Upload
others
View
198
Download
0
Embed Size (px)
Citation preview
SIBANYE STILLWATER – TENDERS ADVERTISED
SUPPLIER SHOW OF INTEREST
Company details
Company name
Contact person details
(Name, contact number
& email)
Tender Event interested in:
Reference number Event Description
#6886 Professional Services for the Construction of the Marikana
Community Health Centre
IMPORTANT INFORMATION:
➢ Complete this document together with the pre-qualification questionnaire and submit
together with all certification and documentation via email to the relevant person (as
advertised) before the closing date and time.
➢ If show of interest document/email is not received on time, the supplier will be disqualified.
➢ The Service Provider can only be part of the tender if registered and approved in the
Sibanye Coupa system.
➢ The Service Provider must have at Least 5 Years’ experience working in the Bapong,
Marikana area North West.
➢ Preference will be given to Local Engineering Firms and the Company must be listed as
registered Engineers.
➢ The Service Provider must have at least 10 Years’ experience in Health Construction.
SUPPLIER
Pre-Qualification Questionnaire
FOR THE
PROFFESIONAL SERVICES
FOR THE CONSTRUCTION OF THE MARIKANA
COMMUNITY HEALTH CENTRE
AT MARIKANA, NORTH WEST PROVINCE FOR
SIBANYE STILLWATER MARIKANA OPERATIONS
(“CLIENT”)
APPLICANT (COMPANY) NAME:
________________________________________________
INDICATE FROM WHICH COMMUNITY:
________________________________________________
DATE: ______________
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
2 Confidential
REFERENCE NUMBER: #6886
PROFFESIONAL SERVICES FOR THE MARIKANA COMMUNITY HEALTH CENTRE
• Interested in Tender YES / NO
NEW VENDOR
EXISTING VENDOR VENDOR NUMBER ______________
COMPANY E-MAIL ADDRESS: __________________________________________________
COMPANY E-MAIL ADDRESS: __________________________________________________
CONTACT NR: ___________________________________________________
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
3 Confidential
Scope of Work Preamble
Marikana Community Health Centre
A Community Health Centre is to be constructed at Marikana as indicated in Figure 1
This is a public building and carries significant risk for Sibanye Stillwater Marikina Operations in the
event of failure of the structure in future. It also forms part of the SLP commitments of Sibanye Stillwater
Marikana Operations, thus it will be open to the scrutiny of the DMR and the North West Province
Department of Health.
NB: Earthworks for the building was completed in December 2019.
Current requirements:
1. All Engineering services / Mechanical / Electrical/ Civil / Geotechnical / Land survey
2. All Architectural Services
3. Quantity Surveying
4. Construction Management
a. Including
i. Site Safety Management
ii. Competent Health and Safety Officer for the client as per the OHS
regulation
5. Assist with the Generation of the Tender Documentation
a. Sibanye Stillwater Marikana Operations Standard Conditions of Procurement will apply
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
4 Confidential
Conditions:
1. Preference will be given to Local Engineering firms 2. Must be registered Engineers 3. Must have at least 10 years’ experience in Health construction
4. Must have at least 5 years’ experience working in the Bapong, Marikana Area.
Scope of will include the following but the client holds the right to reduce any of the scope before or during
the tender process.
3.1 STAGE 1 – Inception 3.2 STAGE 2 - Concept and Viability (also termed Preliminary Design) 3.3 STAGE 3 - Design Development (also termed Detail Design) 3.4 STAGE 4 - Design Development (also termed Detail Design) 3.5 STAGE 5 – Construction Management and Inspection 3.6 STAGE 6 - Close- Out
ALL QUESTIONS TO BE ANSWERED IN DETAIL (PLEASE PRINT OR TYPE)
ENSURE THAT THE EACH PAGE OF QUESTIONNAIRE IS SIGNED
SECTION 1: GENERAL
1. COMPANY / CC DETAILS 1.1 Full name(s) of Company or Closed Corporation:
_____________________________________________________
1.2 Trading as:
_____________________________________________________
1.3 Previous Name(s) (if applicable):
_____________________________________________________
1.4 Date registered at Registrar of Companies:
_____________________________________________________
1.5 Company/CC:
Company Closed Corporation
1.6 Physical Address:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
5 Confidential
1.7 Where do you operate from?
Registered Business Premises
Industrial Premises
Private Residence
Farm or small/holding (Plot)
1.8 Postal Address:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Code:___________________
1.9 Telephone Number:
_____________________________________________________
1.10 Fax Number:
_____________________________________________________
1.11 E-mail Address:
_____________________________________________________
2. COMPANY / CC PROFILE
Attach Details of the following:
2.1 Brief Summary of Company/CC History/ Experience
2.2 Do you currently work as an employee for Sibanye-Stillwater?
2.3 Were you previously employed by Sibanye-Stillwater or
Anglo American Platinum or Lonmin Platinum? If yes, provide more information.
(Dates, Position, Location and Reason for leaving)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
2.4 Have you ever provided a service or product to Sibanye-Stillwater?
2.5 Attach a valid B-BBEE certificate.
Attached Not Attached N/A
Yes No
Yes
Yes
Yes
Yes No
No
No
No
Yes No
Yes No
Yes No
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
6 Confidential
2.6 How does your company connect to the Internet?
Does not connect
Modem
ISDN
ADSL
Other
If other, please specify
____________________________________________________________________
___________________________________________________________________
SECTION 2: TECHNICAL QUESTIONNAIRE
2.1 Technical Questions
2.1.1 Provide your proposed org structure per crew together with the qualifications of your proposed consultants for the Professional Services on the Marikana Community Health Centre?
___________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 2.1.2 Provide your Safety Statistics for the past twelve (12) months. ______________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________ 2.1.3 What Percentage does the Professional services constitute of your total business? ___________________________________________________________________________ ___________________________________________________________________________ 2.2 Are your premises available for inspection? If no, please supply reason ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________
Yes No
ATTACH ALL INFORMATION / ATTACHMENTS APPLICABLE TO SECTION 1 HERE
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
7 Confidential
2.3 Risk Assessment Policy (Mandatory on Safety Critical/Hazardous Items)
2.3.1 Do you have a risk assessment policy?
Attach an example of the proposed risk assessment document
2.4 Tools and Equipment
2.4.1 What tools/ equipment do you propose to utilise for this contract?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2.5 How will you transport your teams between sites and where will your base office be?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2.6 Has your Company ever been investigated or your contract cancelled by any other
company due to technical reasons?
If yes, please state the following
2.6.1 Name of Company who investigated or rejected you: ___________________________________________________________________________ 2.6.2 Service that was investigated? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ 2.6.3 What was done to rectify the problem? ______________________________________________________________________________________________________________________________________________________ ___________________________________________________________________________
Yes No N/A
Attached Not attached N/A
Yes No
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
8 Confidential
2.7 Experience: Supply references relevant to Professional Services rendered in Health
Construction:
Description
Date Completed
Total Value of work
Name of Client
Contact nr
1
2
3
4
5
2.8 Dealings with the Mining Industry
2.8.1 Do you have dealings with other Mining Houses or Mines?
If yes, please specify the type of services, duration and with which Mining Houses
Off Contract
___________________________________________________________________________
__________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
On Contract
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2.9 How many people are currently employed by your company?
__________________________________________________________________________
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
9 Confidential
2.10 Experience
2.10.1 Supply references relevant to Engineering Services rendered:
Description
Date Completed
Total Value of work
Name of Client
Contact nr
1
2
3
4
5
2.10.2 Supply references and proof of services rendered in the Bapong/Marikana area near
Brits North West:
Description
Date Completed
Total Value of work
Name of Client
Contact nr
1
2
3
4
5
ATTACH ALL INFORMATION / ATTACHMENTS APPLICABLE TO SECTION 2 HERE
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
10 Confidential
3.1 Tax number of Company and Subsidiaries
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
3.2 Bank and Bank Number of Companies
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
(Attach a list if space is not adequate)
3.3 If any auditing company is used, supply company’s name, address and telephone
number
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
3.4 Important: Mandatory Attachments
3.4.1 Attach a RECENTLY CERTIFIED copy (please ensure
ALL PAGES are certified) of your CC or Company
Registration Certificate, CC or Company and/or
Owner name-change.
3.4.2 Attach a copy of your company letterhead
3.4.3 Attach an ORIGINAL CANCELLED
Company Cheque or bank statement (bank date stamp required)
SECTION 3: FINANCIAL QUESTIONNAIRE
Attached Not Attached
Attached Not Attached
Attached Not Attached
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
11 Confidential
3.5 Has your company ever investigated or rejected by any other company due to financial
reasons?
If Yes, Please State the Following:
3.5.1 Name of Company who investigated or rejected to:
___________________________________________________________________
3.5.2 Details of irregularities concerned:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
3.5.3 What was done to rectify the problem?
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
4.1 Full names, Telephone Numbers, ID Numbers and Cell Phone Numbers of all Directors,
Partners, Members or Owners of the Company or Closed Corporation
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Yes No
ATTACH ALL INFORMATION / ATTACHMENTS APPLICABLE TO SECTION 3 HERE
SECTION 4: SECURITY QUESTIONNAIRE
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
12 Confidential
4.2 Attach a Legible Copy of the ID Documents of All
Directors, Partners, Members or Owners of the Company
or Closed Corporation
4.3 List the Names of all Businesses in which the above Directors, Partners, Owners or
Members have been involved in.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4.4 Full Names, ID Numbers, Home Addresses and Telephone Numbers of all Manager(s)
And Sales Representatives employed by the Company/CC and Subsidiaries
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4.5 Name all Relatives Employed by Sibanye-Stillwater
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4.6 Name all Persons Employed at Sibanye-Stillwater who may benefit from your dealings
with the Mine
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Attached Not Attached
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
13 Confidential
4.7 State if any of your Employees, including Hired Labour, have ever been convicted of
any Criminal Offence. If so, when, where and what was the offence?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
4.8 Has the Company / Closed Corporation or Any Subsidiaries
or Agent been investigated by any of the Mining Houses
or Mines?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
4.9 Was your Company investigated or rejected by any other
Company because of Security Reasons?
If yes, please supply full details?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Yes No
Yes No
ATTACH ALL INFORMATION / ATTACHMENTS APPLICABLE TO SECTION 4 HERE
SIBANYE-STILLWATER SUPPLIER QUESTIONNAIRE
___________________________________________________________________________
14 Confidential
Ensure that all information provided on this form is true and correct.
Any inaccurate, false or misleading information provided in this questionnaire, could lead
to disqualification and possible investigations.
We the undersigned, duly authorised by our company, the necessary action may be taken
against the Company concerned and we may choose not to do business and/or cease to do
business with such a Company.
TO BE COMPLETED AND SIGNED BY AN AUTHORISED COMPANY REPRESENTATIVE
_______________________________
NAME (PRINT)
_______________________________ _________________________ _______________
Signed Designation Date
PLEASE NOTE: UNSIGNED OR INCOMPLETE QUESTIONNAIRES WILL BE REJECTED
For Queries contact: Hannelie van der Walt
E-mail: [email protected]
SECTION 5: IMPORTANT NOTIFICATIONS