AUTOMOBILE ASSOCIATION OF KENYA
PRE-QUALIFICATION/REGISTRATION OF
SUPPLIERS
SUPPLY OF GOODS, SERVICES AND WORKS FOR
THE FINANCIAL YEAR 2019/2020
DATE POSTED: 12th SEPTEMBER 2019
CLOSING DATE/TIME: 24th SEPTEMBER 2019 AT
12 NOON
Table of Contents
1.
PRE-QUALIFICATION NOTICE ..................................................................... 1
2.
CATEGORIES OF GOODS, SERVICES AND WORKS .............................................. 2
3.
PRE-QUALIFICATION INSTRUCTIONS ............................................................ 4
4.
BRIEF CONTRACT REGULATIONS/GUIDELINES ................................................ 5
5.
PRE-QUALIFICATION DATA INSTRUCTIONS ..................................................... 6
6.
FORM PQ-1: PRE-QUALIFICATION DOCUMENTS ................................................ 8
7.
FORM PQ-2: PRE-QUALIFICATION DATA ........................................................ 9
8.
PQ-3: FINANCIAL POSITION AND TERMS OF TRADE .......................................... 11
9.
FORM PQ-4: CONFIDENTIAL BUSINESS QUESTIONNAIRE FORM.............................. 12
10. FORM PQ 5: PAST EXPERIENCE.................................................................. 14
11. FORM PQ-6: LITIGATION HISTORY .............................................................. 15
12. FORM PQ -7: FIRM’S DECLARATION ............................................................ 16
13. FORM PQ 8: INTEGRITY DECLARATION FORM ................................................. 17
1. PRE-QUALIFICATION NOTICE
PRE-QUALIFICATION OF SUPPLIERS FOR SUPPLY OF GOODS, SERVICES AND WORKS FOR
FINANCIAL YEARS 2018/2019
AA Kenya invites application from interested and eligible bidders for the prequalification/registration as supplier(s) of goods, services and works for the financial
2019/2020.
The pre-qualification tender documents, containing submission information, detailed terms
and conditions of qualification may be obtained from the AA Kenya website
www.aakenya.co.ke
Completed pre-qualification documents in plain sealed envelopes clearly marked on the
envelope;
PRE-QUALIFICATION OF SUPPLIERS 2019/2020
TENDER NUMBER/S
………………………………………………………………….
SUPPLY OF
………………………………………………………………….
Addressed to:
The Procurement Committee
Automobile Association of Kenya
P.O, BOX 40087-00100
Renaissance Corporate Park
Elgon Road, Upper Hill
Nairobi
And be deposited in the tender box located on 8th floor so as to be received on or before
12 noon on Tuesday, 24th September 2019. All bidders must pay a non-refundable fee of
KES. 3,000 via PayBill Number 552692 (Receipt to be included in bid documents)
Documents will be opened immediately thereafter in the presence of bidders or their
representatives who choose to attend.
Enquiries and requests for clarification may be directed through email on
tenders@aakenya.co.ke
Automobile Association of Kenya
1
2. CATEGORIES OF GOODS, SERVICES AND WORKS
CATEGORY A - GENERAL OFFICE SUPPLIES AND SERVICES - AAK/A/2019-2020
N0.
DOCUMENT NUMBER
DESCRIPTION
1
AAK/A/PREQ/01/19-20
2
AAK/A/PREQ/02/19-20
3
AAK/A/PREQ/03/19-20
4
AAK/A/PREQ/04/19-20
5
AAK/A/PREQ/05/19-20
Supply and delivery of General Office Stationery: Bond Papers, Branded Pens
and Printed Materials (Branded Notebooks, Envelopes and Notepads)
Supply and delivery of Computer Consumables/Toners/ Ink and Related
Accessories
Supply and delivery of Computers, Laptops, UPS, ESD Machines, Shredders,
Printers/Scanners, Copiers & Computer Spare Parts
Supply and delivery of Branded Attire and Marketing Materials e.g. Polo
Shirts, Fleece Jackets, Caps, T-Shirts, Banners, Gift Bags, Carrier Bags,
Umbrellas, Customised Gifts Packs etc.
Supply of Branded Uniforms
6
AAK/A/PREQ/06/19-20
Supply and delivery of Office Furniture, Fittings and Fixtures
7
AAK/A/PREQ/07/19-20
Supply of Signage, Billboards, Directional Signs and Instructional Signs
8
AAK/A/PREQ/08/19-20
Supply and delivery of Cleaning Materials, Detergent and Toiletries
9
AAK/A/PREQ/09/19-20
10
AAK/A/PREQ/10/19-20
Supply & Printing of brochures, Certificates, International Driving Permits,
Plastic Membership Cards, Staff IDs, Business Cards, Visitor Passes, Car Passes
and other printed documents
Supply, Installation & Maintenance of CCTV Equipment
11
AAK/A/PREQ/11/19-20
Supply of Customized Branded Mineral water
12
AAK/A/PREQ/12/19-20
Supply & Installation of GPRS/GIS Equipment
13
AAK/A/PREQ/13/19-20
Supply of Electrical Appliances and Fittings
14
AAK/A/PREQ/14/19-20
Supply of Office Cooling Appliances (Air Conditioning)
15
AAK/A/PREQ/15/19-20
Supply of Airtime, Phones and Scratch Cards
16
AAK/A/PREQ/16/19-20
Supply of Generators
17
AAK/A/PREQ/17/19-20
Provision of Reverse Osmosis Plant Water Treatment Chemicals
18
AAK/A/PREQ/18/19-20
Provision of Toilet Dispensers/Hand Dryers/Liquid Soap Dispensers
19
AAK/A/PREQ/19/19-20
Provision of Firefighting, Fire Protection Equipment and Fire Directional Signs
20
AAK/A/PREQ/20/19-20
Provision of IP Telephony & Call Centre Services
21
AAK/A/PREQ/21/19-20
23
AAK/B/PREQ/23/19-20
Provision of Pest Control & Fumigation Services
24
AAK/B/PREQ/24/19-20
25
AAK/B/PREQ/25/19-20
26
AAK/B/PREQ/26/19-20
Provision of Repair & Maintenance of Servers, Computers, Laptops, Storage,
Printers, Copiers, Projectors, Antivirus and other ICT Equipment’s
Provision of Repair and Maintenance of Network Equipment, Data
Communication and Fire Wall
Provision of Plumbing Services
27
AAK/B/PREQ/27/19-20
Provision of Toner Refill Services
28
AAK/B/PREQ/28/19-20
Provision of Furniture Repair Services
29
AAK/B/PREQ/29/19-20
30
AAK/B/PREQ/30/19-20
Provision of Staff Medical Insurance Cover, WIBA, Group Life Cover, Group
Personal Accident, Motor Vehicle Insurance (2020-2021)
Provision of Phone Maintenance and Repair Services
31
AAK/B/PREQ/31/19-20
Provision of Freight Services
Supply & Delivery of Road Sign Boards, Model Town Boards (NTSA Standards)
& Road Cones
22 AAK/A/PREQ/22/19-20 Supply of Protective Clothing e.g. Dustcoats, Overalls, Safety Footwear,
Safety Gloves, Torches etc.
CATEGOTY B - SUPPLY OF SERVICES - AAK/B/2019-2020
2
32
AAK/B/PREQ/32/19-20
Provision of Electrical Services: Category – NCA 8
33
AAK/B/PREQ/33/19-20
Maintenance & Repair of Air Conditioning (AC)
34
AAK/B/PREQ/34/19-20
Provision of Travel Agency Services (IATA certified only)
35
AAK/B/PREQ/35/19-20
Provision of Sanitary Bins Disposal Services
36
AAK/B/PREQ/36/19-20
Provision of Borehole Maintenance Services
37
AAK/B/PREQ/37/19-20
Provision of Courier Services in the AA Kenya Country-Wide Network.
38
AAK/B/PREQ/38/19-20
39
AAK/B/PREQ/39/19-20
40
AAK/B/PREQ/40/19-20
41
AAK/B/PREQ/41/19-20
42
AAK/B/PREQ/42/19-20
43
AAK/B/PREQ/43/19-20
Provision of Reverse Osmosis Plant Maintenance Services and Water Dispenser
Maintenance Services
Provision of Event Management, Conference Facilities, Exhibition & Décor
Services
Provision of Building Works (Office Fit Out, Interior Design and Renovation
Works per region as per the AA branch network): Category – NCA 7
Provision of Garbage Collection and Sewage Exhauster Services(AA House Embakasi)
Provision of repair services for Office Computers, Laptops, Equipment and
Printing Machines
Provision of Generator Service and Repair
44
AAK/B/PREQ/44/19-20
Provision of Hologram Machines Maintenance and Repair Services
45
AAK/B/PREQ/45/19-20
Provision of Catering Services (Outsourced Tea & Food)
46
AAK/B/PREQ/46/19-20
Provision of Bulk SMS Services/Solution and Support
47
AAK/B/PREQ/47/19-20
Provision of Hotel Services, Accommodation and Conference Facilities
48
AAK/B/PREQ/48/19-20
Provision of Security Guard Services in selected branches
49
AAK/C/PREQ/49/19-20
Provision of Cleaning Services in selected branches
50
AAK/D/PREQ/50/19-20
Provision of Firefighting Equipment Servicing Serves
51
AAK/D/PREQ/51/19-20
Provision of Photography and Video Production Services
CATEGORY C: PROVISION OF PROFESSIONAL SERVICES AND CONSULTANCIES- AAK/C/2019-2020
52
AAK/E/PREQ/52/19-20
Provision of Legal Services
53
AAK/E/PREQ/53/19-20
Provision of Training Services
54
AAK/E/PREQ/54/19-20
Provision of Recruitment Services
55
AAK/E/PREQ/55/19-20
Provision of Background Screening Services
56
AAK/E/PREQ/56/19-20
Provision of Health and Safety Audits
57
AAK/E/PREQ/57/19-20
Provision of Market Research and Consumer Satisfaction Surveys
58
59
CATEGORY D: SUPPLY OF MOTOR VEHICLE RELATED SERVICES - AAK/D/2019 -2020
AAK/E/PREQ/58/19-20 Provision of Rescue & Towing Agency Services
AAK/E/PREQ/59/19-20 Provision of Appointed Garage Services (in our branch network)
CATEGORY E: SUPPLY OF MOTOR VEHICLE SPARE PARTS AND SERVICES - AAK/D/2019 -2020
AAK/E/PREQ/60/19-20 Supply and delivery of New Motor Vehicle Spare Parts for Isuzu NPR and NQR
Models
61 AAK/E/PREQ/61/19-20 Supply and delivery of New Motor Vehicle Spare Parts for Toyota/Datsun
1200/1400, Mercedes Benz 911, among other Japanese Model Vehicles
62 AAK/E/PREQ/62/19-20 Supply and delivery of (Ex Japan) General Used Motor Vehicle Spare Parts for
Isuzu, Toyota, and Mercedes Benz 911 model of vehicles.
63 AAK/E/PREQ/63/19-20 Supply and delivery of New Motor Vehicle Tyres and Tubes: 750 R16, 8.25 R
16,950 R 17.5,185 R 13,185 R 14,195 /65 R 15 & 265/65 R 17 & 165R 13.
64 AAK/E/PREQ/64/19-20 Supply and Delivery of Motor Vehicle Batteries: N70, NS70,N40 & N100 - Both
Dry and Wet
65 AAK/E/PREQ/65/19-20 Supply of General Motor Vehicle Engineering Services e.g. Design, Threading,
Skimming, Crankshaft Grinding, Re-Bonding
66 AAK/D/PREQ/66/19-20 Spray Painting of New Vehicles (Saloon & Trucks)
60
3
67
AAK/E/PREQ/67/19-20
Supply of Petroleum Products (Fuel) and Lubricants
68
AAK/E/PREQ/68/19-20
69
AAK/E/PREQ/69/19-20
70
AAK/B/PREQ/70/19-20
Supply of Motorcycles, Motorcycle Parts, Service and Repairs (Yamaha & Hero
hunk)
Supply of Branded Safety Wear Riding Boots, Chest Guard, Riding Suit &
Gloves, Helmets
Provision of Vehicle Upholstery & Cushion Repair Services
71
AAK/B/PREQ/71/19-20
Supply of Automotive Workshop Tools and Machines
72
AAK/B/PREQ/72/19-20
Supply of Towing Winches, Towing Ropes and Ratchet Straps
73
AAK/B/PREQ/73/19-20
Supply of Welding Tools and Consumables (Gas)
74
AAK/B/PREQ/74/19-20
Supply of Motor Vehicle Electrical Parts (Both New and ex-Japan)
75
AAK/B/PREQ/75/19-20
Supply of Motor Vehicle Dual Control Cables and Services
76
AAK/B/PREQ/76/19-20
Provision of Radiator Repair Services
77
AAK/B/PREQ/77/19-20
Supply of New Speed Governors and Speed Governor Repair Services
78
AAK/B/PREQ/78/19-20
Supply of Portable Pressure Pumps
79
AAK/B/PREQ/79/19-20
Supply of Puncture Repair Kits
80
AAK/B/PREQ/80/19-20
Supply of Vehicle Diagnostic Tools
81
AAK/B/PREQ/81/19-20
Supply of Car Accessories
82
AAK/B/PREQ/82/19-20
Supply of Vehicle Tracking Devices
83
AAK/B/PREQ/83/19-20
Supply of Vehicle Tracking Hardware
84
AAK/B/PREQ/84/19-20
Supply of Power Converters
3. PRE-QUALIFICATION INSTRUCTIONS
3.1.Introduction
AA Kenya would like to invite interested candidates who must qualify by meeting the set
criteria as provided in this pre-qualification document to supply and deliver Goods and
Services.
3.2.Pre-Qualification Objective
The main objective is to supply and deliver assorted goods and services under relevant tenders
to AAK as and when required during the stated period.
3.3.Invitation of Pre-qualification
Suppliers registered with Register of Companies under the Laws of Kenya and the relevant
Government Ministry in respective merchandise or services are invited to submit their Prequalification documents so that they may be pre-qualified for submission of quotations.
Prequalification documents will be submitted in complete lots singly or in combination. The
prospective suppliers are required to supply mandatory information for pre-qualification.
4
3.4.Experience
Prospective suppliers and contractors must have carried out successful supply and delivery of
similar items/services to Government/County /Institutions similar size and complexity.
Potential suppliers/contractors must demonstrate the willingness and commitment to meet
the pre-qualification criteria.
3.5.Pre-Qualification Document
This document includes questionnaire forms and documents required of prospective
suppliers.
In order to be considered for pre-qualification, prospective suppliers must submit all the
information herein requested.
3.6.Submission Address for the Pre-Qualification Documents
Completed pre-qualification data and other requested information shall be submitted to
reach;
The Procurement Committee
Automobile Association of Kenya
P.O, BOX 40087-00100
Renaissance Corporate Park
Elgon Road, Upper Hill
Nairobi.
3.7.Questions Arising from Documents
Questions that may arise from the pre-qualification documents should be directed to
tenders@aakenya.co.ke
3.8.Additional Information
The Procurement Committee reserves the right to request submission of additional
information from prospective bidders.
Request for quotations will be made available only to those bidders whose qualifications are
accepted by AAK after scoring more than 80% points after completion of the pre-qualification
process.
4. BRIEF CONTRACT REGULATIONS/GUIDELINES
4.1.Taxes on Imported Materials
The Supplier shall pay custom duty and VAT as required by the Law.
4.2.Custom Clearance
The Contractor shall be responsible for custom clearance of their imported goods and
materials.
5
4.3.Payments
All local purchase shall be on credit of a minimum of sixty (60) days or as may be stipulated
in the Contract Agreement.
5. PRE-QUALIFICATION DATA INSTRUCTIONS
5.1.Pre-Qualification Data Forms
The attached questionnaire forms PQ-1, PQ-2, PQ-3, PQ-4, PQ-5, PQ-6, PQ-7 and PQ-8 are to
be completed by prospective suppliers/contractors who wish to be pre-qualified for
submission of tender for specific tender.
The pre-qualified application forms which are not filled out completely and submitted in the
prescribed manner will not be considered. All the documents that form part of the proposal
must be written in English and in ink.
5.2.Qualification
It is understood and agreed that the pre-qualification data provided by prospective suppliers
is to be used by AA Kenya in determining, according to its sole judgment and discretion, the
qualifications of prospective bidders to perform in respect to the Tender Category as
described by the client.
Prospective bidders will not be considered qualified unless in the judgment of AA Kenya they
possess capability, experience, qualified personnel available and suitability of equipment and
net current assets or working capital sufficient to satisfactorily execute the contract for
goods/services.
5.3.Essential Criteria for Pre-Qualification
5.3.1.
a. Experience: Prospective bidders shall have at least 1 Year Experience in the
supply of goods, services and allied items in case of potential
supplier/contractor should show competence, willingness and capacity to
service the contract.
b. Prospective supplier require special experience and capability to organize
Supply and delivery of items, or service at short notice.
5.3.2. Personnel
The contacts for individual or group to execute the contract must be indicated in form
PQ-2.
5.3.3. Financial Condition
The Supplier’s financial condition will be determined by latest audited financial
statement submitted alongside the pre-qualification documents.
5.3.4. Past Performance
Past performance will be given due consideration in pre-qualifying bidders. Letter of
reference from past customers should be included in Form PQ-5.
6
5.4.
Declaration
Application must include statement Form PQ-7 by the tenderer ensuring the accuracy of the
information given and PQ–8 for integrity declaration.
5.5.
Withdrawal of Pre-Qualification
Should a condition arise between the time the firm is pre-qualified to bid and the bid opening
date which could substantially change the performance and qualification of the bidder or the
ability to perform such as but not limited to bankruptcy, change in ownership or new
commitments the AA reserves the right to reject the tender from such a bidder even though
they have been initially pre-qualified.
The firm must have a fixed Business Premise and must be registered in Kenya with certificate
of Registration, Certificate of Registration and Business permit should be attached.
The firm must show proof that it has paid all its statutory obligations and have current Tax
Compliance Certificate.
5.6.
Pre-Qualification Criteria indicating Maximum Points to be scored
1.
a)
b)
2.
a)
3.
a)
b)
c)
d)
e)
4.
a)
b)
5.
6.
a)
b)
c)
7.
8.
9
10
TOTAL
PRELIMINARY
Copy of Registration Certificate(2 Points)
Copy of Current KRA Compliance Certificate (2 points)
FORM PQ 1 PREQUALIFICATION
Submission of all the other required documents – VAT Certificate,
PIN Certificate, Business Permit (3 Points)
FORM PQ2- REGISTRATION APPLICATION
Name of the Company/Firm/Supplier (0.5 points)
E-mail Address (0.5 points)
Postal Address (0.5 points)
Mobile Number (0.5 points)
All other information filled as required (3 points)
FORM PQ3 – FINANCIAL POSITION & TERMS OF TRADE
Audited & Certified Financial Statements (3 points)
Credit period (not less than 60 days) - ( 3 points)
FORM PQ4 – CONFIDENTIAL BUSINESS QUESTIONAIRE
(must be filled accordingly) - (3 points)
FORM PQ5 – PAST EXPERIENCE
At least 3 Names of the applicants clients in the past two years and
value of the contracts entered into and completed satisfactorily and
the duration of the contract (must be listed) – (6 points)
Signed Contracts/LPOs/LSOs (as prove of a. above) - 2 points
At least 3 recommendation letters from different clients - 3points
FORM PQ6 – LITIGATION HISTORY (filled and signed) - 2 points
FORM PQ7 –STATEMENT( filled and signed) – 2 points
FORM PQ8 –INTEGRITY DECLARATION ( filled and signed)–2 points
Price Catalogue(10 Points)
POINTS
7
Scores
6. FORM PQ-1: PRE-QUALIFICATION DOCUMENTS
All firms must provide:1.
Copies of Certificate of registration.
2.
Copy of VAT Registration Certificate.
3.
Tax Compliance Certificate from KRA (failure to produce this certificate to
approve compliance, will lead to automatic disqualification thus no further
evaluation of your application.
4.
Copy of PIN Certificate of Firm/company or individual.
5.
Copy of Business Permit.
6.
Letter of recommendation from previous organization served.
7.
Towing Agents must attach evidence of having taken all the Insurance covers.
8.
When mandatory for service provision, each firm must attach evidence of
registration with professional bodies/authorities.
9.
E-mail Contacts: Valid and active e-mail address
10.
Bidding Fee Payment Evidence (Bidders are required to make the payment before
24th September using the PayBill number 552692. Once this is done, bidders should
collect receipts from the AA Kenya Head Office and attach to pre-qualification
documents)
8
7. FORM PQ-2: PRE-QUALIFICATION DATA
REGISTRATION OF SUPPLIERS APPLICATION FORM
I/We ……………………………………………………………………………………………… hereby apply for
(Name of Company/Firm-Compulsory)
registration as supplier(s) of
……………………………………………………………………………………………………………………………………………………
(Item Description)
……………………………………………………………………………………………………………………………………………………
(Category)
E-mail Address……………………………………………………………………………………………………………………………
(Compulsory)
Post Office Address ………………………………………………………………………………………………………………….
(Compulsory)
Town …………………………………………………………………………………………………………………………………………
Street …………………………………………………………………………………….…………………………………………………
Name of building …………………………………………………………………………………….……………………………….
Room/Office No ……………………………………………………. Floor No …………………………………..……………
Telephone No. …………………………………………………………………….……………………………………………………
Mobile telephone/cell phone number……………………………………………………….……………………………
(Compulsory)
Full Name of applicant ………………………………………………………………………………………….……………….
(Compulsory)
Other branches Location ………………………………………………………………………………………………………..
ORGANIZATION & BUSINESS INFORMATION
Management Personnel (Contact Person)…………………………………………..………………………………….
Tel. Number of Contact Person ……………………………………………………………………………………………..
Chief Executive ……………………………………………………………………………………………………………………….
General Manager …………………………………………………………………………………………………………..…….…
Other …………………………………………………………………………………………………………………………….………..
9
Partnership (if applicable)
Names of Partners ……………………………………………………………………………………………………………..
Business founded or incorporated …………………………………………………………………………………….
Under present Management since …………………………………………………………………………………….
Net worth equivalent Kshs ………………………………………………………………………………………………..
Bank reference and address ……………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………….
Bonding company reference and address ………………………………………………………………………….
Enclose copy of organization chart of the firm indicating the main fields of activities
………………………………………………………………………………………………………………………………
State any technological innovations or specific attributes which distinguish you from your
Competitors ……………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………………..
Indicate terms of trade/sale
Note – Any information marked compulsory must be provided failure to which the applicant
shall be automatically disqualified
10
8. PQ-3: FINANCIAL POSITION AND TERMS OF TRADE
(1) Attach a copy firm’s two certified financial statements giving summary of assets and
current liabilities/or any other financial support. (compulsory)
(2) State Credit period (minimum proposed is 60 days)……………………………………………………….
(Compulsory i.e. any applicant who does not indicate the credit period and/or who
indicates any credit period less than 60 days may be disqualified)
Note – Any information marked compulsory must be provided failure to which the applicant
shall be automatically disqualified.
11
9. FORM PQ-4: CONFIDENTIAL BUSINESS QUESTIONNAIRE FORM
You are requested to give the particulars indicated in Part 1 and either Part 2 (a), 2 (b) or 2
(c ) whichever applies to your type of business.
You are advised that it is a serious offence to give false information on this form
Part 1 – General
Business Name: ………………………………………………………………………………………………………………
Location of Business Premises: ……………………………………………………………..………………………
Plot No. ……………………………………… Street/Road: …………………………………………….…………….
Postal Address ……………………………………………. Tel No. …………………………………………….…….
Nature of business …………………………………………………………………………………………………………
Current Trade License No. ………………………………………. Expiring date ………………………….
Maximum value of business which you can handle at any one time Kshs ……………………….
Name of your bankers …………………………………………………. Branch ……………………………………
Part 2 (a) – Sole Proprietor
Your Name in full ……………………………………………… Age ……………………………………….
Nationality …………………………….. Country of origin ……………………………………………
* Citizenship details …………………………………………………………………………………………..
Part 2 (b) Partnership
Given details of partners as follows:
Name
Nationality
Citizenship Details
Shares
1
……………………………………………………………………………………………………………..…
2
…………………………………………………………………………………………………………………
3
…………………………………………………………………………………………………………..……
Part 2 (c ) – Registered Company
Private or Public ……………………………………………………………………………….…………………..
State the nominal and issued capital of company –
Nominal Kshs.
Issued Kshs.
Give details of all directors as follows:
12
Name
Nationality
Citizenship Details
Shares
1. …………………………………………………………………………………………………………………….…
2.……………………………………………………………………………………………………………………….…
3.……………………………………………………………………………………………………………………..……
4. …………………………………………………………………………………………………………………………
5. …………………………………………………………………………………………………………………….…..
Date ………………………………………….Seal/Signature of Candidate …………………………………………
13
10. FORM PQ 5: PAST EXPERIENCE
A. NAMES OF THE APPLICANTS CLIENTS IN THE PAST ONE YEAR AND VALUE OF THE
CONTRACTS ENTERED INTO AND COMPLETED SATISFACTORILY
(At least 3 firms)
1.
i.
ii.
iii.
iv.
v.
vi.
Name of client (Organization) ………………………………………………………………..…….
Address of client (Organization) ………………………………………………………….………..
Name of contact person at the client (Organization) ………………………………………
Telephone No. of client ……………………………………………………………………..…………
Value of contract …………………………………………………………………………….……………
Duration of contract (date) …………………………………………………………………..……….
Attach the following documental evidence of existence of contract as above:
i.
signed contracts/LPOs/LSOs
(Compulsory)
2.
i.
ii.
iii.
iv.
v.
vi.
Name of client (Organization) …………………………………………………………….……….….
Address of client (Organization) …………………………………………………………..…….…..
Name of contact person at the client (Organization) …………………………………….…
Telephone No. of client …………………………………………………………………………….……
Value of contract ………………………………………………………………………….……….………
Duration of contract (date) ……………………………………………………………..…………….
Attach the following documental evidence of existence of contract as above:
i.
signed contracts/LPOs/LSOs
(Compulsory)
3.
i.
ii.
iii.
iv.
v.
vi.
Name of clients (Organization) ……………………………………………………………..…….
Address of client (Organization) …………………………………………………………………...
Name of contact person at the client (Organization) ………………………………………
Telephone No. of client …………………………………………………………………………..……
Value of contract ………………………………………………………………………………….………
Duration of contract (date) …………………………………………………………………….…….
Attach the following documental evidence of existence of contract as above:
i.
signed contracts/LPOs/LSOs
(Compulsory)
B. RECOMMENDATION LETTERS FROM THE APPLICANTS’ CLIENTS OF THE LAST FIVE YEARS
Attach at least 3 recommendation letters (from different companies) - Compulsory
14
11. FORM PQ-6: LITIGATION HISTORY
Name of Contract Supplier
Contractors/Suppliers should provide information on any history of litigation or arbitration
resulting from contracts executed in the last five years or currently under execution.
YEAR
AWARD FOR OR AGAINST
NAME OF CLIENT, CAUSE OF DISPUTED
AMOUNT
LITIGATION AND MATTER IN (CURRENT
VALUE,
DISPUTE
KSHS. EQUIVALENT
Name of Authorized Signatory: ……………………………………………………………………………………….…
Title of Authorized Signatory: ……………………………………………………………………………………………
Sign: ……………………………………………………………………………………………………………………………………
Date and Stamp: …………………………………………………………………………………………………….………….
15
12. FORM PQ -7: FIRM’S DECLARATION
Having studied the pre-qualification information for the above project I/We hereby state:
a. The information furnished in our application is accurate to the best of our knowledge.
b. That in case of being pre-qualified we acknowledge that this grants us the right to
participate in due time in the submission of a tender or quotation on basis of provisions
in the tender or quotation documents to follow.
c. We enclose all the required documents and information required for the prequalification and evaluation.
Category No... …………………………………………………………………………………………
Supply/Provision of ………………………………………………………………………………..…
Date ………………………………………………………………………………………………….……
Applicant’s Name ………………………………………………………………………………….….
Represented by (Authorised Signatory) ………………………………………………….…..
Signature ………………………………………………………………………………………………..
(Full name and designation of the person signing and stamp or seal)
16
13. FORM PQ 8: INTEGRITY DECLARATION FORM
I, …………………………………… of P. O. Box ………………………………… being a resident of ………………………
in the Republic of Kenya do hereby make declare as follows: 1.
THAT I am the Chief Executive/Managing Director/Principal Officer /Director of
……………………………… (Name of the Candidate) which is a Candidate in respect of Tender
Number ……………………. to supply goods, render services and/or carry out works for
Automobile Association of Kenya (AA Kenya) and duly authorized and competent to
make this Declaration.
2.
THAT the aforesaid Candidate has not been requested to pay any inducement to any
member of the Board, Management, Staff and/or employees and/or agents of AA Kenya,
which is the procuring entity.
3.
THAT the aforesaid Candidate, its servants and/or agents have not offered and will not
offer any inducement to any member of the Board, Management, Staff and/or
employees and/or agents of AA Kenya.
4.
THAT what is responded to hereinabove is true to the best of my knowledge information
and belief.
______________________________________________________________________
Name of Chief Executive/Managing Director/
Organizations Stamp/Seal
Principal Officer/Director
-------------------------------------------------------------
-------------------------------------------
On this ---------------------- day of ---------------------- 20----------------------
Signed: --------------------------------------------------------------------------------------------------------
17