Appendix 4 Tender application form

Tender ERIN Specific Action Project

	

General statement

By signing this registration form regarding the tender ERIN Specific Action Project (project number: 116698) Tenderer states that:

A	He agrees with the provisions of this registration procedure.	
B	He submits the Tender with due observance of the provisions and details as described in the announcement, the descriptive document with accompanying appendices and any provided summary/summaries of additional information and changes, including any changed draft agreement and other documents.	
C	That all questions have been answered truthfully and in full and that all information provided and details submitted as part of the Tender correspond with reality, and are correct and complete.	
D	He has not made or will not make any changes in formats to be submitted that have been provided by the Contracting authority, with the exception of completing these formats when this is requested in these formats.	
E	He agreed with the following stipulation: Each Tenderer who violates a fundamental principle of the procurement law (such as the principle of equality) through his actions, when this violation resulted or could have resulted in restricting fair competition, will be excluded from this tender procedure. This is also the case when the violation or restriction of the fair competition is only disclosed after sending the notice of the award decision to all Tenderers. Before the Contracting authority decides to exclude a Tenderer for this reason, he will notify the Tenderer in question about his intention, after which the Tenderer is given the opportunity to prove to the Contracting authority that it does not involve a violation of a fundamental principle of the procurement law or a restriction of fair competition.
By submitting this tender, the Tenderer states that he is aware that acting in violation with a fundamental principle of procurement law may result in the above-mentioned consequences. Acting in violation of a fundamental principle of the procurement law will be also defined as a violation of all (mandatory) legislation and regulations that apply to this tender. The Contracting authority can establish the violation of the fundamental principles of the procurement law or the restriction of the fair competition with all means available to him. An irrevocable (judicial) decision is not a necessary requirement in this respect.	
F	In conformity with the statements in art. 2.81 of the Copyright act, Tenderer has considered the obligations by virtue of the provisions regarding the occupational health and safety and the terms of employment when drawing up his Tender, which apply at the location where the work is carried out or, in the absence of a location, he has considered the general international views with regard to occupational health and safety and terms of employment.	
G	He is aware that if Tenderer acts or has acted in violation of the instructions of this European tender during this European tender, or has acted otherwise in violation of the procurement law, the Contracting authority can then put aside the tender of Tenderer in these cases (depending on the phase of the tender), or withdraw any provisional award to Tenderer or dissolve any concluded agreement with Tenderer. In all these cases Tenderer shall not be entitled to compensation or any other payment.	

Decision regarding lots 

It is compulsory to state which lot(s) have been chosen. 
Clearly tick in the next table which lot(s) you will choose as a Tenderer. 

Country of return / Lot (target country)	Choice Tenderer	
01: Algeria		
02: Argentina		
03: Bangladesh		
04: Brazil		
05: China		
06: Eritrea		
07: India		
08: Iraq (Central)		
09: Ivory Coast		
10: Paraguay		
11: Senegal		
12: Somalia (Central)		
13: Sudan		
14: Ukraine		

Signature

This registration form has been completed truthfully and in full and signed by a legal representative of Tenderer.

	Signature Tenderer	
Name: 		
Position:		
Company:		
Signature:		
Date: