INVITATION TO REGISTER ON THE NLC SUPPLIER DATABASE

Reference Number

Description Closing Date & Time

Enquiry Details

IFDB01/2016 The National Lotteries Commission (NLC) invites potential and current suppliers in all nine (9) Provinces to apply for accreditation and registration on the NLC Supplier Database.

18 March 2016 @ 16:30 am

All enquiries related to the supplier database should be in writing and may be directed to database@nlcsa.org.za, attention Ms. Maureen Senyatsi or Mr. Lucky Lesufi Tel: (012) 432 1470/1414/1344

Suppliers are required to download the database forms on the NLC website at www.nlcsa.org.za/opportunities/supplier_database or can be obtained by sending an e-mail to database@nlcsa.org.za

Database Submission: All completed application forms should be posted or hand delivered at any of the NLC

Provincial Office across the country. The NLC reserves the right not to accept any application

2016/2017

APPLICATION FORM

TO REGISTER AS A VENDOR

INTO

NATIONAL LOTTERIES COMMISSION

SUPPLIER DATABASE

FOR SUPPLY OF GOODS AND SERVICES

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SECTION A

1. SUPPLIER DATABASE SUBMISSION

In order to comply with the requirements of the Public Finance Management Act

of 1999 (PFMA) and to ensure compliance with the Preferential Procurement

Policy Framework Act of 2000, (PPPFA) and its regulations, the NLC invites

prospective service providers to be added to their Supplier Database. It is

envisaged, that this database will contribute to efficient administration and

compliance with the PFMA.

1.1 The purpose

The purpose of this database is to give all prospective suppliers an equal

opportunity to submit quotations as and when required by the NLC.

Procurement of all goods and services for NLC is centralised and managed by

Supply Chain Management Unit, under Finance Division based at Head Office in

Pretoria, Hatfield.

1.2 National Lotteries Commission Offices:

Procurement of all goods and services for NLC is centralised and managed by

Supply Chain Management Unit, under Finance Division based at Head Office in

Pretoria, Hatfield.

To be registered on the NLC Supplier Database, suppliers are required to select

one (1) Province of your choice. Preference will be given to suppliers located in a

specific province for a procurement of goods or services for that specific

province. The following are the nine (9) NLC offices across the country. Please

select one (1) NLC Office of your preference.

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No. Province NLC Office Please tick the

relevant box (X)

1. Gauteng Head Office : Pretoria

333 Grosvenor Street

Block D, Hatfield Gardens

Hatfield, Pretoria

2. Eastern Cape East London Office

Waverley Office Park

3-33 Phillip Frame Road

Chislehurst, East London

3. Limpopo Polokwane Office

5 Landros Mare Street Polokwane

4. Kwa-Zulu

Natal

Durban Office

Smartxchange, 5 Walnut Road Durban

5. Free State Welkom Office,

No. 21/322, Corner Stateway and Ryk

Roads, Welkom

6. Northern Cape Kimberly Office

Suite D, 9-11 Roper Street, Kimberly

7. North-West Mahikeng Office

Henque Building, 2313 Aerodome Cresent

(Parallel to Nelson Mandela Drive),

Mafikeng

8. Mpumalanga Nelspruit

25 Roodt Street, Sonheuwel Dorp,

Nelspruit

9. Western Cape Cape Town Office

4th Floor, Manhattan Place, 130 Bree

Street, Cape Town

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1.3 The closing date for submission

1.3.1 The closing date and time for submission is strictly on 18 March 2016 at

16h30.

1.3.2 All database submissions should reach the NLC Office according to

preference of your location on/before closure of business on the stipulated

closing date. NLC office hours are between 8:00 am and 16:30 pm.

1.3.3 No late registration will be considered.

2. CENTRAL SUPPLIER DATABASE (CSD) FOR GOVERNMENT

The Central Supplier Database will serve as the single source of key supplier

information for organs of state from 1 April 2016 providing consolidated,

accurate, up-to-date, complete and verified supplier information to procuring

organs of state. Prospective and current NLC suppliers are required to

self-register on the CSD website www.csd.gov.za. See the attached information

pack as “Annexure A”.

3. REQUIRED DOCUMENTATION 3.1 The following are mandatory documents to be submitted:

Description

1. Certified copy of Company registration documents (CIPC) certificate and Shareholders Certificates (where applicable) Please submit a certified copy.

2. Certified ID copies of Directors/shareholders/partners

3. Declaration of interest (SBD 4) Submit a signed original form.

4. Declaration of bidder’s past supply chain management practices (SBD 8) Submit a signed original form.

5. A valid original tax clearance certificate. Where partnerships, Consortia /Joint Ventures / Sub-contractors are

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involved each party must submit a separate Tax Clearance Certificate.

6. VAT Registration Certificate (where applicable) Please attach a certified copy of certificate

7. B-BBEE Status Level Certificate. Please attach a certified copy of certificate.

8. A letter from the bank (with a valid stamp) confirming banking details

9. Proof of address from the municipality/landlord in a form of electricity /water bill or from the relevant community/tribal authority.

3.2 Failure to comply with the above mandatory requirements will result in the

application being disqualified. 3.3. Suppliers may also submit the following supporting documents:

Description

1 Please attach a certified copy of certificate

2 Any other certificate pertaining to your relevant industry

3 Company profile.

3.3 Failure to comply with all of the above criteria and completion of the

forms as required, as well as submission of supporting documentation will result in the application being disqualified.

3.4 Suppliers will only have an opportunity to apply for or select a maximum

of three (3) commodity categories. 3.5 Leaflets and brochures are also welcomed.

4. INSTRUCTIONS FOR COMPLETION (Please read carefully)

All the forms should be completed and signed with a black pen.

Please clearly mark envelopes with the title “2016/2017 NLC Supplier

Database Registration”, addressed specified above.

The service/s for which the organisation would like to be registered must

be marked by putting a cross (x) in the “applicable” column in the list of

services hereunder.

The province that the supplier is applying for must be clearly marked by

putting(x) next to the province name.

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Applications without the relevant aforementioned information shall be

disqualified.

All queries must be addressed in writing and to SCM Office (only) at

database@nlcsa.org.za with the subject heading.

5. TERMS AND CONDITIONS: 5.1 Any supplier whose name appears on the Tender Defaulters and the

National Treasury’s Database of restricted suppliers as a person/entity

prohibited from doing business with the public sector will not be

considered.

5.2 Only signed original application forms will be accepted. No emailed, faxed,

incomplete or incorrect submissions will be accepted.

5.3 The NLC reserves the right to accept or reject any application.

5.4 The NLC reserves the right to conduct site visits where deemed

necessary.

5.5 Supplier shall be responsible to ensure that information is updated as and

when such change occurs. Information must be submitted to the NLC’s

Supply Chain Management Unit.

5.6 NLC will monitor supplier’s performance on projects awarded. The

evaluation will assist NLC on any future work that may be awarded.

SECTION B

Please tick the relevant box (X)

Province

New supplier

Supplier update

Have you registered with the CSD? (Yes/No)

If yes, please provide with the unique supplier number for the above

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1. COMPANY/SUPPLIER DETAILS

Kindly complete this document accurately as the information

contained herein is required for the following purposes:

To support NLC in the implementation of a system of preferences as

required by the Preferential Procurement Policy Framework Act

(No 5 of 2000).

Failure to complete the form in full may result in the supplier not being

considered for the awarding of any orders or contracts by the NLC.

Supplier/ Name of Company:

Trading name of Company:

Tax Clearance Certificate

Number:

Tax Clearance Expiry Date:

Vat Number:

Income Tax Reference

Number:

Company Registration

Number:

2. CONTACT DETAILS

2.1 Main Contact Person:

Title:

Initials:

Surname:

Position Held:

Business Telephone Number:

Mobile Number:

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Facsimile:

Email Address:

Company Website Address:

2.2 2nd Contact Person:

Title:

Initials:

Surname:

Position Held:

Business Telephone Number:

Mobile Number:

Facsimile:

Email Address:

3. ADDRESS DETAIL (Please attach proof of address from the municipality in a form of electricity/water bill, or from the community/tribal authority) Postal address of company

Physical address of company

Complex/ Office number

Street number

Street name

City/Town

Province

Code

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5. TYPE OF COMPANY (INDICATE WITH X AND PROVIDE

DOCUMENTARY PROOF)

Supplier Grouping Detail: Type of Firm Please tick the relevant box

1. Public Company (Ltd)

2. Private Company (Pty) Ltd

3. Close Corporation (cc)

4. Section 21 Company

5. Joint Venture

6. Consortium

7. Sole Proprietor

8. Foreign Company

9. Partnership

10. Trust

11. Government / Parastatal

12. Other (specify)

6. LIST OF COMMODITIES REQUIRED (PLEASE SELECT A MAXIMUM

OF THREE (3)

Office Consumables

Consumables & Office Supplies

COS.001 Printing Paper

COS.002 Stationary

COS.003 Printer Cartridge

COS.004 Office Equipment - Cost

COS.005 Cutlery & Crockery

COS.006 Groceries / Food Parcels

COS.007 Furniture & Fittings - Cost

COS.008 Conference Venue Accommodation

COS.009 Conference Facilities

COS.012 Electrical Services

COS.013 Other related services(Consumables)

Human Resource

HR.001 Staff Recruitment and Placement

HR.002 Staff Training - Conferences

HR.003 Staff Training - Workshops

HR.004 Temporary Staff - Recruitment Costs

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HR.005 Staff Welfare

HR.006 Other related services (HR)

Marketing and Public Relations

MPR.001 Advertising & Publicity - Publications and Editorials

MPR.002 Advertising & Publicity - Corporate Branding

MPR.003 Advertising & Publicity - Events Management

MPR.004 Advertising & Publicity - Media Services and Monitoring

MPR.009 Other related services (Marketing)

IT & Communication

ICT.001 Telephone - Cell phone

ICT.002 Telephone - Landline

ICT.003 Computer Equipment - Cost

ICT.004 Comp Exp - Repairs and Maintenance

ICT.005 Comp Exp - Licence Renewal Costs

ICT.006 Comp Exp - Consumables

ICT.007 Comp Exp - Data Warehousing

ICT.008 Intangible Assets - Cost

ICT.009 Other related services(IT)

Consultancy & Professional Services

CPS.001 Consulting Fees - Information Technology

CPS.002 Consulting Fees - Advisory Services

CPS.003 Consulting Fees - Legal

CPS.004 Consulting Fees - HR Related Matters

CPS.005 Consulting Fees - Company Secretariat

CPS.006 Consulting Fees - Forensic Investigations

CPS.007 Consulting Fees - Assurance Services

CPS.008 Other related services(Consultancy)

Other Services

TS.01 Travel and Accommodation

CS.01 Courier Services

CS.02 Catering Services

CS.03 Cleaning Services

CS.04 Security

CS.05 Plumbing Services

CS.06 Hygiene and Pest Control

CS.07 Off-site Corporate Storage Facilities

CS.08 Legal Fees

CS.09 Maintenance Services

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CS.10 Postages

CS.11 Third Lottery Licence Costs

INS.01 Insurance - Furniture and Fittings

INS.02 Insurance - Computer Equipment

INS.03 Insurance - Office Equipment

INS.04 Insurance - Motor Vehicle

LC.01 Lease costs - Office Equipment

LC.02 Lease costs - Property

LC.03 Lease costs - Motor Vehicles

OS.01 Outsourced Services

RS.01 Furniture Removal and Storage

7. LIST OF COMMODITIES TO BE OFFERED Please select the above commodities and indicate below the type of goods/services to be offered. Select maximum of three (3) commodities.

Commodities Code from the category listed above

8. Banking Details

Bank:

Branch Code:

Branch Location:

Account Holder:

Account Number:

Account Type:

NB: Please attach a letter of confirmation from the bank (with a valid stamp) verifying account details.

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9. CERTIFICATION I/We the undersigned, who warrant/s that he/she/we is/are duly authorized to do so on behalf of the company, certify that the percentage ownership/shareholders claimed are actively involved in the day to day management of the enterprise and I/we acknowledge that:

a. The information furnished on this form is true and correct b. In the event of a contract being awarded as a result of the above

mentioned information, the contractor may be required to furnish documentary proof to the satisfaction of the National Lotteries Commission that the information is correct.

c. I/we accept that, in addition to cancellation of a contract, action may be taken against me/us should the information furnished prove to be false.

__________________________________ DATE: ____________________ SIGNATURE OF OWNER OR REPRESENTATIVE: NAME IN BLOCK LETTERS: ______________________________________ WITNESSES:

1. …………………………………………………..

2. ……………………………………………………

SBD 4

DECLARATION OF INTEREST

1. Any legal person, including persons employed by the state¹, or persons having a kinship with persons

employed by the state, including a blood relationship, may make an offer or offers in terms of this

invitation to bid (includes a price quotation, advertised competitive bid, limited bid or proposal). In view

of possible allegations of favouritism, should the resulting bid, or part thereof, be awarded to persons

employed by the state, or to persons connected with or related to them, it is required that the bidder or

his/her authorised representative declare his/her position in relation to the evaluating/adjudicating

authority where-

- the bidder is employed by the state; and/or

- the legal person on whose behalf the bidding document is signed, has a relationship with

persons/a person who are/is involved in the evaluation and or adjudication of the bid(s), or where

it is known that such a relationship exists between the person or persons for or on whose behalf

the declarant acts and persons who are involved with the evaluation and or adjudication of the

bid.

2. In order to give effect to the above, the following questionnaire must be completed and submitted with the bid.

2.1 Full Name of bidder or his or her representative: ………………………………………………………….

2.2 Identity Number: …………………………………………………………………………………………………

2.3 Position occupied in the Company (director, trustee, shareholder²): ……………………………………..

2.4 Company Registration Number: ………………………………………………………………………..…….

2.5 Tax Reference Number: ………………………………………………………………………………….………

2.6 VAT Registration Number: ………………………………………………………………………………....

2.6.1 The names of all directors / trustees / shareholders / members, their individual identity numbers, tax

reference numbers and, if applicable, employee / persal numbers must be indicated in paragraph 3

below. ¹“State” means –

(a) any national or provincial department, national or provincial public entity or constitutional institution within the meaning of

the Public Finance Management Act, 1999 (Act No. 1 of 1999);

(b) any municipality or municipal entity;

(c) provincial legislature;

(d) national Assembly or the national Council of provinces; or

(e) Parliament.

²”Shareholder” means a person who owns shares in the company and is actively involved in the management of the enterprise or

business and exercises control over the enterprise.

2.7 Are you or any person connected with the bidder YES / NO

presently employed by the state?

2.7.1 If so, furnish the following particulars:

Name of person / director / trustee / shareholder/ member: ……....………………………………

Name of state institution at which you or the person

connected to the bidder is employed : ………………………………………

Position occupied in the state institution: ………………………………………

Any other particulars:

………………………………………………………………

………………………………………………………………

………………………………………………………………

2.7.2 If you are presently employed by the state, did you obtain YES / NO

the appropriate authority to undertake remunerative

work outside employment in the public sector?

2.7.2.1 If yes, did you attached proof of such authority to the bid YES / NO

document?

(Note: Failure to submit proof of such authority, where

applicable, may result in the disqualification of the bid.

2.7.2.2 If no, furnish reasons for non-submission of such proof:

…………………………………………………………………….

…………………………………………………………………….

…………………………………………………………………….

2.8 Did you or your spouse, or any of the company’s directors / YES / NO

trustees / shareholders / members or their spouses conduct

business with the state in the previous twelve months?

2.8.1 If so, furnish particulars:

…………………………………………………………………..

…………………………………………………………………..

…………………………………………………………………...

2.9 Do you, or any person connected with the bidder, have YES / NO

any relationship (family, friend, other) with a person

employed by the state and who may be involved with

the evaluation and or adjudication of this bid?

2.9.1If so, furnish particulars.

……………………………………………………………...

…………………………………………………………..….

………………………………………………………………

2.10 Are you, or any person connected with the bidder, YES/NO

aware of any relationship (family, friend, other) between

any other bidder and any person employed by the state

who may be involved with the evaluation and or adjudication

of this bid?

2.10.1 If so, furnish particulars.

………………………………………………………………

………………………………………………………………

………………………………………………………………

2.11 Do you or any of the directors / trustees / shareholders / members YES/NO

of the company have any interest in any other related companies

whether or not they are bidding for this contract?

2.11.1 If so, furnish particulars:

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….

3 Full details of directors / trustees / members / shareholders.

Full Name Identity

Number

Personal Tax

Reference Number

State Employee

Number / Persal

Number

4 DECLARATION

I, THE UNDERSIGNED (NAME)………………………………………………………………………

CERTIFY THAT THE INFORMATION FURNISHED IN PARAGRAPHS 2 and 3 ABOVE IS CORRECT.

I ACCEPT THAT THE STATE MAY REJECT THE BID OR ACT AGAINST ME IN TERMS OF

PARAGRAPH 23 OF THE GENERAL CONDITIONS OF CONTRACT SHOULD THIS DECLARATION

PROVE TO BE FALSE.

………………………………….. ..……………………………………………

Signature Date

…………………………………. ………………………………………………

Position Name of bidder

May 2011

SBD 8

DECLARATION OF BIDDER’S PAST SUPPLY CHAIN MANAGEMENT

PRACTICES

1 This Standard Bidding Document must form part of all bids invited.

2 It serves as a declaration to be used by institutions in ensuring that when goods

and services are being procured, all reasonable steps are taken to combat the

abuse of the supply chain management system.

3 The bid of any bidder may be disregarded if that bidder, or any of its directors

have-

a. abused the institution’s supply chain management system;

b. committed fraud or any other improper conduct in relation to such system; or

c. failed to perform on any previous contract.

4 In order to give effect to the above, the following questionnaire must be

completed and submitted with the bid.

Item Question Yes No

4.1 Is the bidder or any of its directors listed on the National Treasury’s Database of

Restricted Suppliers as companies or persons prohibited from doing business with the

public sector?

(Companies or persons who are listed on this Database were informed in writing

of this restriction by the Accounting Officer/Authority of the institution that

imposed the restriction after the audi alteram partem rule was applied).

The Database of Restricted Suppliers now resides on the National Treasury’s

website(www.treasury.gov.za) and can be accessed by clicking on its link at the

bottom of the home page.

Yes

No

4.1.1 If so, furnish particulars:

4.2 Is the bidder or any of its directors listed on the Register for Tender Defaulters in

terms of section 29 of the Prevention and Combating of Corrupt Activities Act (No 12

of 2004)?

The Register for Tender Defaulters can be accessed on the National Treasury’s

website (www.treasury.gov.za) by clicking on its link at the bottom of the home

page.

Yes

No

4.2.1 If so, furnish particulars:

4.3 Was the bidder or any of its directors convicted by a court of law (including a court

outside of the Republic of South Africa) for fraud or corruption during the past five

years?

Yes

No

4.3.1 If so, furnish particulars:

4.4 Was any contract between the bidder and any organ of state terminated during the past

five years on account of failure to perform on or comply with the contract?

Yes

No

4.4.1 If so, furnish particulars:

SBD 8

CERTIFICATION

I, THE UNDERSIGNED (FULL NAME)…………………………………………………

CERTIFY THAT THE INFORMATION FURNISHED ON THIS DECLARATION

FORM IS TRUE AND CORRECT.

I ACCEPT THAT, IN ADDITION TO CANCELLATION OF A CONTRACT,

ACTION MAY BE TAKEN AGAINST ME SHOULD THIS DECLARATION

PROVE TO BE FALSE.

………………………………………... …………………………..

Signature Date

………………………………………. …………………………..

Position Name of Bidder Js365bW

CENTRAL SUPPLIER DATABASEFOR GOVERNMENT

INFORMATION

What is the Central Supplier Database?

Why should a supplier register on the CSD?

The Central Supplier Database (CSD) is a single database to serve as the source of all supplier information for all spheres of government. The purpose of centralising government’s supplier database is to reduce duplication of effort and cost for both supplier and government while enabling electronic procurement processes.

From 1 September 2015 prospective suppliers will be able to self-register on the CSD website www.csd.gov.za. Suppliers can capture and update their information on the CSD at any time, in preparation for the utilisation of supplier data through procurement and financial systems used by all organs of state from 1 April 2016. The period from 1 September 2015 to 31 March 2016, will be referred to as the Interim Period.

Once information has been verified with external data sources, a unique supplier number and security code will be allocated and communicated to the supplier. Suppliers will be required to keep their data updated regularly and should confirm at least once a year that their data is still current and updated. Automatic re-verification of relevant supplier data against SARS, CIPC etc. will be done regularly (daily, weekly, monthly, etc.) as required.

Apart from registering and capturing supplier information on the CSD, suppliers currently on any database of organs of state need to maintain their records through the current supplier systems for the period 1 September 2015 to 31 March 2016.

During the interim period, suppliers must provide their CSD supplier number and unique security code as well as any other relevant documentation (not yet electronically verified by the CSD) to the organs of state. Organs of state will use the CSD supplier number and unique security code to view/print the verified supplier information from the CSD in order to maintain their current supplier databases.

• Suppliers will only be required to register once when they do business with government;

• A supplier will be able to ensure their data is up-to-date, complete and accurate;

• Standardised and electronic verification of supplier information leading to reduced fraud with paper copies and manual processes;

• Supplier will not be required to submit physical tax clearance and business registration certificate to organs of state; and

• Single source of supplier information to all organs of state.

All suppliers will be required to complete required information on the CSD website and must ensure it is complete, accurate and compre-hensive. The following would be amongst the required information:

• Supplier information i.e. supplier type, identification number, supplier name, trading name and country of origin;

• Supplier contact i.e. preferred contact person, preferred communication method, email address, cell phone number, telephone number, etc.;

• Supplier address i.e. country, province, municipality, city, suburb, ward and postal code;

• Bank account information;• Supplier tax information;• Ownership information, i.e. name and identification number of

directors, members etc.;• Association to any other suppliers i.e. branch, consortium

member etc.; and• Commodities the supplier can supply.

A valid email address, identity number, cell phone number and bank account details are mandatory in order to register on the CSD. Apart from the above, it is foreseen that B-BBEE information will be included in the CSD.

Contact National Treasury for further clarity on the process at csd@treasury.gov.za or 012 406 9222.

What happens on 1 September 2015?

What will be required for suppliers to register?

How will the interim period work?

Who can be contacted for further information on the CSD?

Additional functionality

Auto verification of supplier information with SARS, CIPC etc

CSD Registration Process

Complete tax information

Complete bank account information

Complete address information

Complete contact information

Complete supplier identification information

Complete ownership information

(if non-CIPC company)

Complete associations (if relevant)

Complete commodities information

Complete B-BBEE information

(future phase)

Maintain users

Click on Submit

A CSD supplier number and unique security code

is auto-generatedand communicated

Organs of state access verified CSD

supplier information

Access the CSD site on

www.csd.gov.za

Register a new CSD account

Receive an activation

email and OTP

Activate account

and enter OTP

Log in on the CSD

www.csd.gov.za

B-BBEE

Supplier self-registration

Supplier self-registers on the CSDSupplier provides his CSD Supplier Number and Unique Security Code as well as any other relevant documentation (not yet electronically verified by the CSD) to the department(s) or organs of state.

Interim Benefits/ Reduced administrative burden• Supplier only captures registration information once (quality measures applied to ensure complete, accurate and up-to-date

information) accessible by all spheres of government• In-process electronic verification (i.e. tax, business registration and bank account check-digit and branch information) and in-process

member/ director detail obtainment - no paper copies required = reduced fraud

CSD Supplier Nr | Supplier Unique Security Code | Relevant other documentation

Department(s) or organs of state use the supplier number and unique security code to view/ print the verified supplier information from the CSD

Organs of state access the supplier information on the CSD

Interim Registration Process

Interim Process• Interim process until organs of state access the supplier

information on the CSD• Replacement of paper-based registration form

1 April 20161 September 2015

1 2 3

TAX

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CENTRAL SUPPLIER DATABASEFOR GOVERNMENT

INFORMATION