Part 1: Potential supplier Information Please answer the following questions in full. Note that every organisation that is being relied on to meet the selection must complete and submit the Part 1 and Part 2 self-declaration. Section 1 Potential supplier information Question Question Response number 1.1(a) Full name of the potential supplier submitting the information. 1.1(b) (i) Registered office address (if applicable) – 1.1(b) (ii) Registered website address (if applicable) – 1.1(c) Trading status public limited company limited company limited liability partnership partnership sole trader sector (please specify your trading status) 1.1(d) Date of registration in country of origin 1.1(e) Company registration number (if applicable) 1.1(f) Charity registration number (if applicable) 1.1(g) Head office DUNS number (if applicable) 1.1(h) Registered VAT number Yes ☐ 1.1(i) Is it a requirement for you to possess a particular No ☐ authorisation, or be a member of a particular organisation in order to provide the services specified in this procurement? 1.1(j) If you responded yes to 1.1(i), please provide additional details of what is required and confirmation that you have complied with this. 1.1(k) Trading name(s) that will be used if successful in this procurement 1.1(l) Relevant classifications (state whether you fall within one of these, and if so which one) Voluntary Community Social Enterprise (VCSE) Sheltered Workshop Public service mutual Yes ☐ 1.1(m) Are you a Small, Medium or Micro Enterprise (SME)? No ☐ Details of Persons of Significant Control (PSC), where 1.1(n) appropriate: - Name; - Date of birth;
Part 1: Potential supplier Information Please answer the following questions in full. Note that every organisation that is being relied on to meet the selection must complete and submit the Part 1 and Part 2 self-declaration. Section 1 Potential supplier information Question number Question Response 1.1(a) Full name of the potential supplier submitting the information. 1.1(b) – (i) Registered office address (if applicable) 1.1(b) – (ii) Registered website address (if applicable) 1.1(c) Trading status public limited company limited company limited liability partnership partnership sole trader sector (please specify your trading status) 1.1(d) Date of registration in country of origin 1.1(e) Company registration number (if applicable) 1.1(f) Charity registration number (if applicable) 1.1(g) Head office DUNS number (if applicable) 1.1(h) Registered VAT number 1.1(i) Is it a requirement for you to possess a particular authorisation, or be a member of a particular organisation in order to provide the services specified in this procurement? Yes ☐ No ☐ 1.1(j) If you responded yes to 1.1(i), please provide additional details of what is required and confirmation that you have complied with this. 1.1(k) Trading name(s) that will be used if successful in this procurement 1.1(l) Relevant classifications (state whether you fall within one of these, and if so which one) Voluntary Community Social Enterprise (VCSE) Sheltered Workshop Public service mutual 1.1(m) Are you a Small, Medium or Micro Enterprise (SME)? Yes ☐ No ☐ 1.1(n) Details of Persons of Significant Control (PSC), where appropriate: - Name; - Date of birth;
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