INSIKA FOUNDATION PROSPECTIVE SUPPLIER … Supplier Database... · INSIKA PROSPECTIVE SUPPLIER DATABASE APPLICATION DATABASE FORM APPLICATION DETAILS Description: Reference: Invitation

INSIKA PROSPECTIVE SUPPLIER DATABASE APPLICATION DATABASE FORM

APPLICATION DETAILS

Description:

Reference:

Invitation for prospective suppliers and professional service providers to register on the Insika Foundation Supplier Database

INSIKA/PSD/2017-18

RESPONDENT DETAILS

This page must be completed and submitted with each sealed application

Company Name:

Co Registration:

CSD Vendor Nr:

Contact person:

Contact number:

Email address:

PROVINCE: (Please tick the Province/s that you are able to supply) MUNICIPALITY & DISTRICT: (Please indicate the Municipality and District you are based in)

Province: KZN GP

Municipality

District

http://www.google.co.za/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&ved=0ahUKEwik69itgqzMAhWHtBoKHUvUAeIQjRwIBw&url=http://bursary.seniorjournalism.com/2014/08/cooperative-governance-traditional-affairs-cogta-2014-2015-internship-programme/&psig=AFQjCNEHC7P9r3bw9_PD844LM_KD1h7YWw&ust=1461750293199584

INSIKA FOUNDATION PROSPECTIVE SUPPLIER DATABASE APPLICATION 2017/18

Page 2

DOCUMENTS IN THIS APPLICATION PACK

Respondents are to ensure that they have received all pages of this document, which consists of the following sections: SECTION 1 Documents in this section are for information /instruction to respondents and must not be returned with applications.

A. Background

B. Application submission conditions and instructions

C. Application evaluation process

SECTION 2 Documents in this section must be completed and returned or supplied with applications.

A. Prospective supplier information form

B. Commodity list (Goods & Services)

SECTION 3 Documents in this section must be completed/ supplied and returned with applications.

A. Compliance checklist


Page 3

SECTION 1: A. BACKGROUND

This section is for information only, do not return with the application

The Community Work Programme (CWP) is a government programme based in the Department of Coorporative Governance. The primary purpose of the programme is to create an employment safety net (basic minimum income) for the unemployed especially in the rural communities. The programme supplements livelihood strategies by providing a basic level of income security. Each site employs 1 000 or more participants. The programme/ participants need the following goods and services:

1. Goods Protective Wear, Tools, Agricultural inputs etc

2. Services Various Training Courses

The sites are managed by Implementing Agents (IA’s). Insika Foundation is an Implementing Agent for: Gauteng Merafong Local Municipality City of Johannesburg District - Region E Kwazulu-Natal Ilembe District Zululand District uThungulu District uMgungundlovu District uThukela District Amajuba District eThekwini In order to comply with the regulations of the Public Finance Management Act and to ensure a competitive procurement process, Insika Foundation invites prospective suppliers of the goods/ services as indicated above, to apply for a listing on Insika Foundation’s prospective supplier database. It is important to note that should an applicant/ supplier be successful in their application to be added to the prospective supplier database, Insika Foundation is under no obligation to utilise their services. Successful applicants are not in any way guaranteed future business.


Page 4

SECTION 1: B. APPLICATION SUBMISSION CONDITIONS AND INSTRUCTIONS


1 FRAUD AND CORRUPTION 1.1 All suppliers are to take note of the implications of contravening the Prevention

and Combating of Corrupt Activities Act, Act No 12 of 2004 and any other Act applicable.

2 NOTES TO ALL SUPPLIERS SEEKING REGISTRATION ON THE DATABASE

OF PROSPECTIVE SUPPLIERS OF INSIKA FOUNDATION 2.1 The purpose of this database is to give all prospective suppliers an equal

opportunity to submit quotations to Insika Foundation. 2.2 Attached please find, inter alia, an official prospective supplier application form to

assist in compiling the list according to legislation. It is imperative that applicants read the prospective supplier application document carefully, complete it in full and sign where appropriate.

3 REQUEST FOR CLARIFICATIONS/ QUERIES

Any clarification required by a supplier regarding the supplier application document/ process must be requested from the following contact details: Insika SCM Officer Tel: 011 695 6800 Fax: 086 762 6839 Email: [email protected]

OR alternatively contact the following project co-ordinators:

Name & Surname Cell Number Sites

Hangwi Masakona 074 631 3714 Merafong Local Municipality,

City of Johannesburg District Region E

Zamani Ngidi 062 877 5633 Indaka, Dannhauser, Newcastle, Ladysmith

Nompumelelo Ngubane

061 007 2975 Impendla, Umshwathi, Mkhambathini

Bongani Majola 074 341 4077 Maphumulo, Mthonjaneni, Inkandla

Bongekile Zulu 074 649 3559 Phongola, Nongoma, uLundi, eDumbe

Zabiwe Mkhize 076 338 1061 uMlalazi/eShowe, Mandeni,KwaDukuza, Ntambanana, Umfolozi, City of Umhlathuze

mailto:[email protected]


Page 5

4 SUBMITTING THE APPLICATION DOCUMENT PACK 4.1 All applications must be submitted via email to [email protected]

with the Reference number and Company name on the subject line.

4.2 A copy of the application document pack must be returned to the Insika SCM Officer at Insika Foundation via post or hand delivery at the following addresses:

Postal Address Physical Address

Gauteng

Insika Foundation P.O Box 3840 Halfway House 1685

Elethu House, Suite G4/Block 27 Thornhill Office Park 94 Bekker Road Midrand 1685

KZN

Insika Foundation P.O Box 1431 Umhlanga Rocks 4320

Mashona House 4A Royal Palm Suites 6 Palm Boulevard Umhlanga Ridge 4319

4.3 Prospective supplier application document packs should be submitted in a sealed

envelope, marked with:

Reference Number INSIKA/PSD/2017-18. The name and address of the applicant.

5 CLOSING OF APPLICATIONS

Please note that the closing date is 31 March 2018. Please ensure that you first register on the National Treasury Central Database before submitting this application form.


Page 6

SECTION1: C. APPLICATION EVALUATION PROCESS


ALL SUPPLIERS MUST TAKE NOTE OF THE EVALUATION PROCESS THAT WILL BE

FOLLOWED FOR THIS APPLICATION PROCESS

1. EVALUATION PROCESS

Evaluation of the responses will be completed in the phases noted hereunder:

1.1 STAGE 1: RESPONSIVENESS CHECK

Please note: Applications without the completed/ submitted documents mentioned below will be regarded as non-responsive and disqualified immediately

1.1.1 The completed application form,

1.1.2 An original valid tax clearance certificate submitted (ensure that Insika always

has the most recent and valid copy),

1.1.3 B-BBEE Certificate or Sworn affidavit signed by a Commissioner of Oaths (ensure that Insika always has the most recent and valid copy),

1.1.4 Company registration certificate submitted,

1.1.5 Proof of Registration with National Treasury Central Supplier Database (CSD)

1.1.6 Certified ID copies of Director/s of the company

1.1.7 Proof of Banking Details of the company 1.1.8 A valid VAT registration certificate (VAT103) submitted if applicable, 1.1.9 Company profile of the entity (training service providers only)

1.1.10 Proof of accreditation where applicable (training service providers only)


Page 7

1.2 STAGE 2: OTHER REASONS FOR DISQUALIFICATION 1.2.1 In addition to the above compliance check, Insika Foundation will reject an

application to be registered if the supplier has: Committed a proven corrupt or fraudulent act in applying to register.

Made an attempt to gain information in a manner deemed to be unfair or

disadvantageous to other respondents or any attempt to influence the outcome of the response evaluation will result in immediate disqualification from the application process.

1.2.2 Insika Foundation will also disregard the application of any supplier if that supplier,

or any of its directors:

Have abused the SCM processes of Insika Foundation in the past; Have committed fraud or any other improper conduct; Have failed to perform or deliver on any previous contract with Insika

Foundation in the past;

1.2.3 Such actions will also be communicated to the National Treasury to incorporate such suppliers on their supplier blacklist.


Page 8

SECTION 2: A. PROSPECTIVE SUPPLIER INFORMATION FORM

All applicants must furnish the following particulars and include it in their submission (Failure to do so will result in your application being disqualified)

2.1 IMPORTANT NOTES

▪ Applicants will be contacted via e-mail and must therefore submit an operating and valid e-mail

address; failure to comply will result in excluding the supplier from the database; ▪ It should be noted that Insika Foundation reserves the right to accept or reject any application

without being obliged to give any reasons in this respect;

2.2 SUPPLIER DETAILS

Supplier Name:

Company / CC Registration Number:

VAT Registration Number (if applicable):

Income Tax Reference Number:

Web Address (if applicable):

E-Mail Address:

Landline Contact Number:

Cell Number:

Number of Full Time Employees:

Number of years in business:

Physical or Postal Address: (compulsory)

2.3 SUPPLIER CLASSIFICATION: (PLEASE TICK THE RELEVANT BOX / BOXES)

ISO

Listed

Importer Services Manufacturer Repairer Black

Owned

Distributor Exporter Sales

2.4 MAIN CONTACT PERSON IN YOUR ORGANIZATION:

Name:

Organization Position:

Landline Number:

Cell Number:

E-Mail Address:


Page 9

SECTION 2: B. COMMODITY LIST (PRODUCTS & SERVICES):

Suppliers of the following products/services are required to register on the database. Please mark the main goods and/ or services your organization supplies. Please note the list below is indicative of the types of goods and services. Additional goods/ services may be required:

Item

Code

Description Tick applicable goods/ services

100 PPE

10001 Conti Suits 65/35 Poly Cotton Branded in full colour Size:

36, 100| Size 38, 100|Size 40, 150|Size 44, 200|Size 46, 150|Size 48, 200| Size 50, 100

10002 Dust Coats Poly Cotton Branded in Full Colour Safety googles

10003 T – Shirts 100% cotton Branded in Full colour. Sizes 280 small, 200 medium 200 large, 200 Xtra large 200 XX large, 120 XXX large

10004 Safety Boots and safety shoes. Bata, Bronx, Bova, Le Maitre, or Frams. Sizes: Size 4, 100|Size 5, 100| Size 6, 200|Size 7, 100|Size 8, 100| Size 9, 100|Size 10, 100

10005 Gumboots- Bata

10006 Disposable Gloves

10007 Industrial Leather Gloves

10008 HBC Work Suits

200 TOOLS AND MATERIAL

20001 Mops

20002 Refuse Bags (100 Pack )

20003 Window Washer

20004 Paint Brushes

20005 Hand Fork

20006 Two-Stroke (Oil) 10L

20007 Grass Cutting Machines

20008 Paint 20L

20009 Paint Roller Tray Sets

20010 Sanding Paper X 5 Sheets

20011 Thinners 20L

20012 Mutton Cloth

20013 HBC Kits

20014 Liquid Soap (Cleaning) 20L


Page 10

Item

Code


20015 Handy Andy 20L

20016 Floor Polish 20L

20017 Seedlings

20018 Box Of Pins

20019 Zips, Buttons And Thread

20020 Welding Mask

20021 Welding Gloves

20022 Electrode Holder

20023 Welding Rods

20024 Steel Bars - Square Bar

20025 Steel Bars - Square Tubing

20026 River Sand

20027 Building Accessories

20028 Cement

300 AGRICULTURAL INPUTS

30001 Cabbage seedlings

30002 Beetroot seedlings

30003 Spinach seedlings

30004 Mustard Spinach seedlings

30005 Green Pepper seedlings

30006 Carrots seedlings

30007 Kale seedlings

30008 Cabbage seeds

30009 Beetroot seeds

30010 Spinach seeds

30011 Mustard Spinach seeds

30012 Green Pepper seeds

30013 Carrots seeds

30014 Kale seeds

30015 Fruit Trees

400 OFFICE EQUIPMENTS

40001 Laptops

40002 Printers/scanners/Fax/Photocopier


Page 11

Item

Code


40003 Office Desks

40004 Office Chairs

40005 Extension Cables

40006 Steel Filing Cabinets

40007 Modems

500 TRAINING COURSES

50001 Home Based Care

50002 HIV/ AIDS

50003 Health & safety

50004 Beauty and nails technology

50005 Cooking

50006 Sewing/ Knitting

50007 Welding

50008 Painting

50009 Plumbing

50010 Brick making

50011 Arts and Craft

50012 Music Arts and Culture

50013 Waste Management/ Recycling

50014 Packaging

50015 Business development and support skills programme

50016 Work readiness

50017 Basic Computer

TRACK RECORD List three largest contracts/projects completed by your organisation in the last three years:

WORK PERFORMED FOR WHOM CONTACT PERSON AND TELEPHONE NUMBERS

CONTRACT FEE


Page 12

I/we the undersigned acknowledge(s) that: ▪ The information furnished in this application is true and correct; ▪ The Equity Ownership claimed is in accordance with the general conditions; ▪ Any conflict of interest has been declared.

Signature of Company Owner or Authorised Representative

Date

Witness Date


Page 13

SECTION 3: A. SUPPLIER COMPLIANCE CHECKLIST

Please tick YES/ NO and return this page including the documents required per this checklist

Please mark the documents that you have included/ submitted in the application pack.

# SUPPLIER RESPONSE CHECKLIST

YES NO

1. The application form (completed and signed)

2. Company registration certificate

3. An original valid tax clearance certificate

4. B-BBEE Certificate or Sworn affidavit signed by a Commissioner of Oaths

5. Proof of Registration with National Treasury Central Supplier Database (CSD)

6. Proof of Banking Details of the company

7. Certified ID copies of Director/s of the company

8. A valid VAT registration certificate (VAT103) submitted if applicable

14. Company profile of the entity (training service providers only)

15. Proof of accreditation where applicable (training service providers only)

16. The application document pack has been emailed to [email protected]

17. Submitted a copy of the application document pack to Insika Foundation via post or hand delivery

mailto:[email protected]