SWORN AFFIDAVIT- COMPANY B-BBEE STATUS VENDORS, SUPPLIERS, CONTRACTORS – I, the undersigned, Full name and Surname Identity number Hereby declare under oath as follows: The contents of this statement are to the best of my knowledge and belief, a true reflection of facts. I am a member/ director/ owner of the following enterprise and am duly authorised to act on its behalf (“enterprise”): Enterprise Name Trading Name Registration Number Enterprise Address I hereby declare under oath that: The enterprise is % black owned The enterprise is % black woman owned Based on the latest management accounts and other information available on the financial year, the income did not exceed ( million rands) ………………………… Please confirm on the table below the B-BBEE level contributor, based on either this EME verification, or the attached verified Scorecard rating BBBEE Sector i.e Generic Company Size, Recognition Scorecard Verification – Scorecard (DTi codes), i.e EME, QSE, QME or ( % ) Expiry Agency Level Construction, Large i.e.100%, Date Name 110%, 125% (where Financial , Transport etc etc applicable) The enterprise is an empowering supplier in terms of the Department of Trade and Industry Codes of Good Practice on Black Economic Empowerment (“Codes”) Access to the following documents has been granted to me (these are available at www.wbho.co.za) the Codes;
SWORN AFFIDAVIT- COMPANY B-BBEE STATUS – VENDORS, SUPPLIERS, CONTRACTORS I, the undersigned, Full name and Surname Identity number Hereby declare under oath as follows: The contents of this statement are to the best of my knowledge and belief, a true reflection of facts. I am a member/ director/ owner of the following enterprise and am duly authorised to act on its behalf (“enterprise”): Enterprise Name Trading Name Registration Number Enterprise Address I hereby declare under oath that: The enterprise is % black owned The enterprise is % black woman owned Based on the latest management accounts and other information available on the financial year, the income did not exceed ………………………… ( million rands) Please confirm on the table below the B-BBEE level contributor, based on either this EME verification, or the attached verified Scorecard rating BBBEE Scorecard Level Sector – i.e Generic (DTi codes), Construction, Financial , Transport etc Company Size, i.e EME, QSE, QME or Large Recognition ( % ) i.e.100%, 110%, 125% etc Scorecard Expiry Date Verification Agency Name (where applicable) The enterprise is an empowering supplier in terms of the Department of Trade and Industry Codes of Good Practice on Black Economic Empowerment (“Codes”) Access to the following documents has been granted to me (these are available at www.wbho.co.za) the Codes;
BED011-B-BBEE-Sworn-Affidavit.docx