Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires ATTACHMENT 1 TO PART 4 Templates recommended for bidders Please provide the information requested in the following templates. CRITERION M1 – BIDDER’S OVERALL EXPERIENCE A Name of client Experience in providing translation services (without machine translation) B C Name, telephone number and email Time period during which translation address of the client’s representative services were provided From “Month year” To “Month year” CRITERION M2 – NUMBER OF WORDS TRANSLATED BY THE BIDDER A Name of client Number of words translated by the bidder (without machine translation) B C Name, telephone number and Time period during which the email address of the client’s translation services were representative provided From “Month year” Page 1 of 10 To “Month year” D Number of words translated during the time period specified in column C. Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires CRITERION M3 – TRANSLATORS PROPOSED BY THE BIDDER AND CRITERION M5 – DOCUMENTS TO BE PROVIDED Surname and first name of the proposed translator Employee (E) or subcontractor (S) E Official document provided S 1) 2) 3) 4) 5) CRITERION M6 AND CRITERION R7 – OFFICE LOCATED IN CANADA IN THE NATIONAL CAPITAL REGION (NCR) Address of the bidder’s office in the NCR: Surnames and first names of the proposed translators who will be assigned to Statistics Canada documents Place of work: Bidder’s office (BO) or elsewhere (E) (BO) 1) 2) 3) 4) 5) Percentage of translators working in the supplier’s office (this percentage must be at least 51% for Criterion M6). Page 2 of 10 (E) Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires CRITERION R1 – BIDDER’S OVERALL EXPERIENCE A Name of client Experience in providing translation services above the requirement of five (5) years indicated in M1 (without machine translation) B C Name, telephone number and email address of the Time period during which client’s representative translation services were provided From “Month year” CRITERION EC1 (OPTIONAL) – PROPOSED TRANSLATORS – TRANSLATION FROM FRENCH INTO ENGLISH AND EDITING IN ENGLISH Surname and first name of the proposed translator Employee (E) or subcontractor (S) E S 1) 2) Page 3 of 10 Official document provided To “Month year” Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires ATTACHMENT 2 TO PART 4 Bidder’s General Information Bidders must provide the following information: Legal name and business address Procurement Business Number or GST number Telephone number Address of the office where the majority of translators assigned to Statistics Canada documents will work Fax number Email address The Bidder must identify the name of the resource who will act as a liaison officer between the administrator of the Contract on the part of the Contractor and the Project Authority of Statistics Canada. Name of the resource Mailing address Phone number Fax number Email address Page 4 of 10 Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires ATTACHMENT 1 TO PART 5 Mandatory Certifications 1. Mandatory Certifications Required Precedent to Contract Award 1.1 Code of Conduct and Certifications - Related documentation By submitting a bid, the Bidder certifies that the Bidder and its affiliates are in compliance with the provisions as stated in Section 01 Code of Conduct and Certifications - Bid of Standard Instructions 2003. The related documentation therein required will assist Canada in confirming that the certifications are true. ____________________________________ Signature of the authorized Representative _______________________________ Date ____________________________________ Print Name 2. Additional Certifications Required Precedent to Contract Award 2.1 Status and Availability of Resources 2.1.1 SACC Manual clause A3005T (2010-08-16), Status and Availability of Resources ____________________________________ Signature of the authorized Representative _______________________ Date ____________________________________ Print Name 2.2 Education and Experience 2.2.1 SACC Manual clause A3010T (2010-08-16), Education and Experience ____________________________________ Signature of the authorized Representative _______________________ Date ____________________________________ Print Name 2.3 Former Public Servant Certification Contracts with former public servants (FPS) in receipt of a pension or of a lump sum payment must bear the closest public scrutiny, and reflect fairness in the spending of public funds. In order to comply with Treasury Board policies and directives on contracts with FPS, bidders must provide the information required below. Page 5 of 10 Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires Definitions For the purposes of this clause,"former public servant" is any former member of a department as defined in the Financial Administration Act, R.S., 1985, c. F-11, a former member of the Canadian Armed Forces or a former member of the Royal Canadian Mounted Police. A former public servant may be: a. an individual; b. an individual who has incorporated; c. a partnership made of former public servants; or d. a sole proprietorship or entity where the affected individual has a controlling or major interest in the entity. "lump sum payment period" means the period measured in weeks of salary, for which payment has been made to facilitate the transition to retirement or to other employment as a result of the implementation of various programs to reduce the size of the Public Service. The lump sum payment period does not include the period of severance pay, which is measured in a like manner. "pension" means a pension or annual allowance paid under the Public Service Superannuation Act (PSSA), R.S., 1985, c.P-36, and any increases paid pursuant to the Supplementary Retirement Benefits Act, R.S., 1985, c.S-24 as it affects the PSSA. It does not include pensions payable pursuant to the Canadian Forces Superannuation Act, R.S., 1985, c.C-17, theDefence Services Pension Continuation Act, 1970, c.D-3, the Royal Canadian Mounted Police Pension Continuation Act , 1970, c.R-10, and the Royal Canadian Mounted Police Superannuation Act, R.S., 1985, c.R-11, theMembers of Parliament Retiring Allowances Act , R.S., 1985, c.M-5, and that portion of pension payable to theCanada Pension Plan Act, R.S., 1985, c.C-8. Former Public Servant in Receipt of a Pension As per the above definitions, is the Bidder a FPS in receipt of a pension? Yes ( )No ( ) If so, the Bidder must provide the following information, for all FPS in receipt of a pension, as applicable: a. name of former public servant; b. date of termination of employment or retirement from the Public Service. Work Force Adjustment Directive Is the Bidder a FPS who received a lump sum payment pursuant to the terms of the Work Force Adjustment Directive? Yes ( )No ( ) If so, the Bidder must provide the following information: a. name of former public servant; b. conditions of the lump sum payment incentive; c. date of termination of employment; Page 6 of 10 Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires d. amount of lump sum payment; e. rate of pay on which lump sum payment is based; f. period of lump sum payment including start date, end date and number of weeks; g. number and amount (professional fees) of other contracts subject to the restrictions of a work force adjustment program. For all contracts awarded during the lump sum payment period, the total amount of fees that may be paid to a FPS who received a lump sum payment is $5,000, including Applicable Taxes. ____________________________________ Signature of the authorized Representative _______________________ Date ____________________________________ Print Name Page 7 of 10 Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires ATTACHMENT 1 TO PART 6 Templates to be completed – Security Requirements Information Section 1 – Security Information on the Bidder Name and address of bidder: Facility Security Clearance Certification and expiry date (Certificate to be provided) The following template SHOULD be completed for EACH proposed translator. Section 2 - Security Information on the translator Name of proposed translator 1: Name of individual as it appears on security clearance application form Supplier to Insert Data Date of birth Level of security clearance obtained Validity period of security clearance obtained Security Screening Certificate and Briefing Form (Copy of certificate to be provided) Name of Federal Government Department under which security clearance was obtained. If the Federal Government Department is other than PWGSC, provide the name, telephone and fax numbers of the security clearance contact person within that department Section 2 - Security Information on the translator Name of proposed translator 2: Name of individual as it appears on security clearance application form Date of birth Level of security clearance obtained Validity period of security clearance obtained Security Screening Certificate and Briefing Form (Copy of certificate to be provided) Name of Federal Government Department under which security clearance was obtained. If the Federal Government Department is other than PWGSC, provide the name, telephone and fax numbers of the security clearance contact person within that department Page 8 of 10 Supplier to Insert Data Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires Section 2 - Security Information on the translator Name of proposed translator 3: Name of individual as it appears on security clearance application form Supplier to Insert Data Date of birth Level of security clearance obtained Validity period of security clearance obtained Security Screening Certificate and Briefing Form (Copy of certificate to be provided) Name of Federal Government Department under which security clearance was obtained. If the Federal Government Department is other than PWGSC, provide the name, telephone and fax numbers of the security clearance contact person within that department Section 2 - Security Information on the translator Name of proposed translator 4: Name of individual as it appears on security clearance application form Supplier to Insert Data Date of birth Level of security clearance obtained Validity period of security clearance obtained Security Screening Certificate and Briefing Form (Copy of certificate to be provided) Name of Federal Government Department under which security clearance was obtained. If the Federal Government Department is other than PWGSC, provide the name, telephone and fax numbers of the security clearance contact person within that department Section 2 - Security Information on the translator Name of proposed translator 5: Name of individual as it appears on security clearance application form Date of birth Level of security clearance obtained Validity period of security clearance obtained Security Screening Certificate and Briefing Form (Copy of certificate to be provided) Name of Federal Government Department under which security clearance was obtained. If the Federal Government Page 9 of 10 Supplier to Insert Data Statistique Canada # de DP: 1920-0009733 Gabarits recommandés aux soumissionnaires Department is other than PWGSC, provide the name, telephone and fax numbers of the security clearance contact person within that department To be completed if one or two translators are proposed in EC1, if applicable Section 3 - Security Information on the translator – Translation from French into English (optional) Mandatory if one translator is proposed Name of proposed translator 1: Name of individual as it appears on security clearance application form Date of birth Level of security clearance obtained Validity period of security clearance obtained Security Screening Certificate and Briefing Form (Copy of certificate to be provided) Name of Federal Government Department under which security clearance was obtained. If the Federal Government Department is other than PWGSC, provide the name, telephone and fax numbers of the security clearance contact person within that department Section 3 - Security Information on the translator – Translation from French into English (optional) Mandatory if one translator is proposed Name of proposed translator 2: Name of individual as it appears on security clearance application form Date of birth Level of security clearance obtained Validity period of security clearance obtained Security Screening Certificate and Briefing Form (Copy of certificate to be provided) Name of Federal Government Department under which security clearance was obtained. If the Federal Government Department is other than PWGSC, provide the name, telephone and fax numbers of the security clearance contact person within that department Page 10 of 10 Supplier to Insert Data Supplier to Insert Data