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SECTION HEADING GOES HERE

ANNEXURE E: DECLARATION OF INTERESTS

1.

No contracts to provide goods or services to Parliament may be provided to the following categories of entities: -  Member of Parliament, Member of the Cabinet, Member of a Provincial Legislature, Member of a Provincial Executive Council, a Municipal Councilor or a person in the employ of the State whose participation in bidding for the contract may result in a conflict of interest;  or any entity in which a person mentioned above is a Director or has a controlling or other substantial interest.  

2.

The bidder is therefore requested to complete Sections a – b of the declaration below in substantiation.

YES/NO

a.

Are you or any person connected with the bidder,a Member of Parliament  or a Cabinet Member?

If yes, state whether you are a Director or have a Controlling or other substantial interest in the bidding company.

……………………………………………..………………………………………

……………………………………………………………………………………

b.

Are you or any person connected with the bidder, a Member the

YES/NO

     Provincial Legislature or a Member of a Provincial Executive Council  

     or a Municipal Councilor ?

If yes, state whether you are a Director or have a Controlling or other substantial interest in the bidding company.

……………………………………………..………………………………………

……………………………………………………………………………………

YES/NO

c.

Are you or any person connected with the bidder,  Employed by the State?

If yes, state whether you are a Director or have a Controlling or other substantial interest in the bidding company.

……………………………………………..………………………………………

……………………………………………………………………………………

d.

Do you, or any person connected with the bidder, have any relationship (family, friend, other) with a person employed by Parliament and who may be involved with

YES/NO

the evaluation and or adjudication of this bid?

Procurement of Catering Services forTaking Parliament to the People: T9/2/2010

INITIAL: _____________

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