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ANNEX IVTECHNICAL PROPOSAL SUBMISSION FORMRequest for Proposal (RFP) no: RFP 21/009Supply and Delivery of a Water Tanker Truck and all its accessories to Funafuti, TuvaluPART A – Firm/Institution BackgroundRegistered Name:Year Established:Physical Address:Postal Address:Telephone Contact:Fax Number:Email:Contact Person:Position of Contact Person:Number of Employees:Firm/Institutional experience on Supply and Delivery of a Water Tanker Truck including past experiences. Please provide two contacts of referees/references of past similar projects conducted. Attach additional details as applicable.1.2.Legal registration of firm(attach documentation)ItemDescriptionResponses By Bidder Confirming Expertise,Experience, Ability, Technical Skills And Resources ToProvide Professional Services To SPC (please providedocumentation to support your proposal)1Compliance 2Handling, Commissioning, Operation and Maintenance 3Quality and Origin of the Water Tanker Truck and its accessories4Water Tanker Truck & Accessories Warranties5Delivery Schedule and Critical Path Activities6Risk/ Mitigation Measures7Relevant Skills and Past Performance8Characteristics/ Specification of the Water Tanker Truck and its AccessoriesANNEX VFINANCIAL PROPOSAL SUBMISSION FORMRequest for Proposal (RFP) no: RFP 21/009Supply and Delivery of a Water Tanker Truck and all its accessories to Funafuti, TuvaluAll costs indicated on the financial proposal should be in CIF inclusive of all applicable taxes.The format shown below should be used in preparing the price schedule.Price Schedule Request for ProposalsAmount in EuroTotal Price (CIF)Cost Exclusive of all duties and taxTOTALAnnex VICONFLICT OF INTEREST I confirm that I, my family members, and the organisation or company that I am involved with are independent from SPC. To the best of my knowledge, there are no facts or circumstances, past or present, or that could arise in the foreseeable future, which might call into question my independence.If it becomes apparent during the procurement process that I may be perceived to have a conflict of interest, I will immediately declare that conflict and will cease to participate in the procurement process, unless or until it is determined that I may continue.ORI declare that there is a potential conflict of interest in the submission of my bid [please provide an explanation with your bid]____________________________________ _______________________Name, SignatureDate Title_____________________ ................
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