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Contract N o CDC/501/14 3 June 2014 Request for Proposal: PROFESSIONAL CONSULTANCY SERVICES FOR THE ST LUCY’S HOSPITAL IN ST CUTHBERTS IN THE EASTERN CAPE PROVINCE PDF processed with CutePDF evaluation edition www.CutePDF.com PDF processed with CutePDF evaluation edition www.CutePDF.com

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Page 1: Request for Proposal - Coega · Request for Proposal documents will be available from 10:00 on Friday, ... For Building Information Modeling (BIM), general integration of design elements

Contract No

CDC/501/14

3 June 2014

Request for Proposal:

PROFESSIONAL CONSULTANCY SERVICES FOR THE ST LUCY’S HOSPITAL IN ST CUTHBERTS IN THE EASTERN CAPE

PROVINCE

PDF processed with CutePDF evaluation edition www.CutePDF.comPDF processed with CutePDF evaluation edition www.CutePDF.com

Page 2: Request for Proposal - Coega · Request for Proposal documents will be available from 10:00 on Friday, ... For Building Information Modeling (BIM), general integration of design elements

DOCUMENT INFORMATION SHEET

Title of Document : Request for Proposal: Professional Consultancy Services for the St Lucy’s Hospital in St Cuthberts in the Eastern Cape Province

Type of Document : Request for Proposal

Document Number : CDC/501/14

Prepared by : Chandrakant Patel

Typed by : Chandrakant Patel

Business Unit : DoH Programme

Prepared for : CDC

Date of Issue : 3 June 2014

Copyright

All rights reserved. No part of this document may be reproduced or distributed in any form or by any means, electronic, mechanical, photocopying or recording

or otherwise, or stored in a database or retrieval system, without the prior written permission of the Coega Development Corporation (Pty) Ltd. ©

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Coega Development Corporation Provincial Projects CDC-Services Department of Health ISO 9001: 2008 Clause 7.4.1 Purchasing Process

This document, and the information or advice which it contains, is provided by the CDC-Services Business

Unit solely for the use by the Dept of Health and the Coega Development Corporation (Pty) Ltd and for

reliance by its Executive Management and the Board in performance of that Business Unit’s duties.

DOCUMENT CONTROL SHEET

The purpose of this form is to ensure that documents are reviewed and approved prior to issue. The form is to be bound into the front of all documents released by the CDC.

PROJECT NAME : PROVINCIAL PROJECTS – DEPARTMENT OF HEALTH

DOCUMENT TITLE : Request for Proposal: Professional Consultancy Services for the St Lucy’s Hospital in St Cuthberts in the Eastern Cape Province

DOCUMENT No. : CDC/501/14

SIGNING OF THE ORIGINAL DOCUMENT We, the undersigned, accept this document as a stable work product to be placed under formal change control as described by the Change Control Procedure document.

ORIGINAL Prepared by Reviewed by Approved by Date:

3 June 2014

Name: Chandrakant Patel

Name: Christo Beukes

Name: Babini Melitafa

Signature:

Signature: Signature:

Distribution: Potential Bidders

REVISION CHART

REVISION 1 Name:

Name:

Name:

Date:

Signature:

Signature:

Signature:

REVISION 2 Name:

Name:

Name:

Date:

Signature: Signature: Signature:

REVISION 3 Name:

Name:

Name:

Date:

Signature: Signature: Signature:

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001- RFP-St Lucy’s Hospital Consultancy Services i 17 June 2014

REQUEST FOR PROPOSAL

Professional Consultancy Services for the St Lucy’s Hospital in St Cuthberts in the Eastern Cape Province

Contract No. CDC/501/14

INVITATION AND SCOPE OF SERVICES

The CDC is inviting capable and competent Professional Service Providers to submit proposals for the

provision of professional consulting services. Respondents must comprise of multidisciplinary project teams

which must be achieved through the formation of Consortium or Joint Venture. Members of the consortium or

JV must comprise of following professionals: an Architect, a Quantity Surveyor, Civil & Structural Engineers, a

Mechanical Engineer and an Electrical Engineer.

Respondents are required to have relevant experience and knowledge in the planning, design, construction

management and final commissioning of the completed health care facilities. The services to be provided will

include the following;

(a) Development of concept design and plans;

(b) Development of detailed designs and tender documentation;

(c) Full time site supervision and contract management during construction phase;

(d) Overall co-ordination and project management activities;

(e) Assisting with the Commissioning of the completed facility and handover to the Health Technology

Commissioning Team; and

(f) Close-out Report.

CONDITIONS

(a) Preference will be given to respondents who comply with the CDC’s Procurement Policy & Procedures.

(b) Preferential Procurement Policy Framework Act (PPPFA) principles shall apply, whereby submissions

will be evaluated according to the provisions of that Act and the Public Finance Management Act

(PFMA) Sections 36 and 49.

The Coega Development Corporation (Pty) Ltd (CDC) is assisting the Provincial Department of Health

(ECDoH) and the Provincial Department of Roads and Public Works (DRPW) with the upgrading of health

care facilities within the Eastern Cape Province. This project entails the construction of the Community

Health Hospital which includes all the associated works that will ensure a fully functional facility.

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001- RFP-St Lucy’s Hospital Consultancy Services ii 17 June 2014

(c) Bidders must submit a valid BBBEE Verification Certificate from SANAS Accredited Verification Agency

or from a Registered Auditor approved by Independent Regulatory Board of Auditors (IRBA) in order to

be eligible for empowerment points. The Exempted Micro Enterprises (EME) may submit a letter from

the Accounting Officer confirming the company turnover.

(d) The following scores will be applied:

(i) Price - 90;

(ii) BBBEE Status - 10.

Request for Proposal documents will be available from 10:00 on Friday, 20th

June 2014 at the CDC’s East

London Office, 2nd

Floor, Liberty Life Quarry View Building, Corner Pearce Street and Quartzite Drive,

Berea, East London and can also be downloaded from the CDC website:

www.coega.com

A mandatory briefing meeting is scheduled for 12:00 on Monday, 30th

June 2014 at the EL Health Resource

Centre, Chelterham Road, East London (situated immediately North of Frere Hospital), where

representatives from Coega Development Corporation will meet prospective tenderers.

One original completed bid document shall be placed in a sealed envelope clearly marked: “CDC/501/14 –

Professional Consultancy Services for the Construction of the St Lucy’s Hospital in St Cuthberts in the

Eastern Cape Province. The closing date and time for the receipt of completed bids is Monday, 14th

July

2014 at 12h00 at the reception desk of the CDC’s East London Office, 2nd

Floor Liberty Life Quarry View

Building, Corner Pearce Street and Quartzite Drive, Berea, East London. Bids will not be opened in public

and no late submissions will be considered.

Failure to provide any mandatory information required in this Bid will result in the submissions being deemed

null and void and shall be considered non-responsive. Respondents must include a valid and original SARS

Tax Compliance Certificate in their submissions in order to be considered.

Telegraphic, telexed, facsimiled or e-mail submissions will not be accepted.

No telephonic or any other form of communication with any other CDC member of staff, other than the

named individual below, relating to this request for bid will be permitted. All enquiries regarding this

bid must be in writing only, and must be directed to:

Luvuyo Matya, Acting Supply Chain Manager; e-mail: [email protected].

The CDC reserves the right not to accept the lowest proposal in part or in whole or any proposal.

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001- RFP-St Lucy’s Hospital Consultancy Services iii 17 June 2014

TABLE OF CONTENTS

1 INTRODUCTION AND BACKGROUND ............................................................................................. 1

2 SCOPE OF WORK ........................................................................................................................... 1

3 PREPARATION OF SUBMISSION .................................................................................................... 6

4 ASSESSMENT CRITERIA .................................................................................................................. 7

4.1 Responsiveness ............................................................................................................................. 7

4.2 Additional Information Required .................................................................................................. 8

4.3 Quantitative Assessment .............................................................................................................. 8

5 TERMS AND CONDITIONS ............................................................................................................. 8

6 DISQUALIFICATION ..................................................................................................................... 10

7 APPENDICES:

A. Financial Proposal

B. Respondent's Information Sheet

C. Tender Offer Evaluation and Scoring

D. Certificate of Independent Bid Determination - Form SBD 9

E. Conditional Assessment Report

F. Compulsory Declaration of Interest Form

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Coega Development Corporation Provincial Projects Department of Health Programme Department of Health ISO 9001:2008 Clause 7.4.1 Purchasing Process

001- RFP-St Lucy’s Hospital Consultancy Services 1 17 June 2014

1 INTRODUCTION AND BACKGROUND

The Coega Development Corporation (Pty) Ltd (CDC) is assisting the Eastern Cape Provincial

Department of Health (DoH) together with the Eastern Cape Provincial Department of Roads and

Public Works (DRPW) in the upgrading of health care facilities within the Eastern Cape Province.

These programmes include all the associated works that will ensure fully functional facilities.

This particular project is a fast-track project to enable the construction of the St Lucy’s Hospital in

Mhlontlo Municipality, O R Tambo District of the Eastern Cape Province and is approximately 61 km

North West of Mthata off Tsolo-Maclear road. This facility requires urgent intervention as the existing

facilities are not complying with the norms and standards of Community Health Hospitals (CHH).

The Department of Health (DoH) and the Management of the St Lucy’s Hospital are in the process of

improving the level and the quality of services in the Province. Hence, the primary objective of the

project is to ensure that the health care services to be provided at this facility are aligned with health

care norms, standards, best practices and regulations. A Community Health Hospital (CHH) should

ideally provide comprehensive integrated CHH services using a one-stop approach on a 24 hour basis

a day and for seven days a week.

2 SCOPE OF WORK

The immediate goal is to design and then the refurbishment and/or construction of the new healthcare

facility to address the immediate needs of the local community in the surrounding areas and ensure a

facility that will meet the Primary Health Care service standards.

The long-term project objective is to ensure that the services provided at the St Lucy’s Hospital meet

the level of service required by the Department of Health, through this immediate intervention. It is

imperative to align the design, components and size of each facility to the population distribution,

socio-economic status, transport access and a host of social and environmental determinants of

health which influences the infrastructure and improves the aesthetics of the building. The existing

hospital has to remain operational during the entire course of the project. Hence, disturbance would

have to be kept to absolute minimum which includes disruption to services, noise levels, dust and

general nuisances.

The scope of work for this project is described here below:

Phase 1: Conditional Assessment of the Existing Hospital Facility (Already done by others-

Appendix E, no need to price)

(a) The physical assessment of existing surrounding facilities in terms of strategic (municipal services

i.e potable water, sewer and electricity supply) and estate planning, ergonomically safe and risk-

free environment, population distribution, socio-economic status, and transport access;

(b) Site topography surveys and cadastral site plans (if required);

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001- RFP-St Lucy’s Hospital Consultancy Services 2 17 June 2014

(c) Environmental plan (if required);

(d) Compilation and submission of a Conditional Assessment Report and

(e) Overall co-ordination and project management activities.

Phase 2: Compilation of Project Brief/Clinical Report for the Community Health Hospital

(Already done by others, no need to price)

(a) Development of a Clinical Brief complete with user requirement as per accommodation

schedules;

(b) Development of a high level conceptual design layout for the facility taking into consideration the

need to make alterations and extensions, reconfiguration of internal arrangements,

refurbishments and external civil works;

(c) Computing estimated costs for the building upgrading works; and

(d) Overall co-ordination and project management activities.

Phase 3: Design of the Upgrading of the Community Health Hospital (Technical Brief)

(a) Review of the Concept Plan (to be provided by others), where necessary and Development of a

detailed concept design in compliance with the Clinical Brief and requirements for sign off /

approval;

(b) Development of detailed design and tender documents. For Building Information Modeling

(BIM), general integration of design elements and design presentations to the Client, “Revit©”

shall be used;

(c) Site supervision during construction phase;

(d) Commissioning of the facility on completion (infrastructure only); and

(e) Overall co-ordination and project management functions ;

The following items are exclusions from the scope:

• Initial planning i.e. development of clinical brief and concept plans

• Clinical equipment and furniture for the facility; and

• HT commissioning for operational readiness.

The Professional Service Provider/s will be expected to produce detailed specifications and drawings

for the works in consultation with the CDC and ECDoH. The specifications should be in line with the

approved project brief specifications as per the norms and standards for health care facilities. The

following services will be provided by the service providers:

Consultants (This RfP document)

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001- RFP-St Lucy’s Hospital Consultancy Services 3 17 June 2014

(a) Health facility planning, standards and approved layout plan (*Refer to IUSS FACILITY GUIDES

– Primary Health Care Facilities Report) containing the requirements with detailed

accommodation schedules, a concept layout of the proposed facility, a cost estimate based on

the concept design and conditional assessment report by the Consultants. Note that the

conditional assessment of the existing facility was already undertaken by other consultants

together with a Clinical Brief Report and proposed Concept Layout. This information will be

issued on appointment of the successful consultancy consortium/JV;

(b) Carry out further geotechnical investigations and site surveying if required;

(b) Further Concept Designs; Detail Design and Tender Documentation for procurement of a building

contractor;

(c) Overall contract administration, project management, co-ordination and construction

management of the works, attend site meetings at least every two weeks and more frequently if

deemed necessary by the CDC Project Manager;

(d) Commissioning of the completed facility (infrastructure only);

(e) Project Close Out.

NOTE:

The project may have to be executed in phases due to restrictions and sequencing of the works so as

not to adversely affect the operational hospital. The phasing will be identified during the development

of the Master Plan, Clinical Brief and Concept Design by others. The Consortium/JV will cooperate

fully at all times with the HT Consultants in the decanting, de-commissioning and commissioning of the

facilities. The project period for design and construction is 30 months.

The detailed stages of the services will be as follows:

2.1.1 Stage 1 - Concept Design (Preliminary Designs)

(i) Advise the End User/Client on the requirement to appoint a Health and Safety

Consultant including its procurement and managing during the construction;

(ii) Communicate the scope of works and accept and comment on the development of

the project brief and concept design with amendments where required;

(iii) Agree with the CDC and the ECDoH on the format and procedures for cost control

and reporting;

(iv) Manage and monitor the preparation of project costing with specific reference to site

matters that may affect the project costs;

(v) Prepare and co-ordinate an Indicative Project Document and Project Programme;

(vi) Manage the integration of concept design presentation to the DoH and ECDoH for

approval; and

(vii) Facilitate the End User/Client approvals.

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001- RFP-St Lucy’s Hospital Consultancy Services 4 17 June 2014

2.1.2 Stage 2 – Detail Design

(i) Establish a design Project Review Committee with one member representing every

stakeholder;

(ii) Conduct monthly project progress design review meetings with the consultants,

hospital management, CDC and ECDoH;

(iii) Manage the performance of the consultant team, with specific reference to

deliverables, and fee payable;

(iv) Manage the performance of the contractor with specific reference to deliverables,

payment, interest and penalties;

(v) Actively pursue the optimisation of the designs and implementation strategies;

(vi) Establish and co-ordinate the formal and informal communication structure,

processes and procedures for the design development of the project;

(vii) Prepare, co-ordinate and agree on a detailed Design and Documentation for the

project;

(viii) Manage, co-ordinate and integrate the design in a sequence to suit the project

design and documentation with consultants;

(ix) Facilitate and manage the end-user participation, by establishing the working group

committee to participate in meetings during the design of the project;

(x) Manage and monitor the timeous submission by the design team of all plans and

documentation to obtain the necessary statutory approvals;

(xi) Conduct Value Engineering exercise with CDC on detail designs for approval;

(xii) Facilitate any input from the design consultants required by Health and Safety

consultant;

(xiii) Establish responsibilities and monitor the information flow (to and from) to all

stakeholders

(xiv) Manage the preparation of cost estimates by the Quantity Surveyor, budgets and

cost reports;

(xv) Cost control to achieve cost effective designs;

(xvi) Facilitate and monitor the timeous technical co-ordination of the design by the design

team;

(xvii) Manage and monitor the planning and documentation of commissioning of the

facility, including change management planning; and

(xviii) Facilitate End User/Client approvals.

2.1.3 Stage 3 - Tender Documentation and Procurement

(i) Prepare and agree on the Project Procurement Programme;

(ii) Prepare and agree on the tendering process and format of tender evaluation;

(iii) Co-ordinate and monitor the preparation of the tender document by the consultants;

(iv) Preparation of Health and Safety Specifications;

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001- RFP-St Lucy’s Hospital Consultancy Services 5 17 June 2014

(v) Prepare Socio Economic Specifications;

(vi) Ensure inclusion of EPWP and SMME work package principles in the designs and

tender documents based on CDC SMME specifications;

(vii) Ensure energy efficient designs;

(viii) Manage the tender process in accordance with the CDC Procurement Policy and

PFMA requirements, including calling for tenders, adjudication of tenders, and

appointment of contractor, all conforming to CIDB and Government procurement

procedures;

(ix) Manage all the risks associated with tendering process; and

(x) Facilitate client approval to proceed with the construction.

2.3.5 Stage 4 - Construction Administration and Site Supervision

(i) Assist with appointment of contractor including signing of JBCC contract;

(ii) Ensure that all contractual obligations from the contractor are met e.g. guarantees,

insurances, programmes, etc are in place;

(iii) Manage the performance of the consultants, with specific reference to deliverables

and fee remuneration;

(iv) Manage the performance of the contractor with specific reference to deliverables,

cost structures, interest and penalties;

(v) Actively pursue the optimisation of the designs and implementation strategies;

(vi) Facilitate the hand-over of site to the contractor;

(vii) Establish and co-ordinate the formal and informal communication structure and

procedures during the construction period;

(viii) Monitor, review and approve the preparation of the contract programme;

(ix) Regularly attend the necessary site meetings;

(x) Monitor the compliance by the contractors of the requirements of the Health and

Safety Consultant;

(xi) Monitor the auditing of the contractors Health and Safety Plan and on site auditing by

the Health and Safety Agent;

(xii) Monitor the compliance by the contractors of the requirements of the Socio -

Economic Deliverables;

(xiii) Report on EPWP and SMME achievements to ECDoH;

(xiv) Establish if any scope may require environmental approval such as heritage approval

permits, etc and action on behalf of ECDoH;

(xv) Manage the preparation of the Environmental Management Plan by Environmental

Consultants (if required);

(xvi) Agree and manage the document schedule to ensure timeous delivery of required

information to the contractor;

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001- RFP-St Lucy’s Hospital Consultancy Services 6 17 June 2014

(xvii) Establish procedure for monitoring, controlling and agreeing all scope and cost

variations not exceeding 5% of the original appointed contract value. Formal

approvals to be obtained from CDC and ECDoH prior to instruction to proceed with

any scope changes;

(xviii) Agree and monitor all quality assurance procedures and implementation thereof by

the consultant and the contractor;

(xix) Monitor, review, approve and certify monthly progress payments of all Service

Providers;

(xx) Receive, review and adjudicate any contractual claims;

(xxi) Monitor the preparation of monthly cost reports by the Quantity Surveyor;

(xxii) Submit all necessary cash flows to the CDC and ECDoH;

(xxiii) Prepare monthly project reports (reporting on project progress and financial

management) including any other submission to the CDC and ECDoH;

(xxiv) Co-ordinate and monitor the defects/snag lists to enable the issue of the Certificate

of Practical Completion;

(xxv) Monitor the execution of the defects items to achieve works completion and the

issue of a Works Completion Certificate;

(xxvi) Monitor the execution of the defects items during the defect period to achieve final

completion and the issue of a Final Completion Certificate;

2.3.6 Stage 6 - Project Close Out

(i) Manage, co-ordinate and monitor all necessary commissioning of all complete works

on the facility for formal hand over to the HT Commissioning Team who will be

responsible for the HT equipment supply and operational commissioning of the

facility;

(i) Manage, co-ordinate and expedite the preparation of As-Built drawings;

(ii) Manage and expedite the issue of all operating and maintenance manuals as well as

warrantees and guarantees;

(iii) Manage, co-ordinate and expedite the preparation and agreement of the final

account by the consultants with the relevant contractors;

(iv) Process final accounts;

(v) Receive and review Close-out Reports from the Consultants/Contractors; and

(vi) Submit a project Close-out Report with project and financial data to the CDC and

ECDoH.

3 PREPARATION OF SUBMISSION

The following items are to be submitted:

(a) The Respondents Information Sheet at the beginning of this document;

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001- RFP-St Lucy’s Hospital Consultancy Services 7 17 June 2014

(b) An organogram of all members of the Consortium/ Joint Venture;

(c) Percentage and description of work to be carried out by each member of the Consortium/ Joint

Venture;

(d) Commitment to the transfer of knowledge i.e. the use of interns and students proposed for this

project by indicating the minimum number (five) to be assigned to this project and remuneration

deemed to be included in the percentage fee by all disciplines for the duration of the

appointment;

(e) The Financial Proposal form (Appendix A) is to be completed by respondents, wherein fees are

reflected as an amount in Rand and the remaining fees expressed as a percentage of the total

construction cost; and

(f) The Tender Offer Evaluation and Scoring document attached (Appendix B) should be carefully

read and all Annexures are to be completed in full.

4 ASSESSMENT CRITERIA

4.3 Responsiveness

The following criteria will be used in assessing the responsiveness of tenders.

Table 1: Mandatory Requirements to be submitted

NO. DESCRIPTION YES NO

1 Valid original Tax Clearance Certificate;

2 Confirmation of signing of attendance register to the mandatory

briefing meeting;

3 Authority of lead partner to sign the documents for JVs;

4 A letter signed by all members of JV, where they occur, confirming the

lead partner;

5 Comprehensive CVs of Professional Service Providers in each

discipline

6 Proof of Registration with Professional Institutions for each discipline

7 Completed and signed Declaration of Interest Register;

8 Financial proposal Schedules (A1, A2 & A3) must be completed and

signed in full and returned; and

9 Completed and signed Certificate of Independent Bid Determination -

Form SBD 9

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001- RFP-St Lucy’s Hospital Consultancy Services 8 17 June 2014

Failure to submit and complete all mandatory information will result in submissions

being deemed null and void and shall be considered “non – responsive” and therefore

not considered.

4.4 Additional Information Required

The following additional information is required for the assessment of bids:

(a) BEE Certificate; and

(b) A capability statement, reflecting the past experience of the respondents on projects of a

similar nature.

4.5 Quantitative Assessment

Bids are to be adjudicated on Price and BEE status. The method of scoring Financial

Proposals and the BEE Verification Certificate is described in the attached Tender Evaluation

and Scoring document.

The allocation of tender adjudication points for this Contract shall be as follows:

Area of Adjudication Maximum Points

Tendered Price (SP) 90

Empowerment Objectives (SE) 10

Total Points (S) 100

5 TERMS AND CONDITIONS

(a) All submissions must be received by the CDC no later than 12:00 noon, Monday, the 14th

July

2014. Respondents must submit their proposals before the closing date and time and any late

submissions will not be considered;

(b) A Clarification (Briefing) meeting has been scheduled for 30 June 2014 at 11:00 am at EL Health

Resource Centre, Chelterham Road, East London;

(c) All submissions and subsequent information received will become the property of the CDC and

will not be returned;

(d) Failure to complete all mandatory information will result in submissions being deemed null and

void and shall be considered “non-responsive” and therefore not considered;

(e) Telegraphic, telexed, faxed or e-mailed submissions will not be accepted;

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001- RFP-St Lucy’s Hospital Consultancy Services 9 17 June 2014

(f) One original document shall be placed in sealed envelopes clearly marked. “CDC/501/14 -

Professional Consultancy Services for the St Lucy’s Hospital in St Cuthberts in the

Eastern Cape Province”

(g) Respondents or their representatives (including the courier services) must ensure that they

register their submissions in the Register for Submissions form that will be provided at the

Reception Desk of the CDC, wherein they will indicate the name of the person delivering the

submission, the number of copies submitted, the time and date of submission and attach their

signatures;

(h) All enquiries and submissions regarding this Request for Proposal must be directed in writing

only to: Mr Luvuyo Matya: Acting Supply Chain Manager, Coega Development Corporation,

Corner Alcyon Road & Zibuko Street, Zone 1, Coega IDZ, Port Elizabeth, 6100.

Email : [email protected]

(i) The contact person reflected above shall be the only point of contact for this contract. Failure to

observe this requirement will lead to immediate disqualification of the respondent;

(j) The CDC reserves the right not to accept any submission. If the CDC does not accept any

submission, it will declare this proposal request process to be closed and may then elect to

negotiate with any party, or to proceed on a completely different basis, or not to proceed with the

services;

(k) Submission of a proposal and its subsequent receipt by the CDC does not represent a

commitment on the part of the CDC to proceed further with any Respondent or any project;

(l) The Respondent shall treat as confidential all documentation, drawings, reports, etc which are

provided pursuant to this RfP;

(m) All documents, drawings, reports, etc prepared by the Respondent pursuant to this RfP shall

become the copyright of the CDC;

(n) No costs incurred by the Respondents in the preparation of their submission will be reimbursed;

(o) All Respondents will be advised as soon as the successful Bidders have been approved

pertaining to the specific contract;

(p) Members of the bidders not to appear in more than one consortium. In the event that this is

unavoidable, such consultant shall sign a confidentiality agreement among the consortium or JV

members to not disclose information to another group. This document to be enclosed in the

bid submission.

(q) Disbursements for printing, typing, binding, etc. unless otherwise stated will be payable as per

the National Department of Roads and Public Work’s Gazetted Rates;

(r) All travel and time cost disbursements within a radius of 65km from the base office in Mthatha (O

R Tambo District) would be deemed to be included in the percentage fees schedule for all

disciplines. Travel and time costs to meetings at special request of CDC will be paid as per the

National Department of Roads and Public Work’s Gazetted Rates on a proven cost basis; and

(s) The Fidic Client/Consultant Model Service Agreement, Fourth Edition 2006, will be used after

appointment of the successful respondent.

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001- RFP-St Lucy’s Hospital Consultancy Services 10 17 June 2014

6 DISQUALIFICATION

Potential Bidders will be disqualified immediately during the tendering stage or during the tender

evaluation and adjudication stage or after the contract has been awarded if they are found to have

conducted or committed any of the following:

(a) Bidders, bidder’s representatives, associates, or shareholders that sought to influence

adjudication process of this tender, or outcomes of the adjudication process, directly or indirectly;

(b) Bidder that failed to follow or observe the lines of communication that are prescribed in the

Advert;

(c) Collusion among bidders;

(d) Misrepresentation of information;

(e) Any Bidder or its principals or both who have engaged in corrupt and fraudulent practices, not

only with the CDC but anywhere else;

(f) Bidder who has pending liquidation, in receivership, bankrupt/insolvent (actually and

commercially);

(g) Tendered price that is unrealistically low and posing commercial risk to the CDC;

(h) Poor past performance on previous contracts; and

(i) Bidder or JV/Consortium partner appearing on National Treasury blacklist.

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APPENDIX A

FINANCIAL PROPOSAL

Schedule A1: Professional Services

Activities per Stage

Disciplines Total per

Activity (all

disciplines) Arch/PA** QS

Civil &

Structural Electrical Mech

Clerk of

Works

% %

% % %

% %

(a) Fee as a percentage of the total construction cost for the review and development of the concept design and cost estimate.

(b) Fee as a percentage of the total construction cost for the detail designs and pre tender cost estimate*.

(c) Fee as a percentage of the total construction cost for the tender document.

(d) Fee as a percentage of the total construction cost for the overall project co-ordination and project management functions/activities.

(e) Fee as a percentage of the total construction cost for full time site supervision during construction.

(f) Fee as a percentage of the total construction cost for the commissioning of the new facility on completion and close out report.

Total Percentage per Discipline & Overall Total

* The cost estimate to include the project life-cycle cost (including the demolition of the facility)

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** Responsibility of the PA functions to be decided by the Consortium/JV.

Schedule A2: Fee Amount Calculation

Estimated Construction Costs (Excluding VAT) R 75 000 000

Fees Tendered Unit Amount

Percentage Basis Fees

Percentage for A1 from Previous Page

(Overall _________% from Schedule A1) R

Fixed Fees

(g) Fee for development of the Project Brief

(including Assessment Report)

Fixed

Fee Not Required

(h) Fee for development of the Master Plan (if

necessary)

Fixed

Fee Not Required

Total Fee Amounts R Schedule A2 – Carry Forward to Page 14 - OFFER

Above fee estimate to exclude VAT

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Schedule A3: Disbursements

Activity Unit Quantity Rate Amount

Geotechnical Investigation [If required] (Proven Costs) Prov Sum 1 R 70,000.00 R 70,000.00

Mark-up & Profit Charge % 1 % R

Topographical and Cadastral survey [If required] (Proven

Costs) Prov Sum 1 R 40,000.00 R 40,000.00

Mark-up & Profit Charge % 1 % R

H & S Agent Services (Proven Costs) Prov Sum 1 R 100,000.00 R100,000.00

Mark-up & Profit Charge % 1 %

Travelling (Proven Costs) as per CDC instruction only km 6000 R R

Travel time (all disciplines) (Proven costs) Hrs 60 R R

Printing, Typing, Binding & Drawings Prov Sum 1 R 40,000.00 R 40,000.00

Accommodation& Meals Nights stay 10 R R

Total Disbursement Amount R

Schedule A3 - Carry

Forward to Page 14 –

FINAL OFFER

Above fee estimate to exclude VAT

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SUMMARY - TOTALS FOR SCHEDULES A2 & A3 FOR FEES &

DISBURSEMENT – FINAL OFFER

From Schedule A2 – Total Amount for Fees (percentage & fixed) R

From Schedule A3 – Total Amount for Disbursements R

Total Consultancy Services Amount Offered (Excluding VAT) R

Notes

(a) All deliverables, but not limited to these listed, will be treated as disbursement at a proven cost by CDC; (b) The disbursement for copies, prints, binding, etc. will be paid as per the National Department of Roads and Public Work’s Gazetted Rates; (c) Disbursements which include travelling and accommodation will be paid based on the assumptions that the offices are within the O R Tambo District (Mthatha

based); and (d) Interns monthly remuneration is deemed to be included in the fixed percentage fees.

We/I _______________________________in my/our capacity ________________________________duly authorized Lead Partner for the ____________________________________________________Consortium/Joint Venture offer the amount of R__________________(exclusive of VAT) (Amount in Words) _______________________________________________________________________________________for rendering Professional Consultancy Services for the St Lucy’s Hospital.

Name of Person: __________________________

Authorized Signature: __________________________

Witness:

Name: ___________________________ Signature: ___________________________

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APPENDIX B

RESPONDENT’S INFORMATION SHEET

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RESPONDENT’S INFORMATION SHEET

This form MUST be filled in by all respondents to this RfP and included as the third page of the Proposal

after the cover page.

Contract No. CDC/501/14

Description of Contract Professional Consultancy Services for the St Lucy’s Hospital in St Cuthberts in the Eastern Cape Province.

Name of Organisation / Joint Venture / Consortium

(Lead Consultant)

Physical Address

Postal Address

Contact Name

Email Address

Telephone Number

Fax Number

Cell Number

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APPENDIX C

TENDER OFFER EVALUATION AND SCORING

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Coega Development Corporation (Pty) Ltd

TENDER OFFER EVALUATION AND SCORING

Empowerment Objectives

Price

SPECIFICATION

TGP 07: 2013

REVISION 07: JANUARY 2013

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Coega Development Corporation Coega IDZ and Port Procurement Unit Zone Development and Operations ISO 9001: 2008 Clause 7.4 Purchasing

EVALUATION AND SCORING OF TENDER OFFERS ON EMPOWERMENT

OBJECTIVES AND PRICE

SPECIFICATION

TGP 07: 2013

REVISION 07: JANUARY 2013

Coega Development Corporation (Pty) Ltd

Coega Business Centre

Zone 1, Coega IDZ

Port Elizabeth, South Africa

6001

Copyright © 2006 Coega Development Corporation (Pty) Ltd

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Coega Development Corporation Coega IDZ and Port Procurement Unit Zone Development and Operations ISO 9001: 2008 Clause 7.4 Purchasing

DOCUMENT CONTROL SHEET

PROJECT NAME : COEGA INDUSTRIAL DEVELOPMENT ZONE AND PORT OF NGQURHA

DOCUMENT TITLE : EVALUATION AND SCORING OF TENDER OFFERS ON EMPOWERMENT

OBJECTIVES AND PRICE

DOCUMENT No. : TGP 07 : 2013

SIGNING OF THE ORIGINAL DOCUMENT

We, the undersigned, accept this document as a stable work product to be placed under formal change

control as described by the Change Control Procedure document.

ORIGINAL Prepared by Reviewed by Approved by

Date:

October 2004

Name:

Andile Ntloko

Name:

-

Name:

Wabo Msizi

Signature:

Signature: Signature:

Revision Prepared by Reviewed by Approved by

Date:

11 August 2006

Name:

Philisa Ndzamela-Qaba

Name:

Bongeka Jojo

Name:

Wabo Msizi

Signature:

Signature: Signature:

Date:

27 October 2006

Name:

Mpumi Mabula

Name:

Peter Inman

Name:

Paul Leese

Signature:

Signature:

Signature:

Date:

27 July 2007

Name:

Carmen Harri

Name:

Luvuyo Matya

Name:

Alan Young

Signature:

Signature:

Signature:

Date:

01 November 2008

Name:

Andile Ntloko

Name:

Luvuyo Matya

Name:

Alan Young

Signature:

Signature: Signature:

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Coega Development Corporation Coega IDZ and Port Procurement Unit Zone Development and Operations ISO 9001: 2008 Clause 7.4 Purchasing

Date:

6 July 2010

Name:

Luvuyo Matya

Name:

Andile Ntloko

Name:

Bongeka Jojo

Signature: Signature: Signature:

Date:

17 January 2013

Name:

Luvuyo Matya

Name:

Andile Ntloko

Name:

Bongeka Jojo

Signature: Signature: Signature:

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Coega Development Corporation Coega IDZ and Port Procurement Unit Zone Development and Operations ISO 9001: 2008 Clause 7.4 Purchasing

TGP Specification 17/01/2013

TABLE OF CONTENTS

ACRONYMS ................................................................................................................... 1

1 INTRODUCTION ....................................................................................................... 1

2 APPLICABLE DOCUMENTATION ........................................................................... 1

3 DEFINITIONS AND INTERPRETATIONS ................................................................. 2

4 TENDER ADJUDICATION POINTS .......................................................................... 5

5. DETERMINATION OF RESPONSIVENESS OF BIDDERS…………………………...7

6. THE QUANTITIATIVE ASSESSMENT…………………………………………...............9

7. GUIDELINES WHEN FUNCTIONALITY IS USED IN THE EVALAUTION

PROCESS……………………………………………………………………………………...10

8. DISQUALIFIERS DURING EVALUATION STAGE…………………………………..10

9 DOCUMENTATION TO BE SUBMITTED IN SUPPORT OF TENDER ................... 10

10 VALIDITY OF PREFERENTIAL REGISTRATION AFFIDAVIT ............................... 11

11 PROOF OF CONTRACTUAL ARRANGEMENT ..................................................... 11

12 OUTSOURCING OF WORKS ................................................................................. 12

13 COMPLIANCE WITH LEGISLATION ...................................................................... 12

14 SUBSTITUTION OF PREFERENTIAL GROUP DURING CONTRACT PERIOD 13

15 RECORDING AND REPORTING BY THE CONTRACTOR ................................ 13

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TGP Specification 17/01/2013

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TGP Specification Page 1 of 14 17/01/2013

ACRONYMS

ABE = Affirmable Business Enterprise

ABVA = Association of BEE Verification Agencies

BBBEE = Broad-based Black Economic Empowerment

BEE = Black Economic Empowerment

EME = Exempted Micro Enterprises

CDC = Coega Development Corporation (Pty) Ltd

CIDB = Construction Industry Development Board

LEP = Local Enterprise Participation

PPPFA = Preferential Procurement Policy Framework Act

SMME = Small, Medium and Micro Enterprises

WEO = Women Equity Ownership

1 INTRODUCTION

This Specification, TGP 07:2013: Tender Offer Evaluation and Scoring shall form the basis for

determining how this tender will be evaluated and scored more particularly with respect to

achievement of Empowerment Objectives and the Tendered Price.

This Specification was developed and adopted by the Coega Development Corporation Pty Ltd

(CDC) to ensure that Broad Based Black Economic Empowerment (B-BBEE) is meaningfully

progressed and that individuals with B-BBEE status, specifically from the Eastern Cape, participate

meaningfully during the execution of contracts awarded by the CDC for the development of the

Coega IDZ and on projects that the CDC implements on behalf of other entities.

2 APPLICABLE DOCUMENTATION

This Specification is to be read together with following applicable documents:

(a) Preferential Procurement Policy Framework Act (PPPFA);

(b) Broad-based Black Economic Empowerment Act (B-BBEE);

(c) CDC’s Procurement Policy & Procedures;

(d) Construction Industry Development Board’s (CIDB’s) Code of Conduct; and

(e) Public Finance Management Act (PFMA).

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3 DEFINITIONS AND INTERPRETATIONS

(a) Affiliated Business: A business entity which has control of or the power to control another

business entity, albeit indirectly, e.g. where a third person has control of or has the power to

control both entities. Indicators of control shall, without limitation, include interlocking

management or ownership, identity of interests among family members, shared facilities and

equipment, or common use of employees.

(b) Accredited Verification Agencies: Enterprises that have been accredited by SANAS and

ABVA on behalf of the DTI to provide an independent opinion on the broad-based economic

empowerment status of enterprises.

(c) Assignment Value: The total Rand value of the money charged to the CDC by a Service

Provider for services rendered to the CDC following a duly authorised appointment to do so

by the CDC.

(d) Black people: refers to African, Coloureds, Chinese and Indian who are citizens of RSA by

birth and are citizens of RSA by naturalisation before 1994.

(e) Black Economic Empowerment: is defined as an integrated and coherent socio-economic

process that directly contributes to the economic transformation of South Africa and brings

about significant increases in the number of black people who manage, own and control the

country’s economy, as well as significant decrease in income inequalities.

(f) Broad Based Black Economic Empowerment: means the economic empowerment of all

black people including black women, workers, youth, people with disabilities and people

living in rural areas, through diverse but integrated socio economic strategies, as defined in

the Act.

(g) Codes of Good Practice : refers to BEE Codes of Good Practice including all the

statements as issued under section 9 of Act 53 of 2003

(h) Contract: A legally binding agreement between the CDC and the Service Provider for the

latter to provide goods and/or services to the former. A contract would be legally binding

only if it has been signed by people who have the delegated authority to do so.

(i) Contractor: Any person, body, or legal entity who has a contract with the CDC for

performing a construction related contract. A Tenderer whose tender has been accepted

becomes a Contractor.

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(j) Control: The possession and exercise of legal authority and power to manage the assets,

goodwill and daily operations of a business and the active and continuous exercise of

appropriate managerial authority and power in determining the policies and directing the

operations of the business.

(k) Employment Intensive Construction: Forms of construction utilising methods and

technologies which realise an increase in the number of employment opportunities

generated over plant based or traditional forms of construction.

(l) Executive Director: A partner in a partnership, a sole proprietor, a director of a company

established in terms of the Companies Act, 1973 (Act 61 of 1973) or a member of a close

corporation registered in terms of the Close Corporation Act, who, jointly and severally with

his other partners, co-directors or co-members, as the case may be, bears the risk of the

business and takes responsibility for the management and liabilities of the partnership,

company, or close corporation on a day to day basis.

(m) Firm: A business entity providing professional services in which at least two thirds of the

Principals are Registered Professionals-in-training.

(n) Joint Venture: An association of firms, companies or businesses for which purpose they

combine their expertise, efforts, skills and knowledge to execute the Contract.

(o) Local Enterprise Participation: A firm, company, business with a permanent office and

infrastructure in the Eastern Cape Province that participates meaningfully in the Performance

of the Works.

(p) Office: A firm which is under the full-time control and operation of a resident Registered

Professional.

(q) Owned: Having all the customary incidents of ownership, including the right of disposition,

and sharing the risks and profits commensurate with the degree of ownership interest as

demonstrated by an examination of the substance, rather than the form of the ownership

arrangements.

(r) Ownership Goal: The percentage of the Tendered Price, as awarded, which represents the

sum of the Rand value of HDI people’s equity in the Performance of the Works.

(s) Preferential Group: Individuals, firms or companies with BEE status and who are targeted

for empowerment.

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(t) Preferential Participation Programme: A programme indicating the means, resources and

methodology by which a Contractor would undertake to engage preferential groups in the

due fulfilment of the Contract.

(u) Prime Contractor: A contractor who contracts with the CDC as the principal or main

contractor or as a joint venture partner to such contractors, to provide goods, services or

works.

(v) Professional Service: The provision on a fiduciary basis of labour and knowledge-based

expertise which is applied with skill, care and diligence in accordance with the provision of

the Professional Service Contract.

(w) Service Provider: Any person or body corporate that is under contract to the CDC for

providing a Professional Service.

(x) Registered Principal: A person within an Office who is professionally registered by the

relevant statutory council, and who is a director, partner, member, profit sharing associate,

shareholder or other category of persons who participates meaningfully in the ownership,

benefits and risks of the Office and is engaged full time in the operation of the Office.

(y) Registered Professional: A full-time employee of an Office, other than a Principal, who is

professionally registered by the relevant statutory council.

(z) Registered Professional-in-training: A full-time employee, other than a Principal, who is

registered by the relevant statutory council as a professional-in-training, has obtained the

necessary tertiary qualifications to register as a professional and is serving an in-house

training period prior to applying to register as a professional.

(aa) Senior Manager: An individual who is responsible for planning, organising, leading and

controlling operations within an organisation and who reports to the Executive Director.

(bb) Services: The provision of labour and/or work carried out by hand or with the assistance of

equipment and plant including the input as necessary of knowledge based expertise.

(cc) Small, Medium and Micro Enterprises: There are two types namely Exempted Small &

Micro Enterprise (ESME’s) and Qualifying Small Enterprise (QSE):

(i) Exempted Small & Micro Enterprises (ESME’s) are defined by the Codes, as

companies with an annual total turnover of R5 million or less.

(ii) Qualifying Small Enterprises (QSE) are defined by the Codes, as companies with an

annual total turnover of between R5 million and R35 million.

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(dd) Sub-contractor: A contractor who contracts with the Prime Contractor to provide works as

part of the total services required by the CDC for that Contract.

(ee) Supplier: A firm that owns, operates or maintains stores, warehouses or other

establishments in which materials or supplies are bought, kept in stock and regularly sold to

the public in the usual course of business; and engages as its principal business, and in its

own name, in the purchase and sale of goods.

(ff) Tender: The offer of prospective suppliers of goods and/or services, submitted in a tender

document which is issued to the public at large.

(gg) Women Equity Ownership (WEO): The collective ownership percentage of full-time

Executive Directors within an enterprise who are women.

4 TENDER ADJUDICATION POINTS

4.1 Points Awarded for Empowerment Objectives

The points system for Service Providers (and Contractors) will be structured in the following

way:

SCORING

CRITERIA

WEIGHTING FOR

80:20

WEIGHTING FOR

90:10 COMMENTS

Price 80 90

Empowerment

Objective 20 10

B-BBEE Certificate

is required

Total points 100 100

The 80:20 weighting applies for contracts less than R1 million (VAT Incl.) whereas the 90:10

weighting applies for all contracts in excess of R1 million (VAT Incl.).

The allocation of tender adjudication points for Contracts shall be as follows:

Area of Adjudication Maximum Points Maximum Points

Tendered Price (SP) 80 90

Empowerment Objectives (SE) 20 10

Total Points (S) 100 100

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In addition to price evaluation, CDC will evaluate contractors, service providers and

professionals based on their B-BBEE status achieved in accordance with the DTI Codes of

Good Practice and companies must submit B-BBEE Verification Certificates from accredited

verification agency or IRBA registered Auditors in order to be eligible for empowerment

points. Exempted Small & Micro Enterprises (ESME’s) enjoy a deemed BEE recognition of

Level 4 contributor and those, which are 50% or more owned by black people are promoted

to a Level 3 contributor. Sufficient evidence of qualification as an Exempted Small Micro-

Enterprises (ESME’s) is a letter from the enterprise’s Accounting Officer confirming that the

turnover is less than R5m or a verification certificate from Independent Regulatory Board for

Auditors (IRBA) or SANAS registered Verification Agency.

Note:

� A Trust, Consortium or Joint Venture will qualify for points for their B-BBEE Status

Level as a legal entity, provided that the entity submits their B-BBEE Status Level

certificate.

� A Trust, Consortium or Joint Venture will qualify for points for their B-BBEE Status

Level as an unincorporated entity provided that the entity submits their consolidated

B-BBEE Scorecard as if they were a group structure and that such a consolidated B-

BBEE Scorecard is prepared for every separate tender.

Empowerment points shall be awarded to a tenderer for attaining the B-BBEE status level of

contributor in accordance with the table below.

CONTRIBUTION LEVEL WEIGHTING FOR

80:20

WEIGHTING FOR

90:10

Level One 20 10

Level Two 18 9

Level Three 16 8

Level Four 12 5

Level Five 8 4

Level Six 6 3

Level Seven 4 2

Level Eight 2 1

Non Compliant Contributor 0

0

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Local Enterprise Participation (LEP Target)

The LEP target is the value of work done by local enterprises, whether as prime contractor, sub-

contractor or supplier, determined as follows:

The value sourced at local level is the value of resources based in the local area or produced in

the local area

The LEP target must be calculated in relation to every entity involved in the project. Management

staff commuting from other areas for the duration of the project will not qualify as local. Plant and

equipment brought in from other areas will not qualify as local. Materials and plant sourced via

local suppliers or agencies will qualify as local. A supplier that has been established locally by a

Tenderer solely for the purpose of servicing the project will not qualify as a local Supplier.

The LEP threshold for CDC contracts is 30%.

The threshold may be increased by the BU up to 50% if scope exists for further local

participation.

SMME / EME Involvement

There should be a minimum participation of 35% SMME’s / EME’s participation of tender value,

excluding VAT, escalation, etc. Each project from every Business Unit must achieve a minimum

of 35% SMME participation. SMMEs must be 100% Black owned or at least majority black

owned.

5 DETERMINATION OF RESPONSIVENESS OF BIDDERS

In deciding on the responsiveness or pre-qualifiers due cognisance must be taken to the fact that

some should always be included in the tender documents and some would depend upon the nature

of the contract and therefore might not always be required. The following responsiveness criteria or

pre-qualifiers will be used in this bid and are subdivided into mandatory and non-mandatory:

5.1 Mandatory Requirements

NO. DESCRIPTION

(1) Valid original Tax Clearance Certificate;

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5.5.2 Additional information required

6. THE QUANTITATIVE ASSESSMENT

(2) Minimum required CIDB Grading;

(3) Signed certificate of attendance to the mandatory Briefing Meeting or copy of

signing of Attendance Register;

(4) Authority of lead partner to sign the documents;

(5) Signed Form of Offer;

(6) Signed Letter of Intent to enter into Joint Venture, Consortium or to subcontract

(where applicable);

(7) Complete Bill of Quantities filled in clearly legible and permanent ink;

(8) Completed and signed Declaration of Interest Register.

(9) Proof of access to key personnel with relevant experience to execute the works;

NO. DESCRIPTION

(1) BBBEE Certificate

(1)

The main JV partner to carry out the highest percentage of the work, to have the

relevant CIDB grading for that category of works in case of contractors, and to lead

contract (where applicable);

(2)

Proposed methodology covering and demonstrating coherence of the:

(i) Work organization programme, (ii) Resource plan, and (iii) Methodology for executing the works.

(3) Access/ownership (availability) of plant & equipment (In case of hiring key plant,

letter conforming the willingness of the hirer to hire equipment to the bidder);

(4) Record of previous projects which may be relevant in the evaluation of the bid and

contact persons (if any);

(5)

Supporting documents on project imperatives:

(i) Plans for promoting and managing safety, health and environmental issues during execution of the project;

(ii) Plans for monitoring and applying quality assurance principles in the execution of the project;

(iii) Plans for addressing socio-economic issues (with specifics on numbers to be achieved) which include:

(1) Maximisation of job opportunities (labour histograms); (2) Creation of opportunities and meaningful involvement of SMMEs; (3) Use of local material/local suppliers; and (4) Training of labour (non –accredited). (5) Proof of office locality (e.g. municipal account, title deed, lease

agreement etc.)

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It is considered that there might be a need for an iterative process between the Stage 1 and Stage

2 in that other things befit Stage 1 might only be apparent in Stage 2. This should be construed as

progressive elaboration of assessment and should be allowed to take place when a need to do so

arises.

6.1 Points Awarded for Tender Price (SP)

The lowest acceptable tendered price should be determined and will be used to calculate the

score for price. A maximum of 80 or 90 points will be allocated to the Tendered Price on the

following basis:

Where: SP = Score obtained by the Tenderer for Price;

Smax = Maximum score that could be obtained for this Contract;

Plowest = Lowest acceptable tender price;

Ptendered = Tendered price being considered.

6.2 Empowerment Scoring, SE

(a) Obtain Broad-based Black Economic Empowerment (B-BBEE) certificate which must

be submitted with tender. (entities issuing the certificates should be registered with

SANAS or IRBA.

(b) In case of JV or Consortium submissions a Consolidated B-BBEE Scorecard must be

submitted and it must be prepared for every separate tender.

6.3 Total Tender Adjudication Points

The total tender adjudication points (S), is given by:

S = SP + SE (Not to Exceed 100 Points)

7 GUIDELINES WHEN FUNCTIONALITY IS INCLUDED AS A CRITERION IN THE

EVALUATION OF BIDS

Functionality – means the measurement according to predetermined norms of a service or

commodity designed to be practical and useful, working or operating, taking into account quality,

reliability, viability and durability of a service or commodity.

)(max tenderedlowestP

PPSS =

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The evaluation of bids must be conducted in the following two stages:

7.1 Firstly, the assessment of functionality must be done in terms of the evaluation criteria and

the minimum threshold be determined. A bid must be disqualified if it fails to meet the

minimum threshold for functionality as per the bid invitation.

7.2 Thereafter, only the qualifying bids are evaluated in terms of the 80/20 or 90/10 preference

points systems, where the 80 or 90 points must be used for price only and the 20 or 10

points are used for empowerment scoring and/or for achieving the prescribed RDP Goals.

8 DISQUALIFIERS DURING EVALUATION STAGE

The following disqualifiers will be used:

8.1 Bidder that sought to influence the adjudication process;

8.2 Collusion among bidders;

8.3 Misrepresentation of information;

8.4 Any service provider or its principals (or both) who have engaged in corrupt and fraudulent

practices, not only with the CDC but anywhere else;

8.5 Bidder who has a pending liquidation, in receivership, bankrupt/insolvent (actually and

commercially)

8.6 Tendered price unrealistically low and posing commercial risks to the client;

8.7 Poor past performance (the focus is on gross poor performance and a clear trend of poor

performance needs to be established).

9 DOCUMENTATION TO BE SUBMITTED IN SUPPORT OF TENDER

(a) The CDC shall require all potential Consultants, SP’s and CONTR’s to submit at tender

stage, a valid certified copy of a Verification Certificate. The Verification Certificate which

indicates the entity’s BEE status must be issued by SANAS Accredited Verification Agency

or IRBA registered Auditors. Similarly, small entities i.e. Exempted Small Micro Enterprises

(ESME’s) will have to submit Exemption Certificates issued by an Accredited Verification

Agency or IRBA registered Auditor’s certificate or similar certificate issued by Accounting

Officers.

(b) The common legislative requirements that are specified by the CDC are CIDB Grading and

valid original Tax Clearance Certificate (TCC).

(c) Tenderers shall submit the Draft Joint Venture Agreement when required to do so.

(d) Tenderers shall deliver to the Employer a works programme clearly specifying the

participation of targeted enterprises per activity.

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(e) Failure by the Tenderer to complete and deliver the information schedules in the form and

within the time specified as agreed by the CDC or its agents/officers, etc., may render the

tender non-responsive and lead to its rejection.

10 VALIDITY OF PREFERENTIAL REGISTRATION AFFIDAVIT

(a) Should a Tenderer either claim or engage an enterprise whose actual black equity and/or

staff composition differs from the actual black equity and/or staff composition for which

credits have been claimed whether incorrectly and/or fraudulently on any tender, such

Tenderer shall immediately be disqualified.

(b) Any Contract awarded on account of false information furnished by the Tenderer in order to

secure preference may be cancelled at the sole discretion of the CDC without prejudice to

any other remedies the CDC may have.

(c) Should the Tenderer be found to have acted fraudulently and/or dishonestly, he/she will be

disqualified from all future tenders for a minimum period of thirty six (36) months, or as

otherwise decided by the CDC.

(d) It is primarily the responsibility of the Tenderer to understand the relevant criteria, definitions

and interpretations associated with a specific preference group before claiming credits for

the engagement of such preference group.

11 PROOF OF CONTRACTUAL ARRANGEMENT

11.1 The Contractor shall submit to the CDC a list of sub-contractors to perform works, services

or supply of goods entered into between the Prime Contractor or Joint Venture at Prime

Contract Level and the sub-contracted preference groups. The CDC may deny the

Contractor credits towards the attainment of his preference group participation percentage in

the absence of a written sub-contract and/or the failure by the Contractor to submit a copy

thereof to the CDC.

11.2 A Joint Venture or Consortium shall submit to the CDC a certified copy of the Joint Venture /

Consortium Agreement, if the Joint Venture/Consortium involves preference groups for

which participation credits are applied. The Contractor shall not impose upon preference

groups unfair conditions of contract. Preference participation credits claimed may be denied

if such contracts contain:

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(i) A right of set-off, session and assignment as well as surety in favour of the employing

contractor;

(ii) Authoritarian rights given to the employing contractor with no recourse to independent

adjudication in the event of a dispute arising;

(iii) Payment procedures based on a pay-when-paid system;

(iv) Unreasonable retention percentages and periods of retention after completion;

(v) Conditions which are more onerous than those which exist in the Contract with the

CDC.

11.3 Groups for which preference credits are applied for shall participate meaningfully during the

Performance of the Works and shall be responsible for clearly defined portions of the works

to be performed or services to be provided with its own work force and using its own

resources or resources hired by it independent of the employing contractor or non-

preference partners in a joint venture.

12 OUTSOURCING OF WORKS

12.1 The Prime Contractor/Service Provider shall execute works in accordance with tender

commitment and may not outsource works without due approval of the CDC Project

Manager.

12.2 An entity must not be awarded points for B-BBEE status level if it is indicated in the tender

documents that such a tenderer intends sub-contracting more than 25% of the value of the

contract to any other enterprise that does not qualify for at least the points that such tenderer

qualifies for, unless the intended sub-contractor is an exempted micro enterprise that has the

capacity and ability to execute the sub-contract.

12.3 An entity awarded a contract may not sub-contract more than 25% of the value of the

contract to any other enterprise that does not have an equal or higher B-BBEE status level

than the person concerned, unless the contract is sub-contracted to an exempted micro

enterprise that has the capacity and ability to execute the sub-contract.

13 COMPLIANCE WITH LEGISLATION

Submissions from entities which do not meet the specified legislative requirements or proof of

suitable arrangements being made with the relevant authorities at the time of tendering will be

rendered non-responsive by the CDC. The common legislative requirements that are specified by

the CDC are CIDB Grading and valid original Tax Clearance Certificate (TCC).

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In cases of Joint Ventures or Consortia, all the JV partners must have valid original TCC by the

time they make a submission. If one of the JV partners has not submitted a valid original TCC, the

entire JV or Consortium shall be regarded as being non-responsive. Sub-contractors must also

comply with Tax Clearance Certificate (TCC) requirements.

14 SUBSTITUTION OF PREFERENTIAL GROUP DURING CONTRACT PERIOD

13.1 Conditions during the Performance of the Works may necessitate terminating the

participation of a Preferential Group. This termination must, however, be authorised by the

designated CDC Project Manager. Key indicators for such justification include, but are not

limited to the following:

(i) Continuous poor productivity and progress by the Preferential Group;

(ii) Continuous non-conformance to quality standards by the Preferential Group

13.2 Each case shall be investigated and a formal written report prepared by the Procurement

Office in consultation with the Project Manager (PM).

15 RECORDING AND REPORTING BY THE CONTRACTOR

The CDC Project Manager shall monitor and ensure that SMME and LEP commitments are

achieved during the duration of the contract, the contractor shall report on monthly basis the

achievements thereof to the consultants and CDC Project Manager. The CDC Project Manager

shall take all necessary actions during the Performance of the Works to bring to the attention of the

Contractor when progress in the attainment of the tendered goal percentage(s) is lacking.

Supply Chain Manager

Andile Ntloko

…………………………………………….. …………………………………………………...

Signature Supply Chain Manager Date of approval

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Coega Development Corporation Provincial Projects Department of Health Programme Department of Health ISO 9001:2008 Clause 7.4.1 Purchasing Process

001- RFP-St Lucy’s Hospital Consultancy Services 17 17 June 2014

APPENDIX D

CERTIFICATE OF INDEPENDENT BID DETERMINATION – FORM SBD 9

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SBD 9

CERTIFICATE OF INDEPENDENT BID DETERMINATION

1 This Standard Bidding Document (SBD) must form part of all bids¹ invited.

2 Section 4 (1) (b) (iii) of the Competition Act No. 89 of 1998, as amended, prohibits an

agreement between, or concerted practice by, firms, or a decision by an association of

firms, if it is between parties in a horizontal relationship and if it involves collusive

bidding (or bid rigging).² Collusive bidding is a pe se prohibition meaning that it cannot

be justified under any grounds.

3 Treasury Regulation 16A9 prescribes that accounting officers and accounting authorities must take all reasonable steps to prevent abuse of the supply chain management system and authorizes accounting officers and accounting authorities to:

a. disregard the bid of any bidder if that bidder, or any of its directors have abused

the institution’s supply chain management system and or committed fraud or any other improper conduct in relation to such system.

b. cancel a contract awarded to a supplier of goods and services if the supplier

committed any corrupt or fraudulent act during the bidding process or the execution of that contract.

4 This SBD serves as a certificate of declaration that would be used by institutions to

ensure that, when bids are considered, reasonable steps are taken to prevent any form

of bid-rigging.

5 In order to give effect to the above, the attached Certificate of Bid Determination (SBD 9)

must be completed and submitted with the bid:

¹ Includes price quotations, advertised competitive bids, limited bids and proposals.

² Bid rigging (or collusive bidding) occurs when businesses, that would otherwise be expected to compete, secretly conspire to raise prices or

lower the quality of goods and / or services for purchasers who wish to acquire goods and / or services through a bidding process. Bid

rigging is, therefore, an agreement between competitors not to compete.

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SBD 9

CERTIFICATE OF INDEPENDENT BID DETERMINATION

I, the undersigned, in submitting the accompanying bid:

________________________________________________________________________

(Bid Number and Description)

in response to the invitation for the bid made by:

______________________________________________________________________________

(Name of Institution)

do hereby make the following statements that I certify to be true and complete in every respect:

I certify, on behalf of:_______________________________________________________that:

(Name of Bidder)

1. I have read and I understand the contents of this Certificate;

2. I understand that the accompanying bid will be disqualified if this Certificate is found not

to be true and complete in every respect;

3. I am authorized by the bidder to sign this Certificate, and to submit the accompanying

bid, on behalf of the bidder;

4. Each person whose signature appears on the accompanying bid has been authorized by

the bidder to determine the terms of, and to sign the bid, on behalf of the bidder;

5. For the purposes of this Certificate and the accompanying bid, I understand that the

word “competitor” shall include any individual or organization, other than the bidder,

whether or not affiliated with the bidder, who:

(a) has been requested to submit a bid in response to this bid invitation;

(b) could potentially submit a bid in response to this bid invitation, based on

their qualifications, abilities or experience; and

(c) provides the same goods and services as the bidder and/or is in the same

line of business as the bidder

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SBD 9

6. The bidder has arrived at the accompanying bid independently from, and without

consultation, communication, agreement or arrangement with any competitor. However

communication between partners in a joint venture or consortium³ will not be construed

as collusive bidding.

7. In particular, without limiting the generality of paragraphs 6 above, there has been no

consultation, communication, agreement or arrangement with any competitor regarding:

(a) prices;

(b) geographical area where product or service will be rendered (market

allocation)

(c) methods, factors or formulas used to calculate prices;

(d) the intention or decision to submit or not to submit, a bid;

(e) the submission of a bid which does not meet the specifications and

conditions of the bid; or

(f) bidding with the intention not to win the bid.

8. In addition, there have been no consultations, communications, agreements or

arrangements with any competitor regarding the quality, quantity, specifications and

conditions or delivery particulars of the products or services to which this bid invitation

relates.

9. The terms of the accompanying bid have not been, and will not be, disclosed by the

bidder, directly or indirectly, to any competitor, prior to the date and time of the official

bid opening or of the awarding of the contract.

³ Joint venture or Consortium means an association of persons for the purpose of combining their expertise, property, capital, efforts, skill

and knowledge in an activity for the execution of a contract.

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SBD 9

10. I am aware that, in addition and without prejudice to any other remedy provided to

combat any restrictive practices related to bids and contracts, bids that are suspicious

will be reported to the Competition Commission for investigation and possible imposition

of administrative penalties in terms of section 59 of the Competition Act No 89 of 1998

and or may be reported to the National Prosecuting Authority (NPA) for criminal

investigation and or may be restricted from conducting business with the public sector

for a period not exceeding ten (10) years in terms of the Prevention and Combating of

Corrupt Activities Act No 12 of 2004 or any other applicable legislation.

………………………………………………… …………………………………

Signature Date

…………………………………………………. …………………………………

Position Name of Bidder

Js914w 2

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Coega Development Corporation Provincial Projects Department of Health Programme Department of Health ISO 9001:2008 Clause 7.4.1 Purchasing Process

001- RFP-St Lucy’s Hospital Consultancy Services 18 17 June 2014

APPENDIX E

CONDITIONAL ASSESSMENT REPORT

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

       

       

Report prepared by b4 Architects cc 17 January 2014 

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                          Report : 17 January 2014 

CONTENTS: 

 

1. METHODOLOGY 2. CLINICAL ASSESSMENT 

2.1. Introduction 2.1.1. History of Facility 

2.2. Location 2.2.1. Site Map 2.2.2. Aerial Photograph 

2.3. Approach 3. KEY FINDINGS 

3.1. District PHC Framework 3.2. Utilization 

3.2.1. Population   3.3. Referral Network 3.4. PHC Service Package 3.5. Staffing 3.6. Geographical Aspects 3.7. Patient Transport 3.8. Assets 3.9. Infrastructure Requirements 

4. CRITICAL AND EMERGING ISSUES 5. RECOMMENDATIONS 6. APPENDIX 1 : BUILDING ASSESSMENT 7. APPENDIX 2 : PHOTOGRAPHIC REPORT 8. APPENDIX 3 : ASSET REGISTER 

 

 

   

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                          Report : 17 January 2014 

1. METHODOLOGY 

 

The Assessment of St Lucy’s Hospital was undertaken by a team of three Architects / Architectural Technologists and an Electrical Engineer conversant in the design and construction of Healthcare projects.  The team undertook a physical assessment of the infrastructure and also a discussion with the Acting Hospital Manager to ascertain information pertinent to the assessment.  The Physical Assessment was undertaken over a period of two days and involved a building by building condition audit assessment both externally and internally (where access was possible).  Each building was assessed on a number of fields and rated on their suitability and present condition using a 5 point scale ranging from New to Failed (Condemn / Replace).  These forms have been compiled into the Building Assessment Report (Appendix A).  A photographic record of each building was made and selected photographs have been included in the Photographic Report (Appendix B).  A variety of online and Department of Health documents were consulted to obtain Demographic and Population Statistical information and insight into the planned classification of Hospitals which were then used to assess the needs of the Hospital.  These documents included : 

Stats SA website and Census 2011 population and demographic stats 

Government Gazette No. 9570, August 2011 : Regulations relating to categories of Hospitals 

Eastern Cape Department of Health Rationalized Service Delivery Platform    

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                          Report : 17 January 2014 

2. CLINICAL ASSESSMENT  2.1. Introduction 

 The Assessment Team consisted of the following individuals with experience in Healthcare Architecture: 

Bryan Brinkman : Professional Architect (b4 Architects) – 15 years Healthcare Architecture experience 

Debbie Haupt : Professional Architect (b4 Architects) – 3 years Healthcare Architecture experience 

Leigh McLaren : Candidate Architect (b4 Architects) – 1 year Healthcare Architecture experience 

Sim Nteleza : Student Architect (b4 Architects) – 2 years part‐time Healthcare Architecture experience 

Pat Callaghan : Professional Electrical Engineer (CA du Toit) – 25 years Healthcare Electrical Engineering experience 

 The Assessment Team visited and audited St Lucy’s Hospital on Thursday the 6th and Friday the 7th December 2014.  During the time on site the team interacted and obtained key information from the following staff: 

Mrs Catherine N. Zazela (Acting Hospital Manager) 

Senior Maintenance Personnel  

2.1.1. History of Facility 

 St Lucy’s Hospital was originally part of the St Cuthberts Mission and originally constructed as a Mission Hospital.  Taken over by the State at an (at present) undefined date, it developed into a 140 bed specialist hospital.  Due to its deteriorating state a decision was taken to construct a new Hospital, Dr Malizo Mpehle Hospital in closer proximity to the town of Tsolo.  The original intention was for Dr Malizo Mpehle Hospital to replace St Lucy’s Hospital, but the public outcry of communities near St Cuthbert’s has created sufficient political pressure for the facility to remain open.  This culminated in the MEC for Health apparently advising that the hospital be turned into a 60 bed facility (this statement was referred to by Hospital Management and was made during a visit to St Lucy’s in the latter part of 2013).   

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                          Report : 17 January 2014 

2.2. Location & Demographics  

St Lucy’s Hospital  is  located  in  the village of St Cuthburts  in  the  foothills of  the mountains  to  the weset of Tsolo.    It  is  located  in  the  Mhlonto  Municipality  in  the  OR  Tambo  District  of  the  Eastern  Cape.    It  is approximately  58km  to  the north‐west of Mthatha  and  is  accessible by  tarred  road off  the  Tsolo‐Maclear tarred road (Provincial Road). 

 

   

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                          Report : 17 January 2014 

2.2.1     Site Map  

 

See following fold out A3 page. 

 

2.2.2   Aerial Photograph 

Google Earth image of St Lucy’s Hospital (middle left)and St Lucy’s Gateway Clinic (upper right quadrant of intersection in the middle of the image). 

The approach road is from the right and the original Mission Station and Church is below the crossroads in the centre of the image. 

   

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                          Report : 17 January 2014 

2.3. Approach & Regulatory Findings 

 

The following documents were utilised as background information for assessing how DoH intends St Lucy’s Hospital to fit into the Healthcare Service Delivery: 

Government Gazette No. 9570, August 2011 : Regulations relating to categories of Hospitals o Page 11 : St Lucy’s Hospital is defined as a Specialist Hospital with 110 beds. 

Eastern Cape Department of Health Rationalized Service Delivery Platform   

The requirements for St Lucys Hospital were then examined against the proposals tabled in the above two documents and with consideration with the estimated population present around St Lucy’s Hospital and the fact that Dr Malizo Mpehle Hospital is geographically in close proximity to St Lucy’s Hospital, with little topographical divide between them (barring a smallish river). 

   

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                          Report : 17 January 2014 

3. KEY FINDINGS  3.1. District PHC Framework 

 The Eastern Cape Department of Health Rationalized Service Delivery Platform document defines the differences between types of Health Facilities as followings:  

Table 1: Minimum travel time and population per type of health facility  

Level of care  Maximum Travel Time Minimum  Population

Clinic  20 mins  24 000 (urban) 

10 000 (rural) (5km)

CHC  40 mins  60 000 – 144 000 

(40‐50km)

Level1  1 hr 300 000 –  900 000

(District Hosp) 

Level2  2 hrs 1 400 000 

(Regional Hosp) 

Level3  3 hrs 2 200 000 

(Tertiary Hosp) 

 Note the following extract from the Eastern Cape Department of Health Rationalized Service Delivery Platform document:  

“In the Eastern Cape Province context, the number of the clinics and CHHs cannot be calculated solely on the basis of population coverage as the great variation in population densities and the topographical challenges will render that approach inappropriate for certain facilities.  The addition of municipality clinics will also contribute in duplication and facility oversupply in certain areas.” 

 

There are at present three major hospitals within the Mhlonto Municipality: 

Dr MMM Hospital (Tsolo) o Level 1 Hospital 

Current 194 acute  Proposed 160 acute & step‐down 

Nessie Knight CHH  Currently being redeveloped to into a CHH.  

St Lucy’s Hospital o Formerly approximatey 140 beds 

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                          Report : 17 January 2014 

o Currently 40 Beds o Recommended to be reclassified as a CHH. 

The Eastern Cape Department of Health Rationalized Service Delivery Platform document concludes with the proposal that the Mhlonto sub‐district shall have the following CHHs in addition to Dr MMM Hospital as the District Hospital. 

Mhlakulo CHC 

Qumbu CHC 

St Lucy’s Hospital 

Nessie Knight Hospital  

Please refer to the map of the Mhlonto Municipality in the OR Tambo district on the following page. 

 

 

 

   

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                          Report : 17 January 2014 

Legend: 

Yellow – Level 1 District Hospital 

Blue – CHH 

Red – St Lucy’s (Specialist to be reclassified CHH) 

Green – Specialist Facility 

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B4 Architects Ref : 216‐003                                                                                                                           Report : 17 January 2014 

3.2.1  Population 

 According to Stats SA the OR Tambo District has a population of 1,364,932 people and the Mthlontlo sub‐district a population of 188,226 individuals.  It is worth noting that the Government Gazette Doc No. 9570 of 2011 refers to a population of 1,748,624 people – a significant difference.    

    Although no detailed population statistics are available for the area around St Cuthberts and the nearby communities it is estimated that the catchment population for St Lucy’s Hospital is at in the vicinity of 20 000 individuals as the proximity of Dr Malizo Mpehle Hospital (20 kms) means that many communities nearby St Lucy’s Hospital fall into the catchment area of Dr Malizo Mpehle Hospital. 

 

3.3  Referral Network 

 

St Lucy’s Hospital refers patients onto Dr Malizo Mpehle Hospital for most patients, but also Mthatha General / Nelson Mandela Academic Hospital.  There are three clinics located in the nearby communities which refer patients to St Lucy’s Hospital, including the St Lucy’s Gateway Clinic, Ezingcuka Clinic and a mobile clinic.   Patients are occasionally received from Dr Malizo Mpehle, Nessie Knight and Mthatha General Hospital (septic circumcisions and chronically ill patients) when those hospitals have a shortage of available beds.    

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B4 Architects Ref : 216‐003                                                                                                                           Report : 17 January 2014 

3.4  PHC Service Package  

 

The Hospital used to have a capacity of 140 beds but has subsequently been downgraded to 40 beds.  St Lucy’s Hospital offers the following services / has the following facilities: 

OPD & Casualty 

Radiology 

ARV 

Mortuary 

Physiotherapy 

CSSD Services 

Depot for Laboratory Services 

40 Chronic Patient Beds (according to the official organogram), but the physical beds available are as follows: 

o 32 TB Beds Patients (Male & Female) o 50 Beds Medical & Surgical (Male & Female) 

Nurse Training in conjunction with Lilitha College (one year course) 

Radiology (1): o The X‐Ray was sealed by a representative of the Radiation Control Board relating to problems 

dating back to 2009.  Problems identified at the time (including the Darkroom) have been rectified and tests are being conducted from December 2013 to February 2014.  Once they have been completed and submitted to the Radiation Control Board it is hoped to have a functional Radiology by the end of February 2014.  The (analog) X‐Ray machine is working. 

Theatre (1):  o The single Theatre is also not operational. o It is planned to return it to operational status when the Maternity  and Paediatric Wards are 

reopened and provided there are Theatre Staff available.  According to the Hospital it is intended to only conduct minor procedures as all major procedures (including Caesarean sections) will be performed at Dr Malizo Mpehle Hospital. 

 

The Maternity Ward & Pediatric Ward have both closed and the buildings formerly accommodating these services are unoccupied. 

   

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                           Report : 17 January 2014 

3.5  Staffing  

 The current staff establishment is as follows:  Total number of posts: 152 Filled: 141 Vacant: 11  

STAFF CATEGORY  NO OF POSTS

Clinical Manager/CEO  Nil  

Nursing Service Manager  Nil 

Medical Officers  02 

Pharmacist/Radiographer/Physiotherapist/Dentist  NIL 

Hospital Administrator  NIL 

Operational Managers  03 

Professional Nurses  11 

Post Community Service Professional Nurses  04 

Community Service Professional Nurses  04 

Quality Assurance/OHS Officer/Infection Control  All acting 

Enrolled Nurses  14 

Enrolled Nursing Assistants  28 

Assistant Pharmacists (Post Basic)  01 

Assistant Pharmacists  01 

Physiotherapy Assistants  01 

Supplementary Radiographer  01 

Administration   18 

 Data capturers  02 

Maintenance, Cleaning, Laundry & Catering Services 48 

 Two (2) staff (HRM and Records Clerk) are on contract.  

3.6  Geographical Aspects 

 St Lucy’s Hospital is set in the foothills of a mountain and has a beautiful vista overlooking the valley below.  The view is orientated towards the North so the buildings and site potentially have a very good therapeutic orientation.  St Cuthberts Village is tranquil, pleasant with many trees.    The Hospital is a 15 minute drive off the Tsolo‐Maclear Provincial Road and is accessible by tar road.  It is approximately 20km from Dr Malizo Mpehle Hospital and an hour from Mthatha. 

 

   

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                           Report : 17 January 2014 

3.7  Patient Transport 

 St Lucy’s Hsopital has three vehicles available: 

2 Bakkies 

1 Car  There is no dedicated on site vehicle storage facilities (garages / carports).  Patients requiring transport are transported by Patient Transport vehicle from Dr Malizo Mpehle Hospital. 

 

3.8  Assets 

 Please see Appendix C for the Asset Register received from the Hospital.  Radiology: The X‐Ray was sealed by a representative of the Radiation Control Board relating to problems dating back to 2009.  Problems identified at the time (including the Darkroom) have been rectified and tests are being conducted from December 2013 to February 2014.  Once they have been completed and submitted to the Radiation Control Board it is hoped to have a functional Radiology by the end of February 2014.  The (analog) X‐Ray machine is working. 

 Kitchen: The kitchen equipment has been upgraded recently and appears to be in a satisfactory condition.  Laundry: The laundry building is currently undergoing renovation.  Workshop: The equipment is inadequate and dated and the lack of space results in the workshops being cramped and poorly organized.    Medical Gas: There is a small medical gas bottle installation connected to the Theatre.  The housing / screen around the installation is inadequate and should be replaced if the procedures to be undertaken at the   Mortuary Fridge Cabinets: There are mortuary cabinets which are in working order.  Incinerator: The incinerator should no longer be in use as DoH has a contract in place with Compass Waste that is removing medical waste every Thursday.  However there are dumps of incinerated waste and rubbish scattered near the old incinerator that need to be removed.        

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                           Report : 17 January 2014 

3.9  Infrastructure 

 Water Supply  Water comes from the mountain via the two reservoir tanks through to the hospital.    There is a borehole on site that is supposed to be a backup supply to the hospital, but it is not working at present.  Water samples have been taken during December for testing water quality from the borehole, reservoir tanks and others tanks in the hospital.  Results from these tests are currently awaited.  After heavy rain dirt, stones and rubble block the pipes supplying water from the mountain dam to the reservoir tanks and needs to be cleared.  Sewerage  Sewerage dams are to the north and below the hospital and are treated regularly.    Storm water   There is no on site piped stormwater and no Municipal Stormwater system.  Electricity   The Hospital has an electrical supply from Eskom.  There is an onsite standby generator that is functional for the Hospitals current needs.    Refuse removal  Tsolo Municipality removes general waste on contract once or twice a week as required.  Accommodation   There is a Nurses’ Home on site that is poor condition.  Lilitha Training College are responsible for the condition and renovation of this building.  There is a shortage of suitable accommodation on site as many of the houses are in need of repair or renovation.  They are also scattered around the site and poorly accessed and serviced.  Almost all the rondavels and mudbrick buildings are in a shocking condition, but are used by some staff for accommodation purposes, including the transient Doctors.  They should all be demolished and suitable accommodation provided.   

 

   

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                           Report : 17 January 2014 

4.   CRITICAL AND EMERGING ISSUES: 

 The buildings are old and in various stages of dilapidation.  Most of the ward buildings have had some cosmetic renovation externally which belies their true condition.  Internally the buildings are all in need of extensive renovation.  The Accommodation facilities on site are in very poor condition and some staff are residing in shocking conditions which requires immediate attention.  There is a shortage of Professional Staff (including Doctors) which the poor accommodation available exacerbates.  The Hospital have requested the provision of 5 mobile structures for accommodation of Professionals in 2014.  Radiology has not been functioning, but should be pending the outcome of the tests currently being conducted.  The Hospital site is very large and difficult to maintain due to its expanse.  Credit must be given to the Hospital however as they are trying to maintain the site and keep the grass cut around the main buildings.  The on site road infrastructure is very poor and in rainy conditions must get treacherous.  Due to the haphazard nature of the development of the site there is poor access between the service areas and the wards and accommodation areas.    With the reduction in the capacity of the hospital there is a surpluss of patient accommodation available.      

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                           Report : 17 January 2014 

5.   RECOMMEDATION: 

 

The Norm for the Community Health Hospitals (Community Health Centres) is 60 000 to 144 000 for rural and urban settings respectively.   Thus St Lucy’s Hospital’s catchment population is well below the norm stated above.  It is assumed that the majority of patients requiring care being referred from PHCs will be referred to Dr Mazilo Mpehla Hospital and not St Lucy’s Hospital.  This is borne out by the limited number of clinics that currently refer patients to St Lucy’s Hospital.  St Lucy’s Hospital geographic position and environment (in the lee of the mountain in a tranquil heavily tree’d village) and its low patient load make it an ideal environment for long term patient care (either terminal cases or TB treatment).  The proposed change in bed count to 60 beds (including 10 Maternity and 10 Paediatric and 40 Adult [TB]) is reasonable.    The report thus far has commented on the size of the site and the difficulty in maintaining it and the building assessment report and photographs will bear testimony to the fact that the general state of the facility is poor and/or dilapidated.  Refer to the following diagrams: 

Utilisation Map 

Condition Assessment Map (determined form the individual building assessment) 

Redevelopment Zoning Map  The Redevelopment Zoning Map assesses the site in 10 zones and recommends how the site could be utilized to develop a new upgraded and more compact facility that could provide a manageable facility to meet the proposed bed count.  It is beyond the scope of this report to propose a Masterplan of the redevelopment, but the current site does facilitate the opportunity for a new clinical treatment area (OPD, Wards etc.) to be constructed on available land and for the older structures to be demolished or re‐purposed.      

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B1 OPDB2 MORTUARYB3 PAEDIATRIC WARDB4 MATERNITY WARDB5 PRIMARY CIRCULATIONB6 T.B. WARD FB7 X-RAY DEPARTMENTB8 OPERATING DEPARTMENT, CSSDB9 SURGICAL WARD FB10 GENERAL WARDS M AND FB11 SURGICAL WARD MB12 KITCHENB13 OUTBUILDING (RONDAWEL)B14 STAFF RESIDENCEB15 STAFF RESIDENCEB16 STAFF RESIDENCEB17 STAFF RESIDENCEB18 OUTBUILDING (TOILET BLOCK)B19 OUTBUILDING (TUCK SHOP)B20 SECURITY (GATE HOUSE)B21 RONDAWELB22 STAFF RESIDENCEB23 STORESB24 STORESB25 OUTBUILDING (TOILETS)B26 OUTBUILDING (TOILETS)B27 OUTBUILDING (TOILETS)B28 NURSE TRAININGB29 STAFF RESIDENCEB30 NURSE TRAININGB31 NURSE TRAININGB32 OUTBUILDING (CLOAK ROOM)B33 DININGB34 NURSE TRAININGB35 STAFF RESIDENCEB36 ADMINB37 STORE

B39 STORESB40 STAFF RESIDENCEB41 STAFF HOUSEB42 STAFF HOUSEB43 STAFF HOUSEB44 STAFF HOUSEB45 STAFF RESIDENCEB46 STAFF HOUSEB47 STAFF RESIDENCEB48 STAFF HOUSEB49 ENG PLANTB50 STAFF RESIDENCEB51 STORES

B53 WORKSHOPS

B55 OUTBUILDING (TOILETS)B56 OUTBUILDING (AMBULANCE)B57 OUTBUILDINGB58 PHYSIOTHERAPYB59 STAFF RESIDENCEB60 STAFF RESIDENCEB61 OUTBUILDINGB62 STAFF RESIDENCEB63 STAFF RESIDENCEB64 SECURITY (GUARD HOUSE)B65 RELIGIOUSB66 GATEWAY CLINIC ADMINB67 GATEWAY CLINICB68 STAFF RESIDENCE

B70 OUTBUILDING (CENTRAL TOILET BLOCK)

B72 STAFF HOUSEB73 STAFF RESIDENCEB74 STAFF RESIDENCEB75 STAFF RESIDENCEB76 STAFF RESIDENCE

B38 STAFF RESIDENCE

B52 STAFF RESIDENCE

B54 LAUNDRY

B69 STAFF RESIDENCE

B71 STAFF HOUSE

LEGEND:

B74

B75

B76

B73B72

B70

B68

B67

B66

B65B64

B63

B62

B61

B60

B59

B49B50

B58

B51

B53

B3

B4

B1

B6B17

B7

B8

B9

B10

B55

B56B11

B12

B20

B19

B21B18

B22

B23

B14B16

B15

B29

B28

B24

B25

B26

B27B13

B30

B32

B35

B31

B57

B39

B40

B42

B41

B38

B36

B46

B47

B44

B48

B45B43

B2

B5

B37

B34

B33

B52B54

B71

B69

B32b

N

NEW - NO MAINTANANCE REQUIRED

MINOR MAINTENANCE REQUIRED

MAJOR MAINTENANCE REQUIRED

TO BE DEMOLISHED

Date

Project number

2014

/01/

10 1

2:37

:37

PMSite Plan - Condition Overview

216-003

St Lucy's Hospital

CDC/723/13: PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDSASSESMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCYS HOSPITAL

09-01-2014 216-003/002

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B1 OPDB2 MORTUARYB3 PAEDIATRIC WARDB4 MATERNITY WARDB5 PRIMARY CIRCULATIONB6 T.B. WARD FB7 X-RAY DEPARTMENTB8 OPERATING DEPARTMENT, CSSDB9 SURGICAL WARD FB10 GENERAL WARDS M AND FB11 SURGICAL WARD MB12 KITCHENB13 OUTBUILDING (RONDAWEL)B14 STAFF RESIDENCEB15 STAFF RESIDENCEB16 STAFF RESIDENCEB17 STAFF RESIDENCEB18 OUTBUILDING (TOILET BLOCK)B19 OUTBUILDING (TUCK SHOP)B20 SECURITY (GATE HOUSE)B21 RONDAWELB22 STAFF RESIDENCEB23 STORESB24 STORESB25 OUTBUILDING (TOILETS)B26 OUTBUILDING (TOILETS)B27 OUTBUILDING (TOILETS)B28 NURSE TRAININGB29 STAFF RESIDENCEB30 NURSE TRAININGB31 NURSE TRAININGB32 OUTBUILDING (CLOAK ROOM)B33 DININGB34 NURSE TRAININGB35 STAFF RESIDENCEB36 ADMINB37 STORE

B39 STORESB40 STAFF RESIDENCEB41 STAFF HOUSEB42 STAFF HOUSEB43 STAFF HOUSEB44 STAFF HOUSEB45 STAFF RESIDENCEB46 STAFF HOUSEB47 STAFF RESIDENCEB48 STAFF HOUSEB49 ENG PLANTB50 STAFF RESIDENCEB51 STORES

B53 WORKSHOPS

B55 OUTBUILDING (TOILETS)B56 OUTBUILDING (AMBULANCE)B57 OUTBUILDINGB58 PHYSIOTHERAPYB59 STAFF RESIDENCEB60 STAFF RESIDENCEB61 OUTBUILDINGB62 STAFF RESIDENCEB63 STAFF RESIDENCEB64 SECURITY (GUARD HOUSE)B65 RELIGIOUSB66 GATEWAY CLINIC ADMINB67 GATEWAY CLINICB68 STAFF RESIDENCE

B70 OUTBUILDING (CENTRAL TOILET BLOCK)

B72 STAFF HOUSEB73 STAFF RESIDENCEB74 STAFF RESIDENCEB75 STAFF RESIDENCEB76 STAFF RESIDENCE

B38 STAFF RESIDENCE

B52 STAFF RESIDENCE

B54 LAUNDRY

B69 STAFF RESIDENCE

B71 STAFF HOUSE

LEGEND:

B74

B75

B76

B73B72

B70

B68

B67

B66

B65B64

B63

B62

B61

B60

B59

B49B50

B58

B51

B53

B3

B4

B1

B6B17

B7

B8

B9

B10

B55

B56B11

B12

B20

B19

B21B18

B22

B23

B14B16

B15

B29

B28

B24

B25

B26

B27B13

B30

B32

B35

B31

B57

B39

B40B42

B41

B38

B36

B46

B47

B44

B48

B45B43

B2

B5

B37

B34

B33

B52B54

B71

B69

B32b

N

CLINICAL

SUPPORT

ADMIN

TRAINING

ACCOMMODATION

NOT UTILIZED

Date

Project number

2014

/01/

10 1

2:37

:37

PMSite Plan - Utilisation Plan

216-003

St Lucy's Hospital

CDC/723/13: PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDSASSESMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCYS HOSPITAL

09-01-2014 216-003/001

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B1 OPDB2 MORTUARYB3 PAEDIATRIC WARDB4 MATERNITY WARDB5 PRIMARY CIRCULATIONB6 T.B. WARD FB7 X-RAY DEPARTMENTB8 OPERATING DEPARTMENT, CSSDB9 SURGICAL WARD FB10 GENERAL WARDS M AND FB11 SURGICAL WARD MB12 KITCHENB13 OUTBUILDING (RONDAWEL)B14 STAFF RESIDENCEB15 STAFF RESIDENCEB16 STAFF RESIDENCEB17 STAFF RESIDENCEB18 OUTBUILDING (TOILET BLOCK)B19 OUTBUILDING (TUCK SHOP)B20 SECURITY (GATE HOUSE)B21 RONDAWELB22 STAFF RESIDENCEB23 STORESB24 STORESB25 OUTBUILDING (TOILETS)B26 OUTBUILDING (TOILETS)B27 OUTBUILDING (TOILETS)B28 NURSE TRAININGB29 STAFF RESIDENCEB30 NURSE TRAININGB31 NURSE TRAININGB32 OUTBUILDING (CLOAK ROOM)B33 DININGB34 NURSE TRAININGB35 STAFF RESIDENCEB36 ADMINB37 STORE

B39 STORESB40 STAFF RESIDENCEB41 STAFF HOUSEB42 STAFF HOUSEB43 STAFF HOUSEB44 STAFF HOUSEB45 STAFF RESIDENCEB46 STAFF HOUSEB47 STAFF RESIDENCEB48 STAFF HOUSEB49 ENG PLANTB50 STAFF RESIDENCEB51 STORES

B53 WORKSHOPS

B55 OUTBUILDING (TOILETS)B56 OUTBUILDING (AMBULANCE)B57 OUTBUILDINGB58 PHYSIOTHERAPYB59 STAFF RESIDENCEB60 STAFF RESIDENCEB61 OUTBUILDINGB62 STAFF RESIDENCEB63 STAFF RESIDENCEB64 SECURITY (GUARD HOUSE)B65 RELIGIOUSB66 GATEWAY CLINIC ADMINB67 GATEWAY CLINICB68 STAFF RESIDENCE

B70 OUTBUILDING (CENTRAL TOILET BLOCK)

B72 STAFF HOUSEB73 STAFF RESIDENCEB74 STAFF RESIDENCEB75 STAFF RESIDENCEB76 STAFF RESIDENCE

B38 STAFF RESIDENCE

B52 STAFF RESIDENCE

B54 LAUNDRY

B69 STAFF RESIDENCE

B71 STAFF HOUSE

LEGEND:

B74

B75

B76

B73B72

B70

B68

B67

B66

B65B64

B63

B62

B61

B60

B59

B49B50

B58

B51

B53

B3

B4

B1

B6B17

B7

B8

B9

B10

B55

B56B11

B12

B20

B19

B21B18

B22

B23

B14B16

B15

B29

B28

B24

B25

B26

B27B13

B30

B32

B35

B31

B57

B39

B40B42

B41

B38

B36

B46

B47B44

B48

B45

B43

B2

B5

B37

B34

B33

B52B54

B71

B69

B32b

N

ADVISED TO BE DEMOLISHED

ZONE 1

ZONE 2

ZONE 3

ZONE 4

ZONE 5

ZONE 6

ZONE 7

ZONE 8

ZONE 9

ZONE 10

ZONE 1

ZONE 2

ZONE 3

ZONE 4

ZONE 5ZONE 6

ZONE 7

ZONE 8

ZONE 9ZONE 10

NEED TO BE DEMOLISHED

SEWER PONDS

VALLEY VIEW

VA

LLE

Y V

IEW

Abandoned(Not clear who owns land)

Date

Project number

2014

/01/

10 1

2:37

:37

PMSite Plan - Redevelopment Plan

216-003

St Lucy's Hospital

CDC/723/13: PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDSASSESMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCYS HOSPITAL

09-01-2014 216-003/003

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                                           17 January 2014 

 

St Lucy’s Hospital Redevelopment Plan 

 

Site zoning definitions: 

 

Zone 1 

 

This is where the existing clinical functions currently take place. There is more space available than required and the excess space should be either repurposed or demolished if they will facilitate a better overall site redevelopment. Existing buildings would be more suitable for patient wards and could allow for a level of isolation suitable for TB wards.  

 

Zone 2 

 

Most structures in the area have deteriorated and should be demolished. This will facilitate a tract of land available for development of new clinical functions which is more outpatient orientated due to its proximity to the entrance.  

 

Zone 3 

 

Existing training precinct to remain and the unsuitable structures are to be demolished.  

 

Zone 4 

 

Current administrative and service functions for the hospital exist here. These could continue to function to support the hospital, but may be too far from the core clinical functions to effectively support them.  

 

Zone 5 

 

Existing accommodation occupies this zone which is sporadically located and poorly accessible.  

 

Zone 6 

 

While some structures are in a reasonable condition they may not be sensibly located within an overall master plan and this portion of the site could be fenced off from the rest of the hospital site and abandoned structures demolished. This will help make the extent of the site more manageable.  

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CDC/723/13 : PROFESSIONAL CONSULTANCY SERVICES FOR THE NEEDS ASSESSMENT REPORT FOR THE HEALTH FACILITIES AT ST LUCY’S HOSPITAL 

 

B4 Architects Ref : 216‐003                                                                                                                                           17 January 2014 

 

Zone 7 

 

This area could be used for additional accommodation for the training facilities.  

 

Zone 8 

 

Existing unsuitable structures are recommended to be demolished. Area recommended for new staff and student accommodation (flats and/or houses).  

 

Zone 9 

 

The existing gateway clinic should remain. Site to be consolidated and functions in non‐suitable buildings be relocated and non‐suitable, maintenance intensive structures to be demolished.  

 

Zone 10 

 

Existing structures are to be demolished. This area can be made available to supplement zone 9 if required.  

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Coega Development Corporation Provincial Projects Department of Health Programme Department of Health ISO 9001:2008 Clause 7.4.1 Purchasing Process

001- RFP-St Lucy’s Hospital Consultancy Services 19 17 June 2014

APPENDIX F

COMPULSORY DECLARATION OF INTEREST FORM

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FORM A3: COMPULSORY DECLARATION OF INTEREST FORM

The following particulars must be furnished. In the case of a joint venture, a separate declaration of

interest form in respect of each party to the joint venture must be completed and submitted.

Section 1: Name of enterprise: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Section 2: VAT registration number, if any: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Section 3: CIDB registration number, if any: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Section 4: Particulars of sole proprietors and partners in partnerships

* Complete only if sole proprietor or partnership and attach separate page if more than 3 partners

Name* Identity number* Personal income tax number*

Section 5: Particulars of companies and close corporations

Company registration number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Close corporation number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tax reference number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Section 6: Record of association with CDC member of Staff/Board

If any sole proprietor, partner in a partnership or director, manager, shareholder or stakeholder in a company or close corporation has an association with a CDC member of staff or member of Board, a relative of a CDC member of staff or member of Board please provide information below: An Association is defined as: a business or personal relationship between a group of people or organizations joined together for a purpose.

Name of sole proprietor, partner, director, manager, principal shareholder or stakeholder

Name of the CDC member of staff or Board

Type of relationship (tick appropriate column) Family Friend

*insert separate page if necessary

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FORM A3: COMPULSORY DECLARATION OF INTEREST FORM (continued)

The undersigned, who warrants that he / she is duly authorised to do so on behalf of the enterprise:

i) confirms that the 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;

ii) 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;

iii) 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 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

Company Name