ANNEX C
STANDARD SUBMISSION FORM (AMENDED)
Production and delivery of Customised Promotional Materials
F-SU-18-T01	
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 proposed subcontractor(s) to meet the selection criteria, then the subcontractors shall also complete the forms included under Parts C and D. In any other case, the forms included under Parts C and D shall only be completed by the tenderer or by the partners in case of consortium or group of companies. 
Tenderer must show compliance with the minimum requirements of the technical specifications by completing Forms E.1 and E.2.
Tenderers’ financial offer shall be prepared in accordance with Form F.1.
2. CHOICE OF LOT(S) 
Not applicable.

	
PART 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’ LEGAL REPRESENTATIVE(S)	
Person authorised to sign the contract on behalf of the tenderer:	
Surname		
Forename		
Function		
Telephone		
Fax		
Email		
Contact person regarding this tender:	
Surname		
Forename		
Function		
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/contracts_grants/info_contracts/legal_entities/legal_entities_en.cfm
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/contracts_grants/info_contracts/financial_id/financial_id_en.cfm

FORM A.4 – POWER OF ATTORNEY1
(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-18-T01 (the Contract) to Company 1, Company 2, …, Company N (the Group Members), based on the joint offer submitted by them on [to be completed] for the provision of Production and delivery of customised promotional materials the Supplies, 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 services.
2.	To this effect, the Group Members designate Company [to be completed] as Group Leader2.
3.	Payments by the European Union Agency for Fundamental Rights related to the Supplies shall be made through the Group Leader’s bank account.
4.	The Group Members grant to the Group Leader all the necessary powers to act on their behalf in connection with the supplies. 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 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 to be provided under the Contract. It shall co-ordinate the provision of 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 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	……………………………………………………

______________________
1 To be submitted in case of a joint offer. Each consortium partner must fill and sign the document.
2 The group leader has to be one of the Group Members.

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-18-T01
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:	……………………………………………
PART B & C – EXCLUSION CRITERIA AND SELECTION CRITERIA

AMENDED
FORM B.1 - DECLARATION ON HONOUR ON EXCLUSION CRITERIA AND SELECTION CRITERIA
The undersigned [insert name of the signatory of this form], representing:
(only for natural persons) himself or herself	(only for legal persons) the following legal person:	
ID or passport number: 

(‘the person’)	Full official name:
Official legal form: 
Statutory registration number: 
Full official address: 
VAT registration number: 

(‘the person’)	

1.	declares whether the above-mentioned person is in one of the following situations or not:	
Situation of exclusion concerning the person	YES	NO	
a)	it is bankrupt, subject to insolvency or winding up procedures, its assets are being administered by a liquidator or by a court, it is in an arrangement with creditors, its business activities are suspended or it is in any analogous situation arising from a similar procedure provided for under national legislation or regulations;			
b)	it has been established by a final judgement or a final administrative decision that the person is in breach of its obligations relating to the payment of taxes or social security contributions in accordance with the applicable law			
c)	it has been established by a final judgement or a final administrative decision that the person is guilty of grave professional misconduct by having violated applicable laws or regulations or ethical standards of the profession to which the person belongs, or by having engaged in any wrongful conduct which has an impact on its professional credibity where such conduct denotes wrongful intent or gross negligence, including, in particular, any of the following:		
i)	fraudulently or negligently misrepresenting information required for the verification of the absence of grounds for exclusion or the fulfilment of selection criteria or in the performance of a contract or an agreement;			
ii)	entering into agreement with other persons with the aim of distorting competition;			
iii)	violating intellectual property rights			
iv)	attempting to influence the decision-making process of the contracting authority during the award procedure			
v)	attempting to obtain confidential information that may confer upon it undue advantages in the award procedure			
d)	(d)	it has been established by a final judgement that the person is guilty of the following:		
i)	fraud, within the meaning of Article 3 of Directive (EU) 2017/1371 and Article 1 of the Convention on the protection of the European Communities' financial interests, drawn up by the Council Act of 26 July 1995			
ii)	corruption, as defined in Article 4(2) of Directive (EU) 2017/1371 and Article 3 of the Convention on the fight against corruption involving officials of the European Communities or officials of Member States of the European Union, drawn up by the Council Act of 26 May 1997, and conduct referred to in Article 2(1) of Council Framework Decision 2003/568/JHA, as well as corruption as defined in the applicable law			
iii)	conduct related to a criminal organisation, as referred to in Article 2 of Council Framework Decision 2008/841/JHA			
iv)	money laundering or terrorist financing, within the meaning of Article 1(3), (4) and (5) of Directive (EU) 2015/849 of the European Parliament and of the Council;			
v)	terrorist-related offences or offences linked to terrorist activities, as defined in Articles 1 and 3 of Council Framework Decision 2002/475/JHA, respectively, or inciting, aiding, abetting or attempting to commit such offences, as referred to in Article 4 of that Decision			
vi)	child labour or other offences concerning trafficking in human beings as referred to in Article 2 of Directive 2011/36/EU of the European Parliament and of the Council;			
e)	it has shown significant deficiencies in complying with the main obligations in the performance of a contract or an agreement financed by the Union’s budget, which has led to its early termination or to the application of liquidated damages or other contractual penalties, or which has been discovered following checks, audits or investigations by a contracting authority, the European Anti-Fraud Office (OLAF) or the Court of Auditors			
f)	it has been established by a final judgment or final administrative decision that the person has committed an irregularity within the meaning of Article 1(2) of Council Regulation (EC, Euratom) No 2988/95			
g)	it has been established by a final judgment or final administrative decision that the person has created an entity under a different jurisdiction with the intent to circumvent fiscal, social or any other legal obligations in the jurisdiction of its registered office, central administration or principal place of business.			
h)	(only for legal persons) it has been established by a final judgment or final administrative decision that the person has been created with the intent provided for in point (g).			
i)	for the situations referred to in points (c) to (h) above the person is subject to:
i.	facts established in the context of audits or investigations carried out by the European Public Prosecutor's Office after its establishment, the Court of Auditors, the European Anti-Fraud Office (OLAF) or the internal auditor, or any other check, audit or control performed under the responsibility of an authorising officer of an EU institution, of a European office or of an EU agency or body;
ii.	non-final administrative decisions which may include disciplinary measures taken by the competent supervisory body responsible for the verification of the application of standards of professional ethics;
iii.	 facts referred to in decisions of entities or persons being entrusted with EU budget implementation tasks;
iv.	information transmitted by Member States implementing Union funds;
v.	decisions of the Commission relating to the infringement of Union competition law or of a national competent authority relating to the infringement of Union or national competition law; or
vi.	decisions of exclusion by an authorising officer of an EU institution, of a European office or of an EU agency or body. 			

II – SITUATIONS OF EXCLUSION CONCERNING NATURAL OR LEGAL PERSONS WITH POWER OF REPRESENTATION, DECISION-MAKING OR CONTROL OVER THE LEGAL PERSON AND BENEFICIAL OWNERS
Not applicable to natural persons, Member States and local authorities
2.	The signatory declares that a natural or legal person who is a member of the administrative, management or supervisory body of the above-mentioned legal person, or who has powers of representation, decision or control with regard to the above-mentioned legal person (this covers e.g. company directors, members of management or supervisory bodies, and cases where one natural or legal person holds a majority of shares), or a beneficial owner of the person (as referred to in point 6 of article 3 of Directive (EU) No 2015/849) is in one of the following situations:	YES	NO	N/A	
Situation (c) above (grave professional misconduct)				
Situation (d) above (fraud, corruption or other criminal offence)				
Situation (e) above (significant deficiencies in performance of a contract )				
Situation (f) above (irregularity)				
Situation (g) above (creation of an entity with the intent to circumvent legal obligations)				
Situation (h) above (person created with the intent to circumvent legal obligations)				
III – Situations of exclusion concerning natural or legal persons assuming unlimited liability for the debts of the legal person
3.	declares that a natural or legal person that assumes unlimited liability for the debts of the above-mentioned legal person is in one of the following situations:	YES	NO	N/A	
Situation (a) above (bankruptcy)				
Situation (b) above (breach in payment of taxes or social security contributions)				
IV – Grounds for rejection from this procedure
4.	declares that the above-mentioned person:	YES	NO	
Was previously involved in the preparation of the procurement documents used in this award procedure, where this entailed a breach of the principle of equality of treatment including distortion of competition that cannot be remedied otherwise.			
V – Remedial measures
If the person declares one of the situations of exclusion listed above, it must indicate measures it has taken to remedy the exclusion situation, thus demonstrating its reliability. This may include e.g. technical, organisational and personnel measures to prevent further occurrence, compensation of damage or payment of fines or of any taxes or social security contributions. The relevant documentary evidence which illustrates the remedial measures taken must be provided in annex to this declaration. This does not apply for situations referred in point (d) of this declaration.
VI – Evidence upon request
Upon request and within the time limit set by the contracting authority the person must provide information on natural or legal persons that are members of the administrative, management or supervisory body or that have powers of representation, decision or control, including legal and natural persons within the ownership and control structure and beneficial owners. 
It must also provide the following evidence concerning the person itself and the natural or legal persons on whose capacity the person intends to rely, or a subcontractor and concerning the natural or legal persons which assume unlimited liability for the debts of the person:
For situations described in (a), (c), (d), (f), (g) and (h), production of a recent extract from the judicial record is required or, failing that, an equivalent document recently issued by a judicial or administrative authority in the country of establishment of the person showing that those requirements are satisfied. 
For the situation described in point (b), production of recent certificates 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 person is liable, including for example, VAT, income tax (natural persons only), company tax (legal persons only) and social security contributions. Where any document described above is not issued in the country concerned, it may be replaced by a sworn statement made before a judicial authority or notary or, failing that, a solemn statement made before an administrative authority or a qualified professional body in its country of establishment.
The person is not required to submit the evidence if it has already been submitted for another award procedure of the same contracting authority . The documents must have been issued no more than one year before the date of their request by the contracting authority and must still be valid at that date. 
The signatory declares that the person has already provided the documentary evidence for a previous procedure and confirms that there has been no change in its situation:
Document	Full reference to previous procedure	
Insert as many lines as necessary.		
VII – Selection criteria 
5.	declares that the above-mentioned person complies with the selection criteria applicable to it individually as provided in the tender specifications:	YES	NO	N/A	
(a)	It fulfills the applicable economic and financial criteria indicated in section 20.2.1 of Annex A - Tender Specifications;				
(b)	It fulfills the applicable technical and professional criteria indicated in section 20.2.2 of Annex A - Tender Specifications.				
6.	if the above-mentioned person is the sole tenderer or the leader in case of joint tender, declares that: 	YES	NO	N/A	
(c)	the tenderer, including all members of the group in case of joint tender and including subcontractors if applicable, complies with all the selection criteria for which a consolidated asseessment will be made as provided in the tender specifications.				
VII – Evidence for selection
The signatory declares that the above-mentioned person is able to provide the necessary supporting documents listed in the relevant sections of the tender specifications and which are not available electronically upon request and without delay.
The person is not required to submit the evidence if it has already been submitted for another procurement procedure of the same contracting authority. The documents must have been issued no more than one year before the date of their request by the contracting authority and must still be valid at that date. 
The signatory declares that the person has already provided the documentary evidence for a previous procedure and confirms that there has been no change in its situation: 
Document	Full reference to previous procedure	
Insert as many lines as necessary.		

The above-mentioned person may be subject to rejection from this procedure and to administrative sanctions (exclusion or financial penalty) if any of the declarations or information provided as a condition for participating in this procedure prove to be false.

Full name:………………………………  Date:……………………………

Signature:………………………………  Stamp:…………………………
EVIDENCE FOR SELECTION CRITERIA (ECONOMIC AND FINANCIAL CAPACITY)

FORM C.1 – COPY OF THE PROFIT AND LOSS ACCOUNTS AND BALANCE SHEET
Please attach copy of the profit and loss accounts and balance sheet in accordance with the instructions provided in Annex A – Tender Specifications.

FORM C.2 – 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 (EVIDENCE OF TECHNICAL AND PROFESSIONAL CAPACITY)
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 5 years. Please include one table per project.
The tenderers must accompany the list of principal services or supplies by certificates of satisfactory performance and completion of the services or supplies.
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
Please include in your tender samples of the following items to be requested under the contract:
•	Pen (conference): Chupi ball point pen or equivalent
•	Pen: Parker (jotters style) Ball Point Pen or equivalent including presentation box
•	Lanyards: Colour: white, 20mm, high quality polyester woven fabric, safety breakaway connector, flat fixation for the use with nameplate holders
•	Shopper bags (cotton): +/-38x42cm, at least 105gm, long handled, colour beige (nature)
•	Exhibition bags (paper): +/-35x5x30cm (w,d,h),  holding A4 materials, short handle

Signed (authorised signature) on behalf of the Tenderer
Full name:	……………………………………………
Date:		……………………………………………
Signature:	……………………………………………		Stamp:……………………………………

PART E – MINIMUM REQUIREMENTS

FORM E.1 – MINIMUM REQUIREMENTS
The tenderer declares that it complies with the minimum requirements as specified in Annex A.1 – Technical Specifications, as follows:

Section 14 in Annex A.1 Technical Specifications	Compliance with minimum requirements
(Y/N)	
Contractors shall be able to deliver, as a minimum, all goods listed in the excel Form E.2, meeting the requirements specified therein. 
Please complete the excel Form E.2 attached, as proof of compliance with the minimum technical requirements.		
All goods supplied under the contract must comply with applicable obligations under environmental, social and labour law established by Union law, national law and collective agreements or by the international environmental, social and labour law provisions listed in Annex X to Directive 2014/24/EU, and more specifically, with the international conventions referred to in section 8 of the Technical Specifications.		

Signed (authorised signature) on behalf of the Tenderer
Full name:	……………………………………………
Date:		……………………………………………
Signature:	……………………………………………		Stamp:……………………………………

FORM E.2 – TECHNICAL COMPLIANCE WITH MINIMUM REQUIREMENTS OF THE GOODS TO BE PROVIDED AND DELIVERED UNDER THE CONTRACT

Please complete the enclosed Form E.2 (separate excel file)

Signed (authorised signature) on behalf of the Tenderer
Full name:	……………………………………………
Date:		……………………………………………
Signature:	……………………………………………		Stamp:……………………………………

PART F – FINANCIAL OFFER

FORM F.1 – FINANCIAL OFFER TEMPLATE
Production and delivery of Customised Promotional Materials
F-SU-18-T01
IDENTIFICATION OF THE TENDERER:
Name: 		……………………………………………
Contact person: 	……………………………………………
Address: 		……………………………………………
Phone: 		……………………………………………
Fax: 			……………………………………………
Email: 			……………………………………………

Please present your financial offers in the separate excel table enclosed as Form F.1 – Financial Offer Form and follow the instructions indicated therein to complete it. 
Tenderer’s attention is drawn to the fact that:
-	Any modifications made by the tenderer in the excel files in Form F.1 will render the financial offer unacceptable. Any empty or crossed out price boxes will make the financial offer invalid. 
-	Please make sure that all parts of Form F.1 are dated and signed by an authorised representative of the tenderer. In case of discrepancies between the printed version and the electronic version (excel file), the printed version will prevail.
-	All prices must be quoted in Euro, and, where necessary, using the conversion rates published in the C series of the Official Journal of the European Union on the day when the offer is issued. This information is also available on the website of the European Central Bank at the following URL: http://www.ecb.int/stats/eurofxref/
-	Prices must be inclusive of all costs and expenses, directly and indirectly connected with the services to be provided and including all costs (like overheads, travel and subsistence allowances). 
-	The financial proposal shall exclude all duties, taxes and other charges (including VAT), as FRA is exempt from such charges. According to Articles 3 and 4 of the Protocol on the Privileges and Immunities of the European Communities, the Communities are exempt from all charges, taxes and dues, including value added tax; such charges may not therefore be included in the calculation of the price quoted.  
-	Please include here the link to your online catalogue, if available. 
-	Please enclose printed copies of the catalogues, if available.

Signed (authorised signature) on behalf of the Tenderer
Full name:	……………………………………………
Date:		……………………………………………
Signature:	……………………………………………		Stamp:………………………………………