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PART 3 - TENDER FORM

EOI Number: / LVRC-17-22
EOI Title: / Grazing Lease of Various Lots at Grantham

Content in this form which is shaded and headings are NOT to be altered in any way.

If the format of any section of this form is unsuitable, or if there is insufficient space in any section of this form, include an attachment with the necessary responses and complete the relevant section of this form as "See Attachment". Any such attachment MUST repeat the relevant heading and question from this form and be placed directly following the Tender Form in your proposal.

This Tender Form relates to Council's Request for Tenders identified above. Any terms defined in the Request for Tenders have the same meanings when used in this Tender Form unless indicated otherwise.

Part 2 of this Request for Tenders sets out the conditions for tendering. By submitting this Tender Form, the Tenderer agrees to the conditions in the Request for Tenders and intends that this Tender Form will be a Tender for the purposes of the conditions in the Request for Tenders.

1TENDERER DETAILS

Name of Tenderer ¹
  • If Tenderer is a company – specify the full company name and company directors.
  • If Tenderer is a trust – specify the names of each trustee of the trust.
  • If Tenderer is an individual or partnership, specify the full name of each individual or partner.
  • If Tenderer trades under a business name, specify the registered business name.

Tenderer’s ACN
  • If Tenderer is a company.

Tenderer’s ABN
Tenderer’s postal address
Tenderer’s street address
Tenderer’s phone number
Tenderer’s contact person
For enquiries during the Tender Process, notices and other enquiries. / Name:
Direct Phone:
Email Address:

2LEASE OFFER

Financial Offer
Does your proposal meet Council’s Minimum Lease Terms / Yes No
If No, provide details of any departure from the Minimum Lease Terms and how this benefits Council:
Provide details of any factors that may impact on your ability to commence the Lease on 15 June 2017
Provide details of any proposed innovation with respect to the Tender offer
If submitting an Alternative or Non-Conforming Tender , please outline the benefits to Council
Does this Tender conform to the Request for Tenders in every respect? / Yes No
If No, set out details of each departure requested by the Tenderer:

3FINANCIAL CAPACITY

Tenderers are to provide financial statements for the last 3 years. Are these financial statements attached: / Yes
No
Tenderers are to provide details of any factors that may impact on their ability and capacity to fund their proposal

4EXPERIENCE

Provide a summary of the Tenderer’s experience in undertaking grazing activites
Provide any other comments in support of your suitability for leasing the Land

5TENDERER’S INSURANCE

Details of Tenderer's Workcover insurance / Insurer:
Policy number:
Sum insured:
Current to:
Details of Tenderer's public liability insurance / Insurer:
Policy number:
Sum insured:
Current to:
PLEASE ATTACH A COPY OF YOUR CURRENT INSURANCE CERTIFICATE FOR EACH INSURANCE POLICY MENTIONED ABOVE.

6LEGAL COMPLIANCE

Has the Tenderer or any of the Tenderer's Personnel ever been found guilty of an offence under environmental or other legislation? / YesNo
If Yes, give details:
Has the Tenderer or any of the Tenderer's Personnel ever received notice from a relevant authority of an alleged breach of environmental or other legislation? / YesNo
If Yes, give details:
Is the Tenderer aware of any currently existing circumstances which would place the Tenderer or any of the Tenderer's Personnel in breach of any environmental or other legislation? / YesNo
If Yes, give details:

7CONFLICTS OF INTEREST AND MATERIAL INTERESTS

Does a Conflict of Interest exist? / YesNo
If Yes, give details:
Does a material interest exist, or the risk of a material interest exist, between the Tenderer and any councillor, officer, employee, adviser, consultant or agent of Council in relation to the Tender Process? / YesNo
If Yes, give details:

8RIGHT TO INFORMATION ACT REQUIREMENTS

Is there any part of the Application of concern to the Tenderer, if released under the RTI Act or the IP Act?
Note: This information is being sought for the purposes of applying any relevant exemptions that might be available under the RTI Act or the IP Act. However, Council can not give any guarantee to the Tenderer that the information will be protected from disclosure. / YesNo
If Yes, please specify the component of your Tender and which of the following categories it relates to:
Trade Secret
Commercial Value
Results of Research
Confidential nature

9REFEREES

Does the Tenderer wish to name any referees? / Yes
No
Name of Referee / Organisation / Contact details
Address, phone, email / Why have you named this referee
Details of your previous/current dealings with this referee, when they took place and why they are relevant to assessment of your Tender

10SIGNING

In signing this Tender Form, the persons named below certify that in submitting the Tender on behalf of the Tenderer:-
(i) they have read, understood and complied with the requirements of the Request for Tenders; and
(ii) the enclosed Tender Form and all supporting materials are a true and accurate account of their Tender; and
(iii) they are duly authorised on behalf of the Tenderer to submit this Tender and bind the Tenderer.
10.1 / Is the Tenderer an individual (i.e. sole trader)?
  • If Yes – complete signing clause below.
  • If No – proceed to10.2.
/ Yes No
Signature of Tenderer:
Print full name of Tenderer:
Insert date of signing:
10.2 / Is the Tenderer a partnership?
  • If Yes – complete signing clause below.
  • If No – proceed to 10.3.
/ Yes No
Signature of each partner in the partnership:
Print full name of each person signing above:
Insert date of signing:
10.3 / Is the Tenderer a company?
  • If Yes – complete question and signing clause below.
  • If No – proceed to 10.4
/ YesNo
How many directors does the Tenderer have:
  • If the Tenderer has only one director, that person must sign below.
  • If the Tenderer has 2 or more directors, at least two directors must sign below.
/ One2 or more
Signature(s) of director(s) required to sign:
Print full name of each director signing above:
Insert date of signing:

11PRIVACY STATEMENT

Council is collecting Personal Information from the Tenderer for the purpose of administering the Tender Process and any subsequent Lease. This Personal Information may be shared with Queensland Government departments or agencies, Queensland Government bodies, Non-Government Organisations and/or Commonwealth, States or Territories where required for the purpose of administering the Tender Process and any subsequent Lease. Personal Information will not be otherwise disclosed to any other third party without the consent of the Tenderer, except where authorised or required by law.