ANNEX III

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					Open call for tender No IP/C/LIBE/IC/2010-008                                                          Page 1 of 6




                                                                                                                   ANNEX II


                                                     TENDER FORM 1



     1. INFORMATION ABOUT THE TENDERER

     Please give concise answers


     1.1.     Name:

     1.2.     Legal form:

     1.3.     Country in which the business is registered (where appropriate):

     1.4.     Registration number in the commercial register (where appropriate):




     1.5.     VAT number:

     1.6.     Registered office OR in case of natural persons tendering, address of domicile: 2




     1.7.     Usual office address:
              Tel.:

              Fax:

               E-mail:




1
  Based on Directive 92/50/EEC relating to the coordination of procedures for the award of public service contracts (OJ L 209,
24.7.92), as amended by Directive 97/52/EC (OJ L 328, 28.11.97), Council Regulation 1605/2002 (OJ L 248, 16.09.2002) and
Commission Regulation 2342/2002 (OJ L 357, 31.12.2002).
2
  Tenderers should be aware that invoices can only be paid if the address indicated on the invoice corresponds either to the
address of the registered office/private domicile or, if applicable, to the usual office address indicated on the tender form. In case
of the invoice bearing a different address, the invoice will be rejected.
Open call for tender No IP/C/LIBE/IC/2010-008                          Page 2 of 6




   1.8.    Project leader:

           Name:

           Surname:

           Title (e.g. Dr, Mr, Mrs, Ms):

           Position (e.g. director):

           Tel:

           E-mail:


   1.9.    Representative duly authorised to sign on behalf of the tenderer:

           Name:

           Surname:

           Title (e.g. Dr, Mr, Mrs, Ms):

           Position (e.g. director):

   1.10.   Bank account number:
           IBAN:

           BIC/SWIFT:

           Name of bank:

           Address of bank:
Open call for tender No IP/C/LIBE/IC/2010-008                                             Page 3 of 6


   2. JOINT OR GROUP TENDER

  2.1.   Are you submitting a joint or group tender?                                YES    NO 

         If your answer is YES:

         The Lead tenderer shall list the name of other joint or
         group tenderers

         - JT1...................................................................

         - JT2...................................................................

         - JT3..................................................................



         And note that a tender form for each of the
         submitting parties concerned must be included.
Open call for tender No IP/C/LIBE/IC/2010-008                                                Page 4 of 6


    3. DECLARATION ON HONOUR CONCERNING EXCLUSION
       CRITERIA
   Name of tenderer: __________________________________________

   Official address: ____________________________________________


I, the undersigned, Mr(s) _______________________________, being the representative authorised to sign on
behalf of the tenderer, hereby undertake to supply any documents specifically requested of me and declare to
be aware that:

1. Potential contractors will be disqualified from taking part in the procurement procedure:
a) if they are bankrupt or being wound up, their affairs are being administered by the court, they have entered into
an arrangement with creditors, they have suspended business activities, they are the subject of proceedings
concerning these matters or are in any analogous situation arising from a similar procedure under national laws or
regulations;
b) if they have been convicted of an offence concerning their professional conduct by a judgment which has the
force of 'res judicata';
c) if they have been guilty of grave professional misconduct proven by any means which the European Parliament
can justify;
d) if they have not fulfilled their obligations concerning payment of social-security contributions or taxes in
accordance with legal provisions in the country where they reside, the country of the contracting authority or the
country where the contract will be performed;
e) if they have been the subject of a judgment which has the force of 'res judicata' for fraud, corruption,
involvement in a criminal organisation or any other illegal activity detrimental to the Communities' financial
interests;
f) if they have been declared to be in serious breach of contract for failure to comply with their contractual
obligations, following another procurement procedure or grant award procedure financed by the Community
budget.
Potential contractors must provide proof that they are not in any of the aforementioned situations by furnishing:
i) for points a), b) and e), a recent abstract of the judicial record or, failing this, an equivalent document, recently
issued by a judicial or administrative body in their country of origin or whence they come, showing that
requirements have been met;
ii) for point d), a recent certificate issued by the appropriate body in the country concerned. Where no such
documents or certificates are issued in the country concerned, they may be replaced by a statement under oath
or, failing that, a solemn declaration made by the interested parties before a judicial or administrative body, a notary
or a qualified professional body in their country of origin or whence they come.
Depending on the national legislation of the country in which the tenderers or candidates reside, the documents
referred to in paragraphs i) and ii) shall relate to legal entities and natural persons including company directors or
any person with powers of representation, decision-making or control in relation to the candidates or tenderers;
Potential contractors must sign the declaration, included in the tender form, on exclusion criteria and conflicts of
interest.

2. Contractors or tenderers will be disqualified from contract award procedures in the event of the following:
a) conflict of interests:
potential contractors or tenderers must declare that they:
- do not have any conflict of interests with regard to the contract,
- have not submitted, and undertake not to do so, a tender of any kind whatsoever where the holding of this contract
could be turned to their advantage,
- have not agreed to, sought, tried to obtain or accepted any inducement, whether financial or otherwise, for or on
behalf of any person which directly or indirectly would constitute an illegal or corrupt practice serving as an
incentive or reward linked to the award of the contract;
b) misrepresentation:
- either in furnishing information required by the contracting authority in order to take part in the contract or if they
have failed to furnish said information.


Date _______________________          Place _____________________________

Signature of the representative duly authorised to sign on behalf of the tenderer:____________________________
Open call for tender No IP/C/LIBE/IC/2010-008                                Page 5 of 6


   4. SELECTION CRITERIA

   4.1.   Please attach the curriculum vitae of the project leader and the
                                                                             see Annex ____
          members of the team, including a list of publications issued in
          the field of expertise relevant to the present call for tender


   4.2.   Please attach detailed references for works of a similar nature
                                                                             see Annex ____
          carried out in the past three years, indicating the amount, date
          and stakeholders


   4.3     Please attach detailed references for contracts or projects
                                                                             see Annex ____
           performed for the EU institutions, or other international
           organisations, in the past three years, indicating the amount,
           date and stakeholders.



   4.4    Please attach a detailed organisation chart for the research       see Annex ____
          team and for the company/ institution;




   4.5     Please attach a detailed description of the measures and          see Annex ____
           procedures employed to ensure the quality control of works,
           including a copy of the quality control certification, if any;




   4.6.   Please attach a statement of overall turnover and specific
                                                                             see Annex ____
          turnover related to the services covered by the present call for
          tender for the last 3 financial years.


   4.7.   Please attach a bank statement or the proof of a professional
                                                                             see Annex ____
          risk indemnity insurance.


   4.8    Please attach a declaration signed by each individual expert
                                                                             see Annex ____
          stating his/her acceptance to take part in the contract.
Open call for tender No IP/C/LIBE/IC/2010-008                                  Page 6 of 6


   5. AWARD CRITERIA AND THEIR WEIGHTING

  5.1.    Please attach details of the composition of the research team
                                                                             45%    see Annex ____
          (CVs) (refer to point III.2.3 of the Contract Notice);


  5.2.   Please attach details concerning the proposed methodology,
                                                                             35%    see Annex ____
         approach and means employed to conduct the expertise
         (refer to point II.2.1 of the Contract Notice)


  5.3    Please state the all-in price for conducting the study, including   20%    EUR_______________
         all costs set out in paragraph 12 of Annex I (price in euros, net
         of VAT)

         The prices must be fixed and not subject to change for the
         duration of the contract.



   6. DECLARATION OF ACCEPTANCE

   The undersigned declares that (s)he accepts the terms of all the           YES    NO 
   documents published and received in relation to this call for tender




Done at ______________________ on ________________________




_____________________________ ___________________________
Stamp (if available)          Signature of the representative
                              duly authorised to sign
                              on behalf of the tenderer

				
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