(r409) iym scmu rfq 29-12/13 - Intsika Yethu Municipality

Cell phone NumberFacsimile Number Code: Number:E-mail AddressVat Registration NumberHas an original tax clearance certificate been submitted (MBD 2)?Has a B-BBEE status level verification certificate been submitted? (MBD 6.1)If yes, who issued the certificate?An accounting officer as contemplated in the close corporation act (CCA)A Verification Agency accredited by SANASA Registered Auditor(Tick applicable box)(A B-BBEE status level verification certificate must be submitted in order to qualifyfor preference points for B-BBEE)Are you the accredited representative in South Africa for the Goods/Servicesoffered by you?YES / NOYES/NO□□□YES / NO(IF YES ENCLOSE PROOF)SIGNATURE OF BIDDERDATECAPACITY UNDER WHICH THIS BID IS SIGNEDTOTAL BID PRICE (vat included)AMOUNT IN WORDSIntsika Yethu MunicipalityANY ENQUIRIES REGARDING THE BIDDING PROCEDURE MAY BEDIRECTED TO:Budget and Treasury Office- Supply Chain ManagementContact Person: SCM Officer - Bid AdministrationTel: 047 8740 364Fax: 047 8740 358ANY ENQUIRIES REGARDING THIS TENDER MAY BE DIRECTED TO:Contact Person:Ms N RolsTel: 047 874 8775Fax: 047 874 0226MBD 2