05 - 10021232 - Request to participate and self-declaration of eligibility.docx

We wish to participate in the following GIZ procurement procedure:

Tender number: 10021232

Works/services tendered: Supporting the Financial Institutions Green Transition

Please submit only the information requested and do not enclose any additional annexes.

If you are submitting the self-declaration as part of a candidate/bidding consortium, you must provide all the required information for each member of the consortium in one document. In such cases, please complete the candidate/bidding consortium declaration provided in the procurement documents and submit it with the self-declaration.

The following Part A may be duplicated accordingly in this document for each member of a bidding consortium. Part C of this declaration shall be submitted only once in this document for all members combined.

If eligibility requirements are met through reliance upon the capacities of other entities in accordance with section 47 of the German Regulation on the Award of Public Contract (VgV), please submit an appropriate declaration of eligibility for this case (you can use the published template ‘Declaration of eligibility through reliance upon the capacities of other entities’).

We hereby declare:

A. Commercial eligibility

General statement of the company

Company name:

Company address:

Legal form:

Registered office (country):

Beneficial owners*:

*The EU Anti-Money Laundering Directive sets out how to identify ‘beneficial owners’ of a legal person or company. This directive was implemented in German law via the German Money Laundering Act (Geldwäschegesetz, GWG). In accordance with section 3 of the German Money Laundering Act (German only), a beneficial owner is defined as any natural person who holds a share of at least 25% in a company (German only). GIZ collects this information to ensure compliance with the German Foreign Trade and Payments Act (AWG) and meet eForms requirements.

Additional information

Commercial register number:

District court:

Submission of extracts from the commercial register is required. If you are participating in the procedure as part of a candidate/bidding consortium, submission of these extracts for all companies involved in the consortium is required. The date of issue of the extract from the commercial register must be no older than six months. The excerpts must be submitted in the same language as the self-declaration or in German. If the evidence is in another language only, the original(s) must be submitted together with translations into the language of the procurement procedure.

Brief company profile (max. 20 lines)

Contact in event of queries

Name:

Email:

Tel. no.:

Key financial data

Company size as defined by the Federal Statistical Office (only one applicable option):

Grounds for exclusion

Do any of the grounds for exclusion specified in section 123 of the German Act against Restraints on Competition (GWB) apply in your case?

[ ] YES [ ] NO

If yes, please provide details:

If yes, have self-cleaning measures as specified in section 125 of the German Act against Restraints on Competition (GWB) been taken by the company?

[ ] YES [ ] NO

If yes, please describe the measure taken:

Do any of the grounds for exclusion specified in section 124 (1) of the German Act against Restraints on Competition (GWB) apply in your case?

[ ] YES [ ] NO

If yes, please provide details:

If yes, have self-cleaning measures as specified in section 125 of the German Act against Restraints on Competition (GWB) been taken by the company?

[ ] YES [ ] NO

If yes, please describe the measure taken:

In the last three years, has a custodial sentence of more than three months or a fine of more than 90 daily rates or a fine of more than two thousand five hundred euros, which resulted in an entry in the Competition Register, been imposed on you for noncompliance as specified in section 124 (2) of the German Act against Restraints on Competition (GWB)?

[ ] YES [ ] NO

If yes, have self-cleaning measures been taken by the company?

[ ] YES [ ] NO

If yes, please describe the measure taken:

GIZ will assess the measure taken by the company and decide on a case‑by‑case basis whether exclusion is warranted.

We also undertake to inform GIZ without delay if one of the grounds for exclusion pursuant to sections 123 and 124 (1) of the German Act against Restraints on Competition (GWB), which resulted in an entry in the Competition Register, arises during the procurement procedure or if a custodial sentence of more than three months or a fine of more than 90 daily rates or a fine of more than two thousand five hundred euros is imposed on us during the procurement procedure for non-compliance as specified in section 124 (2) of the German Act against Restraints on Competition (GWB).

Do any of the grounds for exclusion specified in section 22 of the German Supply Chain Due Diligence Act (LkSG) apply in your case?

[ ] YES [ ] NO

If yes, please provide details:

If yes, have self-cleansing measures as specified in section 22 (1) LkSG and section 125 GWB been taken by the company?

[ ] YES [ ] NO

If yes, please describe the measure taken:

EU-Russia sanctions

We hereby submit the following binding declaration (if applicable, also on behalf of the persons represented in the request to participate/offer):

1.) The candidate(s) / tenderer(s) does/do not qualify as (a) person(s), entity(ies) or body(ies) with a connection to Russia referred to in Article 5 k) (1) of Council Regulation (EU) No. 833/2014 in its current version concerning restrictive measures in view of Russia’s actions destabilising the situation in Ukraine,

1. by the Russian nationality of the candidate/tenderer or the establishment of the candidate/tenderer in Russia,
2. by a natural person, entity, or body to which one of the criteria referred to in letter (a) applies holding a stake in the candidate/tenderer by owning proprietary rights of more than 50%,
3. by the candidate/tenderer acting on behalf or at the direction of persons, entities, or bodies to which the criteria referred to in letters (a) and/or (b) apply.

2.) Companies involved in the contract as subcontractors, suppliers or companies whose capacities are used in connection with the provision of proof of eligibility which account for more than 10% of the contract value also do not belong to the group of persons with a connection to Russia within the meaning of the provision and are not subject to EU sanctions, such as those imposed on the persons listed in Annex I to Regulation (EU) No 269/2014, nor are they owned or controlled by any of the persons listed. The criterion to be taken into account when assessing whether a legal person or organisation is owned by another person or organisation is the holding of more than 50% of the ownership rights in an organisation or a majority stake in it.

.

3.) We confirm and will ensure, including but not limited to the term of the contract, that no companies with a connection to Russia within the meaning of the regulation will be involved as subcontractors, suppliers or companies whose capacities are used in connection with the provision of the proof of eligibility, where such companies account for more than 10% of the contract value.

[ ] We hereby certify that we have taken note of the declaration set out above and that it is deemed to have been submitted to the contracting authority upon submission of this document via the GIZ award platform (a signature is not required).

B. Prevailing validity of GIZ’s regulations

We undertake to recognise that all provisions applied by GIZ in relation to the procurement documents used in the procurement procedure shall prevail and hereby declare that, other than the information we submit in our tender, no other content – from previous contracts or other sources for instance, above all our own general terms and conditions of business – shall be deemed to constitute an integral component of our tender.

C. Technical information

Technical eligibility (see Section A. II. of the assessment grid for the eligibility of tenderers)

Evidence of technical eligibility is to be provided on the basis of the criteria specified in the assessment grid [see the grid for assessing the eligibility of candidates in all procedures, A. II. Assessment of technical eligibility (Minimum criteria)].

The following are required as evidence of technical eligibility:

At least 3 references of which 2 in cooperating with financial institutions on MSME sustainable finance, of which 1 on project proposal development for climate finance in cooperation with financial service providers in the last 36 months (reference date: date of publication of this tender) that had a minimum commission value of EUR 100,000.00 (net) (exclusion criterion).

At least 1 reference in the region of in Jordan in the above-mentioned technical fields in the last 36 months (reference date: date of publication of this tender) that had a minimum commission value of EUR 100,000.00 (net) (exclusion criterion).

If references of a subcontractor are provided, a corresponding ‘Declaration of eligibility through reliance upon the capacities of other entities’ must be submitted with the self-declaration. (For this purpose, you can use the published template ‘Declaration of eligibility through reliance upon the capacities of other entities’). Only references with the required minimum commission value in the amount of EUR 100,000.00 (net) will be assessed.

Only ongoing reference projects and reference projects that have finished in the last 36 months (reference date: date of publication of this tender) will be assessed. If a reference fulfils both the criteria for the technical field and for the region/country, it will be used to assess both criteria.

Reference projects will be evaluated only if the reference project description clearly explains why the reference meets the required technical eligibility criterion and makes it possible to clearly assign the reference to a required eligibility criterion (see Table 2 column 9).

Candidates / tenderers that fail to meet the specified criteria will be classed as technically ineligible and excluded from the remaining tender process.

Technical assessment – weighted criteria (see Section B of the assessment grid for the eligibility of tenderers)

A technical ranking on the basis of the assessment criteria listed in Section B. (III. “Weighted criteria”) of the assessment grid for the eligibility of tenderers will be used to obtain the named number of 5 tenderers that will be requested to submit a tender. This will be applied in cases where more than 5 requests to participate that meet the above minimum requirements for tenderer eligibility have been received.

More than the required number of references may be provided but the number of 10**references should not be exceeded. If you are participating in the procedure as part of a candidate/bidding consortium, please note that the total number of references for all members of the consortium combined should not exceed 10*.*

Only references that have the required minimum commission value of EUR 100,000.00 (net) will be assessed.

Only references that have started and/or finished in the last 36 months (reference date: date of publication of this tender) will be assessed. If a reference project satisfies both the minimum criteria and the weighted criteria, it will be counted for both assessments.

Only reference projects will be assessed if the reference project description clearly explains why the reference meets the required technical eligibility criterion and makes it possible to clearly assign the reference to a required eligibility criterion (see Table 2 column 9).

The maximum number of points that can be achieved per weighted criterion is 10 points*.*

Table 2: Overview of references

*official development assistance

We hereby confirm that the details provided above are complete and true and request to participate in this procurement procedure.