PROSPECTIVE SUPPLIER DATABASE APPLICATION FOR KZN DATABASE

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PROSPECTIVE SUPPLIER DATABASE

APPLICATION FOR KZN DATABASE

APPLICATION DETAILS

Description:

Reference:

Invitation for prospective suppliers and

professional service providers to register on

the Insika Foundation CWP supplier database

INSIKA/PSD-KZN/2016-17

RESPONDENT DETAILS

This page must be completed and submitted with each sealed application

Organisation:

Province:

District:

Municipality:

Contact person:

Contact number:

Email address:

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DOCUMENTS IN THIS APPLICATION PACK

Respondents are to ensure that they have received all pages of this document, which consists of the following sections:

SECTION 1

Documents in this section are for information /instruction to respondents and must not be returned with applications.

A. Background

B. Application submission conditions and instructions C. Application evaluation process/criteria

SECTION 2

Documents in this section must be completed and returned or supplied with applications.

A. Prospective supplier information form B. Commodity list (Goods & Services)

SECTION 3

Documents in this section must be completed and returned or supplied with applications.

A. Completed compliance checklist B. Signed SBD Forms:

o SBD 4 Declaration of interest

o SBD 6.1 PPPFA Regulations claim form

o SBD 6.2 Declaration Certificate for Local Production and Content (PPE suppliers only) o SBD 8 Declaration of Bidder's Past SCM Practices

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SECTION 1:

A. BACKGROUND

This section is for information only, do not return with the application

The Community Work Programme (CWP) is a government programme based in the Department of Coorporative Governance. The primary purpose of the programme is to create an employment safety net (basic minimum income) for the unemployed especially in the rural communities. The programme supplements livelihood strategies by providing a basic level of income security.

Each site employs 1 000 or more participants. The programme/ participants need the following goods and services:

1. Goods

Protective Wear, Hardware Tools, IT Equipment, Agricultural inputs etc 2. Services

Various Training

The sites are managed by Implementing Agents (IA’s). Insika Foundation is an Implementing Agent for:

Kwazulu-Natal a) Ilembe District b) Zululand District c) uThungulu District d) uMgungundlovu District e) uThukela District f) Amajuba District

In order to comply with the regulations of the Public Finance Management Act and to ensure a competitive procurement process, Insika Foundation invites prospective suppliers of the goods/ services as indicated above, to apply for a listing on Insika Foundation’s prospective supplier database.

Insika intends to utilise this prospective supplier database to obtain quotations and where appropriate the supply of goods/ services that may become necessary for CWP.

It is important to note that should an applicant/ supplier be successful in their application to be added to the prospective supplier database, Insika Foundation is under no obligation to utilise their services. Successful applicants are not in any way guaranteed future business.

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SECTION 1:

B. APPLICATION SUBMISSION CONDITIONS AND INSTRUCTIONS

1 FRAUD AND CORRUPTION

1.1 All suppliers are to take note of the implications of contravening the Prevention and Combating of Corrupt Activities Act, Act No 12 of 2004 and any other Act applicable.

2 NOTES TO ALL SUPPLIERS SEEKING REGISTRATION ON THE DATABASE OF PROSPECTIVE SUPPLIERS OF INSIKA FOUNDATION

2.1 The purpose of this database is to give all prospective suppliers an equal opportunity to submit quotations to Insika Foundation.

2.2 Attached please find, inter alia, an official prospective supplier application form to assist in compiling the list according to legislation. It is imperative that applicants read the prospective supplier application document carefully, complete it in full and sign where appropriate.

2.3 The database will remain valid until Insika Foundation decides to re-establish the database.

2.4 Insika Foundation will regularly update the Supplier database.

3 REQUEST FOR CLARIFICATIONS/ QUERIES

3.1 Any clarification required by a supplier regarding the meaning or interpretation of the prospective supplier application document, or any other aspect concerning the application is to be requested by letter, fax or e-mail or telephone to the following contact details:

Insika SCM Officer

Email: [email protected] Fax: 086 762 6839

Postal Address:

Insika Foundation – Insika SCM Officer P.O Box 1431

Umhlanga Rocks 4320

OR

Insika Foundation - Insika SCM Officer Mashona House

4A Royal Palm Suites 6 Palm Boulevard Umhlanga Ridge 4319

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OR alternatively contact the following project co-ordinators: Name & Surname Cell Number Sites

Zamani Ngidi 084 962 4936 Indaka, Dannhauser

Msizi Madlala 082 757 7984 Indwedwe, Impendle,

Mkhambathini

Bongani Majola 074 341 4077 Maphumulo, Mthonjaneni, Inkandla

Thabo Mlotshwa 083 513 5330 Nongoma, Pongola, eDumbe Xolisani Ngubane 082 548 6232 uMlalazi/eShowe,

Mandeni,KwaDukuza, Ntambanana

4 SUBMITTING THE APPLICATION DOCUMENT PACK

4.1 All applications must be in a sealed envelope with the Reference number prominently displayed.

4.2 The application document pack can be returned to Insika SCM Officer at Insika Foundation via post or courier.

4.3 Alternatively the application document pack can be hand delivered to the following address:

Insika Foundation - Insika SCM Officer Mashona House

4A Royal Palm Suites 6 Palm Boulevard Umhlanga Ridge 4319

4.4 Prospective supplier application document packs should be submitted in a sealed envelope, marked with:

 Reference Number INSIKA/PSD-KZN/2016-17  The name and address of the applicant.

5 CLOSING DATE FOR APPLICATIONS

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SECTION1:

C. APPLICATION EVALUATION PROCESS

ALL SUPPLIERS MUST TAKE NOTE OF THE EVALUATION PROCESS THAT WILL BE FOLLOWED FOR THIS APPLICATION PROCESS

1. EVALUATION PROCESS

1.1 Evaluation of the responses will be completed in the phases noted hereunder.

1.2 STAGE 1: RESPONSIVENESS CHECK (COMPULSORY)

Please note: Applications without the completed/ submitted documents mentioned below will be regarded as non-responsive and disqualified immediately

1.2.1 The completed application form,

1.2.2 An original valid tax clearance certificate submitted, 1.2.3 Company registration certificate submitted,

1.2.4 Certified ID copies of Director/s of the company 1.2.5 Proof of Banking Details of the company

1.2.6 A valid VAT registration certificate (VAT103) submitted if applicable 1.2.7 SBD 4 - Declaration of interest completed, signed and submitted

1.2.8 SBD 6.1 - Preference points claim form in terms of the Preferential Procurement Regulation, 2001 submitted

1.2.9 SBD 6.2 – Declaration Certificate for Local Production and Content completed, signed and submitted (PPE suppliers only)

1.2.10 SBD 8 - Declaration of bidder’s past SCM practices completed, signed and submitted

1.2.11 SBD 9 – Certificate of independent Bid Determination

1.2.12 B-BBEE Certificate of a supplier in terms of the Codes of Good Practice issued by the DTI in terms of the B-BBEE Act

1.2.13 Company profile of the entity (training service providers only)

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1.3 STAGE 2: EVALUATION CRITERIA

1.3.1 Suppliers who are regarded as responsive, as determined through paragraph 1.2 above will be evaluated further. If complete information is not submitted the supplier will be regarded as non-responsive and the application will not be evaluated further. 1.3.2 Points will be awarded for B-BBEE Status Level of Contribution in terms of Regulation 5 (2) and 6 (2) of the Preferential Procurement Regulations, preference points must be awarded to a bidder for attaining the B-BBEE status level of contribution in accordance with the table below:

B-BBEE Status Level of Contributor Number of points (80/20 system) 1 20 2 18 3 16 4 12 5 8 6 6 7 4 8 2 Non-compliant contributor 0 1.3.3 Assessment Criteria CRITERIA Yes No 1. Compliance documents all submitted and signed

2. BEE status

1.3.4 The Insika SCM Officer will evaluate all applications from suppliers and compile the supplier database for approval by the Accounting Authority.

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1.4 STAGE 3: OTHER REASONS FOR DISQUALIFICATION

1.4.1 In addition to the above evaluation, Insika Foundation will reject an application to be registered if the supplier has:

 Committed a proven corrupt or fraudulent act in applying to register.

 Made an attempt to gain information in a manner deemed to be unfair or disadvantageous to other respondents or any attempt to influence the outcome of the response evaluation will result in immediate disqualification from the application process.

1.4.2 Insika Foundation will also disregard the application of any supplier if that supplier, or any of its directors:

 Have abused the SCM processes of Insika Foundation in the past;  Have committed fraud or any other improper conduct;

 Have failed to perform or deliver on any previous contract with Insika Foundation in the past;

1.4.3 Such actions will also be communicated to the National Treasury to incorporate such suppliers on their supplier blacklist.

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SECTION 2:

A. PROSPECTIVE SUPPLIER INFORMATION FORM

All applicants must furnish the following particulars and include it in their submission (Failure to do so will result in your application being disqualified)

5.1 IMPORTANT NOTES

 Applicants will be contacted via e-mail and must therefore submit an operating and valid e-mail address; failure to comply will result in excluding the supplier from the database;

 It should be noted that Insika Foundation reserves the right to accept or reject any application without being obliged to give any reasons in this respect;

5.2 SUPPLIER DETAILS

Supplier Name: Company / CC Registration Number: VAT Registration Number (if applicable): Income Tax Reference Number (compulsory): Web Address (if applicable):

E-Mail Address (compulsory):

Landline Contact Number: Cell Number:

Number of Full Time Employees: Number of years in business:

Postal Address: (compulsory)

Code

Physical Address: (compulsory)

5.3 SUPPLIER CLASSIFICATION: (PLEASE TICK THE RELEVANT BOX / BOXES) ISO

Listed

Importer Services Manufacturer Repairer Black Owned

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5.4 MAIN CONTACT PERSON IN YOUR ORGANIZATION: Name: Organization Position: Landline Number: Cell Number: E-Mail Address:

5.5 ACCOUNTS CONTACT PERSON IN YOUR ORGANIZATION:

Name:

Organization Position: Landline Number: Cell Number: E-Mail Address:

5.6 COMMODITY LIST (PRODUCTS & SERVICES):

Suppliers of the following products/services are required to register on the database. Please mark the main services your organization can supply:

Item #

Description Tick applicable

goods/ services

100 PPE

10001 Conti Suits 100% Poly Cotton Branded in full colour 10002 Dust Coats Poly Cotton Branded in Full Colour

Safety googles

10003 Sun Hats Poly Cotton branded in full colour 10004 Safety Boots

10005 Gumboots

10006 Disposable Gloves 10007 Industrial Leather Gloves 10008 HBC Work Suits

10009 T – Shirts 100% cotton Branded in Full colour. 10010 Dust Masks

200 TOOLS AND MATERIAL

20001 _Mops

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Item #

goods/ services

20003 _{Window Washer} 20004 _{Paint Brushes} 20005 _{Hand Fork}

20006 _{Two-Stroke (Oil) 10L} 20007 _{Grass Cutting Machines} 20008 _{Paint 20L}

20009 _{Paint Roller Tray Sets} 20010 _{Sanding Paper X 5 Sheets} 20011 _{Thinners 20L}

20012 _{Mutton Cloth} 20013 _{HBC Kits}

20014 _{Liquid Soap (Cleaning) 20L} 20015 _{Handy Andy 20L}

20016 _{Floor Polish 20L} 20017 _Seedlings 20018 _Pesticides 20019 _{First Aid Kits}

20020 _{Beads = Different Colour} 20021 _{Raffia = Different Colour}

20022 _{Fleure Wools = Different Colours} 20023 _Scissors 20024 _{Sewing Machines} 20025 _{Curtain Material} 20026 _Unpick 20027 _{Measuring Tape} 20028 _{Box Of Pins}

20029 _{Machine Needle Size 14 &16} 20030 _{Shoe Soles All Sizes}

20031 _{Inner Soles} 20032 _{Leather Aprons} 20033 _{Crochette Needles} 20034 _{Shoe Needles}

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Item #

goods/ services

20035 _{Contact Glue} 20036 _{Sewing Cloth}

20037 _{Zips, Buttons And Thread} 20038 _{Welding Mask}

20039 _{Welding Gloves} 20040 _{Electrode Holder} 20041 _{Welding Rods}

20042 _{Steel Bars - Square Bar} 20043 _{Steel Bars - Square Tubing} 20044 _{River Sand}

20045 _{Building Accessories} 20046 _Cement

20047 _{Brick Making Machines} 20048 _{Jerry Cans}

300 _{AGRICULTURAL INPUTS}

30001 _{Cabbage seedlings} 30002 _{Beetroot seedlings} 30003 _{Spinach seedlings}

30004 _{Mustard Spinach seedlings} 30005 _{Green Pepper seedlings} 30006 _{Carrots seedlings} 30007 _{Kale seedlings} 30008 _{Cabbage seeds} 30009 _{Beetroot seeds} 30010 _{Spinach seeds}

30011 _{Mustard Spinach seeds} 30012 _{Green Pepper seeds} 30013 _{Carrots seeds} 30014 _{Kale seeds} 30015 _{Fruit Trees} 30016 _{Shade Tress}

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Item #

goods/ services 40001 _Laptops 40002 _{Printers/scanners/Fax/Photocopier} 40003 _{Office Desks} 40004 _{Office Chairs} 40005 _{Extension Cables} 40006 _{Steel Filing Cabinets} 40007 _Modems

500 _{TRAINING COURSES}

50001 _{Home Based Care} 50002 _{HIV/ AIDS}

50003 _{Health & safety}

50004 _{Early Childhood Development} 50005 _Cooking 50005 _{Sewing/ Knitting} 50006 _Welding 50007 _Painting 50008 _Plumbing 50009 _{Brick making}

50010 _{Plant Production/ Agriculture} 50011 _{First Aid}

5.7 TRACK RECORD

List three largest contracts/projects completed by your organisation in the last three years:

WORK PERFORMED

FOR WHOM CONTACT PERSON AND TELEPHONE NUMBERS

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I the undersigned acknowledge that:

 The information furnished is true and correct;

 The Equity Ownership claimed is in accordance with the general conditions;

 Any conflict of interest has been declared.

Signature of Owner or Authorised Representative

Date

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SECTION 3:

SUPPLIER COMPLIANCE CHECKLIST

Documents in this section must be completed and returned with the application

Please mark the documents that you have included/ submitted in the application pack.

# SUPPLIER RESPONSE CHECKLIST YES NO

1. The application form (completed and signed) 2. An original valid tax clearance certificate 3. Company registration certificate

4. Certified ID copies of Director/s of the company

5. Proof of Banking Details of the company

6. A valid VAT registration certificate (VAT103) submitted if applicable

7. SBD 4 - Declaration of interest

8. SBD 6.1 - Preference points claim form in terms

of the Preferential Procurement Regulation, 2001

9. SBD 6.2 – Declaration Certificate for Local

Production and Content

10. SBD 8 - Declaration of bidder’s past SCM practices

11. SBD 9 – Certificate of independent Bid Determination

12. Certificate regarding the B-BBEE status of a supplier in terms of the Codes of Good Practice issued by the DTI in terms of the B-BBEE Act 13. Company profile of the entity (training service

providers only)

12. Proof of accreditation where applicable (training service providers only)