Expression of Interest EOI/17/2016

Café – Storey Park: Returnable Schedules

Closing Date: 10:30am Monday 19 December 2016

Pecuniary Interest Statutory Declaration

The Respondent shall complete the following:

I, / (Full Name)
of / (Respondents Business Name & Address)
do solemnly and sincerely declare, in respect of: / EOI17/2016
or any contract arising from this EOI, that:
I have no direct or indirect pecuniary interest in the above matter except as set out in the Schedule to this Declaration.
I Further acknowledge that the term “pecuniary interest” shall have the extended meaning as follows:-
  • as defined by Chapter 14, Sections 442 and 443 of the Local Government Act 1993
and the Local Government Amendment Act 2005:-
“442(1) [Pecuniary Interest] For the purposes of this Chapter, a pecuniary interest is an interest that a person has in a matter because of reasonable likelihood or expectation of appreciable financial gain or loss to the person.
(2) [Remoteness] A person does not have a pecuniary interest in a matter if the interest is so remote or insignificant that it could not be reasonably be regarded as likely to influence any decision the person might make in relation to the other matter or if the interest is of a kind specified in section 448.
443(1) [Interest in a matter] For the purposes of this Chapter, a person has a pecuniary interest in a matter if the pecuniary interest is the interest of:
(a)the person; or
(b)the person’s spouse or de facto partner or a relative of the person, or a partner or employer of the person, or.
(c)a company or other body of which the person, or a nominee, partner or employer of the person, is a member.
Schedule to this Declaration (declare any Pecuniary Interest here):
My signature appears below as evidence of this declaration:
Signed: / Witness:
Name: / Name:
Dated the: / Day of / 20

Expression of Interest EOI/17/2016

Café – Storey Park: Returnable Schedules

Closing Date: 10:30am Monday 19 December 2016

Past Performance and Experience

Respondents shall present evidence of their quality, experience and proven success in this type of undertaking in the past:

Description of Business / Dates of Management / Name of Cafe / Contact Name / Contact Phone

Expression of Interest EOI/17/2016

Café – Storey Park: Returnable Schedules

Closing Date: 10:30am Monday 19 December 2016

Vision Statement

Respondents shall provide a one (1) page vision statement:
This could include details of the fit-out, operation hours, business plan, proposed operating budget

References

Provide at least three referees who can attest to the Respondent’s capabilities in undertaking any contract arising from this EOI. Note: Council reserves the right to make it’s own independent enquiries.

First Referee
Company/Organisation (if applicable):
Postal Address:
Suburb: / Postcode:
Contact Person (if applicable):
Email Address: / Mobile:
Business Phone: / Fax:
Second Referee
Company/Organisation (if applicable):
Postal Address:
Suburb: / Postcode:
Contact Person (if applicable):
Email Address: / Mobile:
Business Phone: / Fax:
Third Referee
Company/Organisation (if applicable):
Postal Address:
Suburb: / Postcode:
Contact Person (if applicable):
Email Address: / Mobile:
Business Phone: / Fax:

RespondentContact Details

Respondents are to provide contact details for further communications with the Client as required:

Tenderer:
Company/Organisation (if applicable):
Postal Address:
Suburb: / Postcode:
Physical Address:
Suburb: / Postcode:
Contact Person: / Position:
Email Address: / Mobile:
Business Phone: / Fax: / ABN:

Indicative Pricing Breakdown

Respondents shall provide indicative pricing breakdown to include at a minimum:
Lease Term Proposed(maximum 21 years):
Annual Rent:
Upfront Contribution to Capital Works:
Any Lease Renegotiation Provisions:
Any In-kind Contribution:

Director Guarantee

Please confirm your agreement to a director guarantee to the value of two years rental income:
Please cross out where necessary
I / We hereby agree to a director(s) guarantee to the equivalent of two years rental income
or
I / We do not agree to a director(s) guarantee to the equivalent of two years rental income and propose the following amendment:
My signature appears below as evidence of this agreement:
Signed: / Witness:
Name: / Name:
Dated the: / Day of / 20