ࡱ> { kbjbjzz l!&:::NNN8tNe3(!<"tF#<H2J2J2J2J2J2J2$568Zn2:#R!"t!"##n2t 3%%%#v8H2%#H2%%9/"t0@QF #/42530e3/|A9$A9 t0t0A9:0##%#####n2n2%###e3####A9######### :  REQUEST FOR QUOTATION (RFQ) SERVICES/WORKS BASIC DETAILS OF YOUR FIRM OR ORGANISATION BASIC DETAILS OF YOUR FIRM OR ORGANISATIONThe trading name of the firm or organisation seeking to contract with the CouncilContact person for enquiries about this form: please state name and job title/post) Address for correspondence (with post code) Registered office address (if different from above) Addresses of other offices (if applicable)Phone number of person named in 1.2Fax number of person named in 1.2E-mail address (if available) of person named in 1.2Website of firm or organisation (if any)Legal status of organisation Please tick as appropriate. Sole trader c Public limited company c Private limited company c Limited partnership c Limited liability partnership c Social enterprise c Cooperative c Registered charity c Voluntary, community interest or faith sector organization c Other (please specify) c Company registration number and date (if registered at Companies House)Charity Commission or other registration number (if applicable) VAT registration number (if applicable) If your organization is part of a Group, please state the name and Companies House registration number of the parent company.Are you acting as the lead organisation for a consortium?Yes c No cIf you answered Yes to 1.14, please list the members of your consortium. How many staff does your organisation have in total? Include part-time staff and volunteers.& & & & & What types of works, services or supplies are you interested in tendering for?  2Y INSURANCE 2.1 Please indicate the levels of insurance cover that you hold: Public liability Employers liability Professional Indemnity (if applicable) Cover for working with, removal and disposal of asbestos-containing materials (if applicable) Product liability (if applicable)  The council expects a minimum level of 10million for Public Liability, 5million for Employers Liability. If you do not have the sufficient levels, please tick this box if you are willing to get the required minimum standards prior to award. c 3EXPERIENCE AND REFERENCE CONTRACTS3.1Please summarise your experience within the past 3 (three) years of undertaking contracts similar to those for which you wish to tender, including contracts for local authority clients, other public sector bodies, voluntary organisations, community groups and private sector organisations. (maximum 150 words)3.2Please provide brief details of 3 (three) significant private or public sector contracts which your organisation has performed within the past 2 (two) years. Contract 1Contract 2Contract 33.3Client/customer organisation (name) Website (if available)3.4Customer contact name, phone number and email * 3.5Date contract awarded3.6Date contract completed3.7Brief description of contract (maximum 100 words)  3.8Contract value3.9If you cannot provide information on at least one reference contract, please briefly explain why (maximum 100 words)  Note: The customer contact should be prepared to speak to the Council, if required, in order to confirm the accuracy of the information provided here. Health & Safety Any organisation employing five or more people has by law to prepare and bring to the attention of employees a written Health and Safety Policy Statement. A Heath and Safety Policy usually has three distinct sections namely: General Policy Statement a short statement outlining the organisations commitment to health and safety, signed and dated by the senior organisation official (for example the Managing Director) Organisation how the organisation addresses health and safety; lines of communication between managers and staff; and any specific duties/responsibilities assigned within the organisation this should be relatively straightforward for small organisations. Arrangements the systems and procedures in place for ensuring employees health and safety at work. System means processes and procedures to ensure that health and safety is properly managed and that legal requirements are met. The Council may request that you provide at short notice a copy of your Health and Safety Policy, any codes of safe working practices issued to employees, and/or risk assessments. You should have these documents readily available. 4HEALTH & SAFETY4.1Does your organisation have a health and safety policy supported by documented health and safety procedures? Yes c No c4.2Does your organisation either have a person on the staff qualified in health and safety or have access to competent advice from an external health and safety specialist?Yes c No c4.3Is your organisation a member of a recognised health and safety accreditation scheme such as CHAS (Contractors Health and Safety Assessment Scheme)Yes c No c4.4Can you confirm that your organisation has not been prosecuted under any relevant health and safety legislation within the last five years?Yes c No c 5SAFEGUARDING 5.1Do the activities of your organisation involve procedures for child protection and/or the safeguarding of vulnerable adults?Yes c No c5.2Are your staff prepared to have CRB checksYes c No c Proposed scoring of Selection Questionnaire 1. Basic Details of Organisation 1.1 to 1.17 not scored; for information only, but must be answered in full. Failure to provide any item of information will be considered non-compliant and the applicant may not be considered further in the evaluation. 2. Insurance 2.1 pass/fail; fail If the contractor does not have the minimum level of insurance cover or cannot provide it for any of the applicable insurances 3.Experience & references 3.1- 3.9 pass/fail; fail If the contractor does not provide references 4. Health and Safety 4.1 pass/fail; fail If the contractor does not have the necessary standard industry health and safety accreditation and if the company fails to provide the certificates. 5.Safeguarding 5.1 pass/fail; fail If the contractor is not prepared to have their staff working on this project have CRB checked. REQUEST FOR QUOTATION (RFQ) PLEASE NOTE THIS IS NOT AN ORDER If this quotation is successful then an Official Order will be raised. 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Conditions are on Council terms unless specified otherwise. Also, LCCs requirement will need to meet LCC and other industry standards/policies, please see below for full details. Quotations will only be accepted on this Document ONLY. However, you may attach associated documents if necessary.DETAILS OF REQUIREMENTName of Company Providing Quote: Leicester City Council is looking for quotations from qualified providers to provide water hygiene and tap descaling services. School kitchens list of sites attached 85 locations, requiring water hygiene / tap descaling required at regular intervals Jan Mar, April- July, Sept Dec. Testing to include all taps located in the area of the kitchen including any storerooms where sinks might be located ( usually in a COSHH store ) or, cloakroom facilities within the kitchen area. DEVIATION/VARIATION (from the above Specification) QUOTATION TOTAL (the Contract Price) +VAT if applicableiMPORTANT INFORMATION FOR THE supplier The above Quotation should remain open for acceptance by Leicester City Council for a minimum of 30 days from the deadline for submissions date, as shown in the Source Leicestershire advert. To the Supplier: If your quotation expires later than this date, then please state here the exact date: Your signature . for and behalf of ... 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