Verification Report - Dairy/Creamery/Scottish Haulier (Scottish Milk Only)

Intervention Skimmed Milk Powder – Purchase by tender SMP8 (TENDER)

Tender application and claim for payment

Commission Regulation (EU) No. 1272/2009 as amended.
Notes about this form
A  Please use BLOCK CAPITALS.
B  To be received by the Rural Payments Agency no later than the closing time on the day the tender closes.
C  Any amendments must be initialled.
D  Do not use correction fluid.
E  If you need help to fill in this form, please contact operations on 0191 226 5219/5851 / Data Protection
Defra is the data controller for personal data you give to us or we hold about you. We use it in line with the Data Protection Act. For more information, go to www.gov.uk/rpa, choose ‘Contact RPA’ and click on ‘Personal information charter’. / Part B – Security
Security of at the rate per tonne specified in the invitation to tender has been lodged with you in the form of (please tick):
Part A – General details / ·  block guarantee
Name and address of tenderer
Tel number (incl area code) / ·  single transaction guarantee
Fax number (incl area code) / ·  cash
Postcode / Trader Registration Number / ·  other (please specify)
Status: sole proprietor partnership company trust
If other, please specify:
Quantity offered for tender in tonnes
Part C
Price to be given in euro per 100kg ex store (not including domestic taxes and expressed to no more than 2 decimal places)
Store where SMP is currently stored / Creamery of manufacture / Creamery approval number / Date of manufacture / Manufacturing creamery lot number / Bag numbers of SMP offered / Tonnage / Price in euro per 100kg
From / To
Price to be given ex store (not including domestic taxes and expressed to no more than 2 decimal places)
Store where SMP is currently stored / Creamery of manufacture / Creamery approval number / Date of manufacture / Manufacturing creamery lot number / Bag numbers of butter offered / Tonnage / Price in euro per 100kg
From / To
Conditions / Declaration
You must:
1  comply with the requirements of Articles 14 of Commission Regulation (EU) No. 1272/2009.
2  only offer SMP:
· made exclusively and directly from skimmed cow's milk;
·  that meets the quality and compositional standards required;
·  of the correct weight and age;
·  that has been packaged and marked properly. / The tenderer:
·  has read and understood Scheme Guide IM(L)21, as may be amended;
·  accepts and has complied with the conditions opposite;
·  will take back any consignment and repay any storage charges incurred by the Agency from the date of takeover on SMP not accepted;
·  claims the subsidy due;
·  has given details that are true and complete to the best of their knowledge and belief. / Signature
Name
(BLOCK CAPITALS)
Capacity of person signing - please specify
(for example: sole proprietor, partner, director, trustee, agent)
Date
WARNING: any person who makes a false declaration may be prosecuted. A false or inaccurate statement can lead to loss of entitlement and recovery of any payments made.
Part D – For official use only
Acknowledgement of receipt / Signature / Agency stamp
Date received / Name
(BLOCK CAPITALS)
Date
Rural Payments Agency, Lancaster House, Hampshire Court, Newcastle upon Tyne NE4 7YH. Tel 0191 226 5219/5851. Fax 0191 226 5101

spin3t ver 4.0 Jan 2015