ࡱ> g Zbjbj cL{z\{z\ezJJJJJ^^^8: l^&l 1(1(1(103Br3,3;======$2amJ33"0333aJJ(1(1Λ:::3vJ(1J(1;:3;::ϐ(1`V$~Q,4L'0Ң4ҢϐϐҢJÑd33:33333aa73333333Ң333333333> :   SHAPE \* MERGEFORMAT  Selection Questionnaire CPH020Q Nutrition and Weight Management e-training for Live Life Better Derbyshire Health Improvement Advisors Company/Organisation:  FORMTEXT  Enter Name   Introductions, Notes for Completion & Evaluation Approach  Instructions Potential Supplier Information: Part 1 The standard Selection Questionnaire is a self-declaration, made by you (the potential supplier). A completed Part 1 provides a formal statement, consequently all organisations that you will rely on to meet the selection criteria will also need to provide a completed Part 1. For example these could be parent companies, affiliates, associates, or essential sub-contractors, if they are relied upon to meet the selection criteria. This means that where you are joining in a group of organisations, including joint ventures and partnerships, each organisation in that group must complete one of these self-declarations. Sub-contractors that you rely on to meet the selection criteria must also complete a self-declaration (although sub-contractors that are not relied upon do not need to complete the self-declaration). When completed, this form and the selection information required shall be submitted as part of your tender return. Exclusion Grounds: Part 2. Not applicable to this procurement Audit and Security Information: Part 3 Section 8.10 All organisations who will be involved in the delivery of the contract, including subcontractors, and who will have access to personal data and/or sensitive personal data should complete Part 1 and Part 3 Section 8.10Supplier Selection Questions: Part 3 Please respond to all of the sections below (as detailed in the Evaluation approach table below the sections that are not relevant to this procurement have been removed). If you are bidding on behalf of a group (consortium) or you intend to use sub-contractors, you should complete all of the selection questions on behalf of the consortium and/or any sub-contractors. If the relevant documentary evidence referred to in the Selection Questionnaire is not provided upon request and without delay we reserve the right to amend the contract award decision and award to the next compliant bidderNotes for CompletionNotes for completion The Council means Derbyshire County Council, or anyone acting on behalf of the Council. You / Your refer to the potential supplier completing this standard Selection Questionnaire i.e. the legal entity responsible for the information provided. The term potential supplier is intended to cover any economic operator as defined by the Public Contracts Regulations 2015 (referred to as the regulations) and could be a registered company; the lead contact for a group of economic operators; charitable organisation; Voluntary Community and Social Enterprise (VCSE); Special Purpose Vehicle; or other form of entity. Please ensure that all questions are completed in full, and in the format requested. If the question does not apply to you, please state N/A. Should you need to provide additional information in response to the questions, please submit a clearly identified annex. The Council recognises that arrangements set out in section 1.2 of the standard Selection Questionnaire, in relation to a group of economic operators (for example, a consortium) and/or use of sub-contractors, may be subject to change and will, therefore, not be finalised until a later date. The lead contact should notify the Council immediately of any change in the proposed arrangements and ensure a completed Part 1 and Part 2 is submitted for any new organisation relied on to meet the selection criteria. The Council will make a revised assessment of the submission based on the updated information. For Part 1 and Part 2 every organisation that is being relied on to meet the selection must complete and submit the self-declaration. For answers to Part 3 - If you are bidding on behalf of a group, for example, a consortium, or you intend to use sub-contractors, you should complete all of the questions on behalf of the consortium and/ or any sub-contractors, providing one composite response and declaration. The Council confirms that it will keep confidential and will not disclose to any third parties any information obtained from a named customer contact, other than to the Cabinet Office and/or contracting authorities defined by the regulations, or pursuant to an order of the court or demand made by any competent authority or body where the Council is under a legal or regulatory obligation to make such a disclosure. Potential Providers must be explicit and comprehensive in their responses to this questionnaire as this will be the single source of information on which responses will be assessed. Potential Providers are advised neither to make any assumptions about their past or current supplier relationships with the Council nor to assume that such prior business relationships will be taken into account in the evaluation procedure. Supporting documents should be provided in English and should be clearly marked with the name of your organisation and the number of the question to which they refer. If you have any queries regarding how to complete this document please address them through the questions and answers stage of the tender. Failure to provide the required information, make a satisfactory response to any question, or supply documentation referred to in responses within the specified timescale may lead to your tender being judged to be non-compliant.Consequences of misrepresentation If you seriously misrepresent any factual information in filling in the Selection Questionnaire, and so induce the Council to enter into a contract, there may be significant consequences. You may be excluded from the procurement procedure, and from bidding for other contracts for three years. If a contract has been entered into you may be sued for damages and the contract may be rescinded. If fraud, or fraudulent intent, can be proved, you or your responsible officers may be prosecuted and convicted of the offence of fraud by false representation, and you must be excluded from further procurements for five years. Evaluation Approach In assessing the answers to the following questions, the Council will be seeking evidence of the Potential Providers suitability to perform the services of the contract in terms of economic and financial standing, technical and professional ability. Qualification criteria will be a combination of factors and will be in accordance with the Public Contract Regulations 2015 Responses to the questions will be evaluated in accordance with the Evaluation Approach detailed below. In the event that none of the responses are deemed satisfactory, the Council reserves the right to consider alternative procurement options. Scoring Principles Required Data Required Data The data provided is for information only and will not be scored / assessed but if the information requested is not provided the bid will be judged to be non-compliant unless there is an acceptable reason for its omission. Pass / Fail Pass The information / evidence has been assessed and judged to be acceptable. Fail No information / evidence has been provided. The standard of the information / evidence provided is unacceptable. The information / evidence has been assessed and does not comply with the minimum acceptable standard. Scoring Section Scoring Requirements 1 Supplier Information 1.1 Potential supplier information 1.2 Bidding model 1.3 Contact detail and declaration Required Data The data provided is for information only and will not be scored or assessed; however if the information requested is not provided your bid will be judged to be non-compliant unless there is an acceptable reason for its omission. 2 Grounds for mandatory exclusion Not applicable to this contract 3 Grounds For Discretionary Rejection Not applicable to this contract 4 Economic and Financial Standing Not applicable to this contract 5 Group financial information Not applicable to this contract 6 Technical and Professional Ability Pass / Fail The decision to Pass / Fail this section is based on an assessment of the information and references provided. Please note: the Council reserves the right to take up the references named and further inspection of current contracts may also be made to resolve any questions about technical efficiency, quality, service levels and reliability. 7 Modern Slavery Act 2015 Pass / Fail The Council must be satisfied that you are complaint with the requirements of the Modern Slavery Act 2015 (if applicable to your organisation) 8.1 Insurance Pass / Fail You must confirm that required insurance levels would be in place and certificates provided prior to the contract award. 8.2 Skill and Apprentices Not applicable to this contract 8.3 Steel Not applicable to this contract 8.4 Supplier Past Performance Not applicable to this contract 8.5 Quality Management Not applicable to this contract 8.6 Disclosure and Barring Service (DBS) Checks Not applicable to this contract 8.7 Construction Industry Scheme (CIS) Not applicable to this contract 8.8 Safeguarding and security Not applicable to this contract 8.9 Business Continuity / Disaster Recovery Not applicable to this contract 8.10 Audit and Information Security Not applicable to this contract 8.11 General Data Protection Regulations Pass / Fail The Council must be satisfied of compliance with all obligations under the General Data Protection Regulations. 8.12 Compliance with equality legislation Not applicable to this contract 8.13 Environmental Management Not applicable to this contract 8.14 Health and Safety Not applicable to this contract 8.15 Regulatory Bodies Not applicable to this contract 8.16 Credit Rating Not applicable to this contract Additional Information The Council expressly reserves the right to require a Potential Provider to provide additional information supplementing or clarifying any of the information provided in response to the requests set out in this questionnaire. The Council may seek independent financial and market advice to validate information declared, or to assist in the evaluation. Failure to provide the required information, make a satisfactory response to any question, or supply documentation referred to in responses, within the timescale given, may mean that your organisation will not be considered further. Bids will be deemed to be non-compliant, and will not be considered further, where they do not achieve a Pass in one or more of the sections included in this selection questionnaire. Part 1 Potential supplier information Please answer the following questions in full. Note that every organisation that is being relied on to meet the selection must complete and submit the Part 1 and Part 2 self-declaration.Section 1Potential Supplier InformationQuestion no.QuestionResponse1.1 (a)Full name of the potential supplier submitting the information FORMTEXT      1.1 (b)  (i)Registered office address (if applicable) FORMTEXT      1.1 (b)  (ii)Registered website address (if applicable) FORMTEXT      1.1 (c)Trading Status: public limited company limited company limited liability partnership other partnership sole trader third sector other (please specify your trading status) FORMTEXT      1.1 (d)Date of registration in country of origin FORMTEXT      1.1 (e)Company registration number (if applicable) FORMTEXT      1.1 (f)Charity registration number (if applicable) FORMTEXT      1.1 (g)Head office DUNS number (if applicable) FORMTEXT      1.1 (h)Registered VAT number  FORMTEXT      1.1 (i) - (i)If applicable, is your organisation registered with the appropriate professional or trade register(s) in the member state where it is established? FORMCHECKBOX  Yes  FORMCHECKBOX  No  FORMCHECKBOX  N/A1.1 (i) - (ii)If you responded yes to 1.1(i) - (i), please provide the relevant details, including the registration number(s). FORMTEXT      1.1 (j) - (i)Is it a legal requirement in the state where you are established for you to possess a particular authorisation, or be a member of a particular organisation in order to provide the services specified in this procurement? FORMCHECKBOX  Yes  FORMCHECKBOX  No  FORMCHECKBOX  N/A1.1 (j) - (ii)If you responded yes to 1.1(j) - (i), please provide additional details of what is required and confirmation that you have complied with this. FORMTEXT      1.1 (k)Trading name(s) that will be used if successful in this procurement FORMTEXT      1.1 (l)Relevant classifications (state whether you fall within one of these, and if so which one) Voluntary Community Social Enterprise (VCSE) Sheltered Workshop Public service mutual FORMTEXT      1.1 (m)Are you a Small, Medium or Micro Enterprise (SME)? FORMCHECKBOX  Yes  FORMCHECKBOX  No1.1 (n)Details of Persons of Significant Control (PSC), where appropriate: Name; Date of birth; Nationality; Country, state or part of the UK where the PSC usually lives; Service address; The date he or she became a PSC in relation to the company (for existing companies 6 April 2016 should be used); Which conditions for being a PSC are met; Over 25% up to (and including) 50%, More than 50% and less than 75%, 75% or more. (Please enter N/A if not applicable) FORMTEXT      1.1 (o)Details of immediate parent company: Full name of the immediate parent company Registered office address (if applicable) Registration number (if applicable) Head office DUNS number (if applicable) Head office VAT number (if applicable) (Please enter N/A if not applicable) FORMTEXT      1.1 (p)Details of ultimate parent company: Full name of the ultimate parent company Registered office address (if applicable) Registration number (if applicable) Head office DUNS number (if applicable) Head office VAT number (if applicable) (Please enter N/A if not applicable) FORMTEXT      Please note: A criminal record check for relevant convictions may be undertaken for the preferred suppliers and the persons of significant in control of them.  Please provide the following information about your approach to this procurement:Section 1Bidding modelQuestion no.QuestionResponse1.2 (a) - (i)Are you bidding as the lead contact for a group of economic operators? FORMCHECKBOX  Yes  FORMCHECKBOX  No If yes, please provide details listed in questions 1.2(a) (ii), (a) (iii) and to 1.2(b) (i), (b) (ii), 1.3, Section 2 and 3. If no, and you are a supporting bidder please provide the name of your group at 1.2(a) (ii) for reference purposes, and complete 1.3, Section 2 and 3.1.2 (a) - (ii)Name of group of economic operators (if applicable) FORMTEXT      1.2 (a) - (iii)Proposed legal structure if the group of economic operators intends to form a named single legal entity prior to signing a contract, if awarded. If you do not propose to form a single legal entity, please explain the legal structure. FORMTEXT      1.2 (b) - (i)Are you or, if applicable, the group of economic operators proposing to use sub-contractors? FORMCHECKBOX  Yes  FORMCHECKBOX  No 1.2 (b) - (ii)If you responded yes to 1.2(b)-(i) please provide additional details for each sub-contractor in the following table: we may ask them to complete this form as well. Name  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       Registered address  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       Trading status  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       Company registration number  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       Head Office DUNS number (if applicable)  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       Registered VAT number  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       Type of organisation  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       SME (Yes/No)  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       The role each sub-contractor will take in providing the works and /or supplies e.g. key deliverables  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       The approximate % of contractual obligations assigned to each sub-contractor  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        Contact details and declaration I declare that to the best of my knowledge the answers submitted and information contained in this document are correct and accurate. I declare that, upon request and without delay I will provide the certificates or documentary evidence referred to in this document. I understand that the information will be used in the selection process to assess my organisations suitability to be invited to participate further in this procurement. I understand that the Council may reject this submission in its entirety if there is a failure to answer all the relevant questions fully, or if false/misleading information or content is provided in any section. I am aware of the consequences of serious misrepresentation.Section 1Contact details and declarationQuestion no.QuestionResponse1.3 (a)Contact name FORMTEXT      1.3 (b)Name of organisation FORMTEXT      1.3 (c)Role in organisation FORMTEXT      1.3 (d)Phone number FORMTEXT      1.3 (e)E-mail address FORMTEXT      1.3 (f)Postal address FORMTEXT      1.3 (g)Signature (electronic is acceptable) FORMTEXT      1.3 (h)Date FORMTEXT       Section 6Technical and Professional Ability6.1Relevant experience and contract examples Please provide details of up to three contracts, in any combination from either the public or private sector; voluntary, charity or social enterprise (VCSE) that are relevant to our requirement. VCSEs may include samples of grant-funded work. Contracts for supplies or services should have been performed during the past three years. Works contracts may be from the past five years. The named contact provided should be able to provide written evidence to confirm the accuracy of the information provided below. Consortia bids should provide relevant examples of where the consortium has delivered similar requirements. If this is not possible (e.g. the consortium is newly formed or a Special Purpose Vehicle is to be created for this contract) then three separate examples should be provided between the principal member(s) of the proposed consortium or Special Purpose Vehicle (three examples are not required from each member). Where the Supplier is a Special Purpose Vehicle, or a managing agent not intending to be the main provider of the supplies or services, the information requested should be provided in respect of the main intended provider(s) or sub-contractor(s) who will deliver the contract. If you cannot provide examples see question 6.3Contract 1Name of customer organisation FORMTEXT      Point of contact in the organisation FORMTEXT      Position in the organisation FORMTEXT      E-mail address FORMTEXT      Description of contract  FORMTEXT      Contract start date FORMTEXT      Contract completion date FORMTEXT      Estimated contract value FORMTEXT      Contract 2Name of customer organisation FORMTEXT      Point of contact in the organisation FORMTEXT      Position in the organisation FORMTEXT      E-mail address FORMTEXT      Description of contract  FORMTEXT      Contract start date FORMTEXT      Contract completion date FORMTEXT      Estimated contract value FORMTEXT      Contract 3Name of customer organisation FORMTEXT      Point of contact in the organisation FORMTEXT      Position in the organisation FORMTEXT      E-mail address FORMTEXT      Description of contract  FORMTEXT      Contract start date FORMTEXT      Contract completion date FORMTEXT      Estimated contract value FORMTEXT      6.2Where you intend to sub-contract a proportion of the contract, please demonstrate how you have previously maintained healthy supply chains with your sub-contractor(s) Evidence should include, but is not limited to, details of your supply chain management tracking systems to ensure performance of the contract and including prompt payment or membership of the UK Prompt Payment Code (or equivalent schemes in other countries) FORMTEXT      6.3If you cannot provide at least one example for question 6.1, in no more than 500 words please provide an explanation for this e.g. your organisation is a new start-up or you have provided services in the past but not under a contract. FORMTEXT       Section 7Modern Slavery Act 2015: Requirements under Modern Slavery Act 2015Question no.QuestionResponse7.1Are you a relevant commercial organisation as defined by section 54 ("Transparency in supply chains etc.") of the Modern Slavery Act 2015 ("the Act")? FORMCHECKBOX  Yes  FORMCHECKBOX  N/A7.2If you have answered yes to question 7.1 are you compliant with the annual reporting requirements contained within Section 54 of the Act 2015?  FORMCHECKBOX  Yes Please provide relevant the url  FORMTEXT        FORMCHECKBOX  No Please provide an explanation  FORMTEXT       Section 8: Additional Questions Suppliers who self-certify that they meet the requirements to the additional questions will be required to provide evidence of this if they are successful at contract award stage.8.1InsuranceQuestion no.QuestionResponsea.Please self-certify whether you already have, or can commit to obtain, prior to the commencement of the contract, the levels of insurance cover indicated below: Employers (Compulsory) Liability Insurance = 5m Public Liability Insurance = 1m Professional Indemnity Insurance = 1m Please note the insurance cover values shall not be less than the amounts detailed above for each and every claim. * It is a legal requirement that all companies hold Employers (Compulsory) Liability Insurance of 5 million as a minimum. Please note this requirement is not applicable to Sole Traders. FORMCHECKBOX  Yes  FORMCHECKBOX  No 8.10Audit and Information Security Individuals, organisations and the voluntary sector are integral in assisting the Council to deliver a variety of essential services across Derbyshire. 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As a responsible organisation, the Council is required by law, to take all reasonable steps to ensure that personal data covered by the Data Protection Act 1998 is protected against unauthorised access or loss. With this in mind, the Council has produced a checklist of the basic information security standards that are required where the storing, handling, processing and/ or retention of personal data are incidental to the service being provided. The following questions should be answered with regard to any personal data or sensitive personal data held in respect of this contract. a.Information Security Policies and Standards The Council has ISO27001 accreditation and has established an Information Security Management System (ISMS) in accordance with the requirements of ISO27001 and ISO27002 code of practice for information security controls. The Provider will be required to provide a level of information security assurance for both Council Information and personal data/sensitive personal data which is compliant with current data protection legislation and information security best practice. Please explain How incidents, which may affect the security of Council Information and personal data/sensitive data are identified, reported and managed. Does your organisation hold any security related certifications and/or accreditations e.g. ISO27001 Response: FORMTEXT      b. Passwords To enable the Council to be satisfied that appropriate levels of Data Security are in place, please answer the following questions with regard to logons to systems or accounts that can be used to access personal data/sensitive personal data. Password Complexity Do passwords comply with the following: A minimum password length of 8 characters.  FORMCHECKBOX  Yes  FORMCHECKBOX  No A minimum of 3 of the 5 components detailed below (please tick to identify):  FORMCHECKBOX  Numeric (0-9)  FORMCHECKBOX  Uppercase (A-Z)  FORMCHECKBOX  Lowercase (a-z)  FORMCHECKBOX  Special Characters (? @, #, %, etc.)  FORMCHECKBOX  Spaces  FORMCHECKBOX  Yes  FORMCHECKBOX  No If No to the above, please confirm if you would commit to implementing these requirements prior to the start of the contract.  FORMCHECKBOX  Yes  FORMCHECKBOX  No Password Change/Refresh Are users forced to change/refresh passwords?  FORMCHECKBOX  Yes  FORMCHECKBOX  No If yes, how often are passwords refreshed?  FORMTEXT       If No to the above, please confirm if you would commit to implementing these requirements prior to the start of the contract.  FORMCHECKBOX  Yes  FORMCHECKBOX  No Password Creation, Storage and Transmission to Users In regard to system administrators please describe: How passwords are created:  FORMTEXT  Response  How passwords are sent/transmitted to users:  FORMTEXT  Response  How password data is stored:  FORMTEXT  Response  Password recovery Please describe how passwords are recovered/reset, e.g in the event of a forgotten password:  FORMTEXT  Response  c.Security of data To aid compliance with the Data Protection Act 1998, the Council requires your organisation to protect personal information. Please provide details about how your organisation protects data, including in your response; Encryption of electronic devices (the Councils Encryption and Cryptographic Controls Policy can be found at  HYPERLINK "https://www.derbyshire.gov.uk/working_for_us/data/sharing_information/default.asp" https://www.derbyshire.gov.uk/working_for_us/data/sharing_information/default.asp ); Encryption of data stored on hard drives and other physical media where there is a requirement to process personal data/sensitive personal data. Encryption of backups where there is a requirement to process personal data/sensitive personal data. Protection and storage of paper records Access to your buildings Response: FORMTEXT      d.Privacy Electronic Communications Regulations 2015 (PECR) The PECR sit alongside the Data Protection Act and give people specific privacy rights in regard to communications, and include specific rules in regard to: marketing calls, emails, texts and faxes; cookies (and similar technologies); keeping communications services secure; and customer privacy as regards traffic and location data, itemised billing, line identification, and directory listings. For additional information:  HYPERLINK "https://ico.org.uk/for-organisations/guide-to-pecr/introduction/what-are-pecr/" https://ico.org.uk/for-organisations/guide-to-pecr/introduction/what-are-pecr/Do the Privacy Electronic Communications Regulations 2015 (PECR) apply to your organisation?  FORMCHECKBOX  Yes  FORMCHECKBOX  NoIf Yes, please confirm that your organisation complies with the PECR requirements. FORMCHECKBOX  Yes  FORMCHECKBOX  Noe.User Accounts Please describe how user accounts of IT systems are created and maintained, including in your response; How requests for new user accounts are verified and authorised; How disabled, suspended and in-active user accounts are managed. Response: FORMTEXT      f.Audit Trail The Council requires the Provider to maintain an audit trail in relation to personal data that is recorded, processed or analysed electronically. Please confirm that the following data would be captured in an audit trail of any IT systems used to process personal data under this contract: Date and time of transaction; User ID and name of the individual undertaking the transaction; Details of the data before and after the transaction; Details of the users MAC or IP Address (subject to whether the connection is internal or external) of the IT equipment for the user making the connection; Details of which activities undertaken by the System Administrator(s) will appear in the audit trail; Data exported from within the system. Response: FORMTEXT      g.Audit Trail Extractions The Council s Audit Services Unit may require the ability to extract the IT system(s) audit trail information (as detailed in the previous requirement) for a user over a defined period. e.g. 3 months. The Councils Audit Services Unit may require the ability to extract the IT system(s) audit trail information (as detailed in the previous requirement) for a user over a defined period. e.g. 3 months. Please confirm whether the audit trail information can be extracted into an electronic format e.g. CSV. 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Please confirm that your organisation is able to meet this requirement. Response: FORMTEXT      i.Third Party organisation Where you intend to use a 3rd party e.g. subcontractors, partner organisations etc. to deliver services under this contract, please confirm how you will ensure that they will comply with these Information Security requirements. Response: FORMTEXT      j.Government-backed Cyber Essentials Plus Please confirm you have the Government-backed Cyber Essentials Plus or equivalent. If no please confirm you are willing to put in place the Government-backed Cyber Essentials Plus or equivalent before the contract commences. Further information is available on the Government-backed scheme: https://www.gov.uk/government/publications/cyber-essentials-scheme-overview  FORMCHECKBOX  Yes  FORMCHECKBOX  No  FORMCHECKBOX  Yes  8.11General Data Protection RegulationsQuestion no.QuestionResponsea. The General Data Protection Regulations which strengthen and unify data protection for individuals came into force on 25 May 2018. Please confirm that you are compliant with the obligations that apply to your organisation. 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