Rft 12284 - Cat 1 - Software and Licensing

1.1(a)
Full name of the potential supplier submitting the information

1.1(b) – (i)
Registered office address (if applicable)

1.1(b) – (ii)
Registered website address (if applicable)

1.1(c)
Trading status, please select one of the following;

1.1(d)
Date of registration in country of origin

1.1(e)
Company registration number (if applicable)

1.1(f)
Charity registration number (if applicable)

1.1(g)
Head office DUNS number (if applicable)

1.1(h)
Registered VAT number

1.1(i) - (i)
If applicable, is your organisation registered with the appropriate professional or trade register(s) in the member state where it is established?

1.1(i) - (ii)
If you responded yes to 1.1(i) - (i), please provide the relevant details, including the registration number(s).

1.1(j) - (i)
Is it a legal requirement in the state where you are established for you to possess a particular authorisation, or be a member of a particular organisation in order to provide the services specified in this procurement?

1.1(j) - (ii)
If you responded yes to 1.1(j) - (i), please provide additional details of what is required and confirmation that you have complied with this.

1.1(k)
Trading name(s) that will be used if successful in this procurement

1.1(l)
Select which classification applies to your company

1.1(m)
Are you a Small, Medium or Micro Enterprise (SME)?
The definition of an SME can be found at: https://ec.europa.eu/growth/smes/business-friendly-environment/sme-definition_en

1.1(n)
Details of Persons of Significant Control (PSC), see Note 1 below, where appropriate:
- Name;
- Date of birth;
- Nationality;
- Country, state or part of the UK where the PSC usually lives;
- Service address;
- The date he or she became a PSC in relation to the company (for existing companies the 6 April 2016 should be used);
- Which conditions for being a PSC are met;
- Over 25% up to (and including) 50%,
- More than 50% and less than 75%,
- 75% or more.

Note 1
UK companies, Societates European (SEs) and limited liability partnerships (LLPs) are required to identify and record the people who own or control their company. Companies, SEs and LLPs need to keep a PSC register, and must file the PSC information with the central public register at Companies House.

(Please enter N/A if not applicable)

1.1(o)
Details of immediate parent company:

- Full name of the immediate parent company
- Registered office address (if applicable)
- Registration number (if applicable)
- Head office DUNS number (if applicable)
- Head office VAT number (if applicable)

(Please enter N/A if not applicable)

1.1(p)
Details of ultimate parent company:

- Full name of the ultimate parent company
- Registered office address (if applicable)
- Registration number (if applicable)
- Head office DUNS number (if applicable)
- Head office VAT number (if applicable)

(Please enter N/A if not applicable)

NOTE: A criminal record check for relevant convictions may be undertaken for the preferred suppliers and the persons of significant in control of them.

1.2(a) - (i)
Are you bidding as the lead contact for a group of economic operators?

If yes, please provide details listed in
questions 1.2(a) (ii), (a) (iii) and to
1.2(b) (i), (b) (ii), 1.3, Section 2 and 3.

If no, and you are a supporting bidder
please provide the name of your group
at 1.2(a) (ii) for reference purposes,
and complete 1.3, Section 2 and 3.

1.2(a) - (ii)
Name of group of economic operators (if applicable)

1.2(a) - (iii)
Proposed legal structure if the group of economic operators intends to form a named single legal entity prior to signing a contract, if awarded. If you do not propose to form a single legal entity, please explain the legal structure.

1.2(b) - (i)
Are you or, if applicable, the group of economic operators proposing to use sub-contractors?

1.2(b) - (ii)
If you responded yes to 1.2(b)-(i) please provide the details, listed below. for each sub-contractor. We may ask them to supply this detail as well.

Name
Registered address
Trading status
Company registration number
Head Office DUNS number (if applicable)
Registered VAT number
Type of organisation
SME (Yes/No)
The role each sub-contractor will take in providing the works and /or supplies e.g. key deliverables
The approximate % of contractual obligations assigned to each sub-contractor

1.3
NOTE: Contact details and declaration

I declare that to the best of my knowledge the answers submitted and information contained in this response are correct and accurate.
I declare that, upon request and without delay I will provide the certificates or documentary evidence referred to in this questionnaire.
I understand that the information will be used in the selection process to assess my organisation’s suitability to be invited to participate further in this procurement.
I understand that the authority may reject this submission in its entirety if there is a failure to answer all the relevant questions fully, or if false/misleading information or content is provided in any section.
I am aware of the consequences of serious misrepresentation.

1.3(a)
Contact name

1.3(b)
Name of organisation

1.3(c)
Role in organisation

1.3(d)
Phone number

1.3(e)
E-mail address

1.3(f)
Postal address

1.3(g)
Signature (Not required this information is captured in the CTM audit trail)

1.3(h)
Date

NOTE: Please answer the following questions in full. Note that every organisation that is being
relied on to meet the selection must complete and submit the Part 1 and Part 2 self declaration.

2.1(a)
NOTE: Regulations 57(1) and (2)

The detailed grounds for mandatory exclusion of an organisation are set out in the 'Standard Selection Guidance', part of the document pack for this requirement, which should be referred to before completing these questions.

Please indicate if, within the past five years you, your organisation or any other person who has powers of representation, decision or control in the organisation been convicted anywhere in the world of any of the offences within the summary listed in the above document.

2.1(a) (i)
Participation in a criminal organisation.

If Yes please provide details at 2.1(b)

2.1(a) (ii)
Corruption.

If Yes please provide details at 2.1(b)

2.1(a) (iii)
Fraud.

If Yes please provide details at 2.1(b)

2.1(a) (iv)
Terrorist offences or offences linked to terrorist activities

If Yes please provide details at 2.1(b)

2.1(a) (v)
Money laundering or terrorist financing

If Yes please provide details at 2.1(b)

2.1(a) (vi)
Child labour and other forms of trafficking in human beings

If Yes please provide details at 2.1(b)

2.1(b)
If you have answered yes to question 2.1(a)(i) - 2.1(a)(vi) inclusive, please provide further details.
Date of conviction, specify which of the grounds listed the conviction was for, and the reasons for conviction,
Identity of who has been convicted
If the relevant documentation is available electronically please provide the web address, issuing authority, precise reference of the documents.

2.2
If you have answered Yes to any of the points above have measures been taken to demonstrate the reliability of the organisation despite the existence of a relevant ground for exclusion ? (Self Cleaning)

2.3(a)
Regulation 57(3)

Has it been established, for your organisation by a judicial or administrative decision having final and binding effect in accordance with the legal provisions of any part of the United Kingdom or the legal provisions of the country in which the organisation is established (if outside the UK), that the organisation is in breach of obligations related to the payment of tax or social security contributions?

2.3(b)
If you have answered yes to question 2.3(a), please provide further details. Please also confirm you have paid, or have entered into a binding arrangement with a view to paying, the outstanding sum including where applicable any accrued interest and/or fines.

NOTE: The authority reserves the right to use its discretion to exclude a potential supplier where it can demonstrate by any appropriate means that the potential supplier is in breach of its obligations relating to the non-payment of taxes or social security contributions.

3.1
NOTE: Regulation 57 (8)

The detailed grounds for discretionary exclusion of an organisation are set out in the 'Standard Selection Guidance', part of the document pack for this requirement, which should be referred to before completing these questions.
Please indicate if, within the past three years, anywhere in the world any of the following situations have applied to you, your organisation or any other person who has powers of representation, decision or control in the organisation.

3.1(a)
Breach of environmental obligations?

If Yes please provide details requested at 3.2 and include details of the breach

3.1 (b)
Breach of social obligations?

If Yes please provide details requested at 3.2 and include details of the breach

3.1 (c)
Breach of labour law obligations?

If Yes please provide details requested at 3.2 and include details of the breach

3.1(d)
Bankrupt or is the subject of insolvency or winding-up proceedings, where the organisation’s assets are being administered by a liquidator or by the court, where it is in an arrangement with creditors, where its business activities are suspended or it is in any analogous situation arising from a similar procedure under the laws and regulations of any State?

If Yes please provide the details requested at 3.2 and include the following information :
• Nature of the bankruptcy / insolvency proceedings;
• explain what measures have been taken to demonstrate the reliability of your organisation despite the existence of a relevant ground for exclusion.

3.1(e)
Guilty of grave professional misconduct?

If Yes please provide the details requested at 3.2 and include the following information:
• Nature of the professional misconduct; and
• explain what measures have been taken to demonstrate the reliability of your organisation despite the existence of a relevant ground for exclusion.

3.1(f)
Entered into agreements with other economic operators aimed at distorting competition?

If Yes please provide the details requested at 3.2 and include the following information :
• details of the agreements that the contractor has entered into, including the names of the other economic operators which are party to the agreements; and
• explain what measures have been taken to demonstrate the reliability of your organisation despite the existence of a relevant ground for exclusion.

3.1(g)
Aware of any conflict of interest within the
meaning of regulation 24 due to the
participation in the procurement procedure?

If Yes please provide the details requested at 3.2 and include the following information :
• details of the actual or perceived conflict of interest; and
• details of the measures that the Tenderer has or proposes to put in place to remedy the actual or perceived conflict of interest.

3.1(h)
Been involved in the preparation of the
procurement procedure?

If Yes please provide the details requested at 3.2 and include the following information :
• nature of the Tenderer’s prior involvement in the preparation of the procurement procedure; and
• the measures that the Tenderer has put in place to remedy any distortion of competition arising from the Tenderer’s prior involvement in the procurement procedure

3.1(i)
Shown significant or persistent deficiencies
in the performance of a substantive
requirement under a prior public contract, a
prior contract with a contracting entity, or a
prior concession contract, which led to early
termination of that prior contract, damages
or other comparable sanctions?

If Yes please provide the details requested at 3.2 and include the following information :
• details of the relevant contract(s);
• details of the relevant contracting entity;
• details of the deficiencies in the Tenderers performance in respect of those contracts;
• details the sanctions applied as a consequence of the Tenderer’s performance (i.e early termination, damages or other) AND
• details the measures the Tenderer has put in place to prevent future performance deficiencies in contract delivery.

3.1(j)
NOTE: Please answer the following statements

3.1(j) - (i)
The organisation is guilty of serious misrepresentation in supplying the information required for the verification of the absence of grounds for exclusion or the fulfilment of the selection criteria.

If Yes please provide the details requested at 3.2 and include the following information :
• explain what measures have been taken to demonstrate the reliability of your organisation despite the existence of a relevant ground for exclusion.

3.1(j) - (ii)
The organisation has withheld such information.

If Yes please provide the details requested at 3.2 and include the following information :
• explain what measures have been taken to demonstrate the reliability of your organisation despite the existence of a relevant ground for exclusion

3.1(j) –(iii)
The organisation is not able to submit supporting documents required under regulation 59 of the Public Contracts Regulations 2015.

If Yes please provide the details requested at 3.2 and include the following information :
• explain what measures have been taken to demonstrate the reliability of your organisation despite the existence of a relevant ground for exclusion

3.1(j)-(iv)
The organisation has influenced the decision-making process of the contracting authority to obtain confidential information that may confer upon the organisation undue advantages in the procurement procedure, or to negligently provided misleading information that may have a material influence on decisions concerning exclusion, selection or award.

If Yes please provide the details requested at 3.2 and include the following information :
• explain what measures have been taken to demonstrate the reliability of your organisation despite the existence of a relevant ground for exclusion

3.2
If you have answered Yes to any of the
above, explain what measures have been taken
to demonstrate the reliability of the
organisation despite the existence of a
relevant ground for exclusion? (Self
Cleaning)

7.1
Are you a relevant commercial organisation as
defined by section 54 (""Transparency in supply
chains etc."") of the Modern Slavery Act 2015 (""the
Act"")?

7.2
If you have answered Yes to question 7.1 are you compliant with the annual reporting requirements contained within Section 54 of the Act 2015?
If Yes please copy / paste the URL into a blank document and upload to the question folder.
If No please upload an explanation to the question folder.

4.3
Please indicate which of the following you have provided to demonstrate your economic/financial standing:
A copy of your audited accounts for the last two years?
Yes / No
If no, provide one of the following: answer with Y/N .

4.3(a)
A statement of the turnover, Profit and Loss, Account/Income Statement, Balance Sheet/Statement of Financial Position and Statement of Cash Flow for the most recent year of trading for this organisation.
Yes / No / N/A

4.3(b)
A statement of the cash flow forecast for the current year and a bank letter outlining the current cash and credit position.
Yes / No / N/A

4.3(c)
Alternative means of demonstrating financial status if any of the above are not available (e.g. forecast of turnover for the current year and a statement of funding provided by the owners and/or the bank, charity accruals accounts or an alternative means of
demonstrating financial status).
Yes / No / N/A

NOTE:
This section is for Information Only
If you have indicated in the Selection Questionnaire question 1.2
that you are part of a wider group, please provide further details
below:

5 (i)
Name of organisation

5 (ii)
Relationship to the Supplier completing these questions

5.1
Are you able to provide parent company accounts if
requested to at a later stage?

5.2
If yes, would the parent company be willing to provide
a Parent Company Guarantee if necessary?

5.3
If no, would you be willing and able to obtain a guarantee
elsewhere (e.g. from a bank)?

6.1
Please provide details, listed below, of up to three contracts, in any combination from either the public or private sector; voluntary, charity or social enterprise (VCSE) that are relevant to our requirement. VCSEs may include samples of grant-funded work. Contracts for supplies or services should have been performed during the past three years. Works contracts may be from the past five years.

The named contact provided should be able to provide written evidence to confirm the accuracy of the information provided below. Consortia bids should provide relevant examples of where the consortium has delivered similar requirements. If this is not possible (e.g. the consortium is newly formed or a Special Purpose Vehicle is to be created for this contract) then three separate examples should be provided between the principal member(s) of the proposed consortium or Special Purpose Vehicle (three examples are not required from each member).

Where the Supplier is a Special Purpose Vehicle, or a managing agent not intending to be the main provider of the supplies or services, the information requested should be provided in respect of the main intended provider(s) or subcontractor(s) who will deliver the contract.
Name of customer organisation
Point of contact in the organisation
Position in the organisation
E-mail address
Description of contract
Contract Start date
Contract completion date
Estimated contract value

6.3
If you cannot provide at least one example for question 6.1, in no more than 500 words please provide an explanation for this e.g. your organisation is a new start-up or you have provided services in the past but not under a contract.

8.1 (a)
Please self-certify whether you already have, or can commit to obtain, prior to the commencement of the contract, the levels of insurance cover indicated in the tender documentation.

9.2 (a)
Do you hold a UKAS accredited independent third party certificate of compliance with BS EN ISO 14001 or a valid Eco-management & Audit Scheme (EMAS) certificate, or equivalent?

If 'Yes' please be prepared to provide evidence and mark the rest of the questions in this section as 'N/A' and move to the next question section.
If 'No' please answer question 9.2 (b) or 9.2 (c) (the relevant question will be included within the SQ).

9.2 (b)
Do you have an EMS which has not been accredited but fully meets the requirements of BS EN ISO 14001, or equivalent?
If 'Yes' please be prepared to provide evidence

9.2 (c)
Do you have an EMS which has not been accredited but fully meets the requirements of BS EN ISO 14001 or equivalent, or are you able to confirm that you are working towards meeting the requirements of BS EN ISO 14001 or equivalent?
If 'Yes' please be prepared to provide evidence

9.3 (a)
Do you hold a UKAS accredited independent third party certificate of compliance with ISO 45001 or equivalent?

Yes/No

If 'Yes' please be prepared to provide evidence and mark the rest of the questions in this section as 'N/A' and move to the next question section.

If 'No' please answer question 9.3 (b)

For the avoidance of doubt, you must be able to provide a positive response to at least one of these questions (9a, b, c or d) to Pass this section

9.3 (b)
Have you within the the last twelve months, successfully met the assessment requirements of a construction-related scheme in registered membership of the Safety Schemes in Procurement (SSIP) forum?
If 'Yes' please be prepared to provide evidence and mark the rest of the questions in this section as 'N/A' and move to the next question section.
If 'No' please answer question 9.3 (c) or 9.3 (d) (the relevant question will be included within the SQ).

9.3 (c)
Does your organisation have a Health and Safety Policy that fully complies with current legislative requirements and meets the requirements of ISO 45001 or equivalent?

Yes / No / N/A

If 'Yes' please be prepared to provide evidence if requested.

9.3 (d)
Does your organisation have a Health and Safety Policy that fully complies with current legislative requirements and meets the requirements of ISO 450011 or equivalent, or are you able to confirm that you are working towards meeting the requirements of BS OHSAS 18001 or equivalent?

Yes / No / N/A

If 'Yes' please be prepared to provide evidence if requested.

9.4 (a)
Do you hold a UKAS accredited independent third party certificate of compliance with BS EN ISO 9001 or equivalent?
If 'Yes' please be prepared to provide evidence and mark the rest of the questions in this section as 'N/A' and move to the next question section.
If 'No' please answer question 9.4 (b)

9.4 (b)
Do you have a policy and organisation for quality management that fully meets the requirements of BS EN ISO 9001 or equivalent?
If 'Yes' please be prepared to provide evidence if requested.

9.4 (c)
Do you have a policy and organisation for quality management that fully meets the requirements of BS EN ISO 9001 or equivalent, or are you able to confirm that you are working towards meeting the requirements of BS EN ISO 9001 or equivalent?
If 'Yes' please be prepared to provide evidence if requested.

9.5 (a)
Do you hold ISO27001 accreditation and/or Cyber Essentials or Cyber Essentials Plus or equivalent?
If yes, please upload your certificate(s) and controlling procedure(s)
If no, please answer q. 9.5 (a) (i)
For the avoidance of doubt, you must be able to provide a positive response to at least one of these questions (9.5a or b) to Pass this section

9.5 (a) (i)
If you answered No to question 9.5 (a), please confirm you are committed to obtaining one of the above mentioned (ISO 27001, Cyber Essentials or Cyber Essentials Plus) prior to contract go live.

10.

You will be awarded a PASS if:
- you select Yes in response to question 10

You will be assigned a FAIL if:
- you do not provide a response at all
OR
- you select No in response to question 10