REPUBLIC OF KENYA

COUNTY GOVERNMENTOF KIRINYAGA

P.O. BOX 260
KUTUS
THE STANDARD TENDER DOCUMENT
AND LIST OF REQUIREMENTS

TENDER NO. CGK/038/2014/2015-2015/2016

PRE QUALIFICATION FOR PROVISION OF SPARE
PARTS, BATTERIES, TYRES AND TUBES FOR
VEHICLES AND MOTOR CYCLES
RECEIPT NO.

CLOSING DATE & TIME: TUESDAY

24TH JUNE 2014 at 12.00 NOON.

PRE-OUAL1FICATION FOR PROVISION OF SPARE PARTS, BATTERIES, TYRES AND

TUBES FOR VEHICLES AND MOTOR CYCLES
PRE-QUALIFICATION
1. Name of contractor..............................................................................................................
Postal

.........................................................................................................................................
....................................................................................................................................................
.................................................................
address

Physical address (Building, road/street)..

Telephone (land line or mobile No...
Name and signature of authorized person (certified Power of Attorney)
Name of directors/proprietors of the company and contact address.
(1)
(2) ..
(3) ............................................................................................................ ......
2. Single business permit (attach certified copy
3. Certificate of registration incorporation (attach certified copy)
4. VAT/ PIN Registration Certificates (attach copies certificate)
5. Copy of certified valid Tax Compliance Certificate (Attach)
6. Particulars of similar works & magnitude done in the last five (5) years
7. Particulars of Professional/Technical Personnel and plants and Equipment for the specified
Works

8. Particulars of financial standing and access to credit lines.

9.

A properly filled Confidential Business Questionnaire and stamped

10. Provide 2 documents one marked original and the other copy bearing all attachments

14. authorization letter as an agents to batteries dealer

CONFIDENTIAL BUSINESS QUESTIONNAIRE FORM

You are requested to give the particulars indicated in Part 1 and either Part 2(a), 2(b) or 2 (c)
whichever applied to your type of business. You are advised that it is a serious offence to give
false information on this form

Part 1 General:
Business Name
Location of business premises.
Plot No Street/Road ..
Postal Address .. Tel No. . Fax . E mail .
Nature of Business ..
Registration Certificate No.
Maximum value of business which you can handle at any one time Kshs.
Name of your bankers .. Branch

Part 2 (a) Sole Proprietor

Your name in full .. Age ..
Nationality Country of origin .
Citizenship details

Part 2 (b) Partnership

Given details of partners as follows:
Name
Nationality
Citizenship Details
Shares
1.
2.
3. ..
4. ..
Part 2 (c ) Registered Company
Private or Public .
State the nominal and issued capital of companyNominal Kshs.
Issued Kshs.
Given details of all directors as follows
Name
Nationality
Citizenship Details
Shares
1
2. ..
3.
4.
5 .
Date .. Signature of Candidate ..

If a Kenya Citizen, indicate under Citizenship Details whether by Birth, Naturalization or

registration.

Previous work done:

Serial
No.

Projects

Clients Name& Value of the Year(s)

the
Address
project (KShs.) Project
was
undertaken

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

List and attach similar works (Note: 3 points will be awarded for those three works).

Signed
by
contractor

Name
of
Signatory

Date