee.thedti.gov.za/

South African National Accreditation System: http://www.sanas.co.za/directory.php Independent Regulatory Board of Auditors: http://irba.co.za/index.php

………………………………………………………………………………………………………………………….. Besigheid of persoon se naam:- / Business or person's name:- / Igama leshishini okanye lomntu

**1. Persentasie aandeelhouding van persone (HBI) in die besigheid wat histories benadeel is as gevolg van onregverdige diskriminasie gebaseerd op ras. Percentage of shareholding of persons (HDI) in the business historically disadvantaged because of unfair discrimination based on race. % Ipersenti yesabelo sabantu kwishishini elalisakuthinteleka ekuxhamleni amalungelo athile ngenxa yobandlululo ngokobuhlanga.

2. Persentasie aandeelhouding van persone (HBI) in die besigheid wat histories benadeel is as gevolg van onregverdige diskriminasie gebaseerd op geslag. Percentage of shareholding of persons (HDI) in the business historically disadvantaged because of unfair discrimination based on gender. % Ipersenti yesabelo sabantu kwishishini elalisakuthinteleka ekuxhamleni amalungelo athile ngenxa yobandlululo ngokwesini.

3. Persentasie aandeelhouding van persone (HBI) in die besigheid wat histories benadeel is as gevolg van onregverdige diskriminasie gebaseerd op gestremdheid. Percentage of shareholding of persons (HDI) in the business historically disadvantaged because of unfair discrimination based on disability. % Ipersenti yesabelo sabantu kwishishini elalisakuthinteleka ekuxhamleni amalungelo athile ngenxa yobandlululo ngokobulwelwe.

4. Persentasie aandeelhouding van persone geklassifiseer as jeug. (18 – 35 Jaar oud). Percentage of shareholding of persons in the business classified as youth. (18 – 35 Years old) % Ipersenti labantu abanezabelo kwinkonzo zoshishino ababizwa ngokuba lulutsha (18 – 35 Yeminyaka)

5. Is u besigheid geleë binne die jurisdiksie van die Distriksmunisipaliteit ? In / Uit In/Ngaphakat hi Is your business established within the area of jurisdiction of the District Municipality? In / Out Ingaba ishishini lakho limi kwingingqi elawulwa nguMasipala wesithili? Ngaphakathi / Uit/Out/Ngap Ngaphandle handle

6. Maak u gebruik van plaaslike arbeid (werkskepping)? Ja / Nee Ja/Yes/Ewe Do you make use of local labour (job creation)? Yes / No Uyawasebenzisa amathuba avelayo odalo lomsebenzi (ukudala umsebenzi)? Ewe / hayi Nee/No/Hayi

15 F. DECLARATION BY SUPPLIER

1 This document serves as a declaration to be used by the municipality in ensuring that when goods and services are being procured, all reasonable steps are taken to combat the abuse of the supply chain management system. No Contract will be awarded to persons in the service of the state.

2 (A) Any prospective supplier, having a kinship with persons in the service of the state, including a blood relationship, may in terms of current legislation register on the Municipality's Database. In view of possible allegations of favouritism, should a resulting bid, or part thereof, be awarded to suppliers connected with or related to persons in the service of the state, it is required that the supplier or his/her authorised representative declare their position in relation to the evaluating/adjudicating authority and/or take an oath declaring his/her interest.

2 (B) The request for registration on the Municipality’s database may be rejected if the supplier or any of its directors/members/partners have:

(i) abused the municipality’s supply chain management system or committed any improper conduct in relation to such system; (ii) been convicted for fraud or corruption during the past five years; (iii) willfully neglected, reneged on or failed to comply with any government, municipal or other public sector contract during the past five years; (iv) being a person whose tax matters are not cleared by the South African Revenue Services; or (v) been listed in the Register for Tender Defaulters in terms of section 29 of the Prevention and Combating of Corrupt Activities Act (No 12 of 2004). In order to give effect to the above, the following questionnaire must be completed by 3. each individual partner/member/director of this enterprise, and signed before a Commissioner of Oaths. (prepare copies of this declaration for each individual)

3.1 Print full Name: ………………………………………………………………...…………………………..

3.2 ID number..………………………………… Company/CC Reg. Nr ……….…………………………..

3.3 Are you presently in the service of the state? * YES/NO

3.3.1 If so, furnish particulars: ……………………………………………………………………..……………

3.4 Have you been in the service of the state for the past twelve months? YES/NO

3.4.1 If so, furnish particulars: ……………………………………………………………………..…………… Do you, have any relationship (family, friend, other) with persons in the service of the state and who may be involved with the evaluation and or adjudication of any 3.5 prospective bid? YES/NO

3.5.1 If so, furnish particulars: ……………………………………………………………………..…………… Are you, aware of any relationship (family, friend, other) between a supplier and any persons in the service of the state who may be involved with the evaluation and or 3.6 adjudication of any bid? YES/NO

3.6.1 If so, furnish particulars: ……………………………………………………………………..…………… Are any of your company’s directors, managers, principle shareholders or 3.7 stakeholders in the service of the state? YES/NO

3.7.1 If so, furnish particulars: ……………………………………………………………………..…………… Is any spouse, child or parent of your company’s directors, managers, principle 3.8 shareholders or stakeholders in the service of the state? YES/NO

3.8.1 If so, furnish particulars: ……………………………………………………………………..…………… Is the supplier or any of its directors/partners listed on the National Treasury’s database as a company or person prohibited from doing business with the public 3.9 sector? YES/NO

3.9.1 If so, furnish particulars: ……………………………………………………………………..……………

16 Is the supplier or any of its directors listed on the Register for Tender Defaulters in terms of section 29 of the Prevention and Combating of Corrupt Activities Act (No 12 3.10 of 2004)? YES/NO

3.10.1 If so, furnish particulars: ……………………………………………………………………..…………… Was the supplier or any of its directors convicted by a court of law (including a court of law outside the Republic of South Africa) for fraud or corruption during the past 3.11 five years? YES/NO

3.11.1 If so, furnish particulars: ……………………………………………………………………..…………… Does the supplier or any of its directors owe any municipal rates and taxes or municipal charges to the municipality / municipal entity, or to any other municipality / 3.12 municipal entity, that is in arrears for more than three months? YES/NO

3.12.1 If so, furnish particulars: ……………………………………………………………………..…………… Was any contract between the supplier and the municipality / municipal entity or any other organ of state terminated during the past five years on account of failure to 3.13 perform on or comply with the contract? YES/NO

3.13.1 If so, furnish particulars: ……………………………………………………………………..……………

CERTIFICATION I, THE UNDERSIGNED, …………………………………………………………………...…………………………...… , IN MY Full names and Surname

CAPACITY AS……………………………………………... OF ……...……………….…………………………………………... Designation Name of Business/Company/CC

CERTIFY THAT THE INFORMATION FURNISHED ON THIS DECLARATION FORM IS CORRECT. I ACCEPT THAT THE STATE MAY ACT AGAINST ME SHOULD THIS DECLARATION PROVE TO BE FALSE.

………………………………………………………………………………... …………………………………….………… Signature Date

Commissioner of Oaths

Signed and sworn to before me at ……………………………………on this...…..…day of .……...…..…...………20 ….… by the Deponent, who has acknowledged that he/she knows and understands the contents of this Affidavit, it is true and correct to the best of his/her knowledge and that he/she has no objection to taking the prescribed oath, and that the prescribed oath will be binding on his/her conscience.

………………………………………………..…………………..…………………… Apply official stamp of authority COMMISSIONER OF OATHS:

Position: ………………………………….………….……… Address …………………………….…………….………… ……………………..……………………………… Telephone: …………………………………..…………………

* MSCM Regulations: “in the service of the state” means to be – This document is compulsory, in terms of

Regulation 44 and 45 of the Supply Chain (a) a member of – (i) any municipal council; Management Regulations, to do business (ii) any provincial legislature; or with any municipality – Failure to submit it (iii) the national Assembly or the national Council of provinces; will disqualify your quotation from the (b) a member of the board of directors of any municipal entity; acquisitioning process. (c) an official of any municipality or municipal entity; (d) an employee of any national or provincial department, national or provincial public entity or constitutional institution within the meaning of the Public Finance Management Act, 1999 (Act No.1 of 1999); (e) a member of the accounting authority of any national or provincial public entity; or an employee of Parliament or a provincial legislature

17 G. CERTIFICATE OF INDEPENDENT BID DETERMINATION (MBD 9)

1. This Municipal Bidding Document (MBD) must form part of all bids¹ invited.

2. Section 4 (1) (b) (iii) of the Competition Act No. 89 of 1998, as amended, prohibits an agreement between, or concerted practice by, firms, or a decision by an association of firms, if it is between parties in a horizontal relationship and if it involves collusive bidding (or bid rigging).² Collusive bidding is a per se prohibition meaning that it cannot be justified under any grounds.

3. Municipal Supply Regulation 38 (1) prescribes that a supply chain management policy must provide measures for the combating of abuse of the supply chain management system, and must enable the accounting officer, among others, to: a. take all reasonable steps to prevent such abuse; b. reject the bid of any bidder if that bidder or any of its directors has abused the supply chain management system of the municipality or municipal entity or has committed any improper conduct in relation to such system; and c. cancel a contract awarded to a person if the person committed any corrupt or fraudulent act during the bidding process or the execution of the contract.

4. This MBD serves as a certificate of declaration that would be used by institutions to ensure that, when bids are considered, reasonable steps are taken to prevent any form of bid rigging.

5. In order to give effect to the above, the attached Certificate of Bid Determination (MBD 9) must be completed and submitted with the bid:

¹ Includes price quotations, advertised competitive bids, limited bids and proposals. ² Bid rigging (or collusive bidding) occurs when businesses, that would otherwise be expected to compete, secretly conspire to raise prices or lower the quality of goods and / or services for purchasers who wish to acquire goods and / or services through a bidding process. Bid rigging is, therefore, an agreement between competitors not to compete.

CERTIFICATE OF INDEPENDENT BID DETERMINATION

I, the undersigned, in submitting the accompanying bid:

………………………………………………………………………………………………………… (Bid Number and Description) in response to the invitation for the bid made by: CAPE WINELANDS DISTRICT MUNICIPALITY do hereby make the following statements that I certify to be true and complete in every respect:

I certify, on behalf of:……………………………………………………………………………………. that: (Name of Bidder) 1. I have read and I understand the contents of this Certificate;

2. I understand that the accompanying bid will be disqualified if this Certificate is found not to be true and complete in every respect;

3. I am authorized by the bidder to sign this Certificate, and to submit the accompanying bid, on behalf of the bidder;

4. Each person whose signature appears on the accompanying bid has been authorized by the bidder to determine the terms of, and to sign, the bid, on behalf of the bidder;

18 5. For the purposes of this Certificate and the accompanying bid, I understand that the word “competitor” shall include any individual or organization, other than the bidder, whether or not affiliated with the bidder, who: (a) Has been requested to submit a bid in response to this bid invitation; (b) Could potentially submit a bid in response to this bid invitation, based on their qualifications, abilities or experience; and (c) Provides the same goods and services as the bidder and/or is in the same line of business as the bidder

6. The bidder has arrived at the accompanying bid independently from, and without consultation, communication, agreement or arrangement with any competitor. However communication between partners in a joint venture or consortium³ will not be construed as collusive bidding.

7. In particular, without limiting the generality of paragraphs 6 above, there has been no consultation, communication, agreement or arrangement with any competitor regarding: (a) Prices; (b) Geographical area where product or service will be rendered (market allocation) (c) Methods, factors or formulas used to calculate prices; (d) The intention or decision to submit or not to submit, a bid; (e) The submission of a bid which does not meet the specifications and conditions of the bid; or (f) Bidding with the intention not to win the bid.

8. In addition, there have been no consultations, communications, agreements or arrangements with any competitor regarding the quality, quantity, specifications and conditions or delivery particulars of the products or services to which this bid invitation relates.

9. The terms of the accompanying bid have not been, and will not be, disclosed by the bidder, directly or indirectly, to any competitor, prior to the date and time of the official bid opening or of the awarding of the contract.

10. I am aware that, in addition and without prejudice to any other remedy provided to combat any restrictive practices related to bids and contracts, bids that are suspicious will be reported to the Competition Commission for investigation and possible imposition of administrative penalties in terms of section 59 of the Competition Act No. 89 of 1998 and or may be reported to the National Prosecuting Authority (NPA) for criminal investigation and or may be restricted from conducting business with the public sector for a period not exceeding ten (10) years in terms of the Prevention and Combating of Corrupt Activities Act No. 12 of 2004 or any other applicable legislation.

………………………………………………… …………..………………………………… Signature Date

…………………………………………………. ….………………….……………………… Position Name of Bidder

³ Joint venture or Consortium 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.

19 H. CREDIT ORDER INSTRUCTION

It is the policy of the Cape Winelands District Municipality to pay all creditors by means of direct bank transfers. Please complete this information and acquire your banker’s confirmation.

Name of Firm or Bank Account Holder: ……………………………………………..………………..

Address: ……………………………….…………………………………………………….....

…………………………………………………………………………...……………

……………………………………………………………………………...…………

Name of Bank: ………………………………………………………….……………………………..

Name of Branch: ……………………………………………………………………………….………..

Branch Code: ………………………………………………………………………….……………..

Account Number: ………………………………………………………………………….……………..

Type of Account: ……………………………………………………………….………………………..

I/we hereby request and authorise the Cape Winelands District Municipality to pay any amounts that may accrue to me/us to the credit of my/our bank account.

I/we understand that a payment advice will be supplied by the Cape Winelands District Municipality in the normal way that will indicate the date on which funds will be available in my/our bank account and details of payment.

I/we further undertake to inform the Cape Winelands District Municipality in advance of any change in my/our bank details and accept that this authority may only be cancelled by me/us by giving thirty days’ notice by prepaid registered post.

……………………………………………… ……………………………….. Initials and Surname Authorised Signature

Date: ………………………..

FOR BANK USE ONLY

I/we hereby certify that the details of our clients bank account as indicated on the credit order instruction is correct:

...... AUTHORISED SIGNATURE(S) OFFICIAL DATE STAMP