ANNEX 1 – to Request for Tender no. 2/05/2017/CD20 dated 22.05.2017
FORM OF TENDER
(template)
I.
Name and address of tenderer and its registration details, including NIP (tax ID):
…………………………………
…………………………………
…………………………………
II.
Name, phone number and e-mail of the contact person:
…………………………………………
………………………………………..
………………………………………..
III.
Information about proposed analytical methods:
Target
Compound:
Analytical
Method:
Qualification/
Validation status
LOD, LLOQ, if
concerns
Acceptance
criteria
IV.
Information about quality system used in Tenderer’s facility
V.
Value of the tender as per the wording of the tender evaluation criterion for price:
a. Net price: ……………………… [in words: ……………………………………………………………..…….]
b. Gross price: ……………………. [in words: ……………………………………………………...………….]
VI.
The date of commencement of work, from the moment of signing the agreement:
VII.
Execution time of object of the contract ( from analysis performance to final repot deliver) considered in evaluation criteria
VIII.
End date of tender validity period:
XX.XX.2017
IX.
I agree to:
a. place the following point to the contract:
“In case of any error occurring, that may affect final results; the Performer
is obligated to find optimal solution that will provide satisfactory results (meeting the initial
arrangements). Samples repetition should be carry out without additional quotation for
within initial timelines”
□ YES
□ NO
b. allow a delegated person from Contracting Entity Company to carry out visit
to make sure the Tender’s company is able to deliver results of appropriate quality before
cooperation starts
□ YES
□ NO
X.
Validity of tenders
I decelerate, that following tender is valid for 90 days from the deadline for submission
of tenders.
Place and date: ………………………..
…..………………………………………………………………….…..
Signature of Tenderer or Tenderer's authorised representative
and company seal (if Tenderer is an entity that runs business activity)
ANNEX 2 – to Request for Tender no. 2/05/2017/CD20 dated 22.05.2017
STATEMENT ON THE ABSENCE OF PERSONAL OR CAPITAL LINKS
I, the undersigned ……………………………………………………………………………………………………………....., [name
and
surname
of
Tenderer
or
its
authorised
representative],
declare
that
……………………………………………………………………………………………………………………………………………….. [name
of tenderer] has / I have no personal or capital links with Contracting Entity.
Capital or personal links are understood as mutual ties between Contracting Entity
or persons authorised to bind Contracting Entity or persons who act on behalf of Contracting Entity in
connection
with
preparing
and
conducting
the
procedure
for
selection
of
a contractor, and the contractor, which are in particular the following:
1.
participation in a partnership as a partner of a civil law partnership or general partnership,
2.
holding a least 10% of shares,
2.
serving as a member of a supervisory body or a managing body, acting as a registered
representative (prokurent) or an attorney,
3.
being a spouse, a relative by lineal consanguinity or affinity, by collateral consanguinity to the
2nd degree or affinity to the 2nd degree, or a person linked by way
of adoption, custody or legal guardianship.
Place and date: ………………………..
..………………………………………………………………….…..
Signature of Tenderer or Tenderer's authorised representative
and company seal (if Tenderer is an entity that runs business activity)
ANNEX 3 – to Request for Tender no. 2/05/2017/CD20 dated 22.05.2017
STATEMENT ON FULFILLING THE FORMAL REQUIREMENTS FOR PARTICIPATION IN THE PROCEDURE
I, the undersigned
…………………………………………………………………………………………………….………….....,
[name and surname of Tenderer or its authorised representative], declare that ………………………………….
[name of tenderer]
1) have/ has the appropriate knowledge and experience to perform the contract in the
highest standards
2) have/ has a financial situation that guarantees the performance of the whole order
Place and date: ………………………..
…..………………………………………………………………….…..
Signature of Tenderer or Tenderer's authorised representative
and company seal (if Tenderer is an entity that runs business activity)