Tender number: 10047257
Contents
Information to be provided by partnerships (including individual consultants) 4
Information to be provided by legal persons 5
Information to be provided by candidate/bidding consortia (service delivery consortia) 5
Economic and financial capacity 6
Minimum requirements for references 6
Overview of reference projects 8
Technical assessment – weighted criteria 9
In the case of bidding consortia and subcontractors, this document must be completed and submitted for each subcontractor or each member of a candidate/bidding consortium.
I/we hereby declare:
General information on the tenderer or on the company authorised to represent a candidate/bidding consortium:
| Name | |
| Postal address | |
| Postcode and town/city | |
| Questions may be addressed to (including email address and telephone number): |
| I, or an expert proposed in the tender, currently hold(s) or previously heldan employment relationship with the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH or one of its predecessor organisations (including internships). I, or an expert proposed in the tender, am/is currently or was previously seconded as a development worker under the German Development Workers Act (Entwicklungshelfer-Gesetz). | [ ] NO [ ] YES, during the period as [ ] YES, GIZ company pensioner [ ] YES, staff member on leave of absence |
| I, or an expert proposed in the tender, or a company that qualifies as a related party, advised GIZ on the award procedure before it started or was involved in preparing the award procedure in another way. | [ ] NO [ ] YES, as follows: |
| For procurement statistics: Are you or is your partnership/company a small or medium-sized enterprise (SME)? You/your company is classified as an SME if it has fewer than 250 employees and an annual turnover of less than EUR 50 million. | [ ] YES [ ] NO |
Grounds for exclusion
Do any of the grounds for exclusion specified in Section 123 or Section 124 of the German Act against Restraints on Competition (GWB) apply in your case?
[ ] YES, under Section 123 GWB [ ] YES, under Section 124 GWB [ ] NO
If yes, please provide details:
If yes, have ‘self-cleaning measures’ under Section 125 GWB been taken?
[ ] YES [ ] NO
If yes, please describe the measure(s):
In the past three years, have you been sentenced to imprisonment of more than three months or a fine under criminal law of more than 90 daily rates or an administrative fine of more than EUR 2,500 based on the grounds for exclusion listed in Section 124 (2) GWB, resulting in an entry in the Central Trade and Industry Register (‘Gewerbezentralregister’) or the Competition Register ('Wettbewerbsregister')?
[ ] YES [ ] NO
If yes, have remedial measures been taken to re-establish reliability?
[ ] YES [ ] NO
If yes, please describe the measure(s):
In the past three years, has an administrative fine of EUR 175,000 or more been imposed due to a violation under Section 24 of the German Supply Chain Act (LkSG)?
[ ] YES [ ] NO
If yes, have ‘self-cleaning measures’ under Section 125 GWB been taken in accordance with Section 22 (1) LkSG?
[ ] YES [ ] NO
If yes, please describe the measure(s):
The Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH will assess the measures taken by the company and decide on a case-by-case basis whether there are grounds for exclusion.
The tenderer also undertakes to promptly inform GIZ if any of the circumstances or grounds for exclusion described above arises during the award procedure.
Precedence of GIZ clauses
The tenderer acknowledges the precedence of all clauses introduced by GIZ into the award procedure through the public tender documents and declares that no content other than that of the tender submitted, including but not limited to previous contracts, other documents and in particular the tenderer’s own general terms and conditions, will be made an integral part of the tender.
Information to be provided by partnerships (including individual consultants)
| Name at birth | |
| Place of birth | |
| Date of birth | |
| I am employed in the public sector. | [ ] NO [ ] YES, on paid leave of absence [ ] YES, on unpaid leave of absence |
In submitting this self-declaration (please check the appropriate box),
[ ] I declare and assure that over the past and next 12 months (ending/commencing on the date of submission of this declaration) I have received/will receive less than 5/6 of my total self-employed income from contracts with GIZ (variant 1).
[ ] I declare that I cannot exclude the possibility that over the past and next 12 months (ending/commencing on the date of submission of this declaration) I have received/will receive more than 5/6 of my total self-employed income from contracts with GIZ. I agree to provide further details of my income over the past 12 months and anticipated income over the next 12 months from self-employment and employment if requested by GIZ (variant 2).
Please note that if your income over the specified period exceeds the 5/6 threshold, you cannot be considered for this contract since full social insurance contributions could then be payable and GIZ could be obliged to deduct income tax. If you falsely declare that over the past and next 12 months you have received/will receive less than 5/6 of your total business income from contracts with GIZ (variant 1) or provide false information on this matter (variant 2), you may be liable to pay damages.
Information to be provided by legal persons
Please attach a copy of your current commercial register entry*/company register entry as a separate file. The copy must not be older than six months prior to the tender submission deadline.* In the case of candidate/bidding consortia, a self-declaration form and a copy of the commercial register entry/company register entry must be provided for each member. Further requirements are set out in section 5.2 of the application terms and conditions.
| Commercial register number / Register number: | |
| Legal form of the company | |
| Responsible court / Responsible public authority | |
| Is your company headquartered in Afghanistan, Belarus, Iran, North Korea, the Palestinian territories, Russia, the occupied regions of Ukraine or Syria? | [ ] YES, in: [ ] NO |
Information to be provided by candidate/bidding consortia (service delivery consortia)
Please attach the ‘Declaration by candidate/bidding consortium (consortium declaration)’ signed by all members as a separate file.
| Name, address | |
| Name, address | |
| Name, address |
Note: In the case of candidate/bidding consortia, all members of the consortium taken as a whole must meet the following eligibility criteria. A statement to this effect must be included in the self-declaration of the authorised lead candidate/bidder. This requirement also applies in the case of a capacity loan. Additionally, each member of a candidate/bidding consortium or other company within the meaning of Section 43 UVgO must submit a separate self-declaration.
Economic and financial capacity
Key company figures
Was your average net annual turnover for the entire business over the last three financial years at least EUR 40.000,00?
[ ] Yes [ ] No
Was the average number of employees and managers over the last three calendar years at least 3?
[ ] Yes [ ] No
Technical capacity
Proof of technical eligibility is provided by naming up to 10 reference projects. Please enter relevant details from the past three years in the table ‘Overview of reference projects’ in line with the required criteria. Candidate/bidding consortia should also enter details of up to 10 reference projects*.*
Candidate/bidding consortia may cite reference projects completed by a single member of the consortium. Candidates that do not meet these minimum criteria will be considered ineligible and excluded from the rest of the tender procedure.
Minimum requirements for references
The assessment of technical eligibility is based solely on reference projects with a minimum contract volume of EUR 15.000,00.
At least 3 reference project(s) in the field of product safety management, conformity assessment, market surveillance
and at least 2 reference project(s) in Europe in the last three years.
We hereby declare:
The minimum requirements for reference projects in the required technical field are fulfilled.
The corresponding reference project numbers (as per the table below) are: numbers
The minimum requirements for reference projects in the required region are fulfilled.
The corresponding reference project numbers (as per the table below) are: numbers
Overview of reference projects(only reference projects with the minimum contract volume stipulated above under ‘Minimum requirements for references’)
| No. | Project title | Commissioning party | Period[1] | Contract value in EUR | Country | Region/ country | Technical experience | ODA-financed[2] (Yes/No) | Project description (brief description of the content of the measure) |
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| 10 |
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Technical assessment – weighted criteria
The reference projects listed in the table above are weighted and assessed using the eligibility criteria given below.
| Criterion | Weighting in % |
| 1. Technical experience (up to five fields) 1.1 Please enter the criteria and weightings 1.2 1.3 1.4 1.5 | |
| 2. Regional experience in | |
| 3. Experience in development cooperation (ODA-financed) | |
| Total | 100* |
*In the assessment, a maximum of 10 points can be awarded for each criterion.
In submitting this document using the GIZ eProcurement Tender Platform, I/we confirm that the information provided above is complete and true.