Procurement Sector

20 February 2014

Version 2.0

Version History / Change from previous version / Date
Version 2.0 / List of forms in index corrected, slight change to format / 20/01/14

This document contains the standard administrative forms required for participation in Eurojust tendering procedures. Please ensure all forms are completed accurately in order to avoid possible exclusion from the tendering procedure. These forms may be copied and presented on the tenderers own headed paper.

These forms must be included in Envelope A of your tender.

Forms

Form 1: Tender overview form

Form 2: Tenderer declaration

Form 3: Consortium and subcontracting administrative information

Form 4: Consortium member declaration

Form 5: Subcontractor declaration

Form 6: Financial capacity

Form 7: Checklist

Form 8: Receipt in the case of hand delivery of the tender

Please note that although the administrative forms are contained in this document additional forms may be attached to the `invitation to tender`and must be completed by the tenderer.

These forms together with the `Instructions and conditions applicable to Eurojust tenders` shall form an inseparable part of the invitation to tender. The terms of the `invitation to tender` shall take precedence over the terms of the present forms.Form 1: Tender overview form

Tender No:

Title:

Tenderer Name
Address
Post Code
Tel
Fax
E-mail
Web Site (if applicable)
Legal Status
Statutory registration number
VAT registration number
Name and contact details of the Contact Person for this tender
Name and title of the Legal Signatory(ies) of the contract
[Name(s) and title(s)]

Consortium and subcontracting (see point 2.6 of the invitation to tender)

Is this tender submitted by a consortium? Yes  No

If `yes` then please provide names of the consortium members in form 3 and complete declarations in form 4

Does this tender foresee subcontracting? Yes  No

If `yes` then please provide names of subcontracted parties in form 3and complete declarations in form 5

Form 2: Tenderer declaration

I the undersigned, as an authorized representative of:

TendererName
Address

hereby declareto have examined and accepted in full the content of the invitation to tender, its annexes and the Instructions to tenderers and conditions applicable to Eurojust tendersreferenced below:

Tender Number
Title

I also hereby acknowledge tohave takenspecial note ofand subsequently declare

  • that I, or the entity I represent, are not in any of the situations concerning exclusion and conflict of interest as described in point 3of the `Instructions to tenderers and conditions applicable to Eurojust tenders`.
  • to have examined and accepted the provisions set in the model contract in their entirety without reservation or restriction;

Name:
Signature:
Position:
Date:

Form 3 - consortium and subcontracting administrative information

Consortium information

Member 1 - Name / Address
Member 2 - Name
Member n…. - Name

Subcontracting information

Subcontractor 1 / Address / Indication of tasks that will be carried out by the subcontractor including % of overall tasks
Subcontractor 2
Subcontractor n…

Please note that all consortium members and subcontractors must also complete forms 4 and 5respectively.

Form 4: Consortium member declaration

To be completed and signed by each member of the consortium in the case thata consortium submits a tender.

I the undersigned, as an authorized representative of:

Tenderer Name
Address

hereby declare

  • the intention to collaborate with [name of the tenderer] in the execution of the tasks related to the tender referenced below;
  • to have examined and accepted in full the content of the invitation to tender, its annexes and the instructions to tenderers and conditions applicable to Eurojust tenders referenced below:

Tender Number
Title

I also hereby acknowledge to have taken special note of and subsequently declare

  • that I, or the entity I represent, are not in any of the situations concerning exclusion and conflict of interest as described in point 3of the `Instructions to tenderers and conditions applicable to Eurojust tenders`.
  • to have examined and accepted the provisions set in the model contract in their entirety without reservation or restriction;

Name:
Signature:
Position:
Date:

Form 5: Subcontractor declaration

To be completed and signed by each respective subcontractor in the case that tasks will be subcontracted.

I the undersigned, as an authorized representative of:

Tenderer Name
Address

hereby declare

  • the intention to collaborate with [name of the tenderer] in the execution of the tasks related to the tender referenced below;
  • hereby declareto have examined and accepted in full the content of the invitation to tender, its annexes and the instructions to tenderers and conditions applicable to Eurojust tenders referenced below:

Tender Number
Title

I also hereby acknowledge to have taken special note of and subsequently declare

  • that I, or the entity I represent, are not in any of the situations concerning exclusion and conflict of interest as described in point 3of the `Instructions to tenderers and conditions applicable to Eurojust tenders`.
  • to have examined and accepted the provisions set in the model contract in their entirety without reservation or restriction;

Name:
Signature:
Position:
Date:

Form 6: Financial Capacity

Tender No:

Title:

As part of theproof required in the invitation to tender point 2.4,tenderers and any consortium members and subcontractors are requested to complete the form below.

This form can also be found in excel format under the procurement page of the Eurojust website.

Tenderer:
Currency and precision of the statements:
Year N:
Profit and loss account
Year N: / Year N-1:
1 / Turnover
2 / Cost of sales
3 / Gross Profit (1-2) / 0 / 0
4 / Operating expenses
5 / Operating Profit (3-4) / 0 / 0
6 / Depreciation and Amortization
7 / Other costs/income
8 / Profit before Interest and Taxation (5-6+/-7) / 0 / 0
9 / Financial operations
10 / Profit on Ordinary Activities before Taxation (8+/-9) / 0 / 0
11 / Tax on profit on ordinary activities
12 / Profit on Ordinary Activities after Taxation (10+/-11) / 0 / 0
13 / Dividends
14 / Retained Profit (12-13) / 0 / 0
Balance sheet
Assets / Year N: / Year N-1:
1 / Intangible assets
2 / Tangible assets
3 / Investments/long-term receivables
4 / Total Long-Term Assets (1+2+3) / 0 / 0
5 / Stock
6 / Debts due within one year
7 / Short-term investments
8 / Cash at bank and in hand
9 / Total Current Assets (5+6+7+8) / 0 / 0
10 / Total Assets (4+9) / 0 / 0
Liabilities
1 / Capital and reserves
2 / Retained earnings
3 / Total Capital (1+2) / 0 / 0
4 / Long-Term Liabilities
5 / Provisions
6 / Accounts payable
7 / Total Short-Term Liabilities (5+6) / 0 / 0
8 / Total Liabilities (3+4+7) / 0 / 0

Form 7: Checklist

Tender No:

Title:

This checklist may be used by the tenderers to ensure that theirtender contains the vital elements and is submitted correctly.

The tender must be submitted in one outer envelope, which contains three separate inner envelopes clearly marked A, B and C.
Envelope A (Eligibility and Capacity) must contain:
1 original of the applicable forms of the tender administrative forms.
1 original (clearly marked as `Original`) and 3 copies (each marked as “Copy”) of the documentation requested in point 2.4 of the invitation to tender.
Envelope B (Technical Proposal) must contain:
1 original and 3 copies (each marked as “Copy”) of the technical proposal.
The front page of the technical proposal shall be signed by a legal representative of the tenderer.
Envelope C (Financial Proposal) must contain:
1 original (clearly marked as “Original”) and 3 copies (each marked as “Copy”) of the financial proposal.
Each page of the Pricing Form shall be signed by a legal representative of the tenderer.
The outer envelope must bee sealed with adhesive tape and signed across the seal in order to guarantee the confidentiality and integrity of data.
Carry the following information:
Tender Ref. No......
Tender Title: ......
TENDER – NOT TO BE OPENED BY INTERNAL MAIL DEPARTMENT
Name of the Tenderer: ------
Address of the Tenderer: ------
------
------
The tender must be dispatched BEFORE the dispatch time and date

Form 8: Receipt in the case of hand delivery of the tender

Tender No:

Title:

This receipt is to be used in the case of hand delivery of the tender. It is the responsibility of the tenderer to ensure that the receipt is completed and signed by the official on consignment of their tender. Tenders may be rejected in the case that tenderers cannot prove the date and time of tender consignment.

Tender Reference no:
Procedure Title:
Name of the Company:
Received on:
DATE:
TIME:
Name and signature of the official taking delivery:
Name and signature of the representative of the tenderer:

COPY OF RECEIPT(to be kept by Eurojust)

Tender Reference no:
Procedure Title:
Name of the Company:
Received on:
DATE:
TIME:
Name and signature of the official taking delivery:
Name and signature of the representative of the tenderer: