REPUBLIC OF KENYA GOVERNMENT OF MAKUENI COUNTY COUNTY TREASURY P.O. BOX MAKUENI

Similar documents
REGISTRATION FOR SUPPLY OF MATERIALS, TOOLS, EQUIPMENTS AND TEACHING MATERIALS FOR POLYTECHNICS

CHIEF EXECUTIVE OFFICER ATHI WATER SERVICES BOARD P.O BOX NAIROBI

PREQUALIFICATION DOCUMENT

SALARIES AND REMUNERATION COMMISSION STANDARD PROCUREMENT

REQUEST FOR REGISTRATION AS SUPPLIER FOR THE PERIOD STARTING 1 ST JULY 2016 AND ENDING 30 TH JUNE 2018

REGISTRATION/PREQUALIFICATION DOCUMENT FOR TAITA TAVETA COUNTY GOVERNMENT (Updating Suppliers Register for Financial Years )

PRE- QUALIFICATION OF SUPPLIERS FOR HOME AFRIKA LIMITED

PREQUALIFICATION DOCUMENT FOR VARIOUS CATEGORIES

CONTINOUS REGISTRATION OF SUPPLIERS

PREQUALIFICATION DOCUMENT FOR VARIOUS CATEGORIES

STANDARD REQUEST FOR QUOTATIONS (SRQ) (CONSULTANCY AND DESIGN)

Selection of Consultants

PROVISION OF SECURITY SERVICES

Request for Expression of Interest

Kenya Seed Company limited

REPUBLIC OF KENYA COUNTY GOVERNMENT OF SIAYA REQUEST FOR PROPOSAL FOR

INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS OF KENYA P.O BOX , NAIROBI. KENYA TEL:

KARATINA UNIVERSITY. TENDER NO.: KarU/OT/0001/

PAKISTAN CIVIL AVIATION AUTHORITY REQUEST FOR PROPOSAL ENERGY PERFORMANCE CONTRACT AT JINNAH INTERNATIONAL AIRPORT

BOMET WATER COMPANY LIMITED

Bank of Uganda REPUBLIC OF UGANDA ADDENDUM TO THE BIDDING DOCUMENT FOR SUPPLY, INSTALLATION AND COMMISSIONING OF A DISK TO

RFP for Export Reports generation and maintenance for India Brand Equity Foundation (IBEF)

TENDER FOR EMPANELMENT OF MANUFACTURERS/SUPPLIERS FOR SUPPLY & INSTALLATION OF MODULAR FURNITURE AT BANK S VARIOUS OFFICES/BRANCHES PAN INDIA

PREQUALIFICATION DOCUMENT

INVITATION TO BID. ITB-214/17 Rehabilitation and Reconstruction of Fallujah Bridge Anbar Governorate, Iraq

REGISTRATION OF SUPPLIERS FOR THE PROVISION OF GOODS, SERVICES AND WORKS FOR THE PERIOD ENDING 30 TH JUNE 2020

Guidelines to Consultant

REQUEST FOR PROPOSALS SERVICES FOR. [Federal Media Network Training] Prepared by. IOM Somalia. [Somalia Stabilization Initiative - SSI]

201 North Forest Avenue Independence, Missouri (816) [September 25, 2017] REQUEST FOR PROPOSAL GRADUATION CAPS AND GOWNS

ITEM RATE TENDER TENDER No. 14 / / ELDB

Request for Proposals. For RFP # 2011-OOC-KDA-00

Creation of Corporate Film for India Brand Equity Foundation (IBEF)

DALTON PUBLIC SCHOOLS REQUEST FOR PROPOSAL. RFP FY18 Drivers Education RFP

PEOPLES UNIVERSITY OF MEDICAL & HEALTH SCIENCES FOR WOMEN NAWABSHAH AT DISTT: SHAHEED BENAZIRABAD

REQUEST FOR PROPOSALS (RFP) FOR: PROVISION OF CONSULTANCY SERVICES FOR DEVELOPMENT OF AN ORGANIZATIONAL STRATEGIC PLAN. REF No.

CHAI SACCO SOCIETY LTD

GUILFORD COUNTY PARTNERSHIP FOR CHILDREN REQUEST FOR PROPOSALS

Y.ukon Business Nomi nee Policy

Lyndon Township Broadband Implementation Committee Lyndon Township, Michigan

Request for Proposal for Digitizing Document Services and Document Management Solution RFP-DOCMANAGESOLUTION1

SUPPLIER REGISTRATION FORM

Design concept for Fairs and Exhibitions

REQUEST FOR QUALIFICATIONS TO PROVIDE PROFESSIONAL ENGINEERING SERVICES CITY OF DADE CITY, FLORIDA. CLOSING DATE: September 19, :00 p.m.

INVITATION FOR BID Notice to Prospective Bidders IFB # Date Stamp Equipment Preventative Maintenance and Repair Services

Contractors who are desirous of tendering for above work and fulfills the Following requirements shall be eligible to apply:

PROCUREMENT AND PROPERTY SERVICES P. O. Box NACOGDOCHES, TX REQUEST FOR PROPOSAL RFP NUMBER REALTOR-2016

Prequalification for Construction Works

SEALED PROPOSAL REQUEST FOR PROPOSAL. Professional Archaelogical Services

Request for Proposals City School District of Albany Empire State After-School Program Coordination and Programming June 14, 2017

RFP for Design, print and production of the Annual Report for India Brand Equity Foundation

REQUEST FOR PROPOSAL FOR Web Hosting. Anniston City Schools. FRP Number FY2012 Web Hosting

Arizona Department of Education

DISTRICT OF COLUMBIA WATER AND SEWER AUTHORITY (DC WATER) REQUEST FOR QUOTE RFQ 18-PR-DIT-27

KDOT Procurement Guidelines for STP/CMAQ Funded Planning, Education, and Outreach Projects Effective 10/1/12

The Request for Proposal consists of the following documents, and should be read in conjunction with any Addenda issued:

PART II: GENERAL CONDITIONS APPLICCABLE TO GRANTS FROM THE NORWEGIAN MINISTRY OF FOREIGN AFFAIRS

TERREBONNE PARISH REQUEST FOR QUALIFICATIONS FOR ENGINEERING SERVICES. Generator Sizing and Installation

TENDER DOCUMENT. For Selection of Surveyor Agency for Survey works at Panagarh Industrial Park of WBIDC

SECOND REQUEST FOR PROPOSALS. for

All proposals must be received by August 30, 2016 at 2:00 PM EST

(1) Vendor Acknowledgement (2) Instructions *(3) Scope/Required Information and Documents Outline Including Notarized Certification

GUIDELINES FOR BUSINESS IMPROVEMENT GRANT PROGRAM BY THE COLUMBUS COMMUNITY & INDUSTRIAL DEVELOPMENT CORPORATION

Energy Efficiency Programs Process and Impact Evaluation

ISABELLA COUNTY REQUEST FOR PROPOSALS COMMISSION ON AGING CATV AND HEADEND EQUIPMENT

Request for Proposal. Internet Access. Houston County Public Library System. Erate Funding Year. July 1, 2017 through June 30, 2018

BID # Hunters Point Community Library. Date: December 20, Invitation for Bid: Furniture & Shelving

December, 2017 Request for Proposals for Airport Business and Financial Consultant At Savannah/Hilton Head International Airport

TOWNSHIP OF LAKE OF BAYS R.F.P REQUEST FOR PROPOSAL

TOWN OF WINDERMERE REQUEST FOR PROPOSALS Race Timing & Event Services

REQUEST FOR PROPOSAL (RFP) Concession Operations for Concession Stand at JOHNSTON HIGH SCHOOL ATHLETIC COMPLEX

Institute of Leadership Development

EXPRESSION OF INTEREST IN APPOINTING A PANEL OF ATTORNEYS

PAL-MAR WATER CONTROL DISTRICT Security-Maintenance Services RFP Proposal Packet

REQUEST FOR PROPOSALS (RFP) AND GENERAL INSTRUCTION TO SERVICE PROVIDERS BID DATA SHEET (BDS)

REQUEST FOR PROPOSAL For East Bay Community Energy Technical Energy Evaluation Services

Social Media Management System

FIRST 5 LA GRAPHIC DESIGN VENDOR REQUEST FOR QUALIFICATIONS (RFQ)

REQUEST FOR PROPOSAL

Consultant for Research and Design Services for Equipment and Systems for Unmanned Aerial Vehicle Drone (UAV) for OSU-Cascades

APPLICATION FORM APPLICATION TO REGISTER AS A VENDOR INTO NATIONAL LOTTERIES BOARD SUPPLIER DATABASE FOR SUPPLY OF GOODS AND SERVICES

CAR I B B E A N C O M M U N I T Y C L I M A T E C H A N G E C E N T E R ( C C C C C ) REQUEST FOR PROPOSAL

SOLICITATION FOR PARTICIPATION IN A REQUEST FOR PROPOSALS FOR CHIEF EXECUTIVE OFFICER (CEO) SEARCH SERVICES JACKSONVILLE, FL SOLICITATION NUMBER 94414

Automated License Plate Reader (ALPR) System. City of Coquitlam. Request for Proposals RFP No Issue Date: January 25, 2017

NORFOLK AIRPORT AUTHORITY NORFOLK INTERNATIONAL AIRPORT

INTERNATIONAL CENTRE OF INSECT PHYSIOLOGY AND ECOLOGY (icipe) REQUEST FOR PROPOSALS (RFP)

Health-Related Website and Social Media Platform Services

REQUEST FOR PROPOSALS (RFP) For HAAD s COFFEE SHOP RENTAL

a) For Electrical Safety Audit

NCC Infrastructure Holdings Limited

ADMINISTRATION DEPARTMENT

THE INSTITUTE OF CHARTERED ACCOUNTANTS OF INDIA (ICAI) APPLICATION FOR

NABET Accreditation Criteria for QMS Consultant Organizations (ISO 9001: 2008)

Request for Qualifications for Selected San Francisco Public Utilities Commission Construction Projects

STATE BANK OF INDIA PREMISES & ESTATE DEPARTMENT 3 RD FLOOR, LOCAL HEAD OFFICE BHADRA, AHMEDABAD PH : (079)

REQUEST FOR PROPOSAL (RFP) # CONSULTANT SERVICES FOR DEVELOPMENT OF A DISTRICT SUSTAINABILITY PLAN

TRAFFIC DATA COLLECTION REQUEST FOR PROPOSALS

General Contractor Services - Small Projects

REQUEST FOR PROPOSALS

Disadvantaged Business Enterprise Supportive Services Program

West Bengal State University

Transcription:

REPUBLIC OF KENYA GOVERNMENT OF MAKUENI COUNTY COUNTY TREASURY P.O. BOX 78-90300 MAKUENI REGISTRATION DOCUMENT FOR SUPPLY AND DELIVERY OF CERTIFIED SEEDS FOR FINANCIAL YEARS 2017-2018 AND 2018-2019 REFERENCE NUMBER: GMC/R/86/2017-2019 1

INTRODUCTION 1. Government of Makueni County will register eligible candidates for supply and delivery of certified seeds from among those who will have submitted documents in accordance with requirements to undertake assignments as described herein. 2. Candidates are invited to submit registration documents for supply and delivery of certified seeds. The registration documents will be the basis for registration and eventual invitation to bid for supply and delivery of the goods. 3. Candidates must familiarize themselves with the requirements of the registration documents including all attachments. 4. Government of Makueni County will not be responsible for any costs or expenses incurred by candidates in connection with preparation or delivery of registration documents including costs associated with preparation of the documents and attachments. Public Procurement and Asset Disposal Act, 2015 requires candidates to observe the highest standards of ethics during the registration process. Pursuant to this provision, relevant words are defined as follows: a. Corrupt practice means the offering, giving, receiving or soliciting of anything of value to influence the action of an officer in the registration process. b. Fraudulent practice means a misrepresentation of facts in order to influence the registration process to the detriment of the public procurement entity. Government of Makueni County will reject an application if it determines that a candidate has engaged in corrupt or fraudulent activities in the registration process. Government of Makueni County will declare a candidate ineligible for pre- registration if, at any time, it determines that the candidate has engaged in corrupt or fraudulent practices in competing for or in executing a similar contract. Government of Makueni County will have the right to inspect the business premises of the candidate as part of the evaluation. 5. Candidates shall furnish information as described in the registration document. 6. This is a registration of suppliers and not a tender for supply of goods and services. 7. All applicants will be notified of the outcome of registration in writing. 2

Table of Contents SECTION I - Invitation for registration SECTION II - Instructions to Candidates Appendix to Instructions to Candidates. SECTION III - Letter of application SECTION IV - Standard Forms General information - (Form1) General experience Record - (Form 2) Particular experience Record - (Form 3) Details of Contract of similar nature and complexity - (Form 3A Personnel capabilities - (Form 5) Candidate Summary - (Form 5A) Equipment capabilities - (Form 6) Financial Capability - (Form 7) Litigation History - (Form 8) SECTION I - INVITATION FOR REGISTRATION (IFR) Government of Makueni County is in the process of registering suppliers for supply and delivery of certified seeds for the financial years 2017-2018 and 2018-2019. Interested and eligible candidates are invited to apply for registration. A detailed Registration document may be downloaded free of charge from the county website www.makueni.go.ke. Completed documents shall be submitted in plain sealed envelope clearly marked GMC/R/86/2017-2019: APPLICATION FOR REGISTRATION FOR SUPPLY AND DELIVERY OF CERTIFIED SEEDS FOR FINANCIAL YEARS 2017-2019 AND BE PLACED AT THE MAKUENI AGRICULTURAL PROJECT BOARDROOM (MAP), NEXT TO MAKUENI LAW COURTS, WOTE OR BE ADDRESSED AND POSTED TO THE COUNTY SECRETARY, GOVERNMENT OF MAKUENI COUNTY P. O. BOX 78-90300, MAKUENI SO AS TO BE RECEIVED BY THE PROCURING ENTITY ON OR BEFORE TUESDAY, NOVEMBER 28, 2017, 10:00 AM. WITH THE WORDS DO NOT OPEN BEFORE TUESDAY, NOVEMBER 28, 2017, 10:00 AM 3

The applications will be opened immediately thereafter in the presence of applicants who choose to attend the opening at MAKUENI COUNTY TREASURY HEADQUARTERS, WOTE Bulky registration documents shall be submitted at the office of The Head of Procurement and Supply Chain Management Services located at Makueni Agricultural Project (MAP) grounds, next to Makueni Law Courts Candidates already registered in the Government of Makueni County vendor master MUST register afresh. Late or incomplete registration documents shall not be accepted. Canvassing or lobbying for the registration shall lead to automatic disqualifications. HEALTH, SAFETY AND ENVIRONMENT POLICY STATEMENT The Government of Makueni County recognizes and appreciates the importance of Health, Safety and Environment in the organization. The Authority prominently places Health, Safety and Environment matters as important Boardroom Agenda. To translate this commitment into actions, the county shall adopt a health, safety and environment policy that shall ensure: - 1. Compliance with all relevant statutory instruments in all matters of Health, Safety and Environment. 2. Appropriate consideration of relevant international conventions and recommendations. 3. Formulation and compliance with rules, regulations and guidelines on matters of Health, Safety and Environment. 4. All reasonably practicable precautions are taken to safeguard the safety and health of all employees and Port users. 5. Appropriate systems for providing adequate information and instructions to all cadres of employees on risks to their health and safety are in place. 6. That all work places and equipment/plant are safe and regularly inspected. 7. All employees and Port Users assume defined responsibilities in matters of health, safety and environment in conformity with this policy. 8. Appropriate training for all employees to enhance their performance is provided. 9. That all Contractors comply with Health, Safety and Environment rules, regulations and guidelines. 10. Adequate provision for prevention and control of fires and proper use of firefighting appliances. 11. Adequate provision for prevention and control of environmental pollution. 12. That Environmental Impact Assessment is carried out for all projects likely to have an impact on the environment. 13. Provision and promotion of First Aid services and activities. 4

14. Contravention of the Health, Safety and Environment Management System attracts severe disciplinary action including dismissal and/or prosecution. 15. Review of the Health, Safety and Environment Management System to conform to changing trends. SECTION II - INSTRUCTIONS TO CANDIDATES 2.1 Scope of registration 2.1.1 The Government of Makueni County hereinafter referred to as the procuring entity intends to register suppliers for the above mentioned category. It is expected that registration applications will be submitted to be received by the procuring entity as per the invitation 2.1.2 Registration is open to eligible firms as indicated in the instructions to applicants. 2.1.3 Registered Suppliers will be invited to tender and requested for quotations as and when need arises for the period indicated in the Invitation for Registration (IFR) upon which registration exercise will be done afresh. 2.2 Submission of Applications Complete Applications shall be received by the Authority as per the invitation 2.2.1 The name and mailing address of the applicant may be marked on the envelope. 2.2.2 All the information requested for registration shall be provided in the English language. Where information is provided in any other language, it shall be accompanied by a translation of its pertinent parts into English language. The translation will govern and will be used for interpreting the information. 2.2.3 Failure to provide information that is essential for effective evaluation of the applicant s qualifications or to provide timely clarification or sub substantiation of the information supplied may result in the applicant s disqualification. 2.2.4 It is a serious offence to provide false information and the procuring entity reserves the right to carry out site visits to verify the information submitted by applicants. 2.3 Eligible Candidates 2.3.1 This invitation for registration is open to all candidates who are eligible as defined in Kenya s Public Procurement Law and Regulations and as indicated in the Invitation for Registration to candidates. 2.4 Qualification Criteria 2.4.1 Registration will be based on meeting the minimum requirements to pass in the criteria set as shown below. 5

ITEM UNDER CONSIDERATION YES/NO REMARKS MANDATORY REQUIREMENTS 1 Attach legible copy of Business Registration/Incorporation Certificate 2 Attach legible copy of valid KRA Tax Compliance Certificate 3 Attach legible copy of Tax Payer Registration PIN Certificate 4 Attach legible copy of valid Trade License 5 Submit fully filled, signed and stamped Confidential Business Questionnaire 6 Limited companies must attach legible copies of directors ID cards and CR 12 7 Partnerships must attach legible copies of partners ID cards and partnership deed/agreement 8 Sole proprietorships must attach legible copies of sole traders ID cards 9 Enterprises owned by youth, women, PWDs and other disadvantaged groups must attach legible copies of ID cards, and registration certificates for their respective preference schemes 10 Attach list with proof of previous works 11 (i) Copy of legible Bank Opinion Letter (ii) Legible copies of certified bank statements for the last twelve (12) months 2.4.2 Clause deleted. 2.4.3 Clause deleted. 2.4.4 Clause Deleted 2.4.5 Equipment capabilities. The applicant should own, or have assured access (through hire, lease, purchase agreement, availability of manufacturing equipment, or other means) the following key items of equipment in full good working order, and must demonstrate that, based on known commitments they will be available for use in the proposed contract. The applicant may also list alternative equipment that it would propose for the contract together with an explanation of the proposal (Registration candidates to list their equipment and attach evidence of ownership or assured access where necessary) 2.4.6 Clause Deleted. 2.4.7 Clause deleted. 6

2.4.8 Litigation history the applicant should provide accurate information on any litigation or arbitration resulting from contracts completed or under its execution over the last five years. A consistent history of awards against the applicant may result in failure of the application. 2.4.9 Applicants must provide details of Facilities, Business Premises and Workshops 2.4.10 Any other information that would support your application for registration 2.5 Clause Deleted 2.6 Public Sector Companies 2.6.1 Any public owned enterprise may be eligible to qualify if, in addition to meeting all the above requirements, it is also legally and financially autonomous, it operates under commercial law, and it is not a dependent agency of another public entity. 2.7 Conflict of Interest 2.7.1 The applicant shall not be associated, nor have been associated in the past, with the employees, management and directors of Government of Makueni County. 2.8. Updating Registration Information 2.8.1 Registered candidates shall be required to update the financial information used for registration at the time of submitting their bids and to confirm their continued compliance with the qualification criteria. A bid shall be rejected if the applicant s qualification thresholds are no longer met at the time of bidding. 2.9. Categories for Registration 2.9.1 Applicants are required to submit a form for Category Application in the format contained herein alongside their Letters of Application clearly indicating the category that they are applying for. Applicants are advised to apply for only those categories they conduct their business. 2.9.2 Clause Deleted. 2.10. Format and Signing of Applications 2.10.1 The Applicant shall prepare two (2) copies of the application, clearly marking each ORIGINAL and COPY, as appropriate. In the event of any discrepancy between them, the original shall govern. 2.10.2 The original and all copies of the Application shall be typed or written in indelible ink and shall be signed by the Applicant or a person or persons duly authorized to bind the Applicant to the contract. The latter authorization shall be indicated by written powerof-attorney accompanying the Application. All pages of the Application, except for un- 7

amended printed literature, shall be numbered and initialed by the person or persons signing the Letter of Application. 2.10.3 The Application shall have no interlineations, erasures, or overwriting except as necessary to correct errors made by the Applicant, in which case such corrections shall be initialed by the person or persons signing the Application. SECTION III - LETTER OF APPLICATION Notes on letter of application The letter of application will be prepared by the applicant and will follow the form presented herein. The letter of application will be prepared on the letterhead of the applicant and will include full postal address, telephone numbers, fax number and Email address. The letter of application will be signed by duly authorized representatives of the applicant. Any clause which does not apply to the applicant in the letter of application herein shall be deleted by the applicant. The letter of application shall be submitted with a duly filled Form for Category Application in the format contained herein and a copy of the cash receipt for purchase of the Registration document SECTION III - LETTER OF APPLICATION (MANDATORY) To. (Name and address of the procuring entity) Date Ladies and/or Gentlemen 1. Being duly authorized to represent and act on behalf of (name of firm) (hereinafter referred to as the Applicant ), and having reviewed and fully understood all of the registration information provided, the undersigned hereby apply to be registered by yourselves as a supplier for the registration (number and name ) 2. Attached to this letter are copies of original documents defining a. the Applicant s legal status b. the principal place of business and c. the place of incorporation (for applicants who are corporations), or the place of registration and the nationality of the owners (for applicants who are partnerships or individually-owned firms). 8

3. Your Agency and its authorized representatives are hereby authorized to conduct any inquiries or investigations to verify the statements, documents, and information submitted in connection with this application, and to seek clarification from our bank and clients regarding any financial and technical aspects. This letter of Application will also serve as authorization to any individual or authorized representative of any institution referred to in the supporting information, to provide such information deemed necessary and as requested by yourselves to verify statements and information provided in this application, such as the resources, experience, and competence of the Applicant. 3. Your Agency and its authorized representatives may contact the following persons for further information. General and managerial inquiries Contract 1 Telephone 1 Contract 2 Telephone 2 Personnel inquiries Contract 1 Telephone 1 Contract 2 Telephone 2 Technical inquiries Contract 1 Telephone 1 Contract 2 Telephone 2 Financial inquiries Contract 1 Telephone 1 Contract 2 Telephone 2 5. This application is made with the full understanding that: (a) (b) Bids by registered applicants will be subject to verification of all information submitted for registration at the time of bidding. Your Agency reserves the right to: amend the scope and value of any contracts bid under this project; in such event, bids will only be called from registered applicants who meet the revised requirements; and reject or accept any application, cancel the registration process, and reject all applications 9

(c) your Agency shall not be liable for any such actions and shall be under no obligation to inform the Applicant of the grounds for them The undersigned declare that the statement made and the information provided in the duly completed application are complete, true, and correct in every detail. For and on behalf of (i.e. business name and organization rubber stamp) Name of applicant, position and signature SECTION IV - STANDARD FORMS Notes on completion of Standard Forms Application Form 1 - Confidential Business Questionnaire This form is to be completed by all applicants. Application Form 2 - General Experience Record This form is to be completed by all applicants. Applicants are not required to enclose testimonials, certificates or publicity materials with their applications. Application Form 3A- Details of Contracts of similar nature and complexity Application Form 5 - Personnel Capabilities This form shall be completed by all applicants and will contain contracts of similar nature completed by the applicant This form is to be completed by all applicants. It shall include specific positions essential to the category for registration applied for. The applicants shall provide the names of at least two candidates qualified to meet the specified requirements stated for each position. This should be accompanied CV detailing relevant experience. Application Form 6 - Equipment Capability (Where Applicable) 10

This form is to be completed by all applicants. It should provide adequate information to demonstrate clearly that the applicant has the capability to meet the requirements for each and all items of equipment listed in the instructions to candidates. A separate form shall be prepared for each item of equipment or for alternative equipment proposed by the applicant. Application Form 7 - Financial Capability including Bank Details and reference Application Form 8 - Litigation History This is additional information to be submitted with the Audited Accounts for the last two (2) years 2015 and 2016.This form shall be completed by every applicant. If necessary, separate sheets should be used to provide complete bank information. This form is to be completed by all applicants. It should provide information on any history of litigation or arbitration resulting from contracts executed in the last five years or currently under execution. Application Form 9 - Facilities, Business Premises and Workshops This form is to be completed by all applicants. It should provide information on the nature of facilities, business premises and workshops (as appropriate). Applicants should attach evidence of whether the facilities are owned, leased or rented. Information provided should contain full physical address and contact details. APPLICATION FORM (1) (MANDATORY REQUIREMENT) CONFIDENTIAL BUSINESS QUESTIONNAIRE You are requested to give the particulars indicated in Part 1 and either Part 2(a), 2(b) or 2(c) whichever applies in your type of business. You are advised that it is a serious offence to give false information on this form Part 1 General: Business Name... Contact Person Cell Phone No... Location of business premises Street/Road... Plot No. Postal Address..Tel No Fax No... 11

Email address.. (Domain registered address MANDATORY) Taxation Registration Certificate No. (Attach copy).. Nature of Business.. Current Trade Licence No.Expiring date... Attach copy of Firm Registration Certificate Electronic Tax Register (ETR) Compliance (attach evidence) Maximum value of business which you can handle at any one time: Kshs... Bank Name... Branch... Account No...Swift Code... Part 2(a) Sole Proprietor Your name in full... Nationality. County of Origin.. *Citizenship details.. Part 2(b) Partnership Given details of partners as follows: Name Nationality Citizenship Shares 1........... 2.......... 3.......... 4.......... Part 2(c ) - Registered Company Private or public.. State the nominal and issued capital of the company: 12

Nominal Kshs Issued Kshs.... Give details of all directors as follows: Name Nationality Citizenship Shares 1...... 2...... 3...... 4...... Date. Signature... Organization Rubber Stamp... NB: Attach a copy of Articles of Association and Memorandum of Association, CR12 Whichever is applicable in your case If the citizen, indicate under Citizenship Details whether by Birth, Naturalization or Registration. Personnel 1. Number of staff employed 2. Qualifications (CEO) 3. Level of experience (CEO) 4. Organization Structure NB: Attach details for numbers 1 to 3 Experience 1. No. of years the company has been in operation. 2. Volume of business transacted in the last 3 years Referees: i.. ii. iii. Scope of clientele - (attach evidence of the key corporate clients you are currently serving) Customer Service i. Do you have a dedicated customer help desk? Yes.. No.. 13

ii. Do you carry out customer satisfaction surveys? Yes.. No.. iii. Do you have a customer technical back up team? Yes..No... FINANCIAL (MANDATORY REQUIREMENT) a) Financial position You will be required to demonstrate that the company s financial position is healthy enough to enable you transact business with Government of Makueni County. b) Magnitude of business Please indicate the maximum amount of business (in financial terms) your company can handle at any given time in Kshs.. c) Credit period Please indicate the credit period you are willing to offer GOVERNMENT OF MAKUENI COUNTY. (GOVERNMENT OF MAKUENI COUNTY s Minimum payment period is 30 days after invoice certification). d) Annual turnover What is your annual turnover in Kshs? FINANCIAL POSITION AND TERMS OF TRADE Part I Assets and Liabilities i. Total Assets in Kshs---------------------------------------------------- ii. iii. iv. Current Assets in Kshs----------------------------------------------- Total Liabilities in Kshs----------------------------------------------- Net worth (Total Assets- Total liabilities) in Kshs--------------- v. Working Capital (Total assets-net worth) in Kshs--------------- Part II TERMS OF TRADE (PAYMENT TERMS) Government of Makueni County will make payment after delivery of goods and services upon issuance of a local purchase/service order. Payment will be made within (thirty) 30 days upon receipt of Invoice and Delivery Note duly signed and stamped by the User and Inspection & Acceptance Committee. N/B Please indicate your payment terms and credit period allowed. 14

Please comment on the client s terms if not favorable to your organization CLIENT DETAILS Give details of at least 3 reputable organizations preferably where you are supplying/ offering these goods/services you applied for. 1. Client Name--------------------------------------------------------------- Address-------------------------------------------------------------------- Tel No---------------------------------------------------------------------- Contact person----------------------------------------------------------- Signature and stamp of client. Position in the organization------------------------------------------- 2. Client Name--------------------------------------------------------------- Address-------------------------------------------------------------------- Tel No---------------------------------------------------------------------- Contact person----------------------------------------------------------- Signature and stamp of client. Position in the organization------------------------------------------- 3. Client Name--------------------------------------------------------------- Address-------------------------------------------------------------------- Tel No.... Contact person----------------------------------------------------------- Signature and stamp of client. Position in the organization------------------------------------------- 4. Client Name--------------------------------------------------------------- Address-------------------------------------------------------------------- Tel No---------------------------------------------------------------------- 15

Contact person----------------------------------------------------------- Signature and stamp of client. Position in the organization------------------------------------------- 5. Client Name--------------------------------------------------------------- Address-------------------------------------------------------------------- Tel No. ---------------------------------------------------------------------- Contact person----------------------------------------------------------- Signature and stamp of client. Position in the organization------------------------------------------- APPLICATION FORM (2) (MANDATORY REQUIREMENT) GENERAL EXPERIENCE RECORD Name of Applicant Annual Turnover Data Year Turnover Kshs. 2014 2015 2016 APPLICATION FORM (3A) DETAILS OF CONTRACTS OF SIMILAR NATURE AND COMPLEXITY Use a separate sheet for each contract and attach copies completion certificate(s) for each contract Name of Applicant 1. Contract Number Contract Name Country 2. Name of Employer 3. Employer Address 4. Nature of works and special features relevant to the contract for which the Applicant wishes to register 5. Contract role (check one) 16

* Sole contract * Management contract * Subcontract * Partner in a joint venture 6. Value of the total contract/subcontract/partner share (in specified currencies at completion, or at date of award for current contract) 7. Date of award 8. Date of completion 9. Contract/subcontract duration (years and months) - years - months 10 Specified requirements APPLICATION FORM (5) PERSONNEL CAPABILITIES Name of Applicant 1. Title of position Name of prime candidate Name of alternate candidate 2. Title of position Name of prime candidate Name of alternate candidate 3. Title of position Name of prime candidate Name of alternate candidate 4. Title of position Name of prime candidate Name of alternate candidate APPLICATION FORM (6) (WHERE APPLICABLE) EQUIPMENT CAPABILITIES Name of Applicant Item of Equipment Equipment information Current status 1. Name of manufacturer 3. Capacity 5. Current location 2. Model and power rating 4. Year of manufacturer 17

6. Details of current commitments.. Source Owner 7. Indicate source of the equipment * Owned * Rented * Leased * Specially manufactured 8. Name 9. Address of owner.. Telephone Contact name and title Fax Email Agreements Details or rental/lease/manufacture agreements specific to the project. APPLICATION FORM (7) BANK DETAILS (MANDATORY REQUIREMENT) Account Name Account Number SWIFT Code Bank Branch Address of bank Telephone 18

Contact name and title APPLICATION FORM (8) (MANDATORY REQUIREMENT) LITIGATION HISTORY Applicants should provide information of any history of litigation or arbitration resulting from contracts executed in the last five years or currently under execution (Instructions to Applicants, para. 4.8) Name of Applicant Year Award FOR or AGAINST Applicant Name of client, cause of litigation, and matter in dispute Disputed amount (current value Kshs.) APPLICATION FORM (9) (MANDATORY REQUIREMENT) FACILITIES, BUSINESS PREMISES AND WORKSHOPS Name of Applicant DECLARATION FORM (MANDATORY REQUIREMENT) We hereby confirm that the above information is correct and true to the best of our knowledge. We further declare that should we be registered as a Supplier and later the above information turns out to be untrue, we shall indemnify Government of Makueni County the full cost of the Contract, the advertisement charges of this tender plus all other damages that may accrue due to our false declaration. Name and Address of Company: 19

M/s... P. O. Box... Town... Telephone No... Fax No... Domain E-Mail Address... Signature... Name in full... Position... Organization Rubber Stamp... Date... GOVERNMENT OF MAKUENI COUNTY COUNTY TREASURY REGISTRATION UPDATE ON PHYSICAL LOCATION OF SERVICE PROVIDERS, CONTRACTORS AND SUPPLIERS Name of applicant: Location of Business County: Sub-County: Ward: Town: Authorized Signatory Name: Signature: 20