Appendix 1A: Evaluation Questionnaire
EVALUATION QUESTIONNAIRE (TO BE COMPLETED AS PART OF TENDER SUBMISSION)
INSTRUCTIONS FOR COMPLETION
The information disclosed in response to this questionnaire will be used in the quality evaluation of submissions.
Please note that, whenever used in this questionnaire, the term ‘organisation’ refers to a sole practitioner, partnership or company, as appropriate, and the term ‘person’ refers to any director, company secretary, partner, associate and any other person occupying a position of authority or responsibility within the firm.
Unless instructed otherwise, when answering the questions, please give details which relate specifically to the company who will be entering into the contract, not to the whole of the group if your company forms part of a group.
Please provide your responses to the questionnaire, incorporating any supporting documentation and answering the questions in the order in which they appear below. All pages should show clearly the name of your company and the number of the question to which it relates.
Responses should be provided in Verdana font in no less than a font size of 12.
The responses to this questionnaire should be specific to this Contract and accord exactly with the section headings, matters, order and referencing in the questionnaire that follows.
Tenderers shall note that generic method statements and those of a general nature which refer to information within company profiles, brochures or other promotional and/or marketing literature will not be acceptable.
Part 1: Organisation Information
Section 1 / Organisation informationQuestion number / Question / Response
1.1(a) / Full name of the organisation submitting the information
1.1(b) – (i) / Registered office address (if applicable)
1.1(b) – (ii) / Registered website address (if applicable)
1.1(c) / Trading status
a)public limited company
b)limited company
c)limited liability partnership
d)other partnership
e)sole trader
f)third sector
g)other (please specify your trading status)
1.1(d) / Date of registration in country of origin
1.1(e) / Company registration number (if applicable)
1.1(f) / Charity registration number (if applicable)
1.1(g) / Head office DUNS number (if applicable)
1.1(h) / Registered VAT number
1.1(i) / Are you a Small, Medium or Micro Enterprise (SME)[1]? / Yes ☐
No ☐
1.1(j) / Details of Persons of Significant Control (PSC), where appropriate: [2]
- Name;
- Date of birth;
- Nationality;
- Country, state or part of the UK where the PSC usually lives;
- Service address;
- The date he or she became a PSC in relation to the company (for existing companies the 6 April 2016 should be used);
- Which conditions for being a PSC are met;
- Over 25% up to (and including) 50%,
- More than 50% and less than 75%,
- 75% or more. [3]
(Please enter N/A if not applicable)
1.1(k) / Details of immediate parent company:
- Full name of the immediate parent company
- Registered office address (if applicable)
- Registration number (if applicable)
- Head office DUNS number (if applicable)
- Head office VAT number (if applicable)
(Please enter N/A if not applicable)
1.1(l) / Details of ultimate parent company:
- Full name of the ultimate parent company
- Registered office address (if applicable)
- Registration number (if applicable)
- Head office DUNS number (if applicable)
- Head office VAT number (if applicable)
(Please enter N/A if not applicable)
Please note: A criminal record check for relevant convictions may be undertaken for the preferred suppliers and the persons of significant in control of them.
Contact details and declaration
I declare that to the best of my knowledge the answers submitted and information contained in this document are correct and accurate.
I declare that, upon request and without delay I will provide the certificates or documentary evidence referred to in this document.
I understand that the information will be used in the selection process to assess my organisation’s suitability to be invited to participate further in this procurement.
I understand that the authority may reject this submission in its entirety if there is a failure to answer all the relevant questions fully, or if false/misleading information or content is provided in any section.
I am aware of the consequences of serious misrepresentation.
Section 1 / Contact details and declarationQuestion number / Question / Response
1.3(a) / Contact name
1.3(b) / Name of organisation
1.3(c) / Role in organisation
1.3(d) / Phone number
1.3(e) / E-mail address
1.3(f) / Postal address
1.3(g) / Signature (electronic is acceptable)
1.3(h) / Date
Part 2: Exclusion Grounds
Please answer the following questions in full. Note that every organisation that is being relied on to meet the selection must complete and submit the Part 1 and Part 2 self-declaration.
Section 2 / Grounds for mandatory exclusionQuestion number / Question / Response
2.1(a) / Regulations 57(1) and (2)
The detailed grounds for mandatory exclusion of an organisation are set out on this webpage, which should be referred to before completing these questions.
Please indicate if, within the past five years you, your organisation or any other person who has powers of representation, decision or control in the organisation been convicted anywhere in the world of any of the offences within the summary below and listed on the webpage.
Participation in a criminal organisation.
Pass/fail / Yes ☐
No ☐
If Yes please provide details at 2.1(b)
Corruption.
Pass/fail / Yes ☐
No ☐
If Yes please provide details at 2.1(b)
Fraud.
Pass/fail / Yes ☐
No ☐
If Yes please provide details at 2.1(b)
Terrorist offences or offences linked to terrorist activities
Pass/fail / Yes ☐
No ☐
If Yes please provide details at 2.1(b)
Money laundering or terrorist financing
Pass/fail / Yes ☐
No ☐
If Yes please provide details at 2.1(b)
Child labour and other forms of trafficking in human beings
Pass/fail / Yes ☐
No ☐
If Yes please provide details at 2.1(b)
2.1(b) / If you have answered yes to question 2.1(a), please provide further details.
Date of conviction, specify which of the grounds listed the conviction was for, and the reasons for conviction,
Identity of who has been convicted
If the relevant documentation is available electronically please provide the web address, issuing authority, precise reference of the documents.
2.2 / If you have answered Yes to any of the points above have measures been taken to demonstrate the reliability of the organisation despite the existence of a relevant ground for exclusion ? (Self Cleaning) / Yes ☐
No ☐
2.3(a) / Regulation 57(3)
Has it been established, for your organisation by a judicial or administrative decision having final and binding effect in accordance with the legal provisions of any part of the United Kingdom or the legal provisions of the country in which the organisation is established (if outside the UK), that the organisation is in breach of obligations related to the payment of tax or social security contributions?
Pass/fail / Yes ☐
No ☐
2.3(b) / If you have answered yes to question 2.3(a), please provide further details. Please also confirm you have paid, or have entered into a binding arrangement with a view to paying, the outstanding sum including where applicable any accrued interest and/or fines.
Please Note: The authority reserves the right to use its discretion to exclude a potential supplier where it can demonstrate by any appropriate means that the potential supplier is in breach of its obligations relating to the non-payment of taxes or social security contributions.
Section 3 / Grounds for discretionary exclusionQuestion / Response (delete as applicable)
3.1 / Regulation 57 (8)
The detailed grounds for discretionary exclusion of an organisation are set out on this webpage, which should be referred to before completing these questions.
Please indicate if, within the past three years, anywhere in the world any of the following situations have applied to you, your organisation or any other person who has powers of representation, decision or control in the organisation.
3.1(a) / Breach of environmental obligations?
Pass/fail / Yes ☐
No ☐
If yes please provide details at 3.2
3.1 (b) / Breach of social obligations?
Pass/fail / Yes ☐
No ☐
If yes please provide details at 3.2
3.1 (c) / Breach of labour law obligations?
Pass/fail / Yes ☐
No ☐
If yes please provide details at 3.2
3.1(d) / Bankrupt or is the subject of insolvency or winding-up proceedings, where the organisation’s assets are being administered by a liquidator or by the court, where it is in an arrangement with creditors, where its business activities are suspended or it is in any analogous situation arising from a similar procedure under the laws and regulations of any State?
Pass/fail / Yes ☐
No ☐
If yes please provide details at 3.2
3.1(e) / Guilty of grave professional misconduct?
Pass/fail / Yes ☐
No ☐
If yes please provide details at 3.2
3.1(f) / Entered into agreements with other economic operators aimed at distorting competition?
Pass/fail / Yes ☐
No ☐
If yes please provide details at 3.2
3.1(g) / Aware of any conflict of interest within the meaning of regulation 24 due to the participation in the procurement procedure?
Pass/fail / Yes ☐
No ☐
If yes please provide details at 3.2
3.1(h) / Been involved in the preparation of the procurement procedure?
Pass/fail / Yes ☐
No ☐
If yes please provide details at 3.2
3.1(i) / Shown significant or persistent deficiencies in the performance of a substantive requirement under a prior public contract, a prior contract with a contracting entity, or a prior concession contract, which led to early termination of that prior contract, damages or other comparable sanctions?
Pass/fail / Yes ☐
No ☐
If yes please provide details at 3.2
3.1(j)
3.1(j) - (i)
3.1(j) - (ii)
3.1(j) –(iii)
3.1(j)-(iv) / Please answer the following statements
The organisation is guilty of serious misrepresentation in supplying the information required for the verification of the absence of grounds for exclusion or the fulfilment of the selection criteria.
The organisation has withheld such information.
The organisation is not able to submit supporting documents required under regulation 59 of the Public Contracts Regulations 2015.
The organisation has influenced the decision-making process of the contracting authority to obtain confidential information that may confer upon the organisation undue advantages in the procurement procedure, or to negligently provided misleading information that may have a material influence on decisions concerning exclusion, selection or award.
Pass/fail / Yes ☐
No ☐
If Yes please provide details at 3.2
Yes ☐
No ☐
If Yes please provide details at 3.2
Yes ☐
No ☐
If Yes please provide details at 3.2
Yes ☐
No ☐
If Yes please provide details at 3.2
3.2 / If you have answered Yes to any of the above, explain what measures been taken to demonstrate the reliability of the organisation despite the existence of a relevant ground for exclusion? (Self Cleaning)
Part 3: Other minimum suitability questions
Section 4 / Economic and Financial StandingQuestion / Response (delete as applicable)
4.1 / As part of your tender submission you must provide a copy of your audited accounts for the last two years.
Please confirm whether or not this has been included as part of your tender submission.
If no, you must provide one of the following:
(answer with Y/N in the relevant box) / Yes ☐
No ☐
(a) A statement of the turnover, Profit and Loss Account/Income Statement, Balance Sheet/Statement of Financial Position and Statement of Cash Flow for the most recent year of trading for this organisation. / Yes ☐
No ☐
(b) A statement of the cash flow forecast for the current year and a bank letter outlining the current cash and credit position. / Yes ☐
No ☐
(c) Alternative means of demonstrating financial status if any of the above are not available (e.g. forecast of turnover for the current year and a statement of funding provided by the owners and/or the bank, charity accruals accounts or an alternative means of demonstrating financial status).
Pass/fail / Yes ☐
No ☐
4.2 / Selwood Housing has provided a financial assessment tool as a means of testing that you meet our criteria for minimum level of economic and financial standing. Please confirm that you have completed and attached the financial assessment tool.
Pass/fail
Note: Selwood Housing will use the criteria in the financial assessment tool to assess the risk to Selwood Housing of your organisation going out of business during the life of the contract, or having inadequate financial resources to perform the contract. The tool includes “Guidance for Suppliers” which sets out the methodology for assessing financial strength and the minimum thresholds that Selwood Housing requires. / Yes ☐
No ☐
Section 5 / Additional Questions
Question / Response (delete as applicable)
5.1 / Please self-certify whether you already have, or can commit to obtain, prior to the commencement of the contract, the levels of insurance cover indicated below:
Employer’s (Compulsory) Liability Insurance = £5m
Public Liability Insurance =£5m
Professional Indemnity Insurance =£2m
Contractors All Risk = £2m
Pass/fail / Yes ☐
No ☐
5.2 / Are you a relevant commercial organisation as defined by section 54 ("Transparency in supply chains etc.") of the Modern Slavery Act 2015 ("the Act")?
Information / Yes ☐
No ☐
5.3 / If you have answered yes to question 5.2 are you compliant with the annual reporting requirements contained within Section 54 of the Act 2015?
Pass/fail / Yes ☐
No ☐
N/A ☐
5.4 / Compliance with equality legislation
In the last three years, has any finding of unlawful discrimination been made against your organisation by an Employment Tribunal, an Employment Appeal Tribunal or any other court (or in comparable proceedings in any jurisdiction other than the UK)?
Pass/fail / Yes ☐
No ☐
5.5 / In the last three years, has your organisation had a complaint upheld following an investigation by the Equality and Human Rights Commission or its predecessors (or a comparable body in any jurisdiction other than the UK), on grounds or alleged unlawful discrimination?
Pass/fail / Yes ☐
No ☐
5.6 / If you have answered “yes" to one or both of questions 5.4 and 5.5,please provide a summary of the nature of the investigation and an explanation of the outcome of the investigation to date. If the investigation upheld the complaint against your organisationplease explain what action (if any) you have taken to prevent unlawful discrimination from reoccurring.
Information / Yes ☐
No ☐
5.7 / Probity
Are any of your organisation's board members, directors, partners or senior managers a current or former (during the last 12 months) board member or employee of Selwood Housing?
Pass/fail / Yes ☐
No ☐
5.8 / Selwood Housing Policies and Standards
Please self-certify that your approach complies with the following Selwood Housing policies and/or standards:
- Group DBS Policy (appendix 2E)
- Health & Safety general code of safe practise (appendix 2F)
- Contractor code of conduct (appendix 2G)
- Single Equalities and Diversity Policy (appendix 2H)
No ☐
5.9 / All contractors must carry identification badges incorporating photographs with them at all times on site. The contractor’s employees may be subject to challenge. The Contractor shall keep a register of badges issued and ensure that the badges of work people who leave the Contractor's employ are surrendered. ID badges are applicable to all sub-contractor’s and visitors. Operatives must adhere to the company dress code and operatives and vehicles should be clearly identifiable.
Please confirm that your organisation complies with the above.
Pass/fail / Yes ☐
No ☐
5.10 / Please self-certify that your organisation has technical and organisational measures in place that are sufficient to ensure that the data processing will a) meet the requirements of the GDPR and b) ensure the protection of the rights of the data subject.
Pass/fail / Yes ☐
No ☐
5.11 / Data sharing agreement.
The successful organisation will be required to agree and sign the Data sharing agreement (appendix 2JI) prior to commencement of the contract, please confirm that your organisation will sign the agreement when called upon by Selwood Housing to do so.
Pass/fail / Yes ☐
No ☐
Section 6 / Technical and Professional Ability
6.1 / Relevant experience and contract examples
Please provide details of up to three contracts, in any combination from either the public or private sector; voluntary, charity or social enterprise (VCSE) that are relevant to our requirement.
VCSEs may include samples of grant-funded work. Contracts for supplies or services should have been performed during the past three years. Works contracts may be from the past five years.
The named contact provided should be able to provide written evidence to confirm the accuracy of the information provided below.
If you cannot provide examples see question 6.2
6.1 Response / Contract 1 / Contract 2 / Contract 3
Name of customer organisation
Point of contact in the organisation
Position in the organisation
E-mail address
Description of contract
Contract Start date
Contract completion date
Estimated contract value
6.2 / If you cannot provide at least one example for questions 6.1, in no more than 500 words please provide an explanation for this e.g. your organisation is a new start-up or you have provided services in the past but not under a contract.
Response
Part 4 Quality and Technical Merit
Section 7 / Fully compliant proposal / Score / Weighting7.1 / Please confirm that your tender proposal is fully compliant with the specification and service levels.
If there are any parts of the specification or service levels that cannot be delivered, please indicate this below.
If applicable please indicate if parts the specification can be met in a different way / Pass / Fail / N/A
Tenderer response
7.2 / Please confirm that your company holds the relevant United Kingdom Accreditation Service licences including Licence to Undertake Work with Asbestos, extending at least 6 months into the contract period. / Pass / Fail / N/A
Tenderer response
7.3 / Please confirm that your company is able and willing to provide a 24/7/365 emergency service as specified within the contract particulars. / Pass / Fail / N/A
Tenderer response
7.4 / Please confirm that all operatives are fully trained to industry standards and certification provided, in line with the Managing and Working with Asbestos Approved Code of Practice (ACOP) Paragraph 251 Training for Licensable Work. / Pass / Fail / N/A
Tenderer response
7.5 / Please confirm that all operatives medical and face fit records will be kept up to date at all times. / Pass / Fail / N/A
Tenderer response
7.6 / Please confirm that electronic copies of consignment notes will be provided on request. Consignment note numbers will be provided at invoice stage. / Pass / Fail / N/A
Tenderer response
Section 8 / Customer care and services / Score / Weighting
8.1 / Please detail how your operational procedures would ensure timely access to properties, and keep the Employer informed of any problems or ‘no access’ issues.
Max 500 Words(appendices and attachments will not be evaluated) / 5 / 3%
Tenderer response
8.2 /
- Describe your approach to providing customer care (both to the Employer's residents and their neighbours), including contact with elderly, infirm or disabled customers, paying particular attention to Selwood Housing’s equality and diversity policy.
- Please detail your procedure for dealing with any complaints that may arise.
Tenderer response
8.3 / Please detail your quality control procedures (e.g. internal auditing, monitoring, etc) and describe how these will ensure that the specified service levels will be maintained at all times
Max 750 Words(appendices and attachments will not be evaluated) / 5 / 9%
Tenderer response
Section 9 / Management of work and management / supervisory structures / Score / Weighting
9.1 / Resource proposal
- Please provide a full organisational structure to deliver the works, including:
- Numbers and locations of operatives to cover the geography of Selwood’s properties, to include procedures in place to maintain required levels in service during periods of staff absence, holiday and sickness, etc.
- Details of any sub-Contractors that will be used to deliver the works. If relevant please explain how you will select and manage sub-contractors to ensure consistent service delivery
- Number (full time equivalent) of managers and supervisors and other indirect labour showing full details of their roles and responsibilities to support delivery.
- Provide full details of the qualifications and experience of the personnel to be assigned to the contract on a daily basis
- Please provide the CV for the Contract Manager who will be directly responsible for delivering the contracts.
Tenderer response
9.2 / Please provide details of your organisations policies and processes for providing your staff / workforce with training and information appropriate to the types of activity that your organisation is likely to undertake
Max 500 Words (appendices and attachments will not be evaluated) / 5 / 6%
Tenderer response
9.3 / Please provide method statements to demonstrate how you will provide the services in accordance with our Specification, in particular:
- Provision of a 24/7 service, and how will you ensure that this is in place at the start of the contract
- Meeting the Employer’s service requirements during normal working hours
- Conducting licensed removal works
- ensuring that on-site welfare provision meets legal requirements and the needs/expectations of your employees
- Co-ordinating activities with other contractors
- Providing documentation to the Employer upon request
Tenderer response
9.4 / Please provide method statements which detail your approach to the following, specifically highlighting procedures to ensure a process of risk assessment capable of supporting safe methods of work and reliable project delivery in line with Selwood Housing’s requirements for safe working practices:
- Working with Asbestos
- Working at Height
- Health & Safety (including recording/reporting of incidents, and procedures in place to check, review & improve performance)
- Lone working
Tenderer response
- Please give a brief description of your organisation’s understanding of the environmental legislation affecting asbestos removal works, and how your organisation ensures compliance with this legislation at all times. Please include details of how your organisation checks, reviews and where necessary improves environmental management performance.
- Please detail any arrangements your organisation has for ensuring that any suppliers with which you engage apply environmental protection measures that are appropriate to the activity for which they are being engaged.
Tenderer response
Section 10 / Silva social enterprise clause / Score / Weighting
10.1 / The Employer is committed to advancing social enterprise. You should indicate (in line with the Appendix 2I) which options you are offering.
Max 500 Words (appendices and attachments will not be evaluated) / 5 / 2%
Tenderer response
[1] See EU definition of SME