ANNEX C
STANDARD SUBMISSION FORM
Design and Production of Communication and Awareness raising Materials (Exhibition Design) and Production of customised promotional Materials
F-SU-12-T02	
SUBMITTED BY:
Name: ……………………………………………
Contact person: ……………………………………
Address: ……………………………………………
Phone: ……………………………………………
Fax: ……………………………………………
Email: ……………………………………………
1. PREAMBLE
Tenderers are requested to include in their tenders all the information and documents requested in the forms attached, in accordance with Annex A – Tender Specifications and the instructions below:
All forms must be dated, signed and stamped by a person authorised to sign on behalf of the tenderer. 
In case of a consortium or group of companies, the tender must be signed by the person appointed in the power of attorney (Form A.4) as authorised to sign the tender on behalf of the consortium or group of companies. 
Each consortium partner must sign a Declaration of Honour with respect to the Exclusion Criteria and Absence of Conflict of Interest (Form B.1). For each identified subcontractor whose intended share of the contract is above 10% of the total contract amount, a signed declaration of honour must also be provided. 
Each identified subcontractor must complete and sign the Letter of Intent included in Form A.6. 
If the tenderer relies on the economic, financial, technical and professional capacity of the identified subcontractor(s) to meet the selection criteria, then the subcontractors shall also complete the forms included under Sections C and D. In any other case, the forms included under Sections C and D shall only be completed by the tenderer or by the partners in case of consortium or group of companies. 
Tenderers’ financial offer shall be prepared in accordance with Form F.1 and shall be submitted in a separate sealed envelope clearly stating “Financial Offer”.
2. CHOICE OF LOT(S) 
Please indicate for which lot(s) you are submitting a tender.
	Lot No	Title	Choice(s)
1	Design and Production of Communication and Awareness raising Materials (Exhibition Design)		
2	Production of customised promotional Materials		
 (Please tick with an X where appropriate)
SECTION A – TENDERERS IDENTIFICATION

FORM A.1 – ADMINISTRATIVE DETAILS	
1. TENDERER’S DETAILS	
Company or organisations’ name		
Legal form 		
Date of registration		
Country of registration		
Registration number		
VAT number		
Address of registered office 		
Contact address (if different)		
URL		
			
2. TENDERERS’ REPRESENTATIVE(S) 	
Person authorised to sign the contract on behalf of the tenderer:	
Name		
Forename		
Position 		
Telephone 		
Fax 		
Email 		
Contact person regarding this tender:	
Name		
Forename		
Position 		
Telephone 		
Fax 		
Email 		
Signed (authorised signature) on behalf of the Tenderer
Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………

FORM A.2 – LEGAL ENTITIES FORM
A standard template in each EU language is available at:
http://ec.europa.eu/budget/execution/legal_entities_en.htm 
Please choose the appropriate form (legal entity form for either individuals, private companies or public entities) and attach the necessary supporting documents as required (see instructions in the file). 

FORM A.3 – BANK IDENTIFICATION FORM
A standard template in each EU language is available at:
http://ec.europa.eu/budget/execution/ftiers_en.htm

FORM A.4 – POWER OF ATTORNEY
(DESIGNATING ONE OF THE COMPANIES OF THE GROUP AS LEADER AND GIVING A MANDATE TO IT)
We, the undersigned:
– Signatory 1 (Name, Function, Company, Registered address, VAT Number)
– Signatory 2 (Name, Function, Company, Registered address, VAT Number)
– …..
– Signatory N (Name, Function, Company, Registered address, VAT Number),
Each of them having the legal capacity required to act on behalf of his/her company,
HEREBY AGREE AS FOLLOWS:
1.	In case the European Union Agency for Fundamental Rights awards the Contract F-SU-12-T02 ( the Contract ) to Company 1, Company 2, …, Company N ( the Group Members), based on the joint offer submitted by them on [complete] for the provision of Supplies ( the Supplies and/or the Services )., all the partners, as co-signatories of the Contract:
a.	Shall be jointly and severally liable towards the European Union Agency for Fundamental Rights for the performance of the Contract.
b.	Shall comply with the terms and conditions of the Contract and ensure the proper execution of their respective share of the Supplies and/or the Services.
2.	To this effect, the Group Members designate Company X as Group Leader. [N.B.: The Group Leader has to be one of the Group Members]
3.	Payments by the European Union Agency for Fundamental Rights related to the Supplies or the Services shall be made through the Group Leader’s bank account .[Provide details on bank, address, account number, etc.].
4.	The Group Members grant to the Group Leader all the necessary powers to act on their behalf in connection with the Supplies and/or the Services. This mandate involves in particular the following tasks :
a.	The Group Leader shall sign any contractual documents — including the Contract — and issue any invoices related to the Supplies or the Services on behalf of the Group Members.
b.	The Group Leader shall act as single point of contact for the European Union Agency for Fundamental Rights in connection with the Supplies and/or the Services to be provided under the Contract. It shall co-ordinate the provision of the Supplies and/or the Services by the Group Members to the European Union Agency for Fundamental Rights, and shall see to a proper administration of the Contract.
Any modification to the present agreement / power of attorney shall be subject to approval from the European Union Agency for Fundamental Rights.
This agreement / power of attorney shall expire when all the contractual obligations of the Group Members towards the European Union Agency for Fundamental Rights in connection with the Supplies and/or the Services to be provided under the Contract have ceased to exist. The parties cannot terminate it before that date without the consent of the European Union Agency for Fundamental Rights.

Signed in …………………… on ……….. ………
Name
Function
Company

FORM A.5 – STATEMENT ON SUBCONTRACTING

Please indicate (by ticking the appropriate box) whether the tenderer intends to subcontract all or part of the performance of the Contract, if awarded. 
□	YES, the tenderer intends to subcontract all or part of the performance of the Contract, if awarded.
□	NO, the tenderer does not intend to subcontract all or part of the performance of the Contract, if awarded.
If YES, please specify which parts of the Contract, and the name and address of any subcontractor(s).
Description	Percentage of the contract	Subcontractor	
	%	Name:
Address:	
	%	Name:
Address:	
	%	Name:
Address:	
	%	Name:
Address:	
Signed (authorised signature) on behalf of the Tenderer
Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………

FORM A.6 – LETTER OF INTENT FOR SUBCONTRACTORS
The undersigned: 
[complete]
Name of the company/organisation: 
[complete]
Address: 
[complete]
Tender reference:
F-SU-12-T02
Declares hereby that, in case the contract is awarded to [name of the tenderer], the company/organisation that he/she represents, intends to collaborate in the execution of the tasks subject to this call for tender, in accordance with the technical specifications and the tender to which the present form is annexed, and is available to carry out its part of the tasks during the period foreseen for the execution of the contract.  
Declares hereby accepting the General Conditions of the Draft Contract attached to the invitation to tender for the above call for tenders, and in particular, those provisions referring to subcontracting and check and audits.

Place and date:

Name and signature:
SECTION B – EXCLUSION CRITERIA

FORM B.1 - DECLARATION OF HONOUR WITH RESPECT TO THE EXCLUSION CRITERIA AND ABSENCE OF CONFLICT OF INTEREST
The undersigned [name of the signatory of this form, to be completed]:
•	in his/her own name (if the economic operator is a natural person)
or
•	representing (if the economic operator is a legal person and the declaration is signed by a director or person with powers of representation)
official name in full:
official legal form:
official address in full:
VAT registration number:
declares that he/she / the company or organisation that he/she represents:
a)	is not bankrupt or being wound up, is not having its affairs administered by the courts, has not entered into an arrangement with creditors, has not suspended business activities, is not the subject of proceedings concerning those matters, and is not in any analogous situation arising from a similar procedure provided for in national legislation or regulations;
b)	or persons having powers of representation, decision making or control over him/her has not been convicted of an offence concerning professional conduct by a judgment of a competent authority of a Member State which has the force of res judicata;
c)	has not been guilty of grave professional misconduct proven by any means which the contracting authorities can justify including by decisions of the EIB and international organisations; 
d)	has fulfilled all its obligations relating to the payment of social security contributions and the payment of taxes in accordance with the legal provisions of the country in which it is established, with those of the country of the contracting authority and those of the country where the contract is to be carried out; 
e)	or persons having powers of representation, decision making or control over him/her has not been the subject of a judgement which has the force of res judicata for fraud, corruption, involvement in a criminal organisation or any other illegal activity detrimental to the Union’s financial interests;
f)	is not a subject of the administrative penalty for being guilty of misrepresentation in supplying the information required by the contracting authority as a condition of participation in the procurement procedure or failing to supply an information, or being declared to be in serious breach of his obligation under contract covered by the budget.
In addition, the undersigned declares on their honour:
g)	they have no conflict of interest in connection with the contract; a conflict of interest could arise in particular as a result of economic interests, political or national affinities, family or emotional ties or any other relevant connection or shared interest;
h)	they will inform the contracting authority, without delay, of any situation considered a conflict of interest or which could give rise to a conflict of interest;
i)	they have not made and will not make any offer of any type whatsoever from which an advantage can be derived under the contract;
j)	they have not granted and will not grant, have not sought and will not seek, have not attempted and will not attempt to obtain, and have not accepted and will not accept any advantage, financial or in kind, to or from any party whatsoever, constituting an illegal practice or involving corruption, either directly or indirectly, as an incentive or reward relating to award of the contract.
k)	that the information provided to the Commission within the context of this invitation to tender is accurate, sincere and complete.
l)	that in case of award of contract, they shall provide the evidence that they are not in any of the situations described in points a, b, d, e above.
For situations described in (a), (b) and (e), production of a recent extract from the judicial record is required or, failing that, a recent equivalent document issued by a judicial or administrative authority in the country of origin or provenance showing that those requirements are satisfied. Where the tenderer is a legal person and the national legislation of the country in which the tenderer is established does not allow the provision of such documents for legal persons, the documents should be provided for natural persons, such as the company directors or any person with powers of representation, decision making or control in relation to the tenderer. 
For the situation described in point (d) above, recent certificates or letters issued by the competent authorities of the State concerned are required. These documents must provide evidence covering all taxes and social security contributions for which the tenderer is liable, including for example, VAT, income tax (natural persons only), company tax (legal persons only) and social security contributions.
For any of the situations (a), (b), (d) or (e), where any document described in two paragraphs above is not issued in the country concerned, it may be replaced by a sworn or, failing that, a solemn statement made by the interested party before a judicial or administrative authority, a notary or a qualified professional body in his country of origin or provenance.
By signing this form, the undersigned acknowledges that they have been acquainted with the administrative and financial penalties described under art 141 and 145 of the Rules of Application (Commission Regulation 1268/2012 of 29/10/2012), which may be applied if any of the declarations or information provided prove to be false.

Full name:……………………………..  Date:………………………… 
Signature:………………………..	Stamp:…………………………
SECTION C – SELECTION CRITERIA (ECONOMIC AND FINANCIAL CAPACITY)

1 - Design and Production of Communication and Awareness raising Materials (Exhibition Design)

FORM C.1 – STATEMENT OF ANNUAL TURNOVER
Please fill in the table below in accordance with the instructions provided in Annex A – Tender Specifications: 
Statement on annual overall turnover (in EURO)	
Tenderer’s name	Current year -2	Current year -1	
Partner 1			
Partner 2			
Etc…			
Total			
(please add rows and columns if needed).] 

Signed (authorised signature) on behalf of the Tenderer

Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………

2 - Production of customised promotional Materials

FORM C.1 – STATEMENT OF ANNUAL TURNOVER
Please fill in the table below in accordance with the instructions provided in Annex A – Tender Specifications: 
Statement on annual overall turnover (in EURO)	
Tenderer’s name	Current year -2	Current year -1	
Partner 1			
Partner 2			
Etc…			
Total			
(please add rows and columns if needed).] 

Signed (authorised signature) on behalf of the Tenderer

Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………

SECTION D – SELECTION CRITERIA (TECHNICAL AND PROFESSIONAL CAPACITY)

1 - Design and Production of Communication and Awareness raising Materials (Exhibition Design)

FORM D.1 – LIST OF PRINCIPAL SERVICES PROVIDED/SUPPLIES DELIVERED
Please complete a table using the format below to summarise the major relevant services provided/supplies delivered relevant to this contract in the last 3 years. Please include one table per project.

Name of legal entity performing the project:		
Project name:		
Client:		
Country:		
Project value (euro):	<Total project value>	
Resources used:	<Total number of person days> or <Number of staff provided>	
Project duration :	From:                           To:                   Duration:   (months)	
Name of consortium partners, if any:		
Project Description:	<Please provide a summary of the project objectives and a description of the main tasks>

(if space not sufficient please adapt the table)

Signed (authorised signature) on behalf of the Tenderer

Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………

FORM D.2 – SAMPLES, PHOTOGRAPHS AND/OR CERTIFICATES
Please include samples as mentioned in section 17.2.2 of the Annex A – tender specifications.

Signed (authorised signature) on behalf of the Tenderer

Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………

2 - Production of customised promotional Materials

FORM D.1 – LIST OF PRINCIPAL SUPPLIES DELIVERED
Please complete a table using the format below to summarise the major relevant supplies delivered relevant to this contract in the last 3 years. Please include one table per project.

Name of legal entity performing the project:		
Project name:		
Client:		
Country:		
Project value (euro):	<Total project value>	
Resources used:	<Total number of person days> or <Number of staff provided>	
Project duration :	From:                           To:                   Duration:   (months)	
Name of consortium partners, if any:		
Project Description:	<Please provide a summary of the project objectives and a description of the main tasks>

(if space not sufficient please adapt the table)

Signed (authorised signature) on behalf of the Tenderer

Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………

FORM D.2 – SAMPLES, PHOTOGRAPHS AND/OR CERTIFICATES
Please include samples as mentioned in section 17.2.2 of the Annex A – tender specifications.

Signed (authorised signature) on behalf of the Tenderer

Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………

SECTION E – FINANCIAL GUARANTEES
This section is not applicable to this tender.
SECTION F – FINANCIAL OFFER

1 - Design and Production of Communication and Awareness raising Materials (Exhibition Design)
FORM F.1 – FINANCIAL OFFER TEMPLATE
[To be submitted in a separate sealed envelope clearly stating "Financial Offer" following the instructions laid down in Annex A – Tender Specifications]
F-SU-12-T02
Design and Production of Communication and Awareness raising Materials (Exhibition Design) and Production of customised promotional Materials
IDENTIFICATION OF THE TENDERER:
Name: ……………………………………………
Contact person: ……………………………………
Address: ……………………………………………
Phone: ……………………………………………
Fax: ……………………………………………
Email: ……………………………………………

Financial proposal in Euro 
(based on the information given in Annexes A and A.1)	
Item	Amount	Format	Print	PRICE	
Brochure 	500	210*255 mm, 36 pages	cover 200g/m, content pages 125g/m 4c		
Flyer 	500	Z-fold 6 pages, open 315x210 mm	150g/m, 4c		
Posters 	4 copies x 5 different designs	A0	150g/m, 4c		
Roll-ups 	2  different designs incl. hardware	800x2000 mm	4c		
Backdrop	2 different designs, panels incl. hardware /	3x3 curved, magnetic fixation, 2600x2224 mm/	4c		
Flat fee for the development of a specific branding as described in the section 3 of Annex A1. -Technical specifications		
Flat fee for lay-out services for the  brochure as described above and in section 3 of the Annex A.1		
Flat fee for lay-out services for  the flyer as described above and in section 3 of the Annex A.1		
Flat fee for lay-out services for the poster as described above and in section 3 of the Annex A.1		
Flat fee for lay-out services for the roll-up as described above and in section 3 of the Annex A.1		
Flat fee for lay-out services for the backdrop as described above and in section 3 of the Annex A.1		
  
hourly rate per profile in Euro	
Profile	Price - extramuros	
lay-out services (person-hour price)		

Signed (authorised signature) on behalf of the Tenderer

Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………

2 - Production of customised promotional Materials
FORM F.1 – FINANCIAL OFFER TEMPLATE
[To be submitted in a separate sealed envelope clearly stating "Financial Offer" following the instructions laid down in Annex A – Tender Specifications]
F-SU-12-T02
Design and Production of Communication and Awareness raising Materials (Exhibition Design) and Production of customised promotional Materials
IDENTIFICATION OF THE TENDERER:
Name: ……………………………………………
Contact person: ……………………………………
Address: ……………………………………………
Phone: ……………………………………………
Fax: ……………………………………………
Email: ……………………………………………

Financial proposal in Euro 
(based on the information given in Annexes A and A.1)	
Item	Amount	Format	Print	PRICE	
Biro 	350	Bic ATLANTIS STIC or equivalent	Logo + URL, 2c		
Neckbands 	350	Color: white, 20mm high quality polyester woven fabric,  safety breakaway connector, flat fixation for the use with  nameplate holders	Logo + URL + conference name, 2c		

Clipboards  	350	Color blue, plastic, metal clip on top, holding A4 materials	Logo + URL + conference name, 2c		
Baseball caps 	350	Made of cloth, color white	On front: logo + theme of the conference and on back: URL all woven		
USB stick 	350	Twister style, 4G	Logo + URL, 2c		
Sport t-shirts  	50 Men, 50 Women	Women, slim cut, size M, colors blue -  Men: regular fit size XL, colors yellow	Back: Logo + text size 20x20 cm on top centered Front: logo+ text 10*10 cm top left side		
Paper bags (exhibition type) 	350	Color: white, holding A4 materials	Logo + URL + conference name, 3c		
Candy box with 50 small mint pills 	350	Metallic, color blue	Logo + URL, 2c		

Signed (authorised signature) on behalf of the Tenderer

Full name:……………………………………..
Date:……………………………………………
Signature:……………………………………...	Stamp:………