details at 3.2 ☐ Yes 3.1(g) Aware of any conflict of interest within the meaning of Regulation 24 of the Public No ☐ Contracts Regulations 2015 due to the participation in the procurement If yes, please provide procedure? details at 3.2 Yes ☐ 3.1(h) Been involved in the preparation of the procurement procedure? No ☐ If yes, please provide details at 3.2 Yes ☐ 3.1(i) Shown significant or persistent deficiencies in the performance of a ☐ No substantive requirement under a prior public contract, a prior contract with a If yes, please provide contracting entity, or a prior concession details at 3.2 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 required for the verification of No ☐ the absence of grounds for exclusion or the fulfilment of the selection criteria. If yes, please provide details at 3.2 3.1(j) (ii) The organisation has withheld such ☐ – Yes information. No ☐ If yes, please provide details at 3.2 3.1(j) (iii) The organisation is not able to submit Yes ☐ – supporting documents required under
details at 3.2 3.1(g) Aware of any conflict of interest within the meaning of Regulation 24 of the Public Contracts Regulations 2015 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 Yes ☐
appendix-3-application-to-join-the-impact-project-dps-1.docx