SELF-DECLARATION FORMS
FORM SD1
SELF DECLARATION THAT THE PERSON/TENDERER IS NOT DEBARRED IN THE
MATTER OF THE PUBLIC PROCUREMENT AND ASSET DISPOSAL ACT 2015.
I .................................................................... of Post Office
Box..............................................being a resident of ............................................. in the
Republic of..............................................do hereby make a statement as follows:-
1. THAT I am the Company Secretary/ Chief Executive/Managing Director/Principal
Officer/Director of ................................................... (insert name of the Company)
who is a Bidder in respect of Tender No........................................
for................................................................................................... (insert tender
title/description) for...........................................(insert name of the Procuring entity)
and duly authorized and competent to make this statement.
2. THAT the aforesaid Bidder, its Directors and subcontractors have not been debarred
from participating in procurement proceeding under Part IV of the Act.
3. THAT what is deponed to herein above is true to the best of my knowledge,
information and belief. ……………………… ………………….. …. ….
…………………… …
(Title) (Signature) (Date)
Bidder Official Stamp
FORM SD2
SELF DECLARATION THAT THE PERSON/TENDERER WILL NOT ENGAGE IN ANY CORRUPT
OR FRAUDULENT PRACTICE
I, ………………………………….... of P.O. Box..............................................being a resident
of....................................................................... in the Republic of ................................... do
hereby
make a statement as follows:-
1. THAT I am the Chief Executive/Managing Director/Principal Officer/Director
of..............................................................……....…………………… (insert name of
the Company) who is a Bidder in respect of Tender No.
.............................................................. for.................................... (Insert tender
title/description)
for.................................................... (insert name of the Procuring entity) and duly
authorized and competent to make this statement.
2. THAT the aforesaid Bidder, its servants and/or agents /subcontractors will not
engage in
any corrupt or fraudulent practice and has not been requested to pay any
inducement
to any member of the Board, Management, Staff and/or employees and/or agents of
……………………..(insert name of the Procuring entity) which is the procuring
entity.
3. THAT the aforesaid Bidder, its servants and/or agents /subcontractors have not
offered
any inducement to any member of the Board, Management, Staff and/or employees
and/or agents of ……………………..(name of the procuring entity).
4. THAT the aforesaid Bidder will not engage/has not engaged in any corrosive
practice
with other bidders participating in the subject tender.
5. THAT what is deponed to herein above is true to the best of my knowledge
information
and belief.
…………………………… ………………...…… …………………
(Title) (Signature) (Date)
Bidder’s Official Stamp
Mandatory
Part 3 (a) – Pursuant to section 33(1) and 33(2) of the public procurement Assets and
Disposal Act2015 and section 26 of the Regulations 2006. This must be signed by all
Directors Partner (s) /SoleProprietor of the Company
1/we the Director(s) of Company/Firm
...................................................................................................................................................
hereby Declare that I /we are not a board member, employee or even a relative to any
employee of mbgathi hospital.