DECLARATION OF INTEREST Any legal person, including persons employed by the State, or persons having a kinship with persons employed by the State, including a blood relationship, may make an offer or offers in terms of this invitation to bid (includes an advertised competitive bid, limited bid or proposal or a written price quotation,). In view of possible allegations of favouritism, should the resulting bid, or part thereof, be awarded to persons employed by the State, or to persons connected with or related to them, it is required that the bidder or his/her authorised representative declare his/her position in relation to the evaluating/ adjudicating authority where – The bidder is employed by the State; and/or The bidder is a Management Board member of Fasset and/or The legal person on whose behalf the bidding document is signed, has a relationship with persons/a person who are/is involved in the evaluation and or adjudication of the bid(s), or where it is known that such a relationship exists between the person or persons for or on whose behalf the declarant acts and persons who are involved with the evaluation and or adjudication of the bid. In order to give effect to the above, the following questionnaire must be completed and submitted with the bid. Full Name of bidder or his or her representative: Identity Number: Position occupied in the Company (director, trustee, shareholder, member, etc): Registration number of company, enterprise, close corporation, partnership agreement or trust Tax Reference Number: VAT Registration Number: The names of all directors/ trustees/ shareholders/ members, their individual identity numbers, tax reference numbers and, if applicable, employee/ PERSAL numbers must be indicated in paragraph 3 below YES / NO Are you or any person connected with the bidder presently employed by the State? If so, furnish the following particulars Name of person/ director/ trustee/ shareholder/ member: Name of State institution at which you or the person connected to the bidder is employed: Position occupied in the State institution: Any other particulars:
DECLARATION OF INTEREST Any legal person, including persons employed by the State, or persons having a kinship with persons employed by the State, including a blood relationship, may make an offer or offers in terms of this invitation to bid (includes an advertised competitive bid, limited bid or proposal or a written price quotation,). In view of possible allegations of favouritism, should the resulting bid, or part thereof, be awarded to persons employed by the State, or to persons connected with or related to them, it is required that the bidder or his/her authorised representative declare his/her position in relation to the evaluating/ adjudicating authority where – The bidder is employed by the State; and/or The bidder is a Management Board member of Fasset and/or The legal person on whose behalf the bidding document is signed, has a relationship with persons/a person who are/is involved in the evaluation and or adjudication of the bid(s), or where it is known that such a relationship exists between the person or persons for or on whose behalf the declarant acts and persons who are involved with the evaluation and or adjudication of the bid. In order to give effect to the above, the following questionnaire must be completed and submitted with the bid. Full Name of bidder or his or her representative: Identity Number: Position occupied in the Company (director, trustee, shareholder, member, etc): Registration number of company, enterprise, close corporation, partnership agreement or trust Tax Reference Number: VAT Registration Number: The names of all directors/ trustees/ shareholders/ members, their individual identity numbers, tax reference numbers and, if applicable, employee/ PERSAL numbers must be indicated in paragraph 3 below Are you or any person connected with the bidder presently employed by the State? YES / NO If so, furnish the following particulars Name of person/ director/ trustee/ shareholder/ member: Name of State institution at which you or the person connected to the bidder is employed: Position occupied in the State institution: Any other particulars:
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