Verification of information supplied relating to references that the Applicants / Business may apply for. I/We, the undersigned, who warrants that I/we are duly authorised to do so on behalf of the supplier, certifies that the information supplied in terms of this documentation including the Annexure(s) with additional information, is correct and accurate and acknowledges that:- The supplier will be required to furnish documentary proof of the information relating to preferences, if required to do so. If the information supplied is found to be incorrect, then may, in addition to any other remedies it may have: Disqualify the supplier/contractor for a particular bid/contract/project it may be considered for, or which had been awarded to the supplier/contractor; Recover from the supplier/contractor for all costs, losses or damages incurred or sustained by as a result of breach of contract; Cancel the contract and claim any damages which may suffer by favourable arrangements after such cancellation and / or; De-register the supplier registered on the Supplier Database SIGNED ON THIS _______ DAY OF _____________________ 20________ AT: ___________________________ ______________________ _________________________ Name of Representative Signature of Authorised Representative ________________________________________________________ Suppliers Name
Verification of information supplied relating to references that the Applicants / Business may apply for. I/We, the undersigned, who warrants that I/we are duly authorised to do so on behalf of the supplier, certifies that the information supplied in terms of this documentation including the Annexure(s) with additional information, is correct and accurate and acknowledges that:- The supplier will be required to furnish documentary proof of the information relating to preferences, if required to do so. If the information supplied is found to be incorrect, then may, in addition to any other remedies it may have: Disqualify the supplier/contractor for a particular bid/contract/project it may be considered for, or which had been awarded to the supplier/contractor; Recover from the supplier/contractor for all costs, losses or damages incurred or sustained by as a result of breach of contract; Cancel the contract and claim any damages which may suffer by favourable arrangements after such cancellation and / or; De-register the supplier registered on the Supplier Database SIGNED ON THIS _______ DAY OF _____________________ 20________ AT: ___________________________ ______________________ _________________________ Name of Representative Signature of Authorised Representative ________________________________________________________ Suppliers Name
service-provider-forms.docx