8.

Sample Forms

SUMMARY
Sample Form No. 1:
Sample Form No. 2:
Sample Form No. 3:
Sample Form No. 4:
Sample Form No. 5:
Sample Form No. 6:
Sample Form No. 7:
Sample Form No. 8:
Sample Form No. 9:
Sample Form No. 10:
Sample Form No. 11:

1. TECHNICAL OFFER SUBMISSION SHEET....................................................................... 3

2. PRICE OFFER SUBMISSION SHEET ............................................................................... 5
3. BID SECURITY ........................................................................................................... 6
4. POWER OF ATTORNEY ................................................................................................ 8
5. CONTRACT AGREEMENT ............................................................................................ 9
6. PERFORMANCE SECURITY ........................................................................................ 11
7. BANK GUARANTEE FOR ADVANCE PAYMENT............................................................. 12
8. MANUFACTURER'S AUTHORIZATION ......................................................................... 13
9. QUALIFICATION STATEMENTS ................................................................................... 14
10. TECHNICAL SPECIFICATION DEVIATION FORM ......................................................... 21
11. COMMERCIAL TERMS DEVIATION FORM.................................................................. 22

1. Technical Offer Submission Sheet

Date: [dd/mm/yyyy]
Bid No.:

To:

[name and address of Procurement Agent]

We, the undersigned, declare that:

(a) We have examined and have no reservations to the Bidding Documents, including Addenda No.:
[insert numbers].
(b) We offer to supply in conformity with the Bidding Documents the following Goods and Related
Services: [description of Goods and Related Services]
(c) We undertake, if our Bid is accepted, to deliver the Goods in accordance with the delivery schedule
specified in the Schedule of Requirements.
(d) Our Bid shall be valid for a period of [number of days] days from the date fixed for the bid
submission deadline in accordance with the Bidding Documents, and it shall remain binding upon us
and may be accepted at any time before the expiration of that period;
(e) If our Bid is accepted, we commit to obtain a Performance Security in the amount of 10% (ten percent)
of the Contract Price for the due performance of the Contract. We commit to provide the Performance
Security to the Procurement Agent within 30 (thirty) calendar days after Procurement Agents
notification of DGCS and Jordanian Authorities no-objection.
(f)

Our company/ies has/have the following nationality: [insert nationality]

(g) We are not in any of the excluding situations listed in ITB Sub-Clause 2.2. In the event that our Bid is
successful, we undertake, if required, to provide the proof usual under the law of the country in which
we are established that we do not fall into the exclusion situations listed in ITB Sub-Clause 2.2. We
also understand that if the information provided is proved false, the award will be considered null and
void.
(h) We agree to abide by the Ethics Clauses in ITB Clause 36 and, in particular, have no potential conflict
of interests or any equivalent relation in that respect with other bidders or other parties in the Bidding
procedure at the time of the submission of this application.
(i)

We are not participating, as Bidders, in more than one Bid in this bidding process;

(j)

[Only in case of consortium] We confirm, as a partner in the consortium, that all partners are jointly
and severally liable by law for the Bid and the execution of the Contract, that the partner in charge is
authorised to bind, and receive instructions for and on behalf of, each member, that the execution of
the Contract, including payments, is the responsibility of the partner in charge, and that all partners in
the consortium are bound to remain in the consortium for the entire period of the contract's execution.

(k) We understand that this Bid, together with your written acceptance thereof included in your
notification of award, shall constitute a binding contract between us, until a formal Contract is
prepared and executed;
(l)

We understand that you are not bound to accept the lowest evaluated bid or any other bid that you
may receive.

[In case of consortium to be constituted after the contract award, the following information must be filled in by each partner]
Printed Name:
In the capacity of:

[Insert title or other appropriate designation]

Signature:
Duly authorized to sign bid for and on behalf of:

Companys seal:

Dated on ________ day of __________________, _______ [date of signing]

2. Price Offer Submission Sheet

Date: [dd/mm/yyyy]
Bid No.:

To:

[name and address of Procurement Agent]

We, the undersigned, declare that:

(a) We have examined and have no reservations to the Bidding Documents, including Addenda No.:
[insert numbers].
(b) We offer to supply in conformity with the Bidding Documents the following Goods and Related
Services: [description of Goods and Related Services]
(c) In accordance with the Price Schedule attached herewith and made part of this bid, the total DDU
Project Site price of our Bid is: [total bid amount in words and figures]

[In case of consortium to be constituted after the contract award, the following information must be filled in by each partner]
Printed Name:
In the capacity of:

[Insert title or other appropriate designation]

Signature:
Duly authorized to sign bid for and on behalf of:

Companys seal:

Dated on ________ day of __________________, _______ [date of signing]

3. Bid Security

Date: [dd/mm/yyyy]
Bid No.:

To: [name and address of Procurement Agent]

Whereas [name of the Bidder] (hereinafter called the Bidder) has submitted its Bid dated [date of
submission of Bid] for the supply of [name and/or description of the Goods and Related Services]
(hereinafter called the Bid).
KNOW ALL PEOPLE by these presents that WE [name of bank] of [name of country], having our
registered office at [address of bank] (hereinafter called the Bank), are bound unto [name of
Procurement Agent] (hereinafter called Procurement Agent) in the sum equal to 5% of the Financial
Offer for which payment well and truly to be made to the said Procurement Agent, the Bank binds itself,
its successors, and assignees by these presents. Sealed with the Common Seal of the said Bank this day
[insert day] of [insert month] [insert year].
THE CONDITIONS of this obligation are:
1. If the Bidder withdraws its Bid during the period of Bid validity specified by the Bidder on the
Technical Offer Submission Sheet, except as provided in ITB Sub-Clause 16.2; or
2. If the Bidder does not accept the correction of errors pursuant to ITB Sub-Clauses 24.4 and 24.5; or
3. If the Bidder, having been notified of the acceptance of its Bid by the Procurement Agent during the
period of bid validity:
(a) fails or refuses to execute the Contract Agreement; or
(b) fails or refuses to furnish the Performance Security, in accordance with ITB Clause 35;
We undertake to pay to the Procurement Agent up to the above amount upon receipt of its first written
demand, without the Procurement Agent having to substantiate its demand, provided that in its demand
the Procurement Agent will note that the amount claimed by it is due to it, owing to the occurrence of one
or all of the three conditions, specifying the occurred condition or conditions.
This guarantee shall be governed by the Uniform Rules for Demand Guarantees (ICC Publication No. 458,
1992) and remain valid and in full force up to and including 30 (thirty) days after the period of bid
validity, and any demand in respect thereof should reach the Bank not later than the above date.
Notwithstanding anything to the contrary, if the Bidder is awarded the Contract, this guarantee shall
remain in full force and effect after expiration of the above mentioned period until the Bidder has
furnished the Performance Security to you.

Name of issuing Bank:

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Printed Name of the Signatory:

In the capacity of:

[Insert title or other appropriate designation]

Signature:

Banks seal:
Dated on ________ day of __________________, _______ [date of signing]

4. Power of Attorney
Bid No.:
KNOW ALL MEN BY THESE PRESENTS that the undersigned [name], [title] of [name of Company]
(hereinafter called the Company), is lawfully authorised to represent and act on behalf of the Company,
whose registered address is [Companys address], and does hereby appoint [name], [title], of [firm] of ___,
whose signature appears below, to be the true and lawful attorney, and authorised the said attorney to sign
the bids, conduct negotiations, sign a Contract and execute all the necessary matters related thereto, in the
name and on behalf of the Company in connection with the execution, completion and maintenance of the
Contract for [description of Goods and Related Services] of the [name of the project] Project, Bid No.
.

OFFICIAL SEAL AND SIGNATURE OF THE COMPANY:

_________________________________

Printed Name of the Legal Representative:

Signature of the Legal Representative:
Printed Name of the Attorney:
In the capacity of:

[Insert title or other appropriate designation]

Signature of the Attorney:

Companys seal:
Printed Name of the Witness:
In the capacity of:

[Insert title or other appropriate designation]

Signature of the Witness:

Address of Witness

Dated on ________ day of __________________, _______ [date of signing]

Note: The Bidder should include such Power of Attorney in its bid in original.

5. Contract Agreement
THIS CONTRACT AGREEMENT made between [name of Purchaser and Procurement Agent] of
[Purchasers country] (hereinafter called the Purchaser and CITC) of the one part and [name of
Supplier] of [city and country of Supplier] (hereinafter called the Supplier) of the other part:
WHEREAS the Purchaser and CITC invited Bids for certain Goods and Related Services, viz., [brief
description of Goods and Related Services] and has accepted a Bid by the Supplier for the supply of those
Goods and Related Services in the sum of [contract price in words and figures] (hereinafter called the
Contract Price).
NOW THIS CONTRACT AGREEMENT WITNESSETH AS FOLLOWS:
(1) In this Agreement words and expressions shall have the same meanings as are respectively
assigned to them in the Conditions of Contract referred to.
(2) The following documents shall be deemed to form and be read and construed as part of the
Contract, viz.:
(a) the Negotiation Agreement;
(b) the Special Conditions of Contract;
(c) the General Conditions of Contract;
(d) the Schedule of Requirements and the Technical Specifications.
(e) the Technical and Price Offer Submission Sheets;
(f) the Price Schedules;
(g) the Purchasers Notification to the Supplier of Award of Contract;
This Contract shall prevail over all other Contract documents. In the event of any discrepancy or
inconsistency within the Contract documents, then the documents shall prevail in the order listed
above.
(3) In consideration of the payments to be made by the Purchaser and CITC to the Supplier as
hereinafter mentioned, the Supplier hereby covenants with the Purchaser and CITC to provide the
Goods and Related Services and to remedy defects therein in conformity in all respects with the
provisions of the Contract.
(4) The Purchaser hereby covenants to pay the Supplier in consideration of the provision of the
Goods and Related Services and the remedying of defects therein, the Contract Price or such other
sum as may become payable under the provisions of the Contract at the times and in the manner
prescribed by the Contract.
IN WITNESS whereof the parties hereto have caused this Agreement to be executed in accordance with
the laws of The Hashemite Kingdom of Jordan.
The effectiveness of this Contract Agreement is subject to its prior signing by both parties, DGCS and
Jordanian Authorities no-objection and Purchaser receipt of Performance Security.

For and on behalf of the Purchaser

Signed:
In the capacity of:
In the presence of:
Date of signature:

[signature of authorized representative/s of the Purchaser]

[title or other appropriate designation]
[identification of official witness]
[insert date of signature]

For and on behalf of the Procurement Agent

Signed:
In the capacity of:
In the presence of:
Date of signature:

[signature of authorized representative(s) of the Procurement Agen]

[title or other appropriate designation]
[identification of official witness]
[insert date of signature]

For and on behalf of the Supplier

Signed:
In the capacity of:
In the presence of:
Date of signature:

[signature of authorized representative(s) of the Supplier]

[title or other appropriate designation]
[identification of official witness]
[insert date of signature]

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6. Performance Security
[The bank, as requested by the successful Bidder, shall fill in this form in accordance with the instructions indicated]

Date: [dd/mm/yyyy]
Bid No.:
To: [name and address of Procurement Agent]
WHEREAS [name of Supplier] (hereinafter called the Supplier) has undertaken, in pursuance of
Contract No. [reference number of the Contract] dated [dd/mm/yyyy] to supply [description of Goods and
Related Services] (hereinafter called the Contract).
AND WHEREAS it has been stipulated by you in the aforementioned Contract that the Supplier shall
furnish you with a bank guarantee issued by a reputable bank for the sum specified therein as security for
compliance with the Supplier's performance obligations in accordance with the Contract.
AND WHEREAS we have agreed to give the Supplier a guarantee:
THEREFORE WE hereby affirm that we are Guarantors and responsible to you, on behalf of the
Supplier, up to a total of [amount of the guarantee in words and figures], and we undertake to pay you,
upon your first written demand declaring the Supplier to be in default under the Contract and without
cavil or argument, any sum or sums within the limits of [amount of guarantee] as aforesaid, without your
needing to prove or to show grounds or reasons for your demand or the sum specified therein.
The law applicable to this guarantee shall be Jordanian law. Any dispute arising out of or in connection
with this guarantee shall be referred to the Jordan International Economic and Trade Arbitration
Commission (CIETAC) in accordance with its arbitration rules/procedures.
This guarantee shall be governed by the Uniform Rules for Demand Guarantees (ICC Publication No. 458,
1992) and remain valid and in full force until 30 (days) after the issuance of the Final Acceptance
Certificate.

Name of issuing Bank:

Printed Name of the Signatory:
In the capacity of:

[Title or other appropriate designation]

Signature:
Banks seal:
Dated on ________ day of __________________, _______ [date of signing]

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7. Bank Guarantee for Advance Payment

[The bank, as requested by the successful Bidder, shall fill in this form in accordance with the instructions indicated]

Date: [dd/mm/yyyy]
Bid No.:
To: [name and address of Procurement Agent]
[Name of Contract]
Gentlemen and/or Ladies:
In accordance with the payment provision included in the SCC Clause 17, in relation to advance
payments, [name and address of Supplier] (hereinafter called the Supplier) shall deposit with the
Procurement Agent a bank guarantee to guarantee its proper and faithful performance under the said
Clause of the Contract in an amount of [amount of guarantee in figures and words].
We, the undersigned [name of bank], legally domiciled in [bank address], as instructed by the Supplier,
agree unconditionally and irrevocably to guarantee as primary obligator and not as surety merely, the
payment to the Procurement Agent on its first demand without whatsoever right of objection on our part
without its first claim to the Supplier, in the amount not exceeding [amount of guarantee in figures and
words].
We further agree that no change or addition to or other modification of the terms of the Contract to be
performed there under or of any of the Contract documents which may be made between the Purchaser
and the Supplier, shall in any way release us from any liability under this guarantee, and we hereby waive
notice of any such change, addition, or modification.
The law applicable to this guarantee shall be Jordanian law. Any dispute arising out of or in connection
with this guarantee shall be referred to the Jordan International Economic and Trade Arbitration
Commission (JIETAC) in accordance with its arbitration rules/procedures.
This guarantee shall be governed by the Uniform Rules for Demand Guarantees (ICC Publication No. 458,
1992) and remain valid and in full force until 45 (forty five) days after the issuance of the Provisional
Acceptance Certificate
Name of issuing Bank:
Printed Name of the Signatory:
In the capacity of:

[Title or other appropriate designation]

Signature:
Banks seal:
Dated on ________ day of __________________, _______ [date of signing]
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8. Manufacturer's Authorization
(See Sub-clause 13. 3 (a) of the Instructions to Bidders)
Date: [dd/mm/yyyy]
Bid No.:

To: [name and address of Procurement Agent]

WHEREAS
We [insert complete name of Manufacturer], who are official manufacturers of [insert type of goods
manufactured], having factories at [insert full address of Manufacturers factories], do hereby authorize
[insert complete name of Bidder] to submit a bid the purpose of which is to provide the following Goods,
manufactured by us [insert name and or brief description of the Goods], and to subsequently negotiate
and sign the Contract with you against Bid No.
We hereby extend our full guarantee and warranty in accordance with Clause 15 of the General
Conditions of Contract, with respect to the Goods offered by the above firm.

[Insert complete name of authorized representative of

Printed Name:

the Manufacturer]
[Title or other appropriate designation name of

In the capacity of:

authorized representative of the Manufacturer]

[Insert complete signature of authorized

Signature:

representative of the Manufacturer]

Duly authorized to sign bid for and on behalf of:

Companys seal:

Note: This letter of authority should be on the letterhead of the Manufacturer and should be signed by a
person competent and having the power of attorney to bind the Manufacturer. The Bidder should include
such letter of authority in its bid in original.

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9. Qualification Statements
Instruction to Applicants
The applicants who are manufacturers shall fill out and submit the Manufacturers Qualification
Statement (form 9.1). The applicants who are Trading Companies (as Agent) shall fill out and submit the
Manufacturers Qualification Statement (form 9.1) and the Trading Companys (as Agent) Qualification
Statement (form 9.2).
Clear and accurate answers should be given to all questions and/or information required in the attached
forms.
The signatory of the qualification information shall guarantee the truth and accuracy of all Statements and
all answers to questions made therein.
The Qualification Statements are to be considered only as support summary documents and they shall by
no means replace any documentary proof requested in the Bidding Documents.
Documents submitted by the applicants will be treated as confidential but will not be returned.
All documents shall be made out in English.

14

9.1 Manufacturers Qualification Statement

(1) Company General Information:

Name of Manufacturer
Company Name
Address of Head Office
Telephone No.
Fax No.
Address of the manufacturer's
representatives in PRC, if any
Telephone No.
Fax No.

(2) Financial Statement Summary

Date of Company Establishment
and/or Registration
Paid-Up Capital
Latest Balance Sheet
(i) Fixed Assets
(ii) Current Assets
(iii) Long Term Liabilities
(iv) Current Liabilities
(v) Net Worth

(3) Additional Manufacturer's Information

Name and location of factory
Items produced
Annual production capacity
Number of employees
Number of years of the
manufacturer in the production of
the goods of the proposal
Are there any component parts which are not produced by the principal manufacturer but supplied by
other manufacturers (sub-contractors)? Yes
No

15

If the answer is yes, please fill in the table below:

Items

Name of
Manufacturer

Address of
Manufacturer's
Manufacturer
Tel/Fax No.

(4) Annual turnover in the last 3 (three) years:

Domestic sales
(EUR)

Year

Export sales
(EUR)

TOTAL
(EUR)

(5) List of domestic and foreign firms to whom the goods have been mainly sold to (up to five firms)
in the last 3 (three) years.
(a) Domestic contracts
No.

Company
Name

Company Address

Item sold

Contract
Period

Value
(EUR)

1
2
3
4
5
(b) Foreign contracts
No.

Company
Name

Company Address

Country

Item sold

Contract
Period

Value
(EUR)

1
2
3
4
5

(6) Contact details of Manufacturer's Reference Bank

Name of Reference Bank
Address of Reference Bank
16

(7) Brief Company Introduction: (chronology, organization, structure, corporate group to which
manufacturer belongs, etc.)

We hereby certify to the best of our knowledge that the foregoing statements are true and correct, that all
available information and data have been supplied herein, and that we agree to show you documentary
proof thereof upon your request.

Name of Manufacturer:
Printed Name of Authorized Representative:
In the capacity of:

[Title or other appropriate designation]

Signature of Authorized Representative:

Company Seal:
Tel/Fax No.:
Dated on ________ day of __________________, _______ [date of signing]

17

9.2 Trading Companys (as Agent) Qualification Statement

(1) Company General Information:
Name of Bidder
Company Name
Address of Head Office
Telephone No.
Fax No.
Address of the manufacturer's
representatives in PRC, if any
Telephone No.
Fax No.

(2) Financial Statement Summary

Date of Company Establishment
and/or Registration
Paid-Up Capital
Latest Balance Sheet
(i) Fixed Assets
(ii) Current Assets
(iii) Long Term Liabilities
(iv) Current Liabilities
(v) Net Worth

(3) Annual turnover in the last 3 (three) years:

Year

Domestic sales
(EUR)

Export sales
(EUR)

TOTAL
(EUR)

(4) List of domestic and foreign firms to whom the goods have been mainly sold to (up to five firms)
in the last 3 (three) years.
(a) Domestic contracts

18

No.

Company
Name

Company Address

Item sold

Value
(EUR)

Period

1
2
3
4
5
(b) Foreign contracts
No.

Company
Name

Company Address

Country

Item sold

Period

Value
(EUR)

1
2
3
4
5

(5) List of Items agreed by the manufacturer to be produced (please attach manufacturer's
qualification statement):

Item

Quantity

Name of
Manufacturer

Manufacturer's
Address

Corporate Group
Manufacturer's
to which
Tel/Fax No.
Manufacturer
Belongs (If Any)

Are there any component parts which are supplied by other manufacturers (sub-contractors)?
Yes
No
If the answer is yes, please fill in the table below:
Name of
Items
Manufacturer

Address of
Manufacturer's
Manufacturer
Tel/Fax No.

(6) Bank Reference Contact Details

Name of Reference Bank
19

Address of Reference Bank

(7) Brief Company Introduction: (Chronology, Organization, Structure, etc.)

We hereby certify to the best of our knowledge that the foregoing statements are true and correct, that all
available information and data have been supplied herein, and that we agree to show you documentary
proof thereof upon your request.

Name:
Printed Name of Authorized Representative:
In the capacity of:

[Title or other appropriate designation]

Signature of Authorized Representative:

Company Seal:
Tel/Fax No.:
Dated on ________ day of __________________, _______ [date of signing]

20

10. Technical Specification Deviation Form

Date: [dd/mm/yyyy]
Bid No.:
Specifications Required
(Purchaser)
Item No.
Description

Specifications Provided
(Bidder)
Item No.
Deviation

Remarks

Name:
Printed Name of Authorized Representative:
In the capacity of:

[Title or other appropriate designation]

Signature of Authorized Representative:

Company Seal:
Tel/Fax No.:

21

11. Commercial Terms Deviation Form

Date: [dd/mm/yyyy]
Bid No.:

Item No.

Commercial Terms in Bidding

Documents

Commercial Terms offered by

the Bidder

Remarks

Name:
Printed Name of Authorized Representative:
In the capacity of:

[Title or other appropriate designation]

Signature of Authorized Representative:

Company Seal:
Tel/Fax No.:

22