Docstoc

Sample Request of Authenticity from Organisation to Bank Official

Document Sample
Sample Request of Authenticity from Organisation to Bank Official Powered By Docstoc
					CONFIDENTIAL
Pre-Qualification Questionnaire for [insert project name]




                     PRE-QUALIFICATION QUESTIONNAIRE

             - FOR USE WITH OJEU THRESHOLD PROCUREMENTS ONLY

                     [Title of Contract or Framework Agreement]


Contract Reference Number


Name of the organisation in whose
name the tender would be
submitted.



Name of person applying
on behalf of the organisation




Contact Email Address
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


Contents
Section Description                                                     Page
        Contents                                                          2
        Definitions                                                       3
1       Introduction, Background Information and Instructions to          4
        Applicants
2       Evaluation Approach                                              10
3       Pre-Qualification Questionnaire
3.1     Supplier Details                                                 13
3.2     Status of Supplier                                               14
3.3     Prime Contractor                                                 15
3.4     Compliance with EC Legislation/UK Procurement Legislation        16
3.5     Financial Matters                                                17
        Bank Authority Form                                              19
3.6     Quality Management                                               20
3.7     Health and Safety                                                21
3.8     Business Capability                                              24
3.9     Training                                                         25
3.10    Environmental Management & Sustainability                        26
3.11    Equalities & Diversity                                           27
3.12    Insurance                                                        29
3.13    Disputes                                                         31
3.14    Project Specific Questions                                       32
3.15    References                                                       34
4       Declarations                                                     35
        Freedom of Information Act 2000 and environmental Information    38
        Regulations 2004




                                                                    2
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

Definitions

For the purpose of this Pre-Qualification Questionnaire the following words
and expressions shall have the following meanings set out below:

“Authorised Officer”
     means:      [insert name] of the [insert department] Service Area, Corporate
                 Directorate of Cornwall Council, Treyew Road, Truro, Cornwall TR1
                 3AY. e-mail address is [insert e-mail address]

“Contract”
     means:        the Contract for the provision of the Services, Supplies or Works,
                   which will be awarded to a successful Supplier;

“Council”
     means:        Cornwall Council, County Hall, Treyew Road, Truro,
                   Cornwall TR1 3AY;

“ITT”
        means:     the Invitation to Tender;

“OJEU”
     means:        the Official Journal of the European Union;

“PQQ”
    means:         this Pre-Qualification Questionnaire;

“Regulations”
     means:        The Public Contracts Regulations 2006 (SI 2006 No.5) or Utilities
                   Contracts Regulations 2006 (SI 2006 No.6) [delete as applicable]

“Services”
     means:        the provision of [insert title of the Services] for the [insert Project
                   Name] as described in this PQQ. [delete if not applicable]

“Supplier”
     means:        any person or persons, firm or firms or company or companies
                   applying to tender for the Services, Supplies or Works, or, where
                   there is more than one organisation applying, the lead
                   organisation;

“Supplies”
     means         the Supplies or materials as described in this PQQ. [delete if not
                   applicable]

“Works”
    means:         the works as set out in this ITT in relation to [insert name of
                   Project] [delete as appropriate]




                                                                               3
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

1.    Introduction, Background Information and
      Instructions to Applicants
1.1   PURPOSE OF THIS DOCUMENT

The Council requires the information sought in this PQQ from potential Suppliers
responding to the Contract Notice in the OJEU Reference Number [insert number]
dated [insert date].
Responses to the PQQ will be used in the first step of selecting Suppliers to tender.
Selected Suppliers will be invited to participate further in the procurement.

This is a competitive procurement conducted in accordance with the Restricted
Procedure, under the Public Contract Regulations 2006 (SI 2006 No. 5) or Utilities
Contracts Regulations 2006 (SI 2006 No.6). [delete if not applicable]

1.2   ORGANISATION OF THIS DOCUMENT

This document contains four main sections and all the contents are detailed below.
Section   1,   Introduction, background information and instructions to Suppliers;
Section   2,   Evaluation Approach;
Section   3,   the PQQ;
Section   4,   Declarations

1.3   BACKGROUND INFORMATION


[Insert background information on the requirement, for example: from where the
requirement developed, strategic importance and links to policy initiatives and/or
wider programmes, other organisations involved. This is a key section of the PQQ.
This information should build on the information within the OJEU Contract
Notice/Tenders in Cornwall Notice. Potential suppliers will need to decide how
important this requirement is to them and compare it to other procurement
opportunities].

The intention is to let a contract/framework [delete as applicable] agreement for a
period of [insert] months commencing on [insert date], with an option to extend for a
further [insert number of months].




                                                                             4
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

1.4 OUTLINE TIMETABLE

The Council proposes the following indicative timetable for this procurement project:

                            [delete if using Open Procedure]


                            Activity                        Date

                Publish Contract Notice                dd/mm/yyyy

                Last day for PQQ request               dd/mm/yyyy


                Despatch of PQQ                        dd/mm/yyyy


                Return of PQQ                          dd/mm/yyyy


                Evaluation of PQQ                      dd/mm/yyyy


                Selection of successful Suppliers      dd/mm/yyyy


                Despatch of ITT                        dd/mm/yyyy


                Return of ITT                          dd/mm/yyyy


                Evaluation of ITT                      dd/mm/yyyy


                Selection of successful Tenderer       dd/mm/yyyy


                Award of Contract                      dd/mm/yyyy


                Setup Period                           dd/mm/yyyy


                Start of Contract                      dd/mm/yyyy


Cornwall Council reserves the right to revise the above timetable at any time.

1.5 INSTRUCTIONS FOR COMPLETION

Completed questionnaires should be submitted as follows;
                [insert number] x paper copies of the PQQ only sent to the
                 Authorised Officer. Please do not send paper copies of supporting
                 documentation.
                An additional electronic version by CD or e-mail including Supporting
                 Information clearly referenced to your organisation, the PQQ
                 Question Number and Contract Reference Number. Information with
                 unclear referencing will not be considered.



                                                                           5
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]
               Please note that all electronic submissions must be either Microsoft
                Word (.doc file) compatible with Windows XP. Drawings or charts
                should be embedded or included as .dwf or jpg file or in printed
                document format (.pdf) for use with Adobe Acrobat.
Prospective Suppliers should answer all questions as accurately and concisely as
possible. Where a question is not relevant to the responder‟s organisation, this should
be indicated, with an explanation.
Supporting information should be presented in the same order as detailed and should
be referenced to the relevant question.

Suppliers should enter their answers in the spaces provided but these spaces can be
expanded to allow full answers to the questions.

Questions should be answered in English. Documents, which are not in the English
language, must be accompanied by an English translation and a certificate by a bona
fide independent translator attesting the authenticity of the translation.

Responses will be evaluated in accordance with the procedures set out in Section 2. In
the event that none of the responses are deemed satisfactory, the Council reserves
the right to consider alternative procurement options.

Failure to furnish the required information, make a satisfactory response to any
question, or supply documentation referred to in responses, within the specified
timescale, may mean that Suppliers will not be invited to participate further.

The Council will not reimburse any expense incurred by the applicants in preparing
their responses to the PQQ or any eventual tender, nor is the Council bound to select
any party or award a contract at the end of the process.

The issue of this PQQ in no way commits the Council to award any contract pursuant
to the procurement process, nor does it constitute an offer to enter into a contractual
relationship.

The Laws of England and Wales shall apply for the purposes of all proceedings relating
to this procurement process and any contract awarded pursuant thereto.

Where any question refers to relevant UK legislation, non UK organisations should
answer on the basis of applicable laws in their jurisdiction.

It is recommended that completed PQQ‟s together with any supporting documentation
are submitted by registered post, or recorded delivery service, or delivered by hand,
not bearing any indication of the Supplier marked on the envelope or in the franking
thereon and clearly marked to the address detailed below.

Duly completed responses must be received no later than 3.00 pm of the date
specified in 1.4. Responses received after this time and date will not be accepted.




                                                                            6
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]




PRE-QUALIFICATION QUESTIONNAIRE – [INSERT TITLE]’’
[Name]
[Title]
[Directorate]
[Service]
[Room xxx]
[Address]

The Council will take up technical and financial references for all Suppliers.

The declaration detailed below should be signed by a Director, Partner, Senior
Manager or Authorised Representative of the Company.

1.6 CONSORTIA AND SUB-CONTRACTING

Where a consortium or sub-contracting approach is proposed, all information
requested should be given in respect of the proposed prime contractor or consortium
leader. Relevant information should also be provided in respect of consortium
members or sub-contractors who will play a significant role in the delivery of the
Services, Supplies or Works under any ensuing Contract. Responses must enable the
Council to assess the overall service proposed.

The Council recognises that arrangements in relation to consortia and sub-contracting
may be subject to future change. Suppliers should therefore respond in the light of
such arrangements as are currently envisaged.

Please provide details of the proportion of any contract awarded under this Contract,
which the prospective Supplier proposes to sub-contract.

The Council intends seeking independent financial and market advice to validate
information declared or to assist in the evaluation. Reference site visits or
demonstrations and/or presentations are unlikely to be requested at this stage.

1.7 QUERIES ABOUT THE PROCUREMENT

The Council will not enter into detailed discussion on the specific requirements of the
contract at this stage.

Any questions about the procurement should be submitted by e-mail to the Authorised
Officer. Any question or request for clarification regarding the PQQ will be
communicated in a suitably anonymous form to all Suppliers participating as well as
the appropriate answer to the question or request for clarification.


1.8 SUPPLIER CONTACT POINT

Suppliers have been asked to include a single point of contact in their organisation for
their response to the PQQ. The Council shall not be responsible for contacting the
Supplier through any route other than the nominated contact. The Supplier must
therefore undertake to notify any changes relating to the contact promptly.

                                                                                 7
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]



1.9   PUBLICITY
Suppliers shall not undertake (or permit to be undertaken) at any time (whether prior
to or after any contract award) any publicity or activity with any section of the media
in relation to this contract award process or the supply of the services, supplies or
works specified other than with the prior written consent of the Council. Such
agreement shall extend to the content of any publicity. In this paragraph the word
"media" includes (but is not limited to) radio, television, newspapers, trade and
specialist press, the internet and e-mail accessible by the public at large and the
representatives of such media.

1.10 FREEDOM OF INFORMATION ACT 2000 AND ENVIRONMENTAL
     INFORMATION REGULATIONS 2004

The Council works in strict accordance with any legislation that requires information
held by the Council to be released to the public. As such the Council will only keep
confidential information that is properly confidential in its nature, paying due regard to
any relevant legislation, and then only for a reasonable amount of time.

As part of the Council‟s duties under access to information legislation, it may be
required to disclose information concerning the procurement process or the Contract
to anyone who makes a reasonable request. Applicants should provide a schedule if
they consider that any of the information provided in their response to this PQQ is
commercially sensitive (meaning it could reasonably cause prejudice to the applicant if
disclosed to a third party). The schedule should list the information, clearly marked as
“Not for disclosure to third parties” together with valid reasons in support of the
information as being exempt from disclosure under the relevant legislation. Please see
the sample schedule at Appendix 2.

The Council will endeavour to consult with the Supplier and have regard to comments
and any objections before it releases any information to a third party under the Act.
However, the Council shall be entitled to determine in its absolute discretion whether
any information is exempt under the Act, or is to be disclosed in response to a request
for information. The Council must make its decision on disclosure in accordance with
the provisions of the legislation and can only withhold information if it is covered by
an exemption from disclosure under the legislation.




                                                                              8
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

2. Evaluation Approach
2.1 SUPPLIER SELECTION


The objective of the selection process is to assess the responses to the PQQ and select
potential Suppliers to proceed to the next stage of the procurement.

Failure to provide a satisfactory response to any of the questions may result in the
Council not proceeding further with the Supplier. The information supplied will be
checked for completeness and compliance before responses are evaluated.

Information Only Questions
The following sections/subsections must be completed but will be used for information
purposes only and not scored:

3.1    Suppliers Details
3.2    Status of Supplier
3.7.1 / 3.7.2 Health and Safety

It is important that where a question does not apply this is recorded as Not applicable
or None in the spaces provided. Please note that although these sections are not
scored insufficient information may lead to disqualification.

Pass / Fail Questions

These criteria will be scored on a pass/fail basis. In the event of a Supplier
being awarded a fail in any of the criteria below the remainder of the PQQ
may not be evaluated.

Listed below are the minimum criteria that Cornwall Council requires to be met and
evidenced by the applicants invited to tender.

3.1.14 Data Protection

Please note that a fail will only be received where it is a requirement of the contract to
be registered under the Data Protection Act but the Supplier answers No to this
question.

3.4    Compliance with EU Legislation/ UK Procurement Legislation
       [status of Supplier in relation to Regulation 23 of the Public Contracts
       Regulations 2006 (SI 2006 No. 5) (A summary of Regulation 23 can be found
       via an electronic link later in this PQQ document).

Please note the answer to this question will only receive a fail where the exclusionary
conditions of the Regulations apply but insufficient or unsatisfactory information has
been provided. Where the exclusionary conditions do not apply this will be considered
a Pass.




                                                                              9
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


3.11    Equalities and Diversity

This section is evaluated on an individual question basis question

Question 3.11.1 will be evaluated as a pass or fail. A pass will be given if all parts (a)
to (g) have been marked as „Yes‟. A fail will be given if any parts (a) to (g) have been
marked as „No‟.

3.12    Insurance

This section is evaluated on an individual question basis.

Question 3.12.1 will be evaluated as a pass or fail. A pass will be given where the
Supplier has insurance that meets or exceeds our minimum required levels. It is
acceptable to provide details of quotations to demonstrate that adequate insurance
will be in place if the Supplier is awarded the Contract. A fail will be given where the
Supplier does not meet or exceed our minimum insurance levels or does not provide
quotations to demonstrate that adequate insurance will be in place if the Supplier is
awarded the Contract.

In the event of the supplier being awarded a „fail‟ on any of the above criteria, the
remainder of their PQQ will not be evaluated.

Scored Questions

The following sections contain mandatory questions, the responses to which will be
evaluated and scored.
Unless detailed below otherwise sections / questions are scored as being „Good‟,
„Adequate‟ or „Poor/Not Complete‟, and the following definitions will apply:

„Good‟ = „Full response given with good detail and evidence‟;
„Adequate‟ = „Partial response, basic detail with some gaps‟;
„Poor/Not Complete‟ = „A limited, or non-complete response‟

Where in the opinion of the Council a particular response is so inadequate that the
applicant has failed to demonstrate a minimum level of competence, the applicant
may be excluded from further consideration.

For some questions the response given will be evaluated in terms of risk. Where this
occurs it will be stated underneath the section heading. The assessment of the level of
risk will be at the discretion of the evaluation team.

If the risk is deemed to be high, this will result in a fail for the question evaluated and
the remainder of the PQQ may not be evaluated. Responses may be evaluated on a
pass/fail basis or used to produce a score. Where responses are being scored on the
basis of risk the following scores will apply:

„Low Risk / None‟ = 3 marks

„Medium Risk‟ = 0 marks

„High Risk‟ = Fail / Disqualify


                                                                              10
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


Weighting

3.3    Prime Contractor                 %
3.5    Financial Matters                %
3.6    Quality Management               %
3.7    Health and Safety                %
3.8    Business Capability              %
3.9    Training                         %
3.10   Environmental Management
       and Sustainability               %
3.11   Equality and Diversity           %
3.12   Insurance                        %
3.13   Disputes                         %
3.14   Project Specific Questions       %
3.15   References                       %


[Insert details regarding an overall threshold (minimum) score if to be decided before
PQQ returns].

Further information on scoring can be found above each of the question sections
found later in this PQQ.



2.2    Award Criteria (Invitation to Tender Stage)

[List award criteria consistent with that covered in OJEU Notice (if applicable – Only
complete this information when you have given full consideration to the appropriate
areas of your tender to be evaluated.]

Following evaluation of PQQ‟s, successful Suppliers will be invited to tender.

The award criteria that will apply at tender stage are as follows:

Technical
%     [insert criteria]
%     [insert criteria]
%     [insert criteria]

Commercial
%   [insert criteria]
%   [insert criteria]
%   [insert criteria]

       Or [delete whichever one is not appropriate to this tender]

The award criteria that will apply at tender stage will be detailed within the ITT
document and given to successful suppliers who have been invited to tender at the
timescales identified in Section 1.4 of this PQQ. [delete as appropriate]



                                                                            11
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]
Where in the opinion of the Council the response is inadequate the Supplier may be
excluded from further consideration.

Please note that the Council reserves the right to change the above Invitation to
Tender evaluation criteria prior to issue. [delete as appropriate]

[Insert details regarding minimum and/or maximum number of companies to be
invited to tender consistent with details given in OJEU notice – if applicable].




                                                                          12
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.       PQQ FOR [INSERT PROJECT NAME]

3.1 Suppliers Details
NOTE TO SUPPLIER: This PQQ section must be completed and the relevant information
provided however the section will not be scored, with the exception of 3.1.14 which will be
evaluated on a pass or fail basis. Please note that if you answer ‘No’ to Q3.1.14 and it is a
requirement of the contract to be registered under the Data Protection Act this will be deemed
as a fail.

 It is important that where a question does not apply this is recorded as ‘Not Applicable’ or
‘None’ in the spaces provided. Please note that although these sections are not scored
insufficient information may lead to disqualification.


 3.1.1     Name of the organisation in
           whose name the tender would
           be submitted.
 3.1.2     Name of person applying on
           behalf of the organisation
 3.1.3     Position in organisation

 3.1.4     Address




 3.1.5     Registered Office of the
           organisation if different from
           the above


 3.1.6     Telephone Number
 3.1.7     Facsimile Number
 3.1.8     e-mail address
 3.1.9     Website address
 3.1.10    Company or Charity
           Registration Number
 3.1.11    If a Registered Company,
           please state if you are Limited
           by Shares, Limited by
           Guarantee or an Unlimited
           Company
 3.1.12    Date of Formation or
           Registration
 3.1.13    VAT Registration Number
 3.1.14    Is your organisation registered                        Yes / No
           under the Data Protection Act
           1998?
           If yes, please provide
           Registration Number




                                                                                   13
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


3.2 Status of Supplier
NOTE TO SUPPLIER: This PQQ section must be completed and the relevant information
provided however the section will not be scored. Please note that failure to provide the
information requested at 3.2.2 and 3.2.5 if applicable may lead to disqualification.


3.2.1    Is your organisation
  (a)    A sole trader?                                                   Yes   /   No
  (b)    A partnership?                                                   Yes   /   No
  (c)    A private limited company?                                       Yes   /   No
  (d)    A public limited company?                                        Yes   /   No
  (e)    A local authority Direct Services Organisation?                  Yes   /   No
  (f)    A charity?                                                       Yes   /   No
         Trading as a company?                                            Yes   /   No
         or
         Number of trustees if not a company?

  (g)    Other - please specify                                           Yes / No




3.2.2    Please confirm that an organisation structure              Yes / No
         chart is enclosed with this completed
         questionnaire?
3.2.3    Is your organisation a subsidiary of another               Yes / No
         Company?
         Please detail the ultimate parent company (if
         applicable)
3.2.4    Executive Directors / Partners
                  Name                                 Responsibility




3.2.5    If the organisation is a member of a Group of               Attached Yes / No
         Companies, please give the name, registered                  /Not applicable
         office address and registration number of the
         Holding/Parent Company and all subsidiaries, and
         provide details of the Group structure and its
         relationship.
         If Yes please provide details below.




                                                                                    14
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]



3.3 Prime Contractor / Partnerships / Consortiums
NOTE TO SUPPLIER: This section must be completed and the responses given will be scored.
This section will be evaluated as a whole and responses scored as being ‘Good’ = 3 points,
‘Adequate’ = 2 points or ‘Poor’ = 0 points.

Where subcontractors/partners are not used then the section will be given the same score as a
‘Good’ answer so as not to disadvantage those who do not intend to use partners or
subcontractors. However at this stage this information is used to assess that those wishing to
use subcontractors and partners have the ability to do so effectively as oppose to the impact
this would have on the delivery of the contract.

3.3.1  Please indicate which box below applies.
       (a) Your organisation is tendering to                   Yes / No
             provide the Services, Supplies
             or Works required (without the
             use of third parties).
       (b) Your organisation is tendering in          Yes / No / Not applicable
             the role of Prime Contractor and
             intends to use third parties to
             provide some of the Services,
             Supplies or Works required.
       (c) Your organisation is tendering in           Yes / No /Not applicable
             the role of Prime Contractor and
             intends to enter into a
             partnership or consortium for
             the provision of the Services,
             Supplies or Works required.
       If your answer is (b) or (c), please identify intended sub-
       contractors/partners (if currently known) below:
  Organisation name           Organisation Address and           Operation Type
                                    contact details                  Supplied




3.3.2    If you intend using sub-contractors/partners for any part of the Services,
         Supplies or Works please indicate the work and percentage below.
                       Contract Operation Type                                %
Supply   type…..                                          Yes / No        % ……….
Supply   type…..                                          Yes / No        % ……….
Supply   type…..                                          Yes / No        % ……….
Supply   type…..                                          Yes / No        % ……….
Supply   type…..                                          Yes / No        % ……….
3.3.3    Please give a brief outline on your policy regarding the use of sub-
         contractors and, if applicable, the extent to which you might envisage
         using them for this requirement.

3.3.4    How does your organisation ensure good working relationships with sub-
         contractors/partners?



                                                                                15
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.4 Compliance with EC Legislation/UK Procurement
Legislation
NOTE TO SUPPLIER: This section will be evaluated on a pass/fail basis. Please note the answer
to this question will only receive a fail where the exclusionary conditions of the Regulations
apply but insufficient or unsatisfactory information has been provided. Where the exclusionary
conditions do not apply this will be considered a Pass.

 3.4.1    Do any of the exclusionary                              Yes / No
          conditions in the Public Contracts
          Regulations 2006 (SI 2006 No. 5) or
          Utilities Contracts Regulations 2006
          (SI 2006 No.6) apply to your
          organisation?
          (A summary of the circumstances of
          Regulation 23 is provided below).

          Please follow the link below to
          obtain details of Regulation 23.
          It is vital that you understand
          the contents of this Regulation
          before answering the above
          question.

          http://www.opsi.gov.uk
 If Yes please provide details below.




                                                                                16
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


3.5 Financial Matters
 NOTE TO SUPPLIER: This section must be completed and the responses given will be scored.
This section will be evaluated as a whole and responses scored as being ‘High Risk’ = ‘Fail /
Disqualify’, ‘Medium Risk’ = 0 points or ‘Low Risk / None’ = 3 points.

The determination of the appropriate risk level will be proportionate and relevant to the
specific Contract being tendered. (If, in the opinion of the Council, the risk of entering into a
future contract with the Supplier is considered unacceptable a failure will be given and the PQQ
not considered further.)


 3.5.1      The Supplier shall provide the following financial information
            for the last three years.
            If the accounts you are submitting are for a year ended more than 10
            months ago, please enclose a copy statement signed by the Director
            responsible for financial affairs, setting out the organisation‟s turnover
            and net profit since the latest accounts, and any known significant
            changes in the balance sheet of the organisation.
    (a)     A copy of the most recent audited accounts for your         Attached Yes /
            organisation that cover the last three years of trading           No
            or for the period that is available if trading for less
            than three years.
    (b)     OR where this information is not available in an            Attached Yes /
            audited form at (a), provide a statement of the                   No
            organisation‟s turnover, profit and loss and cash flow
            position for the most recent full year of trading (or
            part year if full year not applicable) and an end period
            balance sheet.
    (c)     OR Where (b) cannot be provided, a statement of the Attached Yes /
            organisation‟s cash flow forecast for the current year            No
            and a bank letter outlining the current cash and credit
            facility position.
    (d)     OR where (a), (b) or (c) cannot be provided, provide        Attached Yes /
            a separate statement of the organisation‟s turnover               No
            that relates directly to the supply of these services,
            supplies or works for the past three years, or for the
            period the organisation has been trading (if less than
            three years).
    (e)     If the organisation is a subsidiary of a group, (a) to      Attached Yes /
            (c) are required for both the subsidiary and the                  No
            ultimate parent organisation. Where a consortium or
            association is proposed, the information is requested
            for each member organisation including sub-
            contractors.
    (f)     Director‟s and Auditor‟s Reports                            Attached Yes /
                                                                              No
    (g)     Notes to the Accounts                                       Attached Yes /
                                                                              No
    (h)     Parent company and/or other guarantees of                      Yes / No
            performance and financial standing may be required if
            considered appropriate. Please confirm your
            organisation‟s willingness to provide a parent

                                                                                   17
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]
           company guarantee if required.
    (i)    Please confirm your organisation‟s willingness to             Yes / No
           provide a performance bond if required.
 3.5.2     The Council will require as part of the evaluation process a reference
           from each applicant's bankers as to the organisation‟s suitability to
           undertake a contract of this size and nature.
           Please complete the Bank Authority Form below ensuring that
           you have entered all the information. This must be signed by a
           Director of your organisation who has the authority to do so and
           whose signature is acceptable to your bankers. Please do not
           send a photocopy.
           The duly completed form will be sent by the Council to your bankers to
           obtain a reference from them.
           Note: Banks are unwilling to supply references without this
           authority. Failure to provide such an authorisation may mean
           that the Council will be unable to consider your application
           further.
   (a)     Name of Bankers
   (b)     Address of Bankers


   (c)     Bank Authority Form at Appendix 1                  Yes / No
           completed.
 3.5.3     Does your organisation have any                    Yes / No
           outstanding claims or litigation against
           it?
           If yes, please provide details.




                                                                         18
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


                                  BANK AUTHORITY FORM
      Bank/Building Society Details

       Name of your Bank
       Name of your Branch
       Address of your Branch



       Branch Sort Code
       Account Number
       Building Society Roll
       Number (if appropriate)

       Name of your Organisation

       I hereby authorise you to supply the Head of Finance of Cornwall Council,
       information on the financial status of the organisation, Banker's reference
       and legal charges against the organisation, together with detail of any
       mortgages.
       I consent to ……………………………………………………. Bank/Building Society
       debiting my/our account with their standard administration fee.

       Signature
       Printed Name
       Position in organisation
       Date (day, date, month,
       year)
       Telephone Number
       e-mail Address


      Head of Finance
      Cornwall Council
      New County Hall
      Treyew Road
      Truro
      Cornwall
      TR1 3AY




                                                                          19
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.6 Quality Management
NOTE TO SUPPLIER: This section must be completed and the responses given will be scored.
This section will be evaluated as a whole against the requirements of the contract to be
delivered and responses scored as being ‘Good’ = 3 points, ‘Adequate’ = 2 points or ‘Poor’ = 0
points. This means that the evaluator needs to make a judgement about the importance of
these questions in relation to the delivery of the contract. The evaluator can then determine
against those requirements the level of the responses received.

3.6.1    Does your organisation and any of its proposed partners hold recognised
         quality management certification?
         If yes, please provide details of certification achieved.
         Month / Year                             Name of Accreditation Group




3.6.2    Please confirm that any quality management                         Yes / No
         certification is enclosed with this completed
         Questionnaire.
3.6.3    If no to 3.6.2, does your organisation have a quality              Yes / No
         management system or guarantee of performance?
         If yes, please provide details.

3.6.4    If you do not have quality certification or a quality management system,
         please explain why?

3.6.5    Does your organisation and any of its proposed                     Yes / No
         partners possess, or is it working towards Investors in
         People Standard (IiP) or equivalent?
         If yes, please provide details of certification.

3.6.6    Please provide details of any quality management certification for which
         you have applied.




                                                                                 20
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.7 Health and Safety
NOTE TO SUPPLIER: This section must be completed and the responses given will be evaluated
as follows;

3.7.1 to 3.7.2 Information only
3.7.3 to 3.7.13 Individually scored as ‘Good’ = 3 points ‘Adequate’ = 2 points ‘Poor’ = 0
points, ‘Not applicable’ = 3 points.
3.7.3 – This question requires the evaluator to read the Suppliers Health and Safety Policy.
The determination of the quality of the policy will be against industry best practice.
3.7.4 – 3.7.11 and 3.7.13 – These questions require the evaluator to consider the Contract
that is being tendered and the Health and Safety requirements applicable to the delivery of the
contract.
3.7.12 – This question requires the evaluator to read the Suppliers Risk Assessment, Method
Statement and COSHH Assessment examples. The determination of the score will be against
industry best practice.
3.7.14 to 3.7.18 Individually scored as ‘Low Risk’ / ‘None’ = 3 points ‘Medium Risk’ = 0 points
‘High Risk’ = ‘Fail / Disqualify’. These questions are evaluated comparatively to other PQQ
submissions.

 3.7.1      Please provide the details of the person with overall responsibility for
            Health and Safety within your organisation.
            Name
            Title
            Address


            Telephone Number
            e-mail Address
 3.7.2      Please provide the name of the person and contact details of your
            “Competent Person” for the provision of health and safety advice, as
            required by the Management of Health and Safety Regulations 1999, if
            different to above.
            Name
            Title
            Address


            Telephone Number
            e-mail Address
 3.7.3      Please enclose a copy of your organisation‟s, and            Attached Yes /
            any proposed partners, Health and Safety Policy                    No
            and/or other declaration, information or instruction
            issued by your organisation as necessary, to protect
            the health, safety and welfare of your employees.
 3.7.4      Does your organisation hold or is it working towards            Yes / No
            a recognised Health and Safety Certification or
            equivalent standard?
            If yes, please provide details.

 3.7.5      Is your organisation a member of a Health and                Yes / No / Not
            Safety Assessment Scheme?                                      applicable
             If yes, please provide details of date approved.



                                                                                 21
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


           If no, would you be prepared to undertake the            Yes / No / Not
           assessment to become a member of a Health and              applicable
           Safety Assessment Scheme?

 3.7.6     Please provide details below of how your health and safety policies are
           communicated to your employees and administered within your
           organisation. How do you ensure that your employees know about,
           understand and apply your policies and procedures?

 3.7.7     Please provide details of any strategies your organisation has
           introduced to improve safety below.



 3.7.8     Please provide details below of your organisation‟s Health and Safety
           learning, training and development for employees and managers
           attended in the last 3 years? (Details to cover date, course/ training
           undertaken, duration, who attended, etc)


 3.7.9     What is the average number of days per employee per year spent on
           learning, training and development matters specifically tailored to the
           management of Health and Safety?

 3.7.10               Accident Figures for current year and last three years
    Year Ending        Total Employees     Major Injuries        3 Day Reports
  [Current Year]
   [insert years]
   [insert years]
   [insert years]
 3.7.11     Does your organisation undertake Health and               Yes / No
            Safety Audits for all work places, as required
            by the Management of Health and Safety
            Regulations 1999?
            If yes, please provide details below including
            but not limited to dates, auditing organisation
            and an example of the most recent audit
            report produced.

 3.7.12    Please provide details below of your organisation‟s Safety Manual
           contents page and the relevant examples of the following:
           (a) Risk Assessment                                 Attached Yes / No
           (a) Method Statement (relevant to this              Attached Yes / No
                project)
           (a) COSHH Assessment                                Attached Yes / No
 3.7.13    Please provide details below on what measures or systems your
           Company has adopted to ensure the Health and Safety competence of
           sub-contractors?


 3.7.14    In the last three years has your organisation or           Yes / No

                                                                            22
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]
           proposed partners, been prosecuted for
           contravention of the Health and Safety at Work Act
           1974, or equivalent national legislation?
           If yes, please provide details of the nature of the
           case, findings of the Court or result of the
           investigation/notice.




 3.7.15    In the last three years has your organisation or      Yes / No
           proposed partners, been the subject of an
           enforcement action by the Health and Safety
           Executive or similar body charged with improving
           health and safety standards?
           If yes, please provide details below.




 3.7.16    In the last three years has your organisation or      Yes / No
           proposed partners, been issued with any formal
           notices by the Health and Safety Executive or
           similar body charged e.g. Environmental Health
           Officer or Environment Agency with improving
           health and safety standards?
           If yes, please provide details below.




 3.7.17    In the last five years has your organisation or       Yes / No
           proposed partners, had a fatality or dangerous
           occurrence?
           If yes, please provide details below including
           Health and Safety Executive or similar body
           charged with improving health and safety
           standards involvement and action to prevent
           further occurrences.




 3.7.18    In the last three years has your organisation or      Yes / No
           proposed partners, reported any injury accidents or
           dangerous occurrences to the Health and Safety
           Executive or similar body charged with improving
           health and safety standards (as defined by the
           Reporting of Injuries, Diseases and Dangerous
           Occurrences Regulations 1995)
           If yes, please provide details below.




                                                                     23
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


3.8 Business Capability
NOTE TO SUPPLIER: This section must be completed and responses given will be scored. This
section will be evaluated on an individual question basis against the requirements of the
contract and responses will be scored as ‘Good’ = 3 points ‘Adequate’ = 2 points ‘Poor’ = 0
points.

3.8.1 –Good = All principle areas of business activity matches the delivery of the contract
       Adequate = At least one principle area of business activity matches the delivery of the
       contract
       Poor = No principle areas of business activity match the delivery of the contract
3.8.6 -Please note that the answer ‘No’ in this questions will also score 3 points

 3.8.1    Please detail the principal areas of your business activity.


 3.8.2    Please provide details of any experience you have relevant to the
          Contract to be delivered.


 3.8.3    Please provide details of any qualifications your employees have that
          would be utilised in the delivery of the Contract.


 3.8.4    Please provide details of any skills you have within your organisation that
          would be utilised in the delivery of the Contract.


 3.8.5    Which professional or trade bodies does your organisation or key
          personnel belong to?


 3.8.6    Is it proposed to sub-contract any part of the delivery             Yes / No
          of this service?
          If yes, please provide details of which part and how
          would it be managed and funded?


 3.8.7      Please provide details of staff turnover as a percentage of your
            workforce for the last 3 years.
            [insert years]                                                 %
            [insert years]                                                 %
            [insert years]                                                 %
 3.8.8      Please provide any relevant information/comment on your organisation‟s
            staff turnover rates.


 3.8.9      Please provide details of training other than Health                 %
            and Safety as a % of your turnover.




                                                                                  24
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


3.9 Training
NOTE TO SUPPLIER: This section must be completed and responses given will be scored. This
section will be evaluated as a whole and the responses given will be scored as ‘Good’ = 3
points ‘Adequate’ = 2 points ‘Poor’= 0 points. Please note that the evaluator will consider the
quality of the Training Policy when determining the rating of these questions.

 3.9.1      Does your organisation and any of its proposed                Attached Yes /
            partners have a Training policy for new and existing                No
            employees, other than health and safety?
            If Yes please provide details below.




 3.9.2      Please provide details of how your Training policy is communicated to
            your employees and administered within your organisation.




 3.9.3      Please provide a populated example of your training           Attached Yes /
            plan for the forthcoming year.                                      No




                                                                                 25
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.10 Environmental Management & Sustainability
NOTE TO SUPPLIER: This section must be completed and responses given will be scored. This
section will be evaluated on an individual question basis against the requirements of the
contract to be delivered and responses will be scored as follows;

3.10.1 to 3.10.5 ‘Good’ = 3 points ‘Adequate’ = 2 points ‘Poor’ = 0 points
3.10.1 – requires the evaluator to read the Suppliers Environmental Policy. The determination
of the quality of the policy will be against industry best practice.
3.10.6 and 3.10.7 ‘Low Risk / None’ = 3 points ‘Medium Risk’ = 0 points ‘High Risk’ = Fail /
Disqualify

 3.10.1     Please provide a copy of your organisation‟s, and any         Attached Yes /
            proposed partners, Environmental Policy and/or other                No
            declaration, information or instruction issued by your
            organisation as necessary, to ensure compliance with
            environmental legislation.
 3.10.2     Does your organisation hold or is working towards                Yes / No
            recognised Environmental Management and
            Sustainability certification.
            If yes, please provide details

 3.10.3     Please provide details of how your Environmental policy is
            communicated to your employees and administered within your
            organisation.

 3.10.4     Please provide details of any strategies your organisation has
            introduced to reduce the impact of your operation on the environment.
            For example, special emphasis on recycling, the safe use of materials,
            conservation of energy resources etc, or provide details of any areas
            which you consider relevant to the protection of the environment in
            relation to the subject of this procurement.

 3.10.5     Please confirm that your organisation undertakes                 Attached
            internal Environmental audits and provide high level             Yes / No
            evidence that demonstrates your commitment to
            Environmental Management including but not limited
            to your audit programme and an example audit
            report?

 3.10.6     In the last three years has your organisation or                 Yes / No
            proposed partners, been prosecuted for breaking any
            UK or EU, or equivalent national legislation relating to
            the environment?
            If yes, please provide details.

 3.10.7     In the last three years has your organisation or                 Yes / No
            proposed partners, had any notice served upon it by
            an environmental regulator or authority?
            If yes, please provide details.




                                                                                26
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.11 Equalities & Diversity
NOTE TO SUPPLIER: This section must be completed and responses given will be scored. This
section will be evaluated on an individual question basis as follows:

3.11.1 this question will not receive a score but will be evaluated on a ‘Pass/Fail’ basis, with all
parts (a) to (g) marked as ‘Yes’ constituting a ‘Pass’, and any parts (a) to (g) marked as ‘No’
constituting a ‘Fail’
3.11.2 to 3.11.7 and 3.11.10 ‘Good’ = 3 points ‘Adequate’ = 2 points ‘Poor’ = 0 points. The
determination of the quality of the policy will be against industry best practice.
3.11.8 and 3.11.9 ‘Low Risk / None’ = 3 points; ‘Medium Risk’ = 0 points; ‘High Risk’ = ‘Fail /
Disqualify’

3.11.1     Does your organisation comply with its legal obligations relating to the
           following?
  (a)      Race                                                          Yes / No
  (b)      Sexual Orientation                                            Yes / No
  (c)      Disability                                                    Yes / No
  (d)      Age                                                           Yes / No
  (e)      Religion or Belief                                            Yes / No
   (f)     Gender                                                        Yes / No
  (g)      Human Rights                                                  Yes / No
3.11.2     Please provide your Equalities and Diversity Policy.      Attached Yes /
           In addition please attach any of your proposed                   No
           partners Equalities and Diversity Policies.

3.11.3     Please provide details below of how your Equalities and Diversity Policy
           is communicated to your employees.

3.11.4     Please provide details below of any strategies your organisation has to
           introduce Equalities and Diversity.

3.11.5     Please provide details below of your organisations Equalities and
           Diversity training for employees.

3.11.6     Please provide details below of how your organisation monitors Equalities
           and Diversity.

3.11.7     If you are not currently subject to UK legislation, please supply details of
           your experience in working under equivalent legislation, which in your
           country, is designed to eliminate discrimination and to promote equality
           of opportunity.

3.11.8     In the last three years, has any finding of unlawful                  Yes / No
           discrimination been made against your organisation
           by any court of law or industrial or employment
           tribunal?
           If yes, please provide details

3.11.9     In the last three years has your organisation been the                Yes / No
           subject of a formal investigation on grounds of
           alleged unlawful discrimination? If yes, please provide
           details


                                                                                      27
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]


3.11.10   If the answer to question 3.11.7 is in the affirmative or, in relation to
          question 3.11.8 the Commission made a finding adverse to your
          organisation, what steps did you take in consequence of that
          finding/investigation?




                                                                               28
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.12 Insurance
NOTE TO SUPPLIER: This section must be completed and responses given will be scored. This
section will be evaluated on an individual question basis as follows:

3.12.1 Pass or Fail. A pass will be given where the Supplier has insurance that meets or
exceeds our minimum required levels. It is acceptable to provide details of quotations to
demonstrate that adequate insurance will be in place if the Supplier is awarded the Contract. A
fail will be given where the supplier does not meet or exceed our minimum insurance levels or
does not provide quotations to demonstrate that adequate insurance will be in place if the
supplier is awarded the Contract.
3.12.2 ‘Low Risk’ / ‘None’ = 3 points; ‘Medium Risk’ = 2 points; ‘High Risk’ = 0
For this question the following applies;
‘Low Risk’ = No claims in excess of £50,000 detailed
‘Medium Risk’ = total of all claims in excess of £50,000 as a percentage of Supplier turnover
less than 10%
‘High Risk’ = total of claims in excess of £50,000 as a percentage of Supplier turnover more
than 10%

 3.12.1     Please provide details of all insurance cover currently in force. If your
            organisation‟s tender is successful, adequate insurance cover will be
            required. The levels are indicated below. If your current insurance is
            insufficient, please enclose a copy of a quotation from your insurance
            company indicating that the increased cover will be available should you
            be awarded the contract.
            Please enclose a copy of all Certificates
    (a)     Employers Liability (minimum £5m
            cover)
            Insurer
            Policy Number
            Amount of cover £
            Renewal Date
    (b)     Public Liability (minimum £5m cover)
            Insurer
            Policy Number
            Amount of cover £
            Renewal Date
    (c)     Professional Indemnity - where required
            (minimum £2m cover for 12 years)
            Insurer
            Policy Number
            Amount of cover £
            Renewal Date
    (d)     Product Liability (minimum £2m cover)
            Insurer
            Policy Number
            Amount of cover £
            Renewal Date
    (e)     Motor Vehicle (minimum £5m cover)
            Insurer
            Policy Number

                                                                                 29
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]
           Amount of cover £
           Renewal Date
 3.12.2    Please provide details of any open or settled claims in excess of £50,000
           (including outstanding claims) made under your organisation‟s
           Employers, Public, Professional Indemnity or Product Liability insurance
           policy within the last three years.




                                                                            30
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.13 Disputes

NOTE TO SUPPLIER: This section must be completed and responses given will be scored. This
section will be evaluated as a whole and responses will be evaluated as ‘Low Risk’ / ‘None’ = 3
points; ‘Medium Risk’ = 2 points; ‘High Risk’ = 0

 3.13.1     Has your organisation, or any of its proposed partners,           Yes / No
            had penalties, default notices or liquidated damages
            awarded against it during the last three years in respect
            of similar services, supplies or works?
            If yes, please provide details below and answer parts (a)
            and (b).


    (a)     Were the damages in excess of £50,000?                            Yes / No
    (b)     Were the damages greater than 10% of the whole life               Yes / No
            value of the contracted services?
 3.13.2     Has your organisation, or any of its proposed partners,           Yes / No
            withdrawn from a contract after the contract has been
            awarded during the last three years in respect or similar
            services, supplies or works?
            If yes, please provide details.


 3.13.3     Has your organisation, or any of its proposed partners,           Yes / No
            had a contract terminated in the last three years in
            respect of similar services, supplies or works?
            If yes, please provide details.


 3.13.4     During the last three years has your organisation, or             Yes / No
            any of its proposed partners, not had a contract
            renewed due to failure to perform to the terms of
            contract?
            If yes, please provide details.


 3.13.5     Has your organisation, or any of its proposed partners,           Yes / No
            been prosecuted or had any Court judgements against
            it in the last three years?
            If yes, please provide details.


 3.13.6     Is your organisation or any of its proposed partners              Yes / No
            currently involved in an ongoing / unresolved dispute?
            If yes, please provide details.




                                                                                  31
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.14 Project Specific Questions

NOTE TO SUPPLIER: The questions asked in this section are those that would only apply to
individual projects. There will be times when no questions are asked here but it is important to
have this section so that specific questions can be asked if necessary. This section must be
completed and the responses given will be scored. This section will be evaluated on an
individual question basis and responses scored as ‘Good’ = 3 points; ‘Adequate’ = 2 points;
‘Poor’ = 0 points

[insert questions here that are important to your specific project]

Please complete for the lots your organisation anticipates tendering for. [delete as
applicable]

3.12.1


3.12.2


3.12.3


3.12.4


3.12.5


3.12.6


3.12.7


3.12.8


3.12.9


3.12.10


3.12.11


3.12.12


3.12.13




                                                                                  32
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]
3.12.14


3.12.15




                                                            33
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

3.15 References

NOTE TO SUPPLIER: This section must be completed and the responses given will be scored.
This section will be evaluated as a whole and responses scored as being ‘Relevant references’
= 3 points; ‘Partially relevant references’ = 2 points; ‘Irrelevant references = 0 points

 3.15.1     Please provide details of three major contracts you have been awarded
            recently (preferably other Local Authority or Public Sector bodies) for
            the provision of services, supplies or works similar to those required
            by the Council, from whom the Council can take up
            professional/technical references.
            Please note that the Council may elect to contact any of the given
            organisations for a reference. Your permission to do so will be
            assumed unless you explicitly state any objections.
            The referees must be contacted and agree to providing a
            reference prior to this questionnaire being submitted.
 (a)        Customer Name
            Address
            Contact Name
            Telephone Number
            e-mail Address
            Date Contract Awarded
            Length of Contract
            Annual Value of Contract (£)
            Contract Reference and brief
            description of service undertaken
 (b)        Customer Name
            Address
            Contact Name
            Telephone Number
            e-mail Address
            Date Contract Awarded
            Length of Contract
            Annual Value of Contract (£)
            Contract Reference and brief
            description of service undertaken
 (c)        Customer Name
            Address
            Contact Name
            Telephone Number
            e-mail Address
            Date Contract Awarded
            Length of Contract
            Annual Value of Contract (£)
            Contract Reference and brief
            description of service undertaken




                                                                                 34
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

4. Declarations
WHEN YOU HAVE COMPLETED THE QUESTIONNAIRE AND ALL APPLICABLE
APPENDICES, PLEASE READ AND SIGN THE SECTION BELOW.

 I declare that the details submitted in the form of this application are correct to the
 best of my/our knowledge.

 I can confirm that the following information has been included:
       Bank Authority Form
       the last three years‟ audited accounts
       details of insurance cover
       a copy of the health and safety policy statement, signed and dated
       health and safety certificate
       any other procedures, examples and logs requested
       details of quality assurance procedures
       quality management certificate
       brief details of all relevant contracts.
       Organisation Structure Chart
       Organisation of a Group
       Training Policy
       Environmental Policy
       Environmental Management and Sustainability Certification
       Equalities and Diversity Policy

 I understand that the information contained in this PQQ will be held in confidence
 by the Council and used in the evaluation process to assess my organisation‟s
 financial stability and competence to conduct the Contract being tendered by the
 Council.

 I apply for inclusion in the list of Suppliers who will be invited to tender for the
 [insert name of project]

 I accept the conditions and undertakings requested in this PQQ.

 I understand that false information could result in my / our exclusion from the
 contract.

 I declare that my organisation will notify the Council immediately it becomes
 aware of any actual or potential conflict of interest which may arise between the
 interests of the Council and my organisation or any of our clients and that my
 organisation will take immediate steps to remove the cause of any such conflict
 to the complete satisfaction of the Council.

 I understand that it is a criminal offence, punishable by imprisonment, to give or
 offer any gift or consideration whatsoever as an inducement or reward to any
 servant of a public body, and that any such action will empower such body to
 cancel any contract currently in force and will result in my / our exclusion from
 the Contract.

                                                                              35
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]

Mandatory Attachments Checklist

          Organisation Structure Chart (Question 3.2.2 refers)
          Organisation of a Group (if applicable) (Question 3.2.5 refers)
          Audited accounts for last 3 years for organisation and parent organisation
           (Question 3.5.1 refers)
          Quality Management Certificate (Question 3.6.1 refers)
          Health and Safety Policy (Question 3.7.3)
          Health and Safety Certification (Question 3.7.4)
          Training Policy (Question 3.9.1 refers)
          Environmental Policy (Question 3.10.1 refers)
          Environmental Management and Sustainability Certification (Question
           3.10.2)
          Equalities and Diversity Policy (Question 3.11.1 refers)
          Insurance Certificates (Question 3.12.1 refers)
          Bank Authority Form
       Failure to provide the above items of information will disqualify your
       organisation from the next stage of this procurement process.

 Signature
 Printed Name
 Position
 Organisation
 Date (day, date, month, year)
 Telephone Number
 e-mail Address

This form should be signed by a Director, Partner, Senior Manager or
authorised representative of the organisation.
Before returning the questionnaire, please make sure you have
      Answered all the questions appropriate to your organisation;
      Signed the questionnaire; and
      Enclosed all relevant documents.




                                                                             36
DD Month Year
CONFIDENTIAL
Pre-Qualification Questionnaire for [Insert Project Name]




        DOCUMENTS NOT FOR DISCLOSURE TO THIRD PARTIES UNDER THE
           FREEDOM OF INFORMATION ACT 2000 OR ENVIRONMENTAL
                    INFORMATION REGULATIONS 2004

To:   Cornwall Council
      County Hall
      Treyew Road
      Truro
      Cornwall
      TR1 3AY

Contract Reference Number

Name of Organisation

 Question No.    Page No.      Reasons for Non-Disclosure (cite exemption(s) to be
                               considered)




To be kept with the tender documents for consideration should a request for
information under the Freedom of Information Act 2000 or Environmental Information
Regulations 2004 be received. This document can be destroyed in line with the
retention and destruction schedule of the tender documents.




                                                                        37
DD Month Year

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:13
posted:8/10/2011
language:English
pages:37
Description: Sample Request of Authenticity from Organisation to Bank Official document sample