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CONTACT INFORMATION Landline: ( ) Fax no: ( ) Mobile number: E-mail address: Website (n/a if no website): Physical Address: Postal Address: Private Company Public Company Partnership Other Specify: FORM OF ORGANISATION Mark Appropriate with an X Sole Proprietor Trust Closed Corporation DETAILS OF MAJOR CONTRACTS THAT ALLIGN CLOSEST WITH THE ONE ON OFFER, EXECUTED IN THE PAST 5 YEARS 1 2 3 4 Client, Project & Year Description Monetary Value 5 PRESENT ASSIGNMENTS AT HAND (max. 5 - related or unrelated to the one on offer) 1 2 3 4 5 Project Description Monetary Value
1 2 3 CONTACT DETAILS OF THREE MAJOR CLIENTS Client Email Address Telephone Contact Person THE FOLLOWING DOCUMENTS MUST ACCOMPANY THIS SUBMISSION Kindly confirm its inclusion by placing an X in the column adjacent to it. Please ensure that the documents are in order as described below. No. DOCUMENT (X) Proof of insurance and current limits for both public liability 1 and contractor’s all risk insurance 2 VAT registration certificate Proof of banking details by means of: cancelled cheque (or certified copy thereof) or written confirmation of account 3 details from the bank concerned 4 Tax clearance certificate from SARS 5 Registration document (CK1/CK2) of the enterprise Verified certificate, issued by a SANAS accredited verification agency, disclosing the B-BBEE status of the enterprise in terms of the codes of Good Practice, B-BBEE of 6 2007 7 Company Profile Proof of previous experience in Fume Cupboards installations in laboratory construction projects with chilled 8 water HVAC Proof of previous experience in construction projects where the work was required to be interphased with the continued 9 occupation of the works by the client. Are any of the directors, members or proprietors or any of their family members employed at the University of Pretoria? (Mark with an X) Yes If yes, please provide details: No NO LATE SUBMISSIONS WILL BE CONSIDERED. I hereby certify that the information submitted is correct and that all copies of original documents submitted are authentic. I am authorised to sign on behalf of the applicant. Name: Capacity: Signature: ________________________ ________________________ ________________________
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