WPD Pharmaceuticals



Appendix No. 1 to the Request for Bids No. 01/WPD101/2020THE BID FORM..................................., on .............. ............. (place)(date)CONTRACTOR:……………………………………….(name/registered office/address/tax ID (NIP) of the Contractor) AWARDING ENTITY:WPD Pharmaceuticals sp. z o.o.ul. ?wirki i Wigury 101, 02-089 Warszawa THE BIDfor the research service involving process and analytical development, non-GMP and GMP manufacture of drug substance, for consistent generation of the biopharmaceutical recombinant-protein product, as a part of the project No. POIR.01.01.01-00-0912/17, entitled: “Development of a new drug used in the therapy of glioblastoma multiforme”.By joining the contract award procedure, according to the Request for Bids No. 01/2020 announced on the 31th January 2020 on a research service I submit this Bid, on behalf of the RMATION ABOUT THE CONTRACTORThis Bid is submitted by:Contractor [name]:Registered Office [address]:Company Register No. [if applicable]:Tax ID (NIP):Name of the person authorized to represent the Contractor [signing the bid]:The basis of authorization to represent the Contractor:Name of the contact person:Phone No.:E-mail Address:Bank Account No. for payment the renumerationINFORMATION ABOUT THE BIDAccording to the Request for Bids No. 01/WPD101/2020, announced on the 31th January 2020,I submit this Bid and offer the execution of the Contract Object on the following conditions:Total Net Cost:Total Gross Cost if applicableTotal Net/ Total Gross Costin words:STATEMENTS OF THE CONTRACTORI hereby acknowledge that the list of Items described above in the table is of the minimal but not limited character, and thus may be extended by the Contractor recommendations without any further additional costs.I hereby undertake to conduct and accomplish the Items described above in the table, including full reporting, according to and in compliance with the adequate EMA guidelines, GMP requirements, and ICH recommendations (adequately to research works), which will be satisfactory for a further registration of a new drug candidate. I hereby acknowledge that I have read and understand the terms and conditions of the Request for Bids No. 01/WPD101/2020 including Appendices, and I accept its provisions, I acknowledge my requirements and rules of conduct and I do not rise any objections.I hereby acknowledge that the Gross Total Price includes all the costs of the contract execution, including all fees and taxes (including goods and services).I hereby acknowledge that submitted Bid applies in its entirety to the Contract Object specified in the Request for Bids No. 01/WPD101/2020.I hereby acknowledge that I have obtained all necessary information to prepare this Bid.I hereby acknowledge that in the case of selection this Bid, I undertake to sign the contract in the place and time indicated by the Awarding Entity.I hereby acknowledge that the bid is valid for a period specified in the Request for Bids No. 01/2020. Bid validity period starts from the date of the expiry of the bid submission deadline.I hereby acknowledge that there are no circumstances indicated in the Request for Bids No. 01/WPD101/2020 (Section VII), that would result in exclusion of the Contractor from the contract award procedure.I hereby acknowledge that I am able, on request and without delay, to present certificates and other types of evidence in the form of documents, confirming the information contained in this Bid.I hereby acknowledge that we have fulfilled the information obligations provided for in Article 13 or Article 14 of Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data and repealing Directive 95/46/EC (General Data Protection Regulation) (OJ L 119 of 4 May 2016, p.1) to individuals whose personal or direct data we have obtained for the purpose of applying for a public contract in this contract award procedure.APPENDICES:Documents attached to this Bid (delete as appropriate):Appendix No. 1. Power of attorney to represent the Contractor (if applicable)Appendix No. 2. Declaration of the ContractorAppendix No. 3. Declaration of no capital or personal linksAppendix No. 4. List of servicesAppendix No. 5. List of persons dedicated to the service performance with CVAppendix No 6. Certificate of European GMP standard or other equivalent documents recognized by the European UnionAppendix No. 8. Any other documents required by law, such as, actual authorization of the appropriate office for production of recombinant protein, or equivalent, confirming compliance with the requirements described in the Section VI of the Request for Bids No. 01/WPD101/2020.Place ……………….…., on …………… ........................................................(signature of the person(s) authorized to represent the Contractor) ................
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