ANNEXURE B

SBD 4

DECLARATION OF INTEREST
1. Any legal person, including persons employed by the state¹, or persons having a kinship with
persons employed by the state, including a blood relationship, may make an offer or offers in
terms of this invitation to bid (includes an advertised competitive bid, a limited bid, a proposal
or written price quotation). In view of possible allegations of favouritism, should the resulting
bid, or part thereof, be awarded to persons employed by the state, or to persons connected
with or related to them, it is required that the bidder or his/her authorised representative
declare his/her position in relation to the evaluating/adjudicating authority where-

- the bidder is employed by the state; and/or

- the legal person on whose behalf the bidding document is signed, has a relationship
with persons/a person who are/is involved in the evaluation and or adjudication of the
bid(s), or where it is known that such a relationship exists between the person or
persons for or on whose behalf the declarant acts and persons who are involved with
the evaluation and or adjudication of the bid.

2. In order to give effect to the above, the following questionnaire must be completed
and submitted with the bid.

2.1 Full Name of bidder or his or her representative:

………………………………………………………….

• Identity
Number:………………………………………………………………………………………………...

• Position occupied in the Company (director, trustee, shareholder², member):

……………………………………………………………………………………………………………
……….

• Registration number of company, enterprise, close corporation, partnership agreement or

trust:
………………………………………………………………………..………….………………………
……….

• Tax Reference Number:

………………………………………………………………………………………

• VAT Registration Number:

………………………………………………………………………………....
2.6.1 The names of all directors / trustees / shareholders / members, their individual identity
numbers, tax reference numbers and, if applicable, employee / PERSAL numbers must be
indicated in paragraph 3 below.
¹“State” means –
(a) any national or provincial department, national or provincial public entity or constitutional institution within the meaning of the Public
Finance Management Act, 1999 (Act No. 1 of 1999);
(b) any municipality or municipal entity;
 (c) provincial legislature;
(d) national Assembly or the national Council of provinces; or
(e) Parliament.

²”Shareholder” means a person who owns shares in the company and is actively involved in the management of the enterprise or business and exercises
control over the enterprise.

2.7 Are you or any person connected with the bidder YES / NO
presently employed by the state?

• If so, furnish the following particulars:

Name of person / director / trustee / shareholder/ member:

……....………………………………
Name of state institution at which you or the person
connected to the bidder is employed :
………………………………………
Position occupied in the state institution:
………………………………………

Any other particulars:

………………………………………………………………
………………………………………………………………
………………………………………………………………

• If you are presently employed by the state, did you obtain YES / NO
the appropriate authority to undertake remunerative
work outside employment in the public sector?

• If yes, did you attach proof of such authority to the bid YES / NO
document?

(Note: Failure to submit proof of such authority, where

applicable, may result in the disqualification of the bid.

• If no, furnish reasons for non-submission of such proof:

…………………………………………………………………….
…………………………………………………………………….
…………………………………………………………………….

• Did you or your spouse, or any of the company’s directors / YES / NO

trustees / shareholders / members or their spouses conduct
business with the state in the previous twelve months?

• If so, furnish particulars:

…………………………………………………………………..
…………………………………………………………………..
…………………………………………………………………...

• Do you, or any person connected with the bidder, have YES / NO

 any relationship (family, friend, other) with a person
employed by the state and who may be involved with
the evaluation and or adjudication of this bid?
2.9.1 If so, furnish particulars.
……………………………………………………………...
…………………………………………………………..….
………………………………………………………………

2.10 Are you, or any person connected with the bidder, YES/NO
aware of any relationship (family, friend, other) between
any other bidder and any person employed by the state
who may be involved with the evaluation and or adjudication
of this bid?

2.10.1 If so, furnish particulars.

………………………………………………………………
………………………………………………………………
………………………………………………………………

2.11 Do you or any of the directors / trustees / shareholders / members YES/NO

of the company have any interest in any other related companies
whether or not they are bidding for this contract?

2.11.1 If so, furnish particulars:

…………………………………………………………………………….
…………………………………………………………………………….
…………………………………………………………………………….

• Full details of directors / trustees / members / shareholders.

Full Name Identity Personal State Employee

Number Income Tax Number /
Reference Persal Number
Number
4 DECLARATION

I, THE UNDERSIGNED (NAME)………………………………………………………………………

CERTIFY THAT THE INFORMATION FURNISHED IN PARAGRAPHS 2 and 3 ABOVE IS

CORRECT.
I ACCEPT THAT THE STATE MAY REJECT THE BID OR ACT AGAINST ME SHOULD THIS
DECLARATION PROVE TO BE FALSE.

………………………………….. ..……………………………………………
Signature Date

…………………………………. ………………………………………………
Position Name of bidder

November 2011
 SBD 8

DECLARATION OF BIDDER’S PAST SUPPLY CHAIN MANAGEMENT

PRACTICES

1 This Standard Bidding Document must form part of all bids invited.

2 It serves as a declaration to be used by institutions in ensuring that when goods

and services are being procured, all reasonable steps are taken to combat the
abuse of the supply chain management system.

3 The bid of any bidder may be disregarded if that bidder, or any of its directors
have-

a. abused the institution’s supply chain management system;

b. committed fraud or any other improper conduct in relation to such system; or
c. failed to perform on any previous contract.

4 In order to give effect to the above, the following questionnaire must be

completed and submitted with the bid.

Item Question Yes No

4.1 Is the bidder or any of its directors listed on the National Treasury’s Database of Yes No
Restricted Suppliers as companies or persons prohibited from doing business with the
public sector?
(Companies or persons who are listed on this Database were informed in writing
of this restriction by the Accounting Officer/Authority of the institution that
imposed the restriction after the audi alteram partem rule was applied).

The Database of Restricted Suppliers now resides on the National Treasury’s

website(www.treasury.gov.za) and can be accessed by clicking on its link at the
bottom of the home page.

4.1.1 If so, furnish particulars:

4.2 Is the bidder or any of its directors listed on the Register for Tender Defaulters in Yes No
terms of section 29 of the Prevention and Combating of Corrupt Activities Act (No 12
of 2004)?
The Register for Tender Defaulters can be accessed on the National Treasury’s
website (www.treasury.gov.za) by clicking on its link at the bottom of the home
page.

4.2.1 If so, furnish particulars:

4.3 Was the bidder or any of its directors convicted by a court of law (including a court Yes No
outside of the Republic of South Africa) for fraud or corruption during the past five
years?

4.3.1 If so, furnish particulars:

4.4 Was any contract between the bidder and any organ of state terminated during the past Yes No
five years on account of failure to perform on or comply with the contract?
4.4.1 If so, furnish particulars:

SBD 8

CERTIFICATION

I, THE UNDERSIGNED (FULL NAME)…………………………………………………

CERTIFY THAT THE INFORMATION FURNISHED ON THIS DECLARATION
FORM IS TRUE AND CORRECT.

I ACCEPT THAT, IN ADDITION TO CANCELLATION OF A CONTRACT,

ACTION MAY BE TAKEN AGAINST ME SHOULD THIS DECLARATION
PROVE TO BE FALSE.

………………………………………... …………………………..
Signature Date

………………………………………. …………………………..
Position Name of Bidder
Js365bW
 SBD 9
CERTIFICATE OF INDEPENDENT BID DETERMINATION

1 This Standard Bidding Document (SBD) must form part of all bids¹ invited.

2 Section 4 (1) (b) (iii) of the Competition Act No. 89 of 1998, as amended, prohibits an
agreement between, or concerted practice by, firms, or a decision by an association of
firms, if it is between parties in a horizontal relationship and if it involves collusive
bidding (or bid rigging).² Collusive bidding is a pe se prohibition meaning that it cannot
be justified under any grounds.

3 Treasury Regulation 16A9 prescribes that accounting officers and accounting authorities
must take all reasonable steps to prevent abuse of the supply chain management
system and authorizes accounting officers and accounting authorities to:

a. disregard the bid of any bidder if that bidder, or any of its directors have abused
the institution’s supply chain management system and or committed fraud or any
other improper conduct in relation to such system.

b. cancel a contract awarded to a supplier of goods and services if the supplier

committed any corrupt or fraudulent act during the bidding process or the
execution of that contract.

4 This SBD serves as a certificate of declaration that would be used by institutions to

ensure that, when bids are considered, reasonable steps are taken to prevent any form
of bid-rigging.
5 In order to give effect to the above, the attached Certificate of Bid Determination (SBD 9)
must be completed and submitted with the bid:

¹ Includes price quotations, advertised competitive bids, limited bids and proposals.

² Bid rigging (or collusive bidding) occurs when businesses, that would otherwise be expected to compete, secretly conspire to raise prices or
lower the quality of goods and / or services for purchasers who wish to acquire goods and / or services through a bidding process. Bid
rigging is, therefore, an agreement between competitors not to compete.

1
 SBD 9

CERTIFICATE OF INDEPENDENT BID DETERMINATION

I, the undersigned, in submitting the accompanying bid:

(Bid Number and Description)

in response to the invitation for the bid made by:

______________________________________________________________________________
(Name of Institution)

do hereby make the following statements that I certify to be true and complete in every respect:

I certify, on behalf of:_______________________________________________________that:

(Name of Bidder)
1. I have read and I understand the contents of this Certificate;
2. I understand that the accompanying bid will be disqualified if this Certificate is found not
to be true and complete in every respect;
3. I am authorized by the bidder to sign this Certificate, and to submit the accompanying
bid, on behalf of the bidder;
4. Each person whose signature appears on the accompanying bid has been authorized by
the bidder to determine the terms of, and to sign the bid, on behalf of the bidder;
5. For the purposes of this Certificate and the accompanying bid, I understand that the
word “competitor” shall include any individual or organization, other than the bidder,
whether or not affiliated with the bidder, who:

(a) has been requested to submit a bid in response to this bid invitation;
(b) could potentially submit a bid in response to this bid invitation, based on
their qualifications, abilities or experience; and
(c) provides the same goods and services as the bidder and/or is in the same
line of business as the bidder

2
 SBD 9

6. The bidder has arrived at the accompanying bid independently from, and without
consultation, communication, agreement or arrangement with any competitor. However

communication between partners in a joint venture or consortium³ will not be construed

as collusive bidding.
7. In particular, without limiting the generality of paragraphs 6 above, there has been no
consultation, communication, agreement or arrangement with any competitor regarding:
(a) prices;
(b) geographical area where product or service will be rendered (market
allocation)
(c) methods, factors or formulas used to calculate prices;
(d) the intention or decision to submit or not to submit, a bid;
(e) the submission of a bid which does not meet the specifications and
conditions of the bid; or
(f) bidding with the intention not to win the bid.
8. In addition, there have been no consultations, communications, agreements or
arrangements with any competitor regarding the quality, quantity, specifications and
conditions or delivery particulars of the products or services to which this bid invitation
relates.
9. The terms of the accompanying bid have not been, and will not be, disclosed by the
bidder, directly or indirectly, to any competitor, prior to the date and time of the official
bid opening or of the awarding of the contract.

³ Joint venture or Consortium means an association of persons for the purpose of combining their expertise, property, capital, efforts, skill
and knowledge in an activity for the execution of a contract.

3
 SBD 9

10. I am aware that, in addition and without prejudice to any other remedy provided to
combat any restrictive practices related to bids and contracts, bids that are suspicious
will be reported to the Competition Commission for investigation and possible imposition
of administrative penalties in terms of section 59 of the Competition Act No 89 of 1998
and or may be reported to the National Prosecuting Authority (NPA) for criminal
investigation and or may be restricted from conducting business with the public sector
for a period not exceeding ten (10) years in terms of the Prevention and Combating of
Corrupt Activities Act No 12 of 2004 or any other applicable legislation.

………………………………………………… …………………………………
Signature Date

…………………………………………………. …………………………………
Position Name of Bidder
Js914w 2