202607281412_Documentatia de atribuire english.docx

Annex 1

to the Participation notice

APPLICATION FOR PARTICIPATION

To “I.S. Fabrica de Sticlă din Chișinău"

registered address: Chișinău Mun., 20 Transnistria Str.

headquarters: Chișinău Mun., 20 Transnistria Str.

Dear Sirs,

Following the Participation notice No. __________ published through the SIA “RSAP” system: _________

dated _____________________ (day/month/year), regarding the application of the procedure for awarding the contract Aluminium oxide

(name of the low-value procurement contract), we ___________________ ______________________ (denomination/name of the bidder/candidate), have taken note of the conditions and requirements set out in the award documentation and hereby express our interest in participating, as bidder/candidate, having no objections to the award documentation.

Date of completion _____________

Yours sincerely,

Bidder/candidate

_________________________

(authorized signature)

__________________________________________

(name of economic operator)

full address______________________________

tel, fax, e-mail _______________________________

BID (OFFER)

To “I.S. Fabrica de Sticlă din Chișinău"

registered address: Chișinău Mun., 20 Transnistria Str.

headquarters: Chișinău Mun., 20 Transnistria Str.

I. Having examined the procurement documentation relating to________________________

___________________________________________________________________________

(name of the procurement contract announced by the beneficiary)

we hereby submit our bid (offer) for the execution of the above-mentioned procurement contract, namely:

II. Supply (execution, provision):

1.________________________________________________________________________

(description of goods, works, services, quantity, unit price, value excluding VAT)

2.________________________________________________________________________ 3.________________________________________________________________________ 4.________________________________________________________________________ 5.________________________________________________________________________

III. The total value of the offer for the execution of the procurement contract is:

_________________________________________________________MDL, excluding VAT,

(amount in words and figures)

to which VAT in the amount of ____________________________________________MDL is added.

(amount in words and figures)

TOTAL ________________________________________________ MDL with VAT.

IV. Payment terms: _______________________________________________________

V. Delivery terms (work execution):

Delivery time ________ days.

Delivery place _________________________

VI. Provision of warranty obligations (terms and conditions for defect removal) ______________________

VII. Bid validity period __________ days.

__________________________________________________________________________

Date of completion: “_____” _______________ 20__

Name, surname, and position of the person authorized

to represent the economic operator:

________________________

_____________________________________

Date of completion: “_____” _______________ 20__

Name, surname, and position of the person authorized

to represent the economic operator:

________________________________________

________________________________________

(signature and seal)

Annex 2

to the Participation notice

(according to the Regulations on

low-value public procurement)

DECLARATION ON ELIGIBILITY

To “I.S. Fabrica de Sticlă din Chișinău"

registered address: Chișinău Mun., 20 Transnistria Str.

headquarters: Chișinău Mun., 20 Transnistria Str.

Dear Sirs,

The undersigned, authorised representative of _______________________________________________,

(name of economic operator)

acting as a bidder, declare under personal responsbility, under penalty of exclsuion from the procurement procedure and under sanctions applicable to the offence of falsification of public documents, that I am not in any of the situations provided for in art.9 of Law no. 131/2015 on public procurement.

I further undertake, at the request of the Contracting Authority/Entity and for the purpose of verifying and confirming this declaration, to submit without delay any supporting documents available to me.

Date of completion ___________________ Bidder/candidate __________________

(authorised signature)

Annex 2.1

to the Participation notice

DECLARATION

Economic operator’s declaration on personal responsibility on compliance with qualification and selection requirements

The undersigned, ________________________________________ authorised representative of

_______________________________________________ (name of economic operator), acting as a bidder within the sectoral procurement procedure No._______ dated ____/____/____, declare on my personal responsibility that I have read and fully agree with the qualification and selection requirements.

Date of completion:__________________________________

Signed: ____________________________________________

Name/surname: _____________________________________

Position: ___________________________________________

Name of economic operator ___________________________

IDNO of economic operator ___________________________

Annex 3

to the Participation notice

GENERAL INFORMATION

1. Name of the economic operator: ______________________________________________

2. Tax code: ________________________________________________________________

3. Registration decision________________________________________________________

(number, date of registration)

___________________________________________________________________________

(issuing institution)

4. Main areas of activity:________________________________________________________

(to be indicated in accordance with the provisions of the operator’s Articles of Association)

_____________________________________________________________________________

5. Licenses in the field (certificates, authorizations)____________________________________

_______________________________________________________________

____________________________________________

5. Licenses in the field (certificates, authorizations)____________________________________

_____________________________________________________________________________

(number, date, issuing institution, types of activity, period of validity)

6. Companies, subsidiaries, which are part of the group:_________________________________

(name, address)

7. Affiliated structures, companies: _________________________________________________

(name, address)

8. Equity capital on the date of the last balance sheet ___________________________________

(indicate amount and date)

9. Balance sheet value of fixed assets ______________________________ thousand MDL

10. Turnover for the last 3 years (thousand MDL):

Year_________________________ thousand MDL

Year_________________________ thousand MDL

Year ________________________ thousand MDL

11. Total debts of the economic operator __________ thousand MDL,

including: to the budget __________________ thousand MDL

12. Bank details

Date of completion:

____________________________________________

(name, surname, and position of the person authorized to represent the economic operator)

(signature and seal)

Annex 5

to the Participation notice

TECHNICAL SPECIFICATION

Object: Aluminium oxide

no. 89/LD-2026

This table shall be completed by the tenderer in columns 6, 7, 8, and 9:

* The bidder must indicate (mandatory) complete information on the technical characteristics of the proposed goods.

Signed:_______________ Name, surname:_______________________________

Acting as: __________________________________________________________

Bidder: _______________________ Address: ______________________________

Date: “____”__________________

Annex 6

to the Participation notice

PRICE SPECIFICATION

Object: Aluminium oxide

no. 89/LD-2026

This table shall be completed by the tenderer in columns 6, 7, 8, 9 and 10:

Signed:_______________ Name, surname:_______________________________

Acting as: __________________________________________________________

Bidder: _______________________ Address: ______________________________

Date: “____”__________________

Name

Tax code

Bank

SWIFT

IBAN

VAT

Tel/Fax

Mobile

E‐mail

Web

Registered address

Postal address

General Director

Lot I

Aluminium oxide

Al2O3 min. 98.50 % SiO2 max. 0.018 %

Fe2O3 max. 0.020 %

Na2OT max. 0.38 %

CaO max. 0.060 %

P2O5 max. 0.0025 %

K2O max. 0.018 % Ignition loss (3000C -1000oC) 0.5 – 1.0 % Specific surface 60 – 80 m2 /g α

Al2O3 content max. 10 % Angle of repose 30° – 35° Aluminium hydrate content max. 0.5 % Grain size: Fraction >150 µm max. 10% Fraction < 4

s (3000C -1000oC) 0.5 – 1.0 % Specific surface 60 – 80 m2 /g α

Al2O3 content max. 10 % Angle of repose 30° – 35° Aluminium hydrate content max. 0.5 % Grain size: Fraction >150 µm max. 10% Fraction < 45 µm max. 12%

*providing a sample is mandatory

Lot I

Al2O3 min. 98.50 % SiO2 max. 0.018 %

Fe2O3 max. 0.020 %

Na2OT max. 0.38 %

CaO max. 0.060 %

P2O5 max. 0.0025 %

K2O max. 0.018 % Ignition loss (3000C -1000C) 0.5 – 1.0 % Specific surface 60 – 80 m2 /g α

Al2O3 content max. 10 % Angle of repose 30° – 35° Aluminium hydrate content max. 0.5 % Grain size: Fraction >150 µm max. 10% Fraction < 45 µm max. 12%