3.1(g) Aware of any conflict of interest within the Yes meaning of regulation 24 due to the participation No in the procurement procedure? If yes please provide details at 3.2 3.1(h) Been involved in the preparation of the Yes procurement procedure? No If yes please provide details at 3.2 3.1(i) Shown significant or persistent deficiencies in the Yes performance of a substantive requirement under No a prior public contract, a prior contract with a If yes please provide details at 3.2 contracting entity, or a prior concession contract, which led to early termination of that prior contract, damages or other comparable sanctions? 3.1(j) Please answer the following statements 3.1(j) - (i) The organisation is guilty of serious Yes misrepresentation in supplying the information No required for the verification of the absence of If Yes please provide details at 3.2 grounds for exclusion or the fulfilment of the selection criteria. Yes 3.1(j) - (ii) The organisation has withheld such information. No If Yes please provide details at 3.2 Yes 3.1(j) The organisation is not able to submit supporting –(iii) documents required under regulation 59 of the No Public Contracts Regulations 2015. If Yes please provide details at 3.2 Yes 3.1(j)-(iv) The organisation has influenced the process of the contracting authority to No obtain confidential information that may confer If Yes please provide details at 3.2 upon the organisation undue advantages in the procurement procedure, or to negligently provided misleading information that may have a material influence on decisions concerning exclusion, selection or award. 3.2 If you have answered Yes to any of the above, explain what measures been taken to demonstrate the reliability of the organisation despite the existence of a relevant ground for exclusion? (Self Cleaning)
3.1(g) Aware of any conflict of interest within the meaning of regulation 24 due to the participation in the procurement procedure? Yes No If yes please provide details at 3.2 3.1(h) Been involved in the preparation of the procurement procedure? Yes No If yes please provide details at 3.2 3.1(i) Shown significant or persistent deficiencies in the performance of a substantive requirement under a prior public contract, a prior contract with a contracting entity, or a prior concession contract, which led to early termination of that prior contract, damages or other comparable sanctions? Yes No If yes please provide details at 3.2 3.1(j) Please answer the following statements 3.1(j) - (i) The organisation is guilty of serious misrepresentation in supplying the information required for the verification of the absence of grounds for exclusion or the fulfilment of the selection criteria. Yes No If Yes please provide details at 3.2 3.1(j) - (ii) The organisation has withheld such information. Yes No If Yes please provide details at 3.2 3.1(j) –(iii) The organisation is not able to submit supporting documents required under regulation 59 of the Public Contracts Regulations 2015. Yes No If Yes please provide details at 3.2 3.1(j)-(iv) The organisation has influenced the process of the contracting authority to obtain confidential information that may confer upon the organisation undue advantages in the procurement procedure, or to negligently provided misleading information that may have a material influence on decisions concerning exclusion, selection or award. Yes No If Yes please provide details at 3.2 3.2 If you have answered Yes to any of the above, explain what measures been taken to demonstrate the reliability of the organisation despite the existence of a relevant ground for exclusion? (Self Cleaning)
ps2016312-itt-.brighterfutures-selection-v01.docx