STATEMENTS – MECHANICAL PROTECTION INSTALLATION

Tender’s Name: ______

Address: ______

We declare that:

1. We accept the NSG confidentiality agreement

2. We have experience required in Tender Invitation ( 2012-2014).

3. We are in disposal of at least 1 duly qualified person experienced in installation, check-out and start-up of their equipment, able to speak also in English language or in disposal of a translator.

4. We accept NSG PEC 1 and PEC 2 conditions

5. We present our annual turnover for last 3 years (2011-2013)

6. We accept the NSG Supplier code of conduct

7. We fulfill the requirements concerning the company's legal status.

As a proof of above please find attached forms and appendices with detail information.

Signature of dully authorized person on behalf of Tender______

FORMS FOR CONFIRMATION OF TENDER CRITERIA

FORMS

Fill in the following forms, which are confirmations of fulfillment of the bidding criteria by the Tender. The following forms are to be completed, signed and submitted with the above statement confirming the fulfillment of the bidding criteria listed in Tender Invitation:

Form No. 1 – NSG Confidentiality Agreement

Form No. 2 – Tender Experience

Form No. 3 – Tender Personnel

Form No. 4 – PEC 1 and PEC 2 conditions

Form No. 5 – Declaration concerning annual turnover for last 3 years (2011 - 2013)

Form No. 6 – NSG Supplier Code of Conduct

Form No. 7 - Statement concerning the company's legal status.

FORM no. 1

CONFIDENTIALITY AGREEMENT

Tender is invited to open the below attached file, sign it and send the hard copies back to the above indicated NSG contact person.

Signature of dully authorized person on behalf of Tender______

FORM no. 2

TENDER EXPERIENCE

Employer Name / Location and Description of the Works / Value of Contract [PLN or or equivalent in the Tender’s origin country currency] / Additional Comments / Start Date / End Date

Signature of dully authorized person on behalf of Tender______

FORM no. 3

TENDER personnel

Base on information from Tender Invitation, please provide list of required person with their CV (according to the form below)

Person degreed/experienced to perform/manage execution of:
Name: / Current position:
Experience in years: / - In company:
- In industry:
Experience (Major works for which responsible – position, type and value):

Signature of dully authorized person on behalf of Tender______

form no.4

PEC 1 and PEC 2 CONDITIONS

Tender is invited to open the below attached files, sign them and send the hard copies back to the NSG contact person indicated above.

Signature of dully authorized person on behalf of Tender______

FORM no. 5

Statement concerning the company's aNNUAL TURNOVER

We, ……………………………………. declare that our annual turnover amounted:

…………………………………………. for the year 2011

…………………………………………. for the year 2012

…………………………………………. for the year 2013

Signature of dully authorized person on behalf of Tender______

FORM no. 6

NSG SUPPLIER CODE OF CONDUCT

Tender is invited to open the below attached file, sign it and send the hard copies back to the NSG contact person indicated above.

Signature of dully authorized person on behalf of Tender______

FORM no. 7

Statement concerning the company's LEGAL STATUS

We, ………………… ……………………. declare that the bidder on the date of filing the tender offer:

-  is not in the liquidation process,

-  is not pronounced bankrupt.

The Company is notin delay with payments of taxes, charges and/or premiums for the national insurance or the health incurrence.

Signature of dully authorized person on behalf of Tender______