PQQ Document Template

PQQ Document Template

Procuring Organization Name:    Address:

Respondent / Supplier Name:    Registered Address:

Whereas

WHEREAS the Procuring Organization requires prequalification information from potential suppliers in order to evaluate suitability to provide goods and services under future contracts; and

WHEREAS the Respondent has represented that it is willing and able to supply the information requested and to certify the accuracy of such information for the purposes of pre-qualification and potential contracting; and

WHEREAS the Procuring Organization will rely on the responses in this questionnaire as a material element in assessing eligibility to bid for specified opportunities.

Company Information

Private Corporation Public Corporation Partnership Other

Scope of Work

Provide a concise description of the goods, services or works the Respondent is prequalifying to supply.

Experience and References

List up to three relevant projects completed in the last five years. Provide contract value and a client contact for verification.

Insurance & Financial Information

Declarations & Compliance

The Respondent represents and warrants that the information contained in this PQQ is true, accurate and complete. The Respondent acknowledges that intentional misrepresentation may lead to disqualification from procurement processes and may give rise to claims for damages.

No Yes — provide details below

No Yes — provide details below

Payment Terms (for future contract)

Contract Price or Estimated Value:

Late Payment Fee:

Term and Termination

Intended Contract Start Date:    Intended Contract End Date:

Either party may terminate a subsequent contract for material breach if the breach is not remedied within the notice period specified above. Termination for convenience by the Procuring Organization shall require prior written notice in accordance with the notice period.

Confidentiality

All information disclosed in connection with this pre-qualification process that is identified as confidential, or that by its nature would reasonably be considered confidential, shall be held in confidence by the receiving party. The Respondent agrees not to disclose such information to third parties without prior written consent of the Procuring Organization, except as required by law. This obligation shall survive termination of any subsequent contract for a period of three years.

Governing Law

This PQQ and any subsequent contract entered into between the parties shall be governed by and construed in accordance with the laws of:

Entire Agreement

This PQQ, together with any attachments and duly signed supplements, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations, representations or agreements, whether written or oral. Any amendment must be in writing and signed by authorized representatives of both parties.

Certification

The undersigned certifies that to the best of their knowledge the information provided in this PQQ is complete and accurate, and acknowledges that knowingly providing false or misleading information may render the Respondent liable for disqualification and potential legal remedies.

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