2015/2016 DATABASE REGISTRATION FORM
2015/2016 DATABASE REGISTRATION FORMTO ALL SUPPLIERS SEEKING REGISTRATION AS A PREFERRED SUPPLIER ON THEDATABASE OF TSHWANE NORTH TVET COLLEGEAll suppliers are invited to register as a preferred supplier on the database of the Tshwane North TVETCollege. In order to comply with Treasury Regulations 16A, the Tshwane North College developed asupplier database to be used by the Supply Chain Management Unit.The purpose of this database is to give all prospective suppliers an equal opportunity to submitquotations to Tshwane North College and to enhance transparency and equality. The databasewill also contribute to better administration and compliance with the Public Finance ManagementAct, 1999 (Act 1 of 1999) and legal framework.Preference will be given to registered suppliers and in cases where suitable suppliers are not availableon the registered database, Tshwane North College reserves the right to source quotations of thesupply of goods and services outside the database.Attached is an official registration form that will assist in updating the TNC database.Please note that a valid tax clearance certificate must be obtained from the South AfricanRevenue Services (SARS) where the bidder is registered for tax purposes. SARS will furnish thebidder with a Tax Clearance Certificate that will be valid for a period of 12 months from date ofissue. The original Tax Clearance Certificate, Cipro certificate and certified I.D of a contactperson must be submitted together with the application form and bank form (entity maintenance).Failure to submit the original and valid Tax Clearance Certificate will invalidate the application.It is imperative that suppliers read the application document carefully, complete it in fulland sign it.Questions can be sent toJan Chueu:012 401 1976 Email: jan.chueu@tnc.edu.zaSalome Makwala: 012 401 1928 Email: salome.makwala@tnc.edu.zaSophie Mabua:012 401 1944 Email: sophie.mabua@tnc.edu.zaCompleted documents should be sent to:For attention: Supply Chain Management UnitTshw ane Nort h TVET Coll egePO Box 26193Acardia0007Or hand delivered to:For attention: The Supply Chain OfficeRoom W7Kgosi Mampuru StreetCnr Pretorius and KgosiMampuru StreetPretoria1
2015/2016 DATABASE REGISTRATION FORMSUPPLIER APPLICATIONFORMIMPORTANT NOTESPlease read carefully To be completed by the applicant seeking registration as an approved supplier; Applicants must submit all contact details including an email address or fax number, failureto do so will result in the application being excluded; It should be noted that Tshwane North College reserves the right to accept or reject anyapplication without being obliged to give any reasons; Applicants will be notified about the outcome of their application irrespective of whether it ispositive or negative; A maximum of four commodities must be reflected on the application form. Reflectingmore than four commodities will nullify the application; and All the required and supporting documentations must be submitted jointly with the Form Failure to submit all the mandatory documents will lead to your application not beingconsidered. A duly completed Form together with supporting documentation must be submittedto the address indicated on the front page. The Tshwane North College will notaccept electronically sent forms or faxes. Declaration of Interest section is compulsory and must be completed in full.NB: FAILURE TO SUBMIT THE MANDATORY REQUIREMENTS WILL RESULT IN THEAPPLICATION BEING EXCLUDED.2
2015/2016 DATABASE REGISTRATION FORMKINDLY ATTACH THE SUPPORTING DOCUMENTS ON THE TABLE BELOW:REQUIRED SUPPORTING DOCUMENTSMANDANTORY DOCUMENTS1.Original Valid Tax Clearance2.Company Registration Documents (Certified Copies)3.4.Original Bank Statement/ Letter from the bank confirming banking detailsCertified ID Copies Of All ShareholdersOTHER REQUIREMENTS5.6.7.8.9Completed Declarations Of Interest/SBD4 FormsProof of Registration to a Professional Body Regulating your IndustryCompany ProfileBBBEE ScorecardMunicipal Account not older than three monthsSupplier detail:Company / Supplier name:Company / Close Corporation RegistrationNumberVAT registration number (if applicable):Income tax reference number:Web address:E-mail address:Telephone number:Fax number: (compulsory)Number of full time employees:Postal Address: (compulsory)Physical Address:Postal codePostal codeCompany/Supplier Classification: (Please the relevant box or rDistributorExporterSales3
2015/2016 DATABASE REGISTRATION FORM(Please the relevant box)Tax Clearance Certificate AttachedyesNoExpiry date:Supplier Grouping Detail: Type of Firm: (Please the relevant box)1Public Company (Ltd)2Private Company (Pty) Ltd3Close Corporation (cc)4Other (specify5Joint Venture6Consortium7Sole Proprietor8Foreign Company9Partnership10Section 21 Company11Government / ParastatalMain contact person in your organisation:Name:Company Position:Cell phone Number:Fax Number:E-mail address:Contact person (responsible for sales) in your organization:Name:Company Position:Cell phone Number:Fax Number:E-mail address:4
2015/2016 DATABASE REGISTRATION FORMProvincial Offices(Branches)Does Entity also has Provincial Offices (Branches)YesECFSGPKZNLPMPNCNoNWWCALLPROVINCES(If Yes, please tick in which province(s) the Entity has offices/branches/chapters)BANKING DETAILS:Account holderBank nameAccount typeAccount numberBranch nameBranch codeNumber of years at thisbankAuthorization for electronic transfer of funds (EFT) to supplier’s bank accountI, the undersigned hereby authorize T s h w a n e N o r t h C o l l e g e to credit my/the companyaccount via Electronic Funds Transfer as afore mentioned with the amount payable/due to specifiedbeneficiary for goods and services rendered.Please note: If the letter from the bank is not attached, attach stamped bank statement to confirm theinformation given above.Full NameCapacityDateSignature5
2015/2016 DATABASE REGISTRATION FORMTrade names: Maximum of four will be registeredTrade names of commodities(Example: HP or Dell)Description of commodities(Example: cartridge)SMME status of your enterprise: Please use this table to determine the SMME status of your enterprisePlease the relevant box in each columnA. SectorB. Full Time paid employeesMediumSmallAgriculture100Mining andQuarryingManufacturingD. Total Gross asset value(property excluded) (millions)C. Annual Turnover .1Construction2005020520520.15410.40.1Retail and MotorTradeWholesale ce .50.110050105201020.1552.50.50.1Other nity &Social 10.16
2015/2016 DATABASE REGISTRATION FORMSMME status of your enterprise: (Please the relevant box)(According to SMME table) (Compulsory)MicroVery smallSmallMediumLargeCOMPANY CORE BUSINESSTRADE REFERENCES (MIN OF 2)1. REFERENCES:Company nameType of service offeredContact PersonTelephone numberMobile numberE-mail Address2. REFERENCES:Company nameType of service offeredContact PersonTelephone numberMobile numberE-mail AddressI . hereby certify that the information contained in this application istrue and correct and fully understood by me. Thus done and signed aton this, theday of20.Signature7
2015/2016 DATABASE REGISTRATION FORMCOMMODITIES: (PRINCIPAL BUSINESS OR SERVICES) (Maximum of 4 commodities will be registered) (Failure to complete this section will result in the application being decline)(Please the relevant box)COMMODITY .15AdministrationCatering ServicesStationeryOffice EquipmentCleaning MaterialGroceriesKitchen Appliance (supply)Kitchen Appliance (repairs)Lock Smith servicesOffice furniture (supply)Office plantsSecurity services / systemsCourier ServicesHygiene ServicesOffice furniture removalInterior Designer & Decor4.4.14.24.34.44.54.6Consulting ServicesLegal ServicesAccounting and Auditing ServicesLabour Relation ConsultantsTranslationDesign of Office spaceArchitectural6.6.16.26.36.46.5HR ServicesRecruitment ServicesHR Consulting ServicesTeam BuildingHR Training & DevelopmentRecruitment Training for lineManagersHR Wellness SolutionExecutive Training & MentorshipRemuneration ConsultingPayroll OutsourceEmployee Benefit ConsultingOrganizational DevelopmentSETA Accredited Training Provider 6.66.76.86.96.106.116.12COMMODITY 2.2.12.22.32.42.42.62.72.82.92.10Building MaintenanceOffice RenovationsPlumbing ServicesPartitioningPaintingBlinds (installation and repairs)Electrical Spares supplyBuilding MaintenancePlumbing Material SupplyCarpentry material supplyBuilding Material el AgentConference facilities & venuesCar hireFlight bookingsTour Guide5.5.15.25.35.45.55.65.7IT ServicesInternet hostingStorage and backupServers (supply, installation andremoval) SecurityNetworkIT SolutionIT hardwareIT Software 5.85.95.105.115.125.135.14IT ConsumablesIT Support and MaintenancePA SystemPABX SystemPhotocopier MachinesTelecommunication servicesPrinter Repairs and Maintenance 8
2015/2016 DATABASE REGISTRATION FORMMarketing and 17.127.137.147.15Graphic DesignAdvertising and PlacementsCommunication ActivationBranding and Corporate IdentityBrochuresPosters and FlyersAnnual ReportLogo DesignSignageCataloguesBusiness cards printingNewsletterFoldersBranded Corporate ClothingEvent Management 28.3Database ManagementExhibitionsExhibitionsBranding and DisplaysPromotional giftsExhibitionsAudio-visualOn – premises displayExhibitionsTelevision and RadioSocial MediaWeb ManagementMarket ResearchMedia Tracking servicesHospitalityDry Ingredients & vegetable SupplyMeat SupplySeafood & Poultry Supply. Points awarded for B-BBEE Status Level of ContributionIn terms of Regulation 5 (2) and 6 (2) of the Preferential Procurement Regulations, preferencepoints must be awarded to a bidder for attaining the B-BBEE status level of contribution inaccordance with the table below:B-BBEE Status Level ofContributorNumber of points(80/20 system)12021831641258667482Non-compliant contributor0Bidders who qualify as EMEs in terms of the B-BBEE Act must submit a certificate issued by anAccounting Officer as contemplated in the CCA or a Verification Agency accredited by SANAS or aRegistered Auditor. Registered auditors do not need to meet the prerequisite for IRBA’s approvalfor the purpose of conducting verification and issuing EMEs with B-BBEE Status LevelCertificates.Bidders other than EMEs must submit their original and valid B-BBEE status level verification certificate ora certified copy thereof, substantiating their B-BBEE rating issued by a Registered Auditor approved byIRBA or a Verification Agency accredited by SANAS.9
2015/2016 DATABASE REGISTRATION FORMA trust, consortium or joint venture, will qualify for points for their B-BBEE status level as a legal entity,provided that the entity submits their B-BBEE status level certificate.A trust, consortium or joint venture will qualify for points for their B-BBEE status level as anunincorporated entity, provided that the entity submits their consolidated B-BBEE scorecard as if theywere a group structure and that such a consolidated B-BBEE scorecard is prepared for every separatebid.Tertiary institutions and public entities will be required to submit their B-BBEE status level certificates interms of the specialized scorecard contained in the B-BBEE Codes of Good PracticeA person will not be awarded points for B-BBEE status level if it is indicated in the bid documents thatsuch a bidder intends sub-contracting more than 25% of the value of the contract to any other enterprisethat does not qualify for at least the points that such a bidder qualifies for, unless the intendedsubcontractor is an EME that has the capability and ability to execute the sub-contract.A person awarded a contract may not sub-contract more than 25% of the value of the contract to anyother enterprise that does not have an equal or higher B-BBEE status level than the person concerned,unless the contract is sub-contracted to an EME that has the capability and ability to execute the subcontract.BID DECLARATIONBidders who claim points in respect of B-BBEE Status Level of Contribution must complete the following:B-B BBEE STATUS LEVEL OF CONTRIBUTION CLAIMED IN TERMS OF PARAGRAPHSTABLE ABOVE7.1 B-BBEE Status Level of Contribution: . (maximum of 20 points)(Points claimed in respect of paragraph 7.1 must be in accordance with the table reflected in paragraphbelow and must be substantiated by means of a B-BBEE certificate issued by a Verification Agencyaccredited by SANAS or a Registered Auditor approved by IRBA or an Accounting Officer ascontemplated in the CCA).SUB-CONTRACTINGWill any portion of the contract be sub-contracted? YES / NO (delete which is not applicable)If yes, indicate:(i) what percentage of the contract will be subcontracted?. . %(ii) the name of the sub-contractor? .(iii) the B-BBEE status level of the sub-contractor? .(iv) whether the sub-contractor is an EME? YES / NO (delete which is not applicable)Broad-Based Black Economic Empowerment B-BBEE Status: Please read notes below verycarefully before completing.10
2015/2016 DATABASE REGISTRATION FORMTerminology: Commodities: The commodities the company wishes to be registered for as a supplier tothe department. Trade Names: The trade names that the company owns or distributes, which you wish tobe registered for as a supplier to the department. Owned: Having all the customary elements of ownership, including the right of decisionmaking and sharing all the risks and profits commensurate with the degree of ownershipinterests as demonstrated by an examination rather than the form of ownership arrangements. B-BBEE Status Level of Contribution: means broad-based black economic empowermentas defined in section 1 of the Broad-Based Black Economic Empowerment Act B-BBEE Status Level of Contribution: means the B-BBEE status received by a measuredentity based on its overall performance using the relevant scorecard contained in the Codesof Good Practice on Black Economic Empowerment, issued in terms of section 9(1) of theBroad-Based Black Economic Empowerment Act; EME: means any enterprise with an annual total revenue of R5 million or less.11
2015/2016 DATABASE REGISTRATION FORMDECLARATION OF INTEREST1.Any legal person, including persons employed by the state¹, or persons having a kinship with personsemployed by the state, including a blood relationship, may make an offer or offers in terms of thisinvitation to bid (includes an advertised competitive bid, a limited bid, a proposal or written pricequotation). In view of possible allegations of favouritism, should the resulting bid, or part thereof, beawarded to persons employed by the state, or to persons connected with or related to them, it isrequired that the bidder or his/her authorized representative declare his/her position in relation to theevaluating/adjudicating authority where-the bidder is employed by the state; and/or-the legal person on whose behalf the bidding document is signed, has a relationship with persons/aperson who are/is involved in the evaluation and or adjudication of the bid(s), or where it is knownthat such a relationship exists between the person or persons for or on whose behalf the declarantacts and persons who are involved with the evaluation and or adjudication of the bid.2.In order to give effect to the above, the following questionnaire must be completed and submittedwith the bid.2.1Full Name of bidder or his or her representative: .2.2Identity Number: shareholder²,member): .2.4Registration number of company, enterprise, close corporation, partnership agreement or trust: . . .2.5Tax Reference Number: 2.6VAT Registration Number: .2.6.1The names of all directors / trustees / shareholders / members, their individual identity numbers, taxreference numbers and, if applicable, employee / PERSAL numbers must be indicated in paragraph 3below.¹“State” means –(a) any national or provincial department, national or provincial public entity or constitutional institution within the meaning of the Public FinanceManagement Act, 1999 (Act No. 1 of 1999);(b) any municipality or municipal entity;(c) provincial legislature;(d) national Assembly or the national Council of provinces; or(e) Parliament.²”Shareholder” means a person who owns shares in the company and is actively involved in the management of the enterprise or business and exercises control over theenterprise.12
2015/2016 DATABASE REGISTRATION FORM2.7Are you or any person connected with the bidderpresently employed by the state?2.7.1If so, furnish the following particulars:Name of person / director / trustee / shareholder/ member:Name of state institution at which you or the personconnected to the bidder is employed :Position occupied in the state institution:YES / NO . Any other particulars: 2.7.2If you are presently employed by the state, did you obtainthe appropriate authority to undertake remunerative workoutside employment in the public sector?2.7.2.1 If yes, did you attach proof of such authority to the biddocument?YES / NOYES / NO(Note: Failure to submit proof of such authority, whereapplicable, may result in the disqualification of the bid.2.7.2.2 If no, furnish reasons for non-submission of such proof: . . .2.8Did you or your spouse, or any of the company’s directors/YES / NOtrustees / shareholders / members or their spouses conduct businesswith the state in the previous twelve months?2.8.1If so, furnish particulars: . . .2.9Do you, or any person connected with the bidder, haveany relationship (family, friend, other) with a person employedby the state and who may be involved with the evaluation andor adjudication of this bid?2.9.1YES / NOIf so, furnish particulars. . . . 13
2015/2016 DATABASE REGISTRATION FORM2.10 Are you, or any person connected with the bidder,aware of any relationship (family, friend, other) betweenany other bidder and any person employed by the statewho may be involved with the evaluation and or adjudicationof this bid?YES/NO2.10.1 If so, furnish particulars. 2.11 Do you or any of the directors / trustees / shareholders / membersof the company have any interest in any other related companieswhether or not they are bidding for this contract?YES/NO2.11.1 If so, furnish particulars: . . .3Full details of directors / trustees / members / shareholders.Full Name4IdentityNu
2015/2016 DATABASE REGISTRATION FORM 1 TO ALL SUPPLIERS SEEKING REGISTRATION AS A PREFERRED SUPPLIER ON THE . Attached is an official registration form that will assist in updating the TNC database. Please note that a valid tax clearance certificate must be obtained from the South African Revenue Services (SARS) where the bidder is registered .
Management) service providers' database are required to submit the following documents listed below together with the fully completed database registration form. In addition to completion of the database forms, service providers are required to initial each and every page of the database registration form.
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SUPPLIER DATABASE REGISTRATION FORM Rev: 11 Page 1of 9 COMPANY NAME: The completed supplier database registration form must be submitted by email to the following address: Supplier.management@umgeni.co.za Enquiries: 033 341 1008 or 033 341 1581 Umgeni Water uses its external whistle-blowing hotline service managed by an
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