4-IFB-80514 - ANNEXES TO FILL OUT.docx

BIDDER’S IDENTIFICATION

IDENTIFICATION OF The COMPANY

CONTACT PERSON

WEBSITE

CERTIFICATION REGARDING BIDDER’S RESPONSIBILITY

[Insert Legal Name of The Firm] ([Abbreviated Name]) warrants that, to the best of our knowledge and belief, that:

1. [Abbreviated Name] and/or any of its Principals[footnoteRef:1]— [1: “Principal,” for the purposes of this certification, means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a subsidiary, division, or business segment; and similar positions).]

a. Are / are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any NATO entity or national government;

b. Have / have not , within a three-year period preceding this Bid, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public contract or subcontract; violation of antitrust law relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating criminal tax laws, or receiving stolen property;

c. Are / are not presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph b. above;

d. Have / have not, within a three-year period preceding this offer, been notified of any delinquent taxes[footnoteRef:2] in an amount that exceeds EUR 20,000 for which the liability remains unsatisfied. [2: Taxes are considered delinquent if both of the following criteria apply:

(i) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(ii) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.]

2. [Abbreviated Name] has / has not, within a three-year period preceding this offer, had one or more contracts terminated for default by any NATO entity or national government.

3. [Abbreviated Name] shall provide immediate written notice to the Procurement Officer if, at any time prior to contract award, the [Abbreviated Name] learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

This certification is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Bidder knowingly rendered an erroneous certification, in addition to other remedies available to NATO, the Procurement Officer may terminate the contract resulting from this solicitation for default.

Date :

Signature:

Name & Title:

Company:

Proposal Reference:

LIST OF SUBCONTRACTORS

[Insert Legal Name of The Firm] ([Abbreviated Name]) intends to place or use the following sub-contracts for the performance of the Contract under solicitation.

Sub-Contract

[Abbreviated Name] warrants that no more than 50% of the staffing resources or labour hours/work required for the successful completion of the Contract under solicitation will be subcontracted for the entire duration of the Contract. This restriction does not apply to subcontracting to entities or divisions that are part of the same holding entity, company (e.g. local subsidiaries or local partnerships) or network of companies.

Date :

Signature:

Name & Title:

Company:

Bid Reference:

PAST PERFORMANCE REFERENCES

Customer point of contact Name Function Telephone Email

STATEMENT REGARDING CONFLICTS OF INTEREST

[Insert Legal Name of The Firm] ([Abbreviated Name]) warrants that, to the best of our knowledge and belief, there are no relevant facts or circumstances which could give rise to an organizational or personal Conflict of Interest, or that we have disclosed all such relevant information as part of the COI Mitigation Plan as incorporated in this proposal. More particularly, we warrant that:

1. [Abbreviated Name], or any of its affiliates or subcontractors, has not obtained from the Organization, under a separate contract (other than those identified in the COI Mitigation Plan, if any), information that other Bidders don’t possess and that may provide an unfair competitive advantage in this procurement action.

2. [Abbreviated Name], or any of its affiliates or subcontractors, has not provided to the Organization or a prime Contractor of the Organization, under a separate contract (other than those identified in the COI Mitigation Plan, if any), services that establish the ground rules for this procurement action.

IFB 2025/80514

PRICE SCHEDULE

On behalf of the firm stated below I hereby offer providing the Organization with the services and deliverables (collectively referred as “ITEMS”) set forth in the schedule below, at the specified prices, and subject to the terms and conditions stated in this RFP.

QKC52T_TA22NN : Abloy Protec² TA22NN, clé propre avec cylindre.

CY323T (51x56) : Cylindre Protec² OTAN (registre 16T0011), profil TA22NN, avec 3 clés, MK "MKD".

CY323T (41x31) : Cylindre Protec² OTAN (registre 16T0011), profil TA22NN, avec 3 clés, MK "MKD".

K800 : Double cylindre Swiss 22 mm, SKG**, chrome brillant, 32,5/32,5 mm, plan de fermeture, sans clé.

C20200800M : Cylindre double profilé Euro SKG**, 30/30 mm, paneton Euro 35°, nickelé mat.

C202108A0M : Demi-cylindre Euro SKG**, 80/10 mm, paneton réglable 8x45°, nickelé mat.

C20200823M : Cylindre double Euro SKG**, 45/40 mm, paneton Euro 35°, nickelé mat.

C20200824M : Cylindre double Euro SKG**, 50/40 mm, paneton Euro 35°, nickelé mat.

C20200801M : Cylindre double Euro SKG**, 30/35 mm, paneton Euro 35°, nickelé mat.

PL32199T50GS : Assa Abloy cadenas Protec² OTAN, tous sur la même clé, PL321/50, code ébauche 2N.

The prices specified in this Schedule shall be firm and fixed for the initial duration of the Contract. For optional extensions, the stated prices may be subject to a yearly adjustment in accordance with the Clause entitled “Prices and Price Adjustment” of the Special Terms and Conditions, in Part II of the IFB.