Standard Selection Questionnaire.docx

1、Standard Selection QuestionnaireStandard Selection QuestionnairePotential Supplier Information and Exclusion Grounds: Part 1 and Part 2.The standard Selection Questionnaire is a self-declaration, made by you (the potential supplier), that you do not meet any of the grounds for exclusion. If there ar

2、e grounds for exclusion, there is an opportunity to explain the background and any measures you have taken to rectify the situation (we call this self-cleaning).A completed declaration of Part 1 and Part 2 provides a formal statement that the organisation making the declaration has not breached any

3、of the exclusions grounds. Consequently we require all the organisations that you will rely on to meet the selection criteria to provide a completed Part 1 and Part 2. For example these could be parent companies, affiliates, associates, or essential sub-contractors, if they are relied upon to meet t

4、he selection criteria. This means that where you are joining in a group of organisations, including joint ventures and partnerships, each organisation in that group must complete one of these self-declarations. Sub-contractors that you rely on to meet the selection criteria must also complete a self

5、-declaration (although sub-contractors that are not relied upon do not need to complete the self-declaration). When completed, this form is to be sent back to the contact point given in the procurement documents along with the selection information requested in the procurement documentation. Note fo

6、r Contracting Authorities: The following paragraph is optional for inclusion, authorities can delete it if they prefer to receive only Word/ PDF versions of the standard Selection Questionnaire. Alternatively you can submit the completed Exclusion Grounds of the EU ESPD (Part III) as a downloaded XM

7、L file to the buyer contact point along with the selection information requested in the procurement documentation.Supplier Selection Questions: Part 3The procurement document will provide instructions on the selection questions you need to respond to and how to submit those responses. If you are bid

8、ding on behalf of a group (consortium) or you intend to use sub-contractors, you should complete all of the selection questions on behalf of the consortium and/or any sub-contractors.If the relevant documentary evidence referred to in the Selection Questionnaire is not provided upon request and with

9、out delay we reserve the right to amend the contract award decision and award to the next compliant bidder.Consequences of misrepresentationIf you seriously misrepresent any factual information in filling in the Selection Questionnaire, and so induce an authority to enter into a contract, there may

10、be significant consequences. You may be excluded from the procurement procedure, and from bidding for other contracts for three years. If a contract has been entered into you may be sued for damages and the contract may be rescinded. If fraud, or fraudulent intent, can be proved, you or your respons

11、ible officers may be prosecuted and convicted of the offence of fraud by false representation, and you must be excluded from further procurements for five years. INSERT PROCUREMENT NAMEINSERT REFERENCE NUMBERINSERT PROCUREMENT PROCEDURE e.g. OPEN, RESTRICTEDNotes for completion1. The “authority” mea

12、ns the contracting authority, or anyone acting on behalf of the contracting authority, that is seeking to invite suitable candidates to participate in this procurement process.2. “You” / “Your” refers to the potential supplier completing this standard Selection Questionnaire i.e. the legal entity re

13、sponsible for the information provided. The term “potential supplier” is intended to cover any economic operator as defined by the Public Contracts Regulations 2015 (referred to as the “regulations”) and could be a registered company; the lead contact for a group of economic operators; charitable or

14、ganisation; Voluntary Community and Social Enterprise (VCSE); Special Purpose Vehicle; or other form of entity.3. Please ensure that all questions are completed in full, and in the format requested. If the question does not apply to you, please state N/A. Should you need to provide additional inform

15、ation in response to the questions, please submit a clearly identified annex.4. The authority recognises that arrangements set out in section 1.2 of the standard Selection Questionnaire, in relation to a group of economic operators (for example, a consortium) and/or use of sub-contractors, may be su

16、bject to change and will, therefore, not be finalised until a later date. The lead contact should notify the authority immediately of any change in the proposed arrangements and ensure a completed Part 1 and Part 2 is submitted for any new organisation relied on to meet the selection criteria. The a

17、uthority will make a revised assessment of the submission based on the updated information.5. For Part 1 and Part 2 every organisation that is being relied on to meet the selection must complete and submit the self-declaration. 6. Note for Contracting Authorities: The following paragraph is optional

18、 for inclusion if a decision has been made to request a self-declaration of the exclusion grounds from sub-contractors. All sub-contractors are required to complete Part 1 and Part 2. 7. For answers to Part 3 - If you are bidding on behalf of a group, for example, a consortium, or you intend to use

19、sub-contractors, you should complete all of the questions on behalf of the consortium and/ or any sub-contractors, providing one composite response and declaration.The authority confirms that it will keep confidential and will not disclose to any third parties any information obtained from a named c

20、ustomer contact, other than to the Cabinet Office and/or contracting authorities defined by the regulations, or pursuant to an order of the court or demand made by any competent authority or body where the authority is under a legal or regulatory obligation to make such a disclosure.Part 1: Potentia

21、l supplier InformationPlease answer the following questions in full. Note that every organisation that is being relied on to meet the selection must complete and submit the Part 1 and Part 2 self-declaration. Section 1Potential supplier informationQuestion numberQuestionResponse1.1(a)Full name of th

22、e potential supplier submitting the information1.1(b) (i)Registered office address (if applicable)1.1(b) (ii)Registered website address (if applicable)1.1(c)Trading status a) public limited companyb) limited company c) limited liability partnership d) other partnership e) sole trader f) third sector

23、g) other (please specify your trading status)1.1(d)Date of registration in country of origin1.1(e)Company registration number (if applicable)1.1(f)Charity registration number (if applicable)1.1(g)Head office DUNS number (if applicable)1.1(h)Registered VAT number 1.1(i) - (i)If applicable, is your or

24、ganisation registered with the appropriate professional or trade register(s) in the member state where it is established?Yes No 1.1(i) - (ii)If you responded yes to 1.1(i) - (i), please provide the relevant details, including the registration number(s).1.1(j) - (i)Is it a legal requirement in the st

25、ate where you are established for you to possess a particular authorisation, or be a member of a particular organisation in order to provide the services specified in this procurement?Yes No 1.1(j) - (ii)If you responded yes to 1.1(j) - (i), please provide additional details of what is required and

26、confirmation that you have complied with this.1.1(k)Trading name(s) that will be used if successful in this procurement1.1(l)Relevant classifications (state whether you fall within one of these, and if so which one)a) Voluntary Community Social Enterprise (VCSE)b) Sheltered Workshopc) Public service

27、 mutual1.1(m)Are you a Small, Medium or Micro Enterprise (SME)?Yes No 1.1(n)Details of Persons of Significant Control (PSC), where appropriate: - Name; - Date of birth; - Nationality; - Country, state or part of the UK where the PSC usually lives; - Service address; - The date he or she became a PSC

28、 in relation to the company (for existing companies the 6 April 2016 should be used); - Which conditions for being a PSC are met; - Over 25% up to (and including) 50%, - More than 50% and less than 75%, - 75% or more. (Please enter N/A if not applicable)1.1(o)Details of immediate parent company: - F

29、ull name of the immediate parent company- Registered office address (if applicable)- Registration number (if applicable)- Head office DUNS number (if applicable)- Head office VAT number (if applicable)(Please enter N/A if not applicable)1.1(p)Details of ultimate parent company:- Full name of the ult

30、imate parent company- Registered office address (if applicable)- Registration number (if applicable)- Head office DUNS number (if applicable)- Head office VAT number (if applicable)(Please enter N/A if not applicable)Please note: A criminal record check for relevant convictions may be undertaken for

31、 the preferred suppliers and the persons of significant in control of them.Please provide the following information about your approach to this procurement:Section 1Bidding modelQuestion numberQuestionResponse1.2(a) - (i)Are you bidding as the lead contact for a group of economic operators?Yes No If

32、 yes, please provide details listed in questions 1.2(a) (ii), (a) (iii) and to 1.2(b) (i), (b) (ii), 1.3, Section 2 and 3.If no, and you are a supporting bidder please provide the name of your group at 1.2(a) (ii) for reference purposes, and complete 1.3, Section 2 and 3.1.2(a) - (ii)Name of group of economic operators (if applicable)1.2(a) - (iii)Proposed legal structure if the