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duae eng.docx

procesat eligibilityCriteria Limbă: RO

APPROVED

by the Order

Minister of Finance

No. of _________2020

STANDARD FORM OF THE SINGLE DOCUMENT

EUROPEAN PROCUREMENT

The European Single Procurement Document (hereinafter referred to as the DUAE) is a declaration on its own responsibility, through which the economic operator confirms the fulfillment of the qualification and selection criteria necessary for public procurement procedures in the Republic of Moldova.

The form shall be filled in, electronically signed and sent to the contracting authority upon submission of the tender.

A DUAE submitted by the economic operator in the context of a previous public procurement procedure may be reused, provided that the information contained in the form is correct and valid on the date of its submission.

The bidder who submits false information in the DUAE or the supporting documents submitted does not confirm the information indicated in the submitted document is excluded from the public procurement procedure and/or may be liable according to the legislation.

The DUAE form consists of 7 chapters, namely:

Chapter I. Information on the public procurement procedure and the contracting authority/entity;

Chapter II. Information on the economic operator;

Chapter III. Grounds for exclusion from the procurement procedure;

Chapter IV. Qualification and selection criteria for economic operators;

Chapter V. General indications for the selection criteria of economic operators;

Chapter VI. Pre-selection of candidates for the public procurement contract award procedure;

Chapter VII. Final statements.

Submission of the DUAE form when submitting the bid that does not comply with the requirements set out in the Award Documentation leads to the rejection of the bid.

Chapter I. Information on the public procurement procedure and the contracting authority/entity

The compartment is filled in only by the contracting authority/entity.

Chapter II. Information on the economic operator

The compartment is filled only by economic operators.

Chapter III. Grounds for exclusion from the procurement procedure

The compartment is completed by the economic operators.

Chapter IV. Qualification and selection criteria for economic operators

The compartment shall be filled in by the contracting authority/entity (column no.2) and the economic operators (column no.3).

Chapter V. General indications for the qualification and selection criteria

The compartment shall be filled in by the contracting authority/entity (column no.2) and the economic operators (column no.3).

Chapter VII. Final statements

The economic operator declares that the information presented in Chapters II to V (where applicable II-VI) is accurate and correctly provided, fully knowing the consequences of serious cases of false declarations.

The economic operator formally declares that it may provide, at the request of the contracting authority/entity without delay, the certificates and supporting documents requested, unless the contracting authority/entity has the possi

clares that it may provide, at the request of the contracting authority/entity without delay, the certificates and supporting documents requested, unless the contracting authority/entity has the possibility to obtain the supporting documents in question directly by accessing a relevant database, which is available free of charge, provided that the economic operator has provided the necessary information (internet address, issuing authority or body, the exact reference of the documentation) to enable the contracting authority or contracting entity to do so, and access to that information shall be granted, where necessary.

The economic operator formally declares that it agrees that the [name of the contracting authority] as described in Section A of Chapter I shall obtain access to the supporting documents relating to the information it has provided in this DUAE for the purpose of carrying out the procurement procedure (procurement procedure, unique identification number and publication reference in the Official Journal of the European Union (reference number), if applicable].

(To be completed and signed by the economic operator)

Name: [text]

Function: [text]

Date: [date]

Address: [text]

Signature

Position codeContent of the requirementResponse
123
Publication informationPublication informationPublication information
1A.1The number of the notice/invitation published in the Public Procurement Bulletin, and, where applicable, the number of the notice published in the Official Journal of the European Unionocds-b3wdp1-MD-1783585128954
Identity of the contracting authority/entityIdentity of the contracting authority/entityIdentity of the contracting authority/entity
1B.1Name of the contracting authority/entityPublic Institution National Office for Infrastructure Development „Moldova-Proiect”
1B.2Unique identification number (IDNO) of the contracting authority/entity1024601000231
Position codeContent of the requirementsResponse
123
Information on the economic operatorInformation on the economic operatorInformation on the economic operator
2A.1Name of the economic operator|text|
2A.2Country|text|
2A.3Postcode|text|
2A.4City/City|text|
2A.5Legal address|text|
2A.6Website|text|
2A.7Contact person(s)|text|
2A.7.1Telephone|text|
2A.7.2Email address|text|
2A.8Unique identification number (IDNO/IDNP)|number|
2A.9VAT code number|number|
2A.10The organizational-legal form of entrepreneurship activity|text|
2A.11Information on the name of the shareholders/associates/beneficial ownerInformation on the name of the shareholders/associates/beneficial owner
2A.11.1Names of shareholders / associates|text|
2A.11.2Name of the beneficial owner

[beneficial owner – a natural person who ultimately owns or controls a natural or legal person or beneficiary of an investment company or administrator of an investment company, or a pe

eficial owner

[beneficial owner – a natural person who ultimately owns or controls a natural or legal person or beneficiary of an investment company or administrator of an investment company, or a person in whose name an activity or transaction is carried out and/or who holds, directly or indirectly, the ownership or control of at least 25% of the shares or voting rights of the legal person or of the assets in trusteeship]|text|
2A.11.3Nationality of the beneficial owner (permanent legal-political link of the natural person defined in accordance with heading 2A.11.2)|text|
2A.12The economic operator is:

Small Business

Medium-sized enterprise

and others|text|
2A.13If the purchase is reserved: is the economic operator a sheltered workshop or a social enterprise, or will it ensure the performance of the contract in the context of sheltered employment programmes?Yes No
2A.13.1If so, what is the corresponding percentage of workers with disabilities or disadvantaged?|number|
2A.13.2Specify to which category or categories of disabled or disadvantaged workers the employees concerned belong?|text|
2A.14Does the economic operator participate in the public procurement procedure together with other economic operators?Yes No
2A.14.1If Yes, specify the role of the economic operator within the group (leader, responsible for carrying out specific tasks, etc.).|text|
2A.14.2Name the economic operators participating in the respective public procurement procedure.|text|
2A.14.3Specify the name of the participating group.|text|
Note. If you answered Yes to question 2A.14, make sure that those economic operators submit a separate DUAE form.Note. If you answered Yes to question 2A.14, make sure that those economic operators submit a separate DUAE form.Note. If you answered Yes to question 2A.14, make sure that those economic operators submit a separate DUAE form.
Information on the representatives of the economic operatorInformation on the representatives of the economic operatorInformation on the representatives of the economic operator
Indicate the name of the person(s) empowered to represent the economic operator for the purposes of this public procurement procedure.Indicate the name of the person(s) empowered to represent the economic operator for the purposes of this public procurement procedure.Indicate the name of the person(s) empowered to represent the economic operator for the purposes of this public procurement procedure.
2B.1Name and surname|text|
2B.2Position/acting as..|text|
2B.3Country|text|
2B.4Telephone[number]
2B.5Email address|text|
Information on the use of other entities' capacitiesInformation on the use of other entities' capacitiesInformation on the use of other entities' capacities
2C.1Does the economic operator use the capacities of other entities to meet the selection criteria set out in Chapter IV as well as (where applica

formation on the use of other entities' capacities

2C.1Does the economic operator use the capacities of other entities to meet the selection criteria set out in Chapter IV as well as (where applicable) the criteria and rules referred to in Chapter V below?Yes No
Note. If you answered Yes to question 2C.1, submit a separate DUAE form containing the information required in sections A and B of that chapter and chapter III for each of the entities concerned, duly completed and signed by the entities concerned. We draw attention to the fact that it is also necessary to include the technicians or technical bodies involved, whether or not they are part of the economic operator's undertaking, in particular those responsible for quality control and, in the case of public works contracts, the technicians or technical bodies to which the economic operator may call for the execution of the works. To the extent relevant to the specific capacity(s) used by the economic operator, include the information set out in Chapters IV and V for each of the entities concerned.Note. If you answered Yes to question 2C.1, submit a separate DUAE form containing the information required in sections A and B of that chapter and chapter III for each of the entities concerned, duly completed and signed by the entities concerned. We draw attention to the fact that it is also necessary to include the technicians or technical bodies involved, whether or not they are part of the economic operator's undertaking, in particular those responsible for quality control and, in the case of public works contracts, the technicians or technical bodies to which the economic operator may call for the execution of the works. To the extent relevant to the specific capacity(s) used by the economic operator, include the information set out in Chapters IV and V for each of the entities concerned.Note. If you answered Yes to question 2C.1, submit a separate DUAE form containing the information required in sections A and B of that chapter and chapter III for each of the entities concerned, duly completed and signed by the entities concerned. We draw attention to the fact that it is also necessary to include the technicians or technical bodies involved, whether or not they are part of the economic operator's undertaking, in particular those responsible for quality control and, in the case of public works contracts, the technicians or technical bodies to which the economic operator may call for the execution of the works. To the extent relevant to the specific capacity(s) used by the economic operator, include the information set out in Chapters IV and V for each of the entities concerned.
Information on subcontractors on whose capacities the economic operator reliesInformation on subcontractors on whose capacities the economic operator reliesInformation on subcontractors on whose capacities the economic operator relies
2D.1Does the economic operator intend to subcontract any part o
ors on whose capacities the economic operator reliesInformation on subcontractors on whose capacities the economic operator relies
2D.1Does the economic operator intend to subcontract any part of the contract with other economic operators?Yes No
2D.1.1If Yes, list the proposed subcontractors.|text|
Position codeContent of the requirementsResponse
Grounds relating to convictions by final judgment of a courtGrounds relating to convictions by final judgment of a courtGrounds relating to convictions by final judgment of a courtGrounds relating to convictions by final judgment of a court
123
3A.1Participation in a criminal organization.
The economic operator himself or any person who is a member of its administrative, management or supervisory body or who has powers of representation, decision-making or control within it has been convicted by a final decision for participation in a criminal organisation, by a conviction handed down not more than five years ago or in which a period of exclusion directly provided for in the condemnation?Yes No
3A.2Corruption.
Has the economic operator itself or any person who is a member of its administrative, management or supervisory body or who has powers of representation, decision-making or control within it been the subject of a conviction for corruption handed down by a final judgment, by a conviction handed down not more than five years ago or in which a period of exclusion directly provided for in the conviction continues to apply?Yes No
3A.3Fraud.
Has the economic operator itself or any person who is a member of its management, management or supervisory body or who has powers of representation, decision-making or control within it been the subject of a conviction for fraud handed down by a final judgment, by a conviction handed down not more than five years ago or in which a period of exclusion directly provided for in the conviction continues to apply?Yes No
3A.4Terrorist offences or offences related to terrorist activities.
The economic operator himself or any person who is a member of its administrative, management or supervisory body or who has the power of representation, decision-making or control within it has been convicted of terrorist offences or offences related to terrorist activities, handed down by a final judgment, by a conviction handed down not more than five years ago or in which a period of exclusion continues to apply directly provided for in the conviction?Yes No
3A.5Money laundering or terrorist financing.

The economic operator himself or any person who is a member of its administrative, management or supervisory body or who has the power of representation, decision-making or control within it has been convicted of terrorist offences or offences related to terrorist activities, handed down by a final judgment, by a conviction handed down not more than five years ago or in which a period of exclusion continues to app

orist offences or offences related to terrorist activities, handed down by a final judgment, by a conviction handed down not more than five years ago or in which a period of exclusion continues to apply directly provided for in the conviction?Yes No
3A.6Child labour and other forms of human trafficking.
The economic operator himself or any person who is a member of its administrative, management or supervisory body or who has the power of representation, decision-making or control within it has been convicted by a final judgment for child labour and other forms of trafficking in human beings, by a conviction handed down no more than five years ago or during which a period of exclusion directly provided for in the conviction continues to apply?Yes No
3A.7If the answer is Yes to at least one of questions 3A.1 to 3A.6, can you provide evidence that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3A.7.1If Yes, describe these measures.|text|
Reasons for the payment of taxes and/or social security contributionsReasons for the payment of taxes and/or social security contributionsReasons for the payment of taxes and/or social security contributionsReasons for the payment of taxes and/or social security contributions

Payment of taxes

3B.1Has the economic operator fulfilled its obligations regarding the payment of taxes, fees and social contributions in accordance with the legal provisions in force in the Republic of Moldova or in the country in which it is established?Yes No
3B.1.1If No, how was the obligation to pay taxes, fees and social contributions established?|text|
3B.1.2If the infringement in relation to the obligations relating to the payment of taxes, duties and social contributions has been established by a judicial or administrative decision, is that decision final?Yes No
3B.1.3If the infringement with regard to the obligations regarding the payment of taxes, fees and social contributions has been established by a court or administrative decision, specify the date and number of the decision.|text|
3B.2Does the economic operator benefit, under the law, from the staggering of the obligations to pay taxes, fees and social security contributions or other facilities in order to pay them, including late payment increases (penalties) and/or fines?
Note: Fill in only if you answered No, to the question in 3B.1.Yes No
3B.2.1If Yes, is the economic operator able to provide the document on the rescheduling of the obligations to pay taxes, fees and social security contributions or other facilities in order to pay them?Yes No
3B.3Is the economic operator able to provide a tax payment certificate or to provide information on tax compliance?Yes No
3B.4Is the information on the none/existence of arrears from the national public budget available free of charge to the authorities, by accessing a natio
e information on tax compliance?Yes No
3B.4Is the information on the none/existence of arrears from the national public budget available free of charge to the authorities, by accessing a national database? If yes, specify the information that would allow verification.Internet address:

|text|

3B.4Is the information on the none/existence of arrears from the national public budget available free of charge to the authorities, by accessing a national database? If yes, specify the information that would allow verification.Authority or

Issuing body:

|text|

3B.4Is the information on the none/existence of arrears from the national public budget available free of charge to the authorities, by accessing a national database? If yes, specify the information that would allow verification.Exact reference of

Documentation:

| |text|

Inclusion in the economic operators' prohibition listInclusion in the economic operators' prohibition listInclusion in the economic operators' prohibition listInclusion in the economic operators' prohibition list
3C.1Is the economic operator included in the economic operators' prohibited list?Yes No
3C.1.1If the answer is Yes to question 3C.1, can you provide evidence that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3C.1.2If Yes, describe these measures.|text|
Reasons related to insolvency, conflicts of interest or professional misconductReasons related to insolvency, conflicts of interest or professional misconductReasons related to insolvency, conflicts of interest or professional misconductReasons related to insolvency, conflicts of interest or professional misconduct

Environmental, labour and social security obligations

3D.1Has the economic operator violated its environmental obligations in the last 3 years?Yes No
3D.1.1If the answer is Yes to question 3D.1, can you provide evidence showing that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3D.1.2If Yes, describe these measures.|text|
3D.2Has the economic operator violated its obligations in the social field in the last 3 years?Yes No
3D.2.1If the answer is Yes to question 3D.2, can you provide evidence that the measures taken are sufficient to demonstrate reliability, despite the existence of an exclusion ground?Yes No
3D.2.2If Yes, describe these measures.|text|
3D.3Has the economic operator violated the obligations in the field of labor in the last 3 years?Yes No
3D.3.1If the answer is Yes to question 3D.3, can you provide evidence that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3D.3.2If Yes, describe these measures.|text|

Insolvency

3D.4Is the economic operator in a situation of insolvency or liquidation of the entrep
existence of a reason for exclusion?Yes No
3D.3.2If Yes, describe these measures.|text|

Insolvency

3D.4Is the economic operator in a situation of insolvency or liquidation of the entrepreneurial activity as a result of a court decision?Yes No
3D.4.1If the answer is Yes to question 3D.4, can you provide evidence showing that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3D.4.2If Yes, describe these measures.|text|

Assets managed by the liquidator

3D.5Are the assets of the economic operator managed by a liquidator or by a court?Yes No
3D.5.1If the answer is Yes to question 3D.5, can you provide evidence that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3D.5.2If Yes, describe these measures.|text|

Economic activities are suspended

3D.6Are the economic activities of the economic operator suspended?Yes No
3D.6.1If the answer is Yes to question 3D.6, can you provide evidence that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3D.6.2If Yes, describe these measures.|text|

Agreements with other economic operators aimed at distorting competition

3D.7Has the economic operator, in the last 3 years, concluded agreements with other economic operators that have as their object the distortion of competition, a fact established by decision of the body empowered in this regard?Yes No
3D.7.1If the answer is Yes to question 3D.7, can you provide evidence that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3D.7.2If Yes, describe these measures.|text|

Conflict of interest

3D.8Is the economic operator in a situation of conflict of interest that cannot be remedied?Yes No
3D.8.1If the answer is Yes to question 3D.8, can you provide evidence showing that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3D.8.2If Yes, describe these measures.|text|

Professional ethics

3D.9Has the economic operator been convicted, in the last 3 years, by a final decision of a court, for an act that undermined professional ethics or for committing a mistake in professional matters?Yes No
3D.9.1If the answer is Yes to question 3D.9, can you provide evidence that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3D.9.2If Yes, describe these measures.|text|

Integrity

3D.10The economic operator, in the last 3 years, is guilty of a professional misconduct, which calls into question his integrity?Yes No
3D.10.1If the answer is Yes to question 3D.10, can you provide evidence that the measures taken are sufficient to demonstrate reliabil
isconduct, which calls into question his integrity?Yes No
3D.10.1If the answer is Yes to question 3D.10, can you provide evidence that the measures taken are sufficient to demonstrate reliability, despite the existence of a reason for exclusion?Yes No
3D.10.2If Yes, describe these measures.|text|
Position codeContent of the requirementsResponse
123
Capacity to exercise professional activityCapacity to exercise professional activityCapacity to exercise professional activity
4A.1Is the economic operator able to provide the document(s) proving its registration?Yes No
4A.1.1If Yes, indicate the documents of registration of the entrepreneurial activity and the type(s) of activity determined by the legislation, related to the object of the contract award procedure, based on which the company has the right to execute the future public procurement contract.|text|
4A.1.2Are the registration documents of the entrepreneurial activity available free of charge to the authorities from a national database? If yes, specify the information that would allow verification.Internet address:

|text|

4A.1.2Are the registration documents of the entrepreneurial activity available free of charge to the authorities from a national database? If yes, specify the information that would allow verification.Issuing authority or body:

|text|

4A.1.2Are the registration documents of the entrepreneurial activity available free of charge to the authorities from a national database? If yes, specify the information that would allow verification.Exact documentation reference:

|text|

4A.2Does the entrepreneurial activity hold an equivalent certification and/or authorisation related to the subject matter of the contract award procedure under a national scheme?Yes No
4A.2.1If Yes, is the economic operator able to provide the document(s) demonstrating the certification and/or authorisation of its activity?Yes No
4A.2.3Are certification or authorisation documents available free of charge to authorities from a national database? If yes, specify the information that would allow verification.Internet address:

|text|

4A.2.3Are certification or authorisation documents available free of charge to authorities from a national database? If yes, specify the information that would allow verification.Issuing authority or body:

|text|

4A.2.3Are certification or authorisation documents available free of charge to authorities from a national database? If yes, specify the information that would allow verification.Exact documentation reference:

|text|

4A.3Do the types of activity, and/or certification, and/or authorisation for entrepreneurial activity, cover the selection criteria imposed by the contracting authority/entity in the notice/invitation to participate?Yes No
Economic and financial capacityEconomic and financial capacityEconomic and financial capacity

Bank statements

4B.1Is the ec
uthority/entity in the notice/invitation to participate?Yes No
Economic and financial capacityEconomic and financial capacityEconomic and financial capacity

Bank statements

4B.1Is the economic operator able to provide bank statements or, where applicable, evidence of occupational risk insurance in accordance with the requirements of the award documentation?Yes No
4B.1.1Is the information referred to in point 4B.1 available free of charge to the authorities from a national database? If so, specify the information that would allow it to be verified.Internet address:

|text|

4B.1.1Is the information referred to in point 4B.1 available free of charge to the authorities from a national database? If so, specify the information that would allow it to be verified.Issuing authority or body:

|text|

4B.1.1Is the information referred to in point 4B.1 available free of charge to the authorities from a national database? If so, specify the information that would allow it to be verified.Exact documentation reference:

|text|

Annual turnover (sales volume)

4B.2The economic operator shall be able to demonstrate an annual turnover as follows:

Value __ Minimum average annual turnover equal to the value of the lot __ Period __3 years___

Note. The contracting authority shall fill in the value and periodYes No
4B.2.1Specify what the annual turnover is, according to the data in the financial report.Value [number]
4B.2.1Specify what the annual turnover is, according to the data in the financial report.Year |text|

Average annual turnover

4B.3The economic operator shall be able to demonstrate an average annual turnover as follows:

Value __ Minimum average annual turnover equal to the value of the lot ___ Period __3 years___

Note. The contracting authority shall fill in the value and periodYes No
4B.3.1Specify the turnover, according to the data in the financial report.Value [number]
4B.3.1Specify the turnover, according to the data in the financial report.Year |text|
4B.3.1Specify the turnover, according to the data in the financial report.Value [number]
4B.3.1Specify the turnover, according to the data in the financial report.Year |text|
4B.3.1Specify the turnover, according to the data in the financial report.Value [number]
4B.3.1Specify the turnover, according to the data in the financial report.Year |text|
4B.3.1Specify the turnover, according to the data in the financial report.Total average value [number]

Financial Report

4B.4Is the economic operator able to provide the recorded financial report, extracts from the financial report?Yes No
4B.5Is information on the economic and financial situation available free of charge to the authorities, from a national database? If yes, specify the information that would allow verification.Internet address:

|text|

4B.5Is information on the economic and financial situation available free of charge to the a
onal database? If yes, specify the information that would allow verification.Internet address:

|text|

4B.5Is information on the economic and financial situation available free of charge to the authorities, from a national database? If yes, specify the information that would allow verification.Issuing authority or body:

|text|

4B.5Is information on the economic and financial situation available free of charge to the authorities, from a national database? If yes, specify the information that would allow verification.Exact documentation reference:

|text|

Technical and/or professional capacityTechnical and/or professional capacityTechnical and/or professional capacity
4C.1The economic operator is able to provide the documents requested by the contracting authority/entity in the contract notice, which demonstrate the technical and/or professional capacity for the performance of the future contract.Yes No
4C.1.1Is information on technical and/or professional capacity available free of charge to authorities from a national database? If yes, specify the information that would allow verification.Internet address:

|text|

4C.1.1Is information on technical and/or professional capacity available free of charge to authorities from a national database? If yes, specify the information that would allow verification.Issuing authority or body:

|text|

4C.1.1Is information on technical and/or professional capacity available free of charge to authorities from a national database? If yes, specify the information that would allow verification.Exact documentation reference:

|text|

Technical installations and quality assurance measures

4C.2Is the economic operator able to provide details of the technicians or technical bodies, specified in the contract notice/award documentation, that the contracting authority/entity may request, in particular those responsible for quality control in relation to this procurement exercise?Yes No
4C.3Is the economic operator able to provide information on the management and traceability systems used in the supply chain?Yes No
4C.3.1Is the information available free of charge to the authorities, from a national database? If yes, specify the information that would allow verification.Internet address:

|text|

4C.3.1Is the information available free of charge to the authorities, from a national database? If yes, specify the information that would allow verification.Issuing authority or body:

|text|

4C.3.1Is the information available free of charge to the authorities, from a national database? If yes, specify the information that would allow verification.Exact documentation reference:

|text|

Machinery, plant and technical equipment

4C.4Does the economic operator have the machinery and equipment necessary for the proper performance of the public contract?Yes No
4C.5Is the economic operator in a position to provide information on the specific facilities, mac
the machinery and equipment necessary for the proper performance of the public contract?Yes No
4C.5Is the economic operator in a position to provide information on the specific facilities, machinery and equipment required for the performance of the contract, in accordance with the requirements set out in the contract notice and the award documentation?Yes No

Professional training and qualification of staff

4C.6Does the economic operator have qualified staff within the undertaking in accordance with the requirements set out in the contract notice or in the award documentation?Yes No
4C.7Is the economic operator able to provide information on the specialised staff proposed for the performance of the contract, in accordance with the requirements set out in the contract notice and the award documentation?Yes No
4C.8Indicate the average annual number of staff employed in the last three years of activity.Year |text|
4C.8Indicate the average annual number of staff employed in the last three years of activity.Employees [number]
4C.8Indicate the average annual number of staff employed in the last three years of activity.Year |text|
4C.8Indicate the average annual number of staff employed in the last three years of activity.Employees [number]
4C.8Indicate the average annual number of staff employed in the last three years of activity.Year |text|
4C.8Indicate the average annual number of staff employed in the last three years of activity.Employees [number]

Number of management staff members

4C.9Indicate the number of members of the management staff of the economic operator during the last three years.Year |text|
4C.9Indicate the number of members of the management staff of the economic operator during the last three years.People [number]
4C.9Indicate the number of members of the management staff of the economic operator during the last three years.Year |text|
4C.9Indicate the number of members of the management staff of the economic operator during the last three years.People [number]
4C.9Indicate the number of members of the management staff of the economic operator during the last three years.Year |text|
4C.9Indicate the number of members of the management staff of the economic operator during the last three years.People [number]

Samples, descriptions, photos

4C.10Is the economic operator able to provide samples (samples), descriptions and/or photographs of the products/services to be supplied/provided, according to the requirements set out in the award documentation?Yes No

For public works procurement contracts

4C.11During the reference period, did the economic operator carry out works specific to or similar to the object of procurement indicated in the contract notice and in the award documentation?Yes No
4C.11.1If Yes, list them specifying the description of the works, their value, the start date, the date of the acceptance report at
n the contract notice and in the award documentation?Yes No
4C.11.1If Yes, list them specifying the description of the works, their value, the start date, the date of the acceptance report at the end of the works, the beneficiary and other relevant information.|text|
4C.11.1If Yes, list them specifying the description of the works, their value, the start date, the date of the acceptance report at the end of the works, the beneficiary and other relevant information.
4C.11.1If Yes, list them specifying the description of the works, their value, the start date, the date of the acceptance report at the end of the works, the beneficiary and other relevant information.
4C.11.1If Yes, list them specifying the description of the works, their value, the start date, the date of the acceptance report at the end of the works, the beneficiary and other relevant information.
4C.11.1If Yes, list them specifying the description of the works, their value, the start date, the date of the acceptance report at the end of the works, the beneficiary and other relevant information.

For public procurement contracts for goods

4C.12During the reference period, did the economic operator make deliveries specific to the procurement object indicated in the contract notice and in the award documentation?Yes No
4C.12.1If Yes, list them specifying the description of the deliveries, their value, the start date, the date of supply, the beneficiary and other relevant information.|text|
4C.12.1If Yes, list them specifying the description of the deliveries, their value, the start date, the date of supply, the beneficiary and other relevant information.
4C.12.1If Yes, list them specifying the description of the deliveries, their value, the start date, the date of supply, the beneficiary and other relevant information.
4C.12.1If Yes, list them specifying the description of the deliveries, their value, the start date, the date of supply, the beneficiary and other relevant information.

For public service procurement contracts

4C.13During the reference period, did the economic operator provide services similar to the object of procurement indicated in the contract notice and in the award documentation?Yes No
4C.13.1If Yes, list them specifying the description of the services, their value, duration of execution, start date, beneficiary and other relevant information.|text|
4C.13.1If Yes, list them specifying the description of the services, their value, duration of execution, start date, beneficiary and other relevant information.
4C.13.1If Yes, list them specifying the description of the services, their value, duration of execution, start date, beneficiary and other relevant information.
4C.13.1If Yes, list them specifying the description of the services, their value, duration of execution, start date, beneficiary and other relevant information.
4C.13.1If Yes, list them specifying the description of the services, thei

he description of the services, their value, duration of execution, start date, beneficiary and other relevant information.

4C.13.1If Yes, list them specifying the description of the services, their value, duration of execution, start date, beneficiary and other relevant information.
4C.14If the answer is Yes to one of the questions 4C.11 – 4C.13, can you provide evidence demonstrating the performance of the works, the delivery of goods, the provision of similar services according to the requirements of the award documentation?Yes No
Quality Assurance StandardsQuality Assurance StandardsQuality Assurance Standards
4D.1Is the economic operator able to provide certificates issued by independent bodies attesting that the economic operator complies with the quality assurance standards in accordance with the requirements set out in the contract notice and award documentation?Yes No
4D.2Is information on quality assurance standards available free of charge to authorities from a national database? If yes, specify the information that would allow verification.Internet address:

|text|

4D.2Is information on quality assurance standards available free of charge to authorities from a national database? If yes, specify the information that would allow verification.Issuing authority or body:

|text|

4D.2Is information on quality assurance standards available free of charge to authorities from a national database? If yes, specify the information that would allow verification.Exact documentation reference:

|text|

Environmental Protection StandardsEnvironmental Protection StandardsEnvironmental Protection Standards
4E.1Is the economic operator able to provide certificates issued by independent bodies attesting that the economic operator complies with environmental protection standards, in accordance with the requirements set out in the contract notice and award documentation?Yes No
4E.2Is the information on environmental protection standards available free of charge to the authorities, from a national database? If yes, specify the information that would allow verification.Internet address:

|text|

4E.2Is the information on environmental protection standards available free of charge to the authorities, from a national database? If yes, specify the information that would allow verification.Issuing authority or body:

|text|

4E.2Is the information on environmental protection standards available free of charge to the authorities, from a national database? If yes, specify the information that would allow verification.Exact documentation reference:

|text|

Allow controlsAllow controlsAllow controls
4F.1Does the economic operator allow the contracting authority/entity to carry out checks on the economic and financial, production or technical capacities for the performance of the future public procurement contract?Yes No
Position codeContent of the requirementsResponse
123

Ful

conomic and financial, production or technical capacities for the performance of the future public procurement contract?Yes No
Position codeContent of the requirementsResponse
123
Fulfillment of all required selection criteriaFulfillment of all required selection criteria
5A.1Is the economic operator able to provide in the Automated Information System "State Register of Public Procurement" or by electronic means, or if applicable, on paper to the contracting authority: the forms, certificates, notices and other documents indicated by the contracting authority/entity in the contract notice and in the award documentation?

Deadline __3__ days from the request.

Note. The number of days shall be indicated by the contracting authority taking into account the quantity and nature of the documents requested.Yes No
5A.2Is the information enabling the contracting authority/entity to obtain the documents indicated in the contract notice and in the award documentation available free of charge and directly by accessing a national database in any country? If yes, specify the information that would allow verification.Internet address:

|text|

5A.2Is the information enabling the contracting authority/entity to obtain the documents indicated in the contract notice and in the award documentation available free of charge and directly by accessing a national database in any country? If yes, specify the information that would allow verification.Issuing authority or body:

|text|

5A.2Is the information enabling the contracting authority/entity to obtain the documents indicated in the contract notice and in the award documentation available free of charge and directly by accessing a national database in any country? If yes, specify the information that would allow verification.Exact documentation reference:

|text|

Previzualizarea are caracter informativ. Doar originalul oficial din sursă are valoare juridică.