Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
----------------------------------------------------------------------------------------------------------------------------- ---------
Appendix no. 3 to TOR
TENDER FORM
Intended for the Contractor, who is competing for a contract individually
NOTE - The Contractor cannot change the contents of the form alone (all data required by the Contracting
authority must be included). The Contracting authority enables the introduction of additional information as an
additional document.
Ministry of Science and Higher Education
Wspólna 1/3 St.
00-529 Warsaw
TENDER
In replying to the announcement on the tender - Preparing and conducting an internshiptraining programme at the best universities/scientific centres in the world in the scope of
research management and commercialization of results, procedure symbol:
BDG.WZP.311.21.2015.10.MW)
1.
name of the Contractor
……………………………………………………………………..
2.
Contractor's seat/address of conducting
business
……………………………………………………………………..
3.
address to which the Contracting authority
should send correspondence relating to this
procedure (if the address is different from
that in item 2)
……………………………………………………………………..
person(s) authorized to represent the
Contractor
……………………………………………………………………..
name and surname
……………………………………………………………………..
name and surname
basis of representation of the Contractor
(Contractor's internal legal document, power
of attorney, etc.).
……………………………………………………………………..
4.
5.
contact details of the person indicated to
contact the Contracting authority
name and surname
e-mail:
phone:
fax:
……………………………………………………………………..
……………………………………………………………………..
……………………………………………………………………..
……………………………………………………………………..
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 33 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
-------------------------------------------------------------------------------------------------------------------------------------I am/we are submitting an tender for the performance of the subject-matter pursuant to the conditions specified in
the specification of essential terms of the contract.
No.
1.
2.
Specifying costs of the programme and its organization
Gross value*
(currency symbol)
Total substantial cost of the internship-training programme
Total cost for services in connection to the organization of the internshiptraining programme
GROSS TENDER PRICE*
(for 35 participants of the internship-training programme)
(No.1+No.2)
Say gross tender price: ………………………………………………………………………………………………
including the cost ((item 1 + item 2)/35) per one participant
*Gross tender price is the final price specifying the maximum remuneration for the performance of the subjectmatter of the contract - including all expenses (taking into account any discounts and rebates), which the
Contracting authority shall incur for the Contractor's performance of this contract.
1).………………………………………………..
...............................
2).........................................................
(place, date of submission)
( signature(s)
of persons authorized to represent the Contractor)
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 34 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
--------------------------------------------------------------------------------------------------------------------------------------
APPENDICES TO THE TENDER
Appendix
No.
Name of document
1.
Page no.
of the
tender
…………….
A detailed plan of activities including:
1.1 an exact completion date of the Programme within the period specified
by the Contracting authority,
1 . 2 the place of realization of courses,
1 . 3 the number of hours planned for specific forms of courses,
1 . 4 the method and date of providing teaching materials concerning the
courses
2.
A list of lecturers who are to conduct classes under the programme,
containing brief biographies and photographs of lecturers
…………….
3.
A list of centres, which the participants are to visit during the study visits
and internship elements (the list should contain at least 4 positions)
…………….
4.
Information on accommodation of participants containing basic information
on:
…………….
4.1 the conditions of accommodation,
4.2 the location,
4.3 the available means of transport
5.
Power of attorney for representing the Contractor (if applicable)
…………….
(the document must be submitted in original or notarized copy)
6.
The Contractor's declaration on meeting the conditions of participation in the
procedure – appendix no. 4 to the specification of essential terms of the
contract.
7.
Declaration on the lack of grounds for exclusion from the contract award
procedure – appendix no. 5 to the specification of essential terms of the
contract.
8.
Information on not belonging to a capital group – appendix no. 6 to the
specification of essential terms of the contract
…………….
or
Information on belonging to a capital group – appendix no. 7 to the
specification of essential terms of the contract
9.
Information on positions taken in current (global) rankings of universities –
appendix no. 8 to the specification of essential terms of the contract
..............................., date .........................
...............................................................
signature/signatures of persons authorized
to represent the Contractor
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 35 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
--------------------------------------------------------------------------------------------------------------------------------------
Appendix no. 3W to the specification of
essential terms of the contract
TENDER FORM
For Contractors jointly competing for a contract 1
NOTE - The Contractor cannot change the contents of the form alone (all data required by the Contracting
authority must be included). The Contracting authority enables the introduction of additional information as an
additional document.
Ministry of Science and Higher Education
Wspólna 1/3 St.
00-529 Warsaw
TENDER
In replying to the announcement on the tender - Preparing and conducting an internshiptraining programme at the best universities/scientific centres in the world in the scope of
research management and commercialization of results, Procedure symbol:
BDG.WZP.311.21.2015.10.MW)
name of the Contractor (1)
Contractor's seat/address of conducting business
person(s) authorized to represent the Contractor
1.
…………………………………………………………
…
…………………………………………………………
…
…………………………………………………………
…
name and surname
…………………………………………………………
…
name and surname
basis of representation of the Contractor
(Contractor's internal legal document, power of
attorney, etc.).
name of the Contractor (2)
Contractor's seat/address of conducting business
person(s) authorized to represent the Contractor
…………………………………………………………
…
…………………………………………………………
…
…………………………………………………………
…
…………………………………………………………
…
name and surname
…………………………………………………………
…
name and surname
basis of representation of the Contractor
(Contractor's internal legal document, power of
attorney, etc.).
…………………………………………………………
…
1
Contractors may jointly compete for a contract. In the case of Contractors jointly competing for a contract, the Contractors
appoint a proxy to represent them in the contract award procedure or to represent them in the procedure and conclusion of the
agreement on public procurement.
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 36 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
-------------------------------------------------------------------------------------------------------------------------------------name of the Contractor (..)
…………………………………………………………
…
…………………………………………….………
…
…………………………………………………………
…
2.
Power of attorney of Contractors jointly
competing for a contract
3.
the person authorized to represent the proxy who
is a legal person of Contractors jointly competing
for a contract (do not complete item 3 if item 2 is
completed)
4.
address to which the Contracting authority should
send correspondence relating to this procedure
5.
contact details of the person indicated to contact
the Contracting authority
name and surname
e-mail:
phone:
fax:
…………………………………………………………
…
name(company )1- or name and surname2
…………………………………………………………
…
name and surname
…………………………………………………………
…
I am/we are submitting an tender for the performance of the subject-matter of the contract pursuant to the
conditions specified in the specification of essential terms of the contract.
No.
1.
2.
Specifying costs of the programme and its organization
Gross value*
(currency symbol)
Total substantial cost of the internship-training programme
Total cost for services in connection to the organization of the internshiptraining programme
GROSS TENDER PRICE*
(for 35 participants of the internship-training programme)
(No.1+No.2)
Say gross tender price: ………………………………………………………………………………………………
including the cost ((item 1 + item 2)/35) per one participant
*Gross tender price is the final price specifying the maximum remuneration for the performance of the subjectmatter of the contract - including all expenses (taking into account any discounts and rebates), which the
Contracting authority shall incur for the Contractor's performance of this contract
1).………………………………………………..
...............................
(place, date of submission)
1
2
2).........................................................
( signature(s)
of persons authorized to represent the Contractor)
In the case of the proxy being a legal person
In the case of the proxy being a natural person
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 37 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
--------------------------------------------------------------------------------------------------------------------------------------
APPENDICES TO THE TENDER
Appendix
No.
Name of document
1. A detailed plan of activities including:
1 . 1 an exact completion date of the Programme within the period specified by the Contracting authority,
1.2 the place of realization of courses,
1.3 the number of hours planned for specific forms of courses,
1 . 4 the method and date of providing teaching materials concerning the courses
2. A list of lecturers who are to conduct classes under the programme, containing brief biographies and
photographs of lecturers
3. A list of centres, which the participants are to visit during the study visits and internship elements (the list
should contain at least 4 positions)
4. Information on accommodation of participants containing basic information on:
4.1 the conditions of accommodation,
4.2 the location,
4.3 the available means of transport
5. Power of attorney to represent the Contractor (if applicable)
(the document must be submitted in original or notarized copy)
6. Power of attorney for the Proxy of Contractors jointly competing for a contract
and/or power of attorney for the person acting on behalf of the Proxy (the document must be submitted in
original or notarized copy)
7. The Contractor's declaration on meeting the conditions of participation in the procedure / procedure – appendix
no. 4 to the specification of essential terms of the contract.
8. Declaration on the lack of grounds for exclusion from the contract award procedure – appendix no. 5 to the
specification of essential terms of the contract.
9.
Information on not belonging to a capital group – appendix no. 6 to the specification of
essential terms of the contract (if applicable)
or
Information on belonging to a capital group – appendix no. 7 to the specification of
essential terms of the contract (if applicable)
10. Information on positions taken in current (global) rankings of universities – appendix no. 8
to the specification of essential terms of the contract
..............................., date .........................
...............................................................
(signature/signatures of persons authorized
to represent the Contractor)
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 38 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
--------------------------------------------------------------------------------------------------------------------------------------
Appendix no. 4 to TOR
Ministry of Science and Higher Education
Wspólna 1/3 St.
00-529 Warsaw
DECLARATION1
on meeting the conditions of participation in the procedures
Preparing and conducting an internship-training programme at the best universities/scientific centres in the
world in the scope of research management and commercialization of research results
Procedure symbol: BDG.WZP.311.21.2015.10.MW
…………………………………………………………………………………………………
Name(s) and surname(s) of person(s) authorized to represent the Contractor
……………………………………………………………………………………………….....
on behalf of:
………………………………………………………………………………………
name of (company)seat /address of conducting business
I declare that the Contractor meets the conditions of participation in the contract award procedure, referred to in
art. 22 sec. 1 of the act of 29 January 2004 Public Procurement Act (OJ of Laws of 2013 item 907 as amended),
concerning:
1)
possessing the rights to execute specific operations or activities, if legal regulations enforce the obligation
to possess them,
2)
possessing knowledge and experience;
3)
possessing appropriate technical potential and human resources capable of performing the tender
4)
economic and financial situation
………………………………………
1)……...…………………………………….
(place, date of submission)
2) …………………………………………..
(signature/signatures
of persons authorized to represent the Contractor)
1
Declaration shall be submitted by each Contractor jointly competing for a contract. In the case of Contractors jointly
competing for a contract, all Contractors or the Proxy on their behalf shall sign the declaration.
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 39 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
--------------------------------------------------------------------------------------------------------------------------------------
Appendix no. 5 to TOR
Ministry of Science and Higher Education
Wspólna 1/3 St.
00-529 Warsaw
Concerns: competing for a contract Preparing and conducting an internship-training programme at the
best universities/scientific centres in the world in the scope of research management and commercialization
of research results
Procedure symbol: BDG.WZP.311.21.2015.10.MW
DECLARATION1)
on demonstrating a lack of grounds for exclusion from the contract award procedure
…………………………………………………………………………………………………
name and surname of person(s) authorized to represent the Contractor
………………………………………………………………………………………………….
on behalf of
………………………………………………………………………………………………….
name of (company) seat /address of conducting business
I declare that as at the date of submitting tenders there are no grounds for exclusion from the procedure based on
art. 24 sec. 1 of the act of 29 January 2004 Public Procurement Act (OJ of Laws of 2013 item 907 as amended).
………………………………………
1) …………………………………….
(place, date of submission)
2)……………………………….......
(signature/signatures
of persons authorized to represent the Contractor)
1)
Declaration shall be submitted by each Contractor competing individually for a contract. In the case of Contractors jointly
competing for a contract, each of the Contractors submits the declaration separately.
Pursuant to art. 24 of the act of 29 January 2004 - Public Procurement Act (OJ of 2013 item 907 as
amended) the following shall be excluded from the contract award procedure:
1.
Contractors for whom liquidation was initiated or who have been declared bankrupt, except for Contractors
who, following announcement of their bankruptcy, entered into an arrangement approved under a valid court
order, provided such an arrangement does not provide for satisfaction of creditors by liquidations of the
bankrupt's assets;
2.
Contractors, who are in arrears with payment of taxes, fees or social and health insurance premiums, with the
exception of cases, when they had acquired a legal exemption, deferment or division into instalments of
overdue payments or suspension, in whole, of execution of the decision of the relevant body;
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 40 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
-------------------------------------------------------------------------------------------------------------------------------------3. natural persons who have been effectively sentenced for an offense committed in connection with a public
procurement procedure, an offense against the rights of persons performing paid work, an offense against the
environment, an offense consisting in bribery, an offense against economic turnover or another offense
committed for financial gain, as well as a fiscal offense or offense consisting in participation in an organized
group or association aiming to commit an offense or a fiscal offense;
4.
general partnerships whose partner has been effectively sentenced for an offense committed in connection
with a public procurement procedure, an offense against the rights of persons performing paid work, an
offense against the environment, an offense consisting in bribery, an offense against economic turnover or
another offense committed for financial gain, as well as a fiscal offense or offense consisting in participation
in an organized group or association aiming to commit an offense or a fiscal offense;
5.
partnerships, whose partner or board member has been effectively sentenced for an offense committed in
connection with a public procurement procedure, an offense against the rights of persons performing paid
work, an offense against the environment, an offense consisting in bribery, an offense against economic
turnover or another offense committed for financial gain, as well as a fiscal offense or offense consisting in
participation in an organized group or association aiming to commit an offense or a fiscal offense;
6.
limited partnerships and limited-joint-stock partnerships whose general partner has been effectively
sentenced for an offense committed in connection with a public procurement procedure, an offense against
the rights of persons performing paid work, an offense against the environment, an offense consisting in
bribery, an offense against economic turnover or another offense committed for financial gain, as well as a
fiscal offense or offense consisting in participation in an organized group or association aiming to commit an
offense or a fiscal offense;
7.
legal persons whose active member of the management body has been effectively sentenced for an offense
committed in connection with a public procurement procedure, an offense against the rights of persons
performing paid work, an offense against the environment, an offense consisting in bribery, an offense
against economic turnover or another offense committed for financial gain, as well as a fiscal offense or
offense consisting in participation in an organized group or association aiming to commit an offense or a
fiscal offense;
8.
collective entities with respect to which a court of law ruled the ban to apply for contracts, on the basis of
provisions on liability of collective entities for acts prohibited under penalty;
9.
Contractors being natural persons who were validly sentenced for an offense referred to in Article 9 or Article
10 of the Act of June 15, 2012 on the consequences of delegating work to foreigners residing unlawfully in
the territory of the Republic of Poland (OJ item 769) – for a period of 1 year from the date of the sentence
becoming final;
10. Contractors being a general partnership, professional partnership, limited partnership, limited joint-stock
partnership or natural person whose partner, board member, general partner or active member of the
management body respectively have been validly sentenced for an offense referred to in Article 9 or Article
10 of the Act of June 15, 2010 on the consequences of delegating work to foreigners residing unlawfully in
the territory of the Republic of Poland – for a period of 1 year from the date of the sentence becoming final.
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 41 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
--------------------------------------------------------------------------------------------------------------------------------------
Appendix no. 6 to TOR
Contractor(s) shall submit correspondingly only Appendix 6 or only Appendix 7 to the specification of essential
terms of the contract
Ministry of Science and Higher Education
Wspólna 1/3 St.
00-529 Warsaw
Concerns: contract award procedure Preparing and conducting an internship-training programme at
the best universities/scientific centres in the world in the scope of research management and
commercialization of results
Procedure symbol: BDG.WZP.311.21.2015.10.MW
INFORMATION ON NOT BELONGING TO ANY CAPITAL GROUP 1
…………………………………………………………………………………………………
name and surname of person(s) authorized to represent the Contractor
on behalf of
…………………………………………………………………………………………………
name of (company) seat /address of conducting business
I inform you that the aforementioned Contractor does not belong to any capital group
within the meaning of the act of 16 February 2007 on competition and consumer protection
(OJ of 2015 item 184).2
………………………………………
1) …………………………………….
(place, date of submission)
2)……………………………….......
(signature/signatures
of persons authorized to represent the Contractor)
1
A capital group shall be understood as all entrepreneurs, who are controlled in a direct or indirect manner by a single
entrepreneur.
2
In the case of Contractors jointly competing for a contract The information is submitted by each of the
Contractors separately.
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 42 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
--------------------------------------------------------------------------------------------------------------------------------------
Appendix no. 7 to TOR
Contractor(s) shall submit correspondingly only Appendix 6 or only Appendix 7 to the specification of essential
terms of the contract
Ministry of Science and Higher Education
Wspólna 1/3 St.
00-529 Warsaw
Concerns: contract award procedure Preparing and conducting an internship-training programme at
the best universities/scientific centres in the world in the scope of research management and
commercialization of results
Procedure symbol: BDG.WZP.311.21.2015.10.MW
INGORMATION ON BELONGING TO A CAPITAL GROUP1
…………………………………………………………………………………………………
name and surname of person(s) authorized to represent the Contractor
on behalf of
…………………………………………………………………………………………………
name of (company) seat /address of conducting business
I inform you that the aforementioned Contractor belongs to a capital group within the
meaning of the act of 16 February 2007 on competition and consumer protection (OJ of 2015
item 184), which consists of the following entities2:
No.
Names of entities belonging to the capital group
1
2
……….
………………………………………………………………………………..
………………………………………
1) …………………………………….
(place, date of submission)
2)……………………………….......
(signature/signatures
of persons authorized to represent the Contractor)
1
A capital group shall be understood as all entrepreneurs, who are controlled in a direct or indirect manner by a single
entrepreneur.
2 In the case of belonging to a capital group, all entities belonging to the same capital group must be listed. In the case of
Contractors jointly competing for a contract, information/list of entities belonging to the same capital group is submitted
separately by each of the Contractors.
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 43 of 44
Ministry of Science and Higher Education
Open tender: Preparing and conducting an internship-training programme at the best universities/scientific centres in the world in
the scope of research management and commercialization of results
Procedure symbol: BDG.WZP.311.21.2015. 10.MW
--------------------------------------------------------------------------------------------------------------------------------------
Appendix no. 8 to the the specification of
essential terms of the contract
Information on positions taken in current (global) rankings of universities.
No.
Name of ranking indicated by the Contracting authority1
1.
Shanghai ranking for 2014
2.
"U-Multirank. Research and Research Linkages Ranking"
3.
"Center for World University Rankings" for 2014
Name of ranking proposed by the Contractor along with the website
address2
………………………………………
Position
in the ranking
indicated by the
Contracting authority
Position
in the ranking
indicated by the
Contractor
1) …………………………………….
(place, date of submission)
2)……………………………….......
(signature/signatures
of persons authorized to represent the Contractor)
Ranking in accordance with the requirements of the Contracting authority – Chapter XV of the specification of essential
terms of the contract
2
One additional current ranking of worldwide universities proposed by the Contractors – meeting the requirements indicated
in Chapter XV of the specification of essential terms of the contract
1
-------------------------------------------------------------------------------------------------------------------------------------------------------
Page 44 of 44