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SECTION HEADING GOES HERE

DECLARATION

I hereby agree that, in the event of false, incorrect or misleading information being provided in this declaration, the Secretary to Parliament of the Republic of South Africa shall have the right to:

-recover any losses or damages sustained by Parliament under such agreement

-restrict the supplier from further business with Parliament depending on the materiality of the misrepresentation and the degree of prejudice suffered.

Name of Representative: _________________________________________________

Identity number: ________________________________________________________

Signature:    ___________________________________   Date: __________________

(DULY AUTHORISED TO SIGN FOR AND ON BEHALF OF THE ABOVE ENTITY)

COMMISSIONER OF OATHS

I certify that the above has acknowledged that he/she knows and understands the contents of this document, that he/she does not have any objection to taking the oath, and that he/she considers it to be binding on his/her conscience, and which was sworn to and signed before me at ____________________ on this the ________ day of _____________ 200___, and that the administering oath complied with the regulations contained in Government Gazette No. R 1258 of 21 July 1972, as amended.

________________________________ (Sign)

________________________________ (Name)

COMMISSIONER OF OATHS STAMP

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

INITIAL: _____________

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