APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
THE SOUTH AFRICAN
NATIONAL ROADS AGENCY
LIMITED SOC (SANRAL)
APPLICATION No. HO 1004-58400-2015 / FS
FOR
APPLICATION TO BE LISTED ON DATABASE OF NON-AUDIT FINANCIAL
ADVISORY SERVICE: PANEL OF SERVICE PROVIDERS.
THIS DOCUMENT COMPILED BY:
The South African National Roads Agency SOC Ltd
48 Tambotie Ave,
Val de Grace,
Pretoria, 0184
Tel: (012) 844 8000
Fax: (012) 844 8200
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
APPLICATION NO: HO 1004-58400-2015 - FS
APPLICATION TO BE LISTED ON DATABASE OF NON-AUDIT FINANCIAL ADVISORY
SERVICES: PANEL OF SERVICE PROVIDERS
APPLICATION NOTICE AND INVITATION
CLOSING DATE (AT 14H00): 11 December 2015
The South African National Roads Agency SOC Ltd (SANRAL) invite interested and suitable
professional service providers to apply to be listed on the database for provision of non-audit
financial advisory services. This may include VAT, Income tax or IFRS specialist advice and
other services.
The South African National Roads Agency SOC Ltd is committed to transformation,
employment equity and staff advancement, and to supporting black economic
empowerment.
As a State Owned Entity, SANRAL complies with the PFMA and Treasury Regulations in
terms of procurement.
Preferences are offered to firms who comply with the requirements stated in the application
data.
The electronic application documents in Adobe Acrobat PDF format is obtainable from The
South African National Roads Agency SOC Ltd’s website, at www.sanral.co.za >service
provider zone> current tenders from the 23rd November 2015.
No clarification meeting will be held.
The closing time for receipt of applications is 14h00 on 11 December 2015
The application and supporting documents shall be sealed in an envelope or package clearly
marked "Application HO 1004-58400-2015/FS: APPLICATION TO BE LISTED ON DATABASE OF
NON-AUDIT FINANCIAL ADVISORY SERVICES: PANEL OF SERVICE PROVIDERS”.
” and shall be delivered to SANRAL’s Northern Region offices in Pretoria at N0 38 Ida Street, Menlo
Park, Pretoria, 0080
Telegraphic, telephonic, telex, email, facsimile and late application will not be accepted.
Requirements for sealing, addressing, delivery, opening and assessment of applications are stated in
the application Data.
Queries relating to issues arising from these documents may be addressed to
Ms Eunice Phiri
Tel: No (012) 844 8000
Fax No (012) 844 8200
E-mail: phirie@nra.co.za
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
1.
BACKGROUND
The South African National Roads Agency SOC Limited (SANRAL) is a company
established in terms of the South African National Roads Agency Limited and
National Roads Act, Act 7 of 1998. It has its corporate office located in Pretoria and
has four regional offices namely: Northern Region (Menlyn, Pretoria), Eastern
Region (Pietermaritzburg), Southern Region (Port Elizabeth) and Western Region
(Bellville). The South Africa National Roads Agency SOC Limited (SANRAL) requires
the services of suitably qualified finance professionals to provide non-audit financial
advisory services, which may include VAT, Income tax or IFRS specialist advice
services and other services for a period of 24 months.
The objective is to identify eligible Professional Service Providers who will be
shortlisted to submit quotations for provision of non-audit services to SANRAL
whenever needed.
2. GENERAL CONDITIONS
2.1 This request for applications is issued in terms of the Public Finance
Management Act 1 of 1999 (PFMA), the Preferential Procurement Policy
Framework Act 5 of 2000 (PPPFA), and Supply Chain Management
Regulations issued by the National Treasury.
2.2 The inclusion of any Service Provider on the Panel does not guarantee
any work to such Service Provider nor does it constitute any contract
between SANRAL and such Service Provider for any work whatsoever.
2.3 SANRAL shall not be responsible for, or pay for, any expenses or losses
which may be incurred by the applicant in the preparation and submission
of the application or any other presentation or meeting or any anything
whatsoever in connection herewith.
2.4 SANRAL does not bind itself to accept all or any application. No
correspondence will be entered into with regard to its decision.
2.5 SANRAL will only consider applications from applicants who can prove to
the satisfaction of SANRAL that they:
2.5.1 have the necessary financial resources to undertake and
complete the services;
2.5.2 are experienced in the performance of services of a similar
scope, complexity, extent and duration. In making an
assessment in this regard, SANRAL shall be entitled to have
regard to, inter alia, the scope, complexity, extent and duration
of previous services undertaken or proposed for by the
proposer;
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
2.5.3 have sufficient employees who possess the high level of skill
and expertise commensurate with the type of services applied
for, which skill and expertise must be detailed in the application.
2.6 Each applicant undertakes to accept the jurisdiction of the relevant lawcourts of the Republic of South Africa.
2.7 In the case of an applicant from an entity not resident in the Republic of
South Africa (foreign) the applicant shall state in his application the name
of his accredited agent in the Republic of South Africa in whom the
necessary legal capacity is vested and who has been duly appointed to
sign any contract.
2.8 SANRAL reserves to itself the right, in its sole discretion, to reject any
application where it appears to SANRAL that the applicant does not
comply with any of the requirements set out in this application.
3 GENERAL REQUIREMENTS:
3.1 In order to qualify to form part of the panel of services providers the following
requirements and documentation are specified:





Applicant’s profile and experience.
Applicants BBBEE credentials
Applicants verifiable references
All the documentation referred to in this document must be submitted.
Applicants registration or affiliations with any regulatory body (IRBA, SAIT,
SAIPA or SAIBA)
3.2 Fees payable for services rendered will be solicited through a quotation basis.
4 PREPARATION AND SUBMISSION OF APPLICATION
4.1
Applications must reach the offices of the SANRAL’s Northern Region offices
in Menlyn, Tshwane 38 Ida Street, Menlo Park, (S25° 46’ 44.7” E028° 16’
29.3”) before 14h00 on 11 December 2015 and must be enclosed in a sealed
envelope which must be clearly marked " APPLICATION HO 1004-584002015/FS: APPLICATION TO BE LISTED ON DATABASE OF NON-AUDIT FINANCIAL
ADVISORY SERVICES: PANEL OF SERVICE PROVIDERS”.
4.2
Applications are to be submitted in the marked Tender box of SANRAL’s
Northern Region offices in Menlyn, Tshwane 38 Ida Street, Menlo Park,
Pretoria.
4.3
Please note that this application closes punctually at 14h00 on 11 December
2015.
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
4.4
No late submissions will be considered under any circumstances whatsoever.
4.5
Failure to submit all the documentation referred to in this document may result
in a submission being disqualified.
4.6
The responses to this application will be opened and recorded in public as
soon as practicable after the expiry of the time advertised for receiving them.
4.7
Applications received after the closing of the application will not be opened or
evaluated and will be returned to the Applicant.
4.8
Telegraphic, telephonic, telex, email, facsimile and late applications will not
be accepted.
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
ANNEXURE: FORM A
1. BUSINESS PARTICULARS
1.1. Name Of Business As Registered With The Registrar Of Companies/Close Corporations
Business registration number
NB: Attach copy of business registration certificate
1.2. Service provider’s business type
1.3.
VAT registration number
NB: Attach copy Tax Clearance Certificate
Tax Clearance Certificate Expiry Date
Income Tax Reference Number
1.4. Postal Address
1.5.
Telephone No:
1.6.
Cell. No.
Physical Address
Fax No:
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
1.7.
E-Mail Address (If Available):
1.8.
Contact Person:
1.9
Name of person authorized for signing
Capacity under which the application is signed:
Date signed;
Signature:
2. Please indicate (X) the geographical areas where your business has offices. Please provide
addresses, telephone numbers and contact person for different offices (Add separate sheet)
Regions
Mark ( X )
Northern region – Pretoria
Eastern region – Pietermaritzburg
Western region – Cape Town
Southern region – Port Elizabeth
3. Range of services offered in relation to the principal business of the enterprise
4. Are you registered with a professional body for the services that you provide?
YES
NO
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
If so, please state particulars:
Name of
Organisation
Contact
Person
Telephone
number
Membership
number
Date of
membership
5. BEE INFORMATION
% Of BEE Ownership
Provide BEE verification certificate( (from ABVA
accredited verification agencies)
NB: Attach BEE certificate
5.1. PREVIOUS EXPERIENCE RECORD
Service provider’s Relevant Experience including three most recent public sector clients .List the most
important contracts/assignments completed by your firm in the last three years.
WORK PERFORMED
6.
FOR WHOM
CONTACT PERSON
AND TELEPHONE
NUMBERS
Service Provider’s Area of Expertise. List all your area of expertise




November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS




7.
TEAM STRUCTURE
Personnel Complement (Add separate sheet to list all personnel)
No
First Name
Surname
Male/
Fema
le
Position
Accreditation
Relevant
Experience(years)
Geographical
Location
where service
is available
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
FORM B:
COMPULSORY ENTERPRISE QUESTIONNAIRE
The following particulars must be furnished. In the case of a joint venture, separate enterprise
questionnaires in respect of each partner must be completed and submitted.
Section 1:
Name of enterprise: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 2:
VAT registration number, if any: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 3: Regulatory body registration number, if any: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.........
Section 4:
Particulars of sole proprietors and partners in partnerships
Name*
Identity number*
Personal income tax number*
* Complete only if sole proprietor or partnership and attach separate page if more than 3 partners
Section 5:
Particulars of companies and close corporations
Company registration number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Close corporation number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax reference number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 6: Record in the service of the state
Indicate by marking the relevant boxes with a cross, if any sole proprietor, partner in a partnership or
director, manager, principal shareholder or stakeholder in a company or close corporation is currently
or has been within the last 12 months in the service of any of the following:
 a member of any municipal council
 a member of any provincial legislature
 a member of the National Assembly or the
National Council of Province
 a member of the board of directors of any
municipal entity
 an official of any municipality or municipal
entity

an employee of any provincial department,
national or provincial public entity or
constitutional institution within the meaning of
the Public Finance Management Act, 1999 (Act
1 of 1999)
 a member of an accounting authority of any
national or provincial public entity

an employee of Parliament or a provincial
legislature
If any of the above boxes are marked, disclose the following:
Name of sole proprietor,
partner, director, manager,
principal
shareholder
or
stakeholder
Name of institution, public office, board
or organ of state and position held
Status of service
(tick appropriate
column)
Current
Within last
12 months
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
*insert separate page if necessary
Section 7: Record of spouses, children and parents in the service of the state
Indicate by marking the relevant boxes with a cross, if any spouse, child or parent of a sole
proprietor, partner in a partnership or director, manager, principal shareholder or stakeholder in a
company or close corporation is currently or has been within the last 12 months been in the service of
any of the following:
 a member of any municipal council
 a member of any provincial
legislature
 a member of the National Assembly
or the National Council of Province
 a member of the board of directors of
any municipal entity
 an official of any municipality or
municipal entity
Name of spouse, child or
parent

an employee of any provincial department,
national or provincial public entity or
constitutional institution within the meaning of
the Public Finance Management Act, 1999 (Act
1 of 1999)

a member of an accounting authority of any
national or provincial public entity

an employee of Parliament or a provincial
legislature
Name of institution, public office, board
or organ of state and position held
Status of service
(tick appropriate
column)
Current Within last
12 months
*insert separate page if necessary
The undersigned, who warrants that he / she is duly authorised to do so on behalf of the enterprise:
i) authorizes the SANRAL to obtain a tax clearance certificate from the South African Revenue
Services that my / our tax matters are in order;
ii) confirms that neither the name of the enterprise or the name of any partner, manager, director or
other person, who wholly or partly exercises, or may exercise, control over the enterprise appears
on the Register of Tender Defaulters established in terms of the Prevention and Combating of
Corrupt Activities Act of 2004;
iii) confirms that no partner, member, director or other person, who wholly or partly exercises, or may
exercise, control over the enterprise, has within the last five years been convicted of fraud or
corruption;
iv) confirms that I / we are not associated, linked or involved with any other tendering entities
submitting tender offers and have no other relationship with any of the tenderers or those
responsible for compiling the scope of work that could cause or be interpreted as a conflict of
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
interest; and
iv) confirms that the contents of this questionnaire are within my personal knowledge and are to the
best of my belief both true and correct.
Signed
Date
Name
Position
Enterprise
name
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
FORM C:
TAX CLEARANCE CERTIFICATE REQUIREMENTS
IT IS A CONDITION OF THIS APPLICATION THAT THE TAXES OF THE SUCCESSFUL
PROPOSER MUST BE IN ORDER, OR THAT SATISFACTORY ARRANGEMENTS HAVE
BEEN MADE WITH SOUTH AFRICAN REVENUE SERVICES (SARS) TO MEET THE
PROPOSER’S TAX OBLIGATIONS.
1.
In order to meet this requirement Applicants are required to complete in full form
TCC 001 “Application for a Tax Clearance Certificate” and submit it to any SARS
office nationally. The Tax Clearance Certificate Requirements are also applicable to
foreign Proposers / individuals who wish to submit proposals.
2.
SARS will then furnish the Applicant with a Tax Clearance certificate that will be
valid for a period of 1 (one) year from the date of approval.
3.
The ORIGINAL Tax clearance Certificate must be submitted and attached to this
form together with this Application. Failure to submit the original and valid Tax
Clearance Certificate will result in the invalidation of the Application. Certified copies
of the Tax Clearance Certificate will not be accepted.
4.
In Applications where Consortia/Joint Ventures/Sub-Contractors are involved, each
party must submit a separate ORIGINAL Tax Clearance Certificate.
5.
Copies of the TCC 001 “Application for a tax Clearance Certificate” form are
available from any SARS branch or nationally on the website www.sars.gov.za
Applications for the Tax Clearance Certificates may also be made via e-Filing. In order to
use this provision, taxpayers will need to register with SARS as e-Filers through the website
www.sars.gov.za.
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
Form D:
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 a price quotation, advertised competitive bid, limited bid or proposal). 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: ………………………………
2.2
Identity Number: ………………………….....................................................
2.3
Position
occupied
in
the
Company
(director,
trustee,
……………………………………....................................................................
2.4
Company Registration Number: ………………………………………................
2.5
Tax Reference Number: ……………………………………………………..........
2.6
2.6.1
VAT Registration Number: ……………………………………………………
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.
shareholder²):
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.
sumnaidoo@deloitte.co.za2.7
/ NO
Are you or any person connected with the bidder
YES
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
presently employed by the state?
2.7.1
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:
………………………………………………………………
………………………………………………………………
………………………………………………………………
2.7.2
If you are presently employed by the state, did you obtain
the appropriate authority to undertake remunerative
work outside employment in the public sector?
2.7.2.1 If yes, did you attached proof of such authority to the bid
document?
YES / NO
YES / NO
(Note: Failure to submit proof of such authority, where
applicable, may result in the disqualification of the bid.
2.7.2.2 If no, furnish reasons for non-submission of such proof:
…………………………………………………………………….
…………………………………………………………………….
…………………………………………………………………….
2.10
2.8
Did you or your spouse, or any of the company’s directors /
trustees / shareholders / members or their spouses conduct
business with the state in the previous twelve months?
2.8.1
If so, furnish particulars:
…………………………………………………………………..
…………………………………………………………………..
…………………………………………………………………...
YES / NO
2.9
Do you, or any person connected with the bidder, have
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?
2.9.1If so, furnish particulars.
……………………………………………………………...
…………………………………………………………..….
………………………………………………………………
YES / NO
Are you, or any person connected with the bidder,
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
YES/NO
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
of this bid?
2.10.1 If so, furnish particulars.
………………………………………………………………
………………………………………………………………
………………………………………………………………
2.11 Do you or any of the directors / trustees / shareholders / members
of the company have any interest in any other related companies
whether or not they are bidding for this contract?
YES/NO
2.11.1 If so, furnish particulars:
…………………………………………………………………………….
…………………………………………………………………………….
…………………………………………………………………………….
3
Full details of directors / trustees / members / shareholders.
Full Name
4
Identity
Number
Personal
Tax State
Reference Number
Number
Number
Employee
/ Persal
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 IN TERMS OF
PARAGRAPH 23 OF THE GENERAL CONDITIONS OF CONTRACT SHOULD THIS
DECLARATION PROVE TO BE FALSE.
…………………………………..
Signature
..……………………………………………
Date
………………………………….
Position
………………………………………………
Name of bidder
May 2011
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
Form E:
DECLARATION OF PROPOSER’S PAST SUPPLY CHAIN
MENT PRACTICES
MANAGE-
In order to give effect to the above, the following questionnaire must be completed and
submitted with the proposal.
Item
1.
1.1
2.
2.1
3.
3.1
4.
4.1
Question
Yes
Is the Proposer or any of its directors listed on the National
Treasury’s database as companies or persons prohibited from
doing business with the public sector?
If so, furnish particulars:
No
Is the Proposer or any of its directors listed on the Register for
Proposal Defaulters in terms of section 29 of the Prevention
and Combating of Corrupt Activities Act (No 12 of 2004)?
If so, furnish particulars:
Was the Proposer or any of its directors convicted by a court of
law (including a court outside the Republic of South Africa) for
fraud or corruption during the past five years?
If so, furnish particulars:
Was any contract between the Proposer and any organ of state
terminated during the past five years on account of failure to
perform on or comply with the contract?
If so, furnish particulars:
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 Applicant
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
Form F:
BEE VERIFICATION CERTIFICATE
Please attach hereto a BEE Verification Certificate issued by a SANAS accredited BEE
Verification Agency for allocating preference points.
In the event that no certificate is attached or the BEE Verification Agency does not comply
with the above, preference points of zero (0) will be allocated.
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
FORM G: LITIGATION HISTORY FOR
Name of Applicant or Partner of a Joint Venture / Consortium
____________________________________________________________________
Applicants, including each of the partners of a joint venture / consortium, shall provide
information on any history of litigation or arbitration resulting from contracts executed in the
last five years or currently under execution. A separate sheet should be used for each
partner of a joint venture / consortium.
(For RSA Rand Equivalent use exchange rate US$1 = R7 or €1 = R9 or £1 = R12)
Year
Award for or
Against
Applicant
Name of Client, Cause of Litigation,
and Matter in Dispute
Disputed
Amount
(current
value, RSA
Rand
Equivalent
Applicants must indicate any litigation other than above where Applicant is involved as either
witness, expert witness or supporting any action.
Year
Name of Client, Cause of Litigation, and Matter in Dispute
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
Signature
________________________
:
Designation
______________________
:
Company
________________________
:
November 2015
APPLICATION FOR LISTING ON DATABASE OF NONAUDIT FINANCIAL ADVISORY SERVICES: PANEL OF
SERVICE PROVIDERS
FORM H: COMPANY PROFILE AND EXPERIENCE
Please attach company profile and experience illustrating point 3 of this application to
this form.
November 2015