Common use of INFORMATION FORM Clause in Contracts

INFORMATION FORM. [The Tenderer shall fill in this Form in accordance with the instructions indicated below. No alterations to its formatshall be permitted and no substitutions shall be accepted.] Date [insert date (as day, month and year) of Tender submission] ITT No [insert number of Tendering process] Alternative No [insert identification No if this is a Tender for an alternative] 1. Tenderer's Name [insert Xxxxxxxx's legal name] 2. In case of JV, legal name of each member [insert legal name of each member in JV] 3. Tenderer's actual or intended country of registration [insert actual or intended country of registration] 4. Tenderer's year of registration [insert Tenderer's year of registration] 5. Xxxxxxxx's Address in country of registration [insert Tenderer's legal address in country of registration] 6. Xxxxxxxx's Authorized Representative Information Name [insert Authorized Representative's name] Address [insert Authorized Representative's Address] Telephone [insert Authorized Representative's telephone/fax numbers] Email Address [insert Authorized Representative's email address] 7. Attached are copies of original documents of [check the box(es) of the attached original documents] i) Legal and financial autonomy ii) Operation under commercial law iii) Establishing that the Tenderer is not under the supervision of the agency of the Procuring Entity A current tax clearance certificate or tax exemption certificate in case of Kenyan tenderers issued by the KenyaRevenue Authority in accordance with ITT 4.14. 8. Included are the organizational chart, a list of Board of Directors, and the beneficial ownership. TENDER-SECURING DECLARATION FORM [The Bidder shall complete this Form in accordance with the instructions indicated] Date [insert date(as day, month and year) of Tender No [insert number of tendering process] To [insert complete name of 1. I We understand that, according to your conditions, bids must be supported by a Tender-Securing Declaration.

INFORMATION FORM. [The Tenderer shall fill fill in this Form in accordance with the instructions indicated below. No alterations to its formatshall format shall be permitted and no substitutions shall be accepted.] Date [insert date (as day, month and year) of Tender submission] ITT No [insert number of Tendering process] Alternative No [insert identification No if this is a Tender for an alternative] 1. Tenderer's Name Name: [insert XxxxxxxxTenderer's legal name] 2. In case of JV, legal name of each member [insert legal name of each member in JV] 3. Tenderer's actual or intended country of registration [insert actual or intended country of registration] 4. Tenderer's year of registration registration: [insert Tenderer's year of registration] 5. Xxxxxxxx's Address in country of registration [insert Tenderer's legal address in country of registration] 6. Xxxxxxxx's Authorized Representative Information Name Name: [insert Authorized Representative's name] Address Address. [insert Authorized Representative's Address] Telephone [insert Authorized Representative's telephone/fax numbers] Email Address Address: [insert Authorized Representative's email address] 7. Attached are copies of original documents of [check the box(es) of the attached original documents] i) Legal and financial financial autonomy ii) Operation under commercial law iii) Establishing that the Tenderer is not under the supervision of the agency of the Procuring Entity A current tax clearance certificate certificate or tax exemption certificate certificate in case of Kenyan tenderers issued by the KenyaRevenue Kenya Revenue Authority in accordance with ITT 4.14. 8. Included are the organizational chart, a list of Board of Directors, and the beneficial beneficial ownership. TENDER-SECURING DECLARATION FORM [The Bidder shall complete this Form in accordance with the instructions indicated] Date Date: [insert date(as day, month and year) of Tender No Tender No. [insert number of tendering process] To [insert complete name of 1. I We understand that, according to your conditions, bids must be supported by a Tender-Securing Declaration.

INFORMATION FORM. [The Tenderer shall fill in this Form in accordance with the instructions indicated below. No alterations to its formatshall format shall be permitted and no substitutions shall be accepted.] Date [insert date (as day, month and year) of Tender submission] ITT No [insert number of Tendering process] Alternative No [insert identification No if this is a Tender for an alternative] 1. Tenderer's ’s Name [insert Xxxxxxxx's Tenderer’s legal name] 1 For the avoidance of doubt, a party's ineligibility to be awarded a contract shall include, without limitation, (i) applying for pre-qualification, expressing interest in A consultancy, and tendering, either directly or as a nominated sub-contractor, nominated consultant, nominated manufacturer or supplier, or nominated service provider, in respect of such contract, and (ii) entering into an addendum or amendment introducing a material modification to any existing contract. 2. In case of JV, legal name of each member member: [insert legal name of each member in JV] 3. Tenderer's ’s actual or intended country of registration registration: [insert actual or intended country of registration] 4. Tenderer's ’s year of registration registration: [insert Tenderer's ’s year of registration] 5. Xxxxxxxx's Tenderer’s Address in country of registration registration: [insert Tenderer's ’s legal address in country of registration] 6. Xxxxxxxx's ’s Authorized Representative Information Name Name: [insert Authorized Representative's ’s name] Address Address: [insert Authorized Representative's ’s Address] Telephone Telephone: [insert Authorized Representative's ’s telephone/fax numbers] Email Address Address: [insert Authorized Representative's ’s email address] 7. Attached are copies of original documents of [check the box(es) of the attached original documents] i) ] 🞎 Articles of Incorporation (or equivalent documents of constitution or association), and/or documents of registration of the legal entity named above, in accordance with ITT 4.4. 🞎 In case of JV, Form of intent to form JV or JV agreement, in accordance with ITT 4.1. 🞎 Acurrent tax clearance certificate or tax exemption certificate in case of Kenyan tenderers issued by the the Kenya Revenue Authority in accordance with ITT 4.14. 🞎 In case of state-owned enterprise or institution, in accordance with ITT 4.6 documents establishing: Legal and financial autonomy ii) autonomy • Operation under commercial law iii) law • Establishing that the Tenderer is not under the supervision of the agency of the Procuring Entity A current tax clearance certificate or tax exemption certificate in case of Kenyan tenderers issued by the KenyaRevenue Authority in accordance with ITT 4.14. 8. Included 8.Included are the organizational chart, chart and a list of Board of Directors, and the beneficial ownership. TENDER-SECURING DECLARATION FORM [The Bidder shall complete this Form in accordance with the instructions indicated] Date [insert date(as day, month and year) of Tender No [insert number of tendering process] To [insert complete name of 1. I We understand that, according to your conditions, bids must be supported by a Tender-Securing Declaration.

INFORMATION FORM. [The Tenderer shall fill in this Form in accordance with the instructions indicated below. No alterations to its formatshall format shall be permitted and no substitutions shall be accepted.] Date [insert date (as day, month and year) of Tender submission] ITT No [insert number of Tendering process] Alternative No [insert identification No if this is a Tender for an alternative] 1. Tenderer's Name [insert XxxxxxxxTenderer's legal name] 2. In case of JV, legal name of each member [insert legal name of each member in JV] 3. Tenderer's actual or intended country of registration [insert actual or intended country of registration] 4. Tenderer's year of registration [insert Tenderer's year of registration] 5. XxxxxxxxTenderer's Address in country of registration [insert TendererXxxxxxxx's legal address in country of registration] 6. Xxxxxxxx's Authorized Representative Information Name [insert Authorized Representative's name] Address [insert Authorized Representative's Address] Telephone [insert Authorized Representative's telephone/fax numbers] Email Address [insert Authorized Representative's email address] 7. Attached are copies of original documents of [check the box(es) of the attached original documents]] Articles of Incorporation (or equivalent documents of constitution or association), and/ordocuments of registration of the legal entity named above, in accordance with ITT 4.4. In case of JV, Form of intent to form JV or JV agreement, in accordance with ITT 4.1. In case of state-owned enterprise or institution, in accordance with ITT4.6 documents establishing: i) Legal and financial autonomy ii) Operation under commercial law iii) Establishing that the Tenderer is not under the supervision of the agency of the Procuring Entity A current tax clearance certificate or tax exemption certificate in case of Kenyan tenderers issued by the KenyaRevenue Kenya Revenue Authority in accordance with ITT 4.14. 8. Included are the organizational chart, a list of Board of Directors, and the beneficial ownership. TENDER-SECURING DECLARATION FORM [The Bidder shall complete this Form in accordance with the instructions indicated] Date [insert date(as day, month and year) of Tender No [insert number of tendering process] To [insert complete name of 1. I We understand that, according to your conditions, bids must be supported by a Tender-Securing Declaration.

INFORMATION FORM. [The Tenderer shall fill fill in this Form in accordance with the instructions indicated below. No alterations to its formatshall format shall be permitted and no substitutions shall be accepted.] Date [insert date (as day, month and year) of Tender submission] ITT No [insert number of Tendering process] Alternative No [insert identification No if this is a Tender for an alternative] 1. Tenderer's Name Name: [insert XxxxxxxxTenderer's legal name] 2. In case of JV, legal name of each member [insert legal name of each member in JV]member 3. Tenderer's actual or intended country of registration registration: [insert actual or intended country of registration]intended 4. Tenderer's year of registration registration: [insert Tenderer's year of registration] 5. Xxxxxxxx's Address in country of registration [insert Tenderer's legal address in country of registration]address 6. Xxxxxxxx's Authorized Representative Information Name Name: [insert Authorized Representative's name] Address Address. [insert Authorized Representative's Address] Telephone [insert Authorized Representative's telephone/fax numbers] Email Address Address: [insert Authorized Representative's email address] 7. Attached are copies of original documents of [check the box(es) of the attached original documents]Articles of Incorporation (or equivalent documents of constitution or association), and/or documents of registration of the legal entity named above, in accordance with ITT 4.4. In case of JV, Form of intent to form JV or JV agreement, in accordance with ITT 4.1. In case of state-owned enterprise or institution, in accordance with ITT4.6 documents establishing: i) Legal and financial financial autonomy ii) Operation under commercial law iii) Establishing that the Tenderer is not under the supervision of the agency of the Procuring Entity A current tax clearance certificate certificate or tax exemption certificate certificate in case of Kenyan tenderers issued by the KenyaRevenue Kenya Revenue Authority in accordance with ITT 4.14. 8. Included are the organizational chart, a list of Board of Directors, and the beneficial beneficial ownership. TENDER-SECURING DECLARATION FORM [The Bidder shall complete this Form in accordance with the instructions indicated] Date Date: [insert date(as day, month and year) of Tender No Tender No. [insert number of tendering process] To [insert complete name of 1. I We understand that, according to your conditions, bids must be supported by a Tender-Securing Declaration.

INFORMATION FORM. [The Tenderer shall SHALL fill in this Form in accordance with the instructions indicated below. No alterations to its formatshall format shall be permitted and no substitutions shall be accepted.] Date Date: [insert date (as day, month and year) of Tender submission] ITT No No. [insert number of Tendering process] Alternative No No: [insert identification No if this is a Tender for an alternative] 1. Tenderer's Name [insert Xxxxxxxx's legal name] 2. In case of JV, legal name of each member [insert legal name of each member in JV]member 3. Tenderer's actual or intended country of registration registration: [insert actual or intended country of registration]intended 4. Tenderer's year of registration registration: [insert Tenderer's year of registration] 5. Xxxxxxxx's Address in country of registration [insert Tenderer's legal address in country of registration]address 6. Xxxxxxxx's Authorized Representative Information Name [insert Authorized Representative's name] Address Address. [insert Authorized Representative's Address] Telephone [insert Authorized Representative's telephone/fax numbers] Email Address Address: [insert Authorized Representative's email address] 7. Attached are copies of original documents of [check the box(es) of the attached original documents]Articles of Incorporation (or equivalent documents of constitution or association), and/or documents of registration of the legal entity named above, in accordance with ITT 4.4. In case of JV, Form of intent to form JV or JV agreement, in accordance with ITT 4.1. In case of state-owned enterprise or institution, in accordance with ITT4.6 documents establishing: i) Legal and financial autonomy ii) Operation under commercial law iii) Establishing that the Tenderer is not under the supervision of the agency of the Procuring Entity A current tax clearance certificate or tax exemption certificate in case of Kenyan tenderers issued by the KenyaRevenue Kenya Revenue Authority in accordance with ITT 4.14. 8. Included are the organizational chart, a list of Board of Directors, and the beneficial ownership. TENDER-SECURING DECLARATION FORM [The Bidder shall complete this Form in accordance with the instructions indicated] Date [insert date(as day, month and year) of Tender No [insert number of tendering process] To [insert complete name of 1. I We understand that, according to your conditions, bids must be supported by a Tender-Securing Declaration.

INFORMATION FORM. [The Tenderer shall fill in this Form in accordance with the instructions indicated below. No alterations to its formatshall format shall be permitted and no substitutions shall be accepted.] Date Date: [insert date (as day, month and year) of Tender submission] ITT No No. [insert number of Tendering process] Alternative No No: [insert identification No if this is a Tender for an alternative] 1. Tenderer's Name [insert Xxxxxxxx's legal name] 2. In case of JV, legal name of each member [insert legal name of each member in JV] 3. Tenderer's actual or intended country of registration [insert actual or intended country of registration] 4. Tenderer's year of registration [insert Tenderer's year of registration]of 5. XxxxxxxxTenderer's Address in country of registration [insert Tenderer's legal address in country of registration] 6. Xxxxxxxx's Authorized Representative Information Name Name: [insert Authorized Representative's name] Address [insert Authorized Representative's Address] Telephone Telephone: [insert Authorized Representative's telephone/fax numbers] Email Address [insert Authorized Representative's email address] 7. Attached are copies of original documents of of. [check the box(es) of the attached original documents] i) Legal and financial autonomy ii) Operation under commercial law iii) Establishing that the Tenderer is not under the supervision of the agency of the Procuring Entity A current tax clearance certificate or tax exemption certificate in case of Kenyan tenderers issued by the KenyaRevenue Kenya Revenue Authority in accordance with ITT 4.14. 8. Included are the organizational chart, a list of Board of Directors, and the beneficial ownership. TENDER-SECURING DECLARATION FORM [The Bidder shall complete this Form in accordance with the instructions indicated] Date [insert date(as day, month and year) of Tender No [insert number of tendering process] To [insert complete name of 1. I We understand that, according to your conditions, bids must be supported by a Tender-Securing Declaration.OTHER FORMS

INFORMATION FORM. [The Tenderer shall fill in this Form in accordance with the instructions indicated below. No alterations to its formatshall format shall be permitted and no substitutions shall be accepted.] Date [insert date (as day, month and year) of Tender submission] ITT No [insert number of Tendering process] Alternative No [insert identification No if this is a Tender for an alternative] 1. Tenderer's Name [insert Xxxxxxxx's legal name] 2. In case of JV, legal name of each member [insert legal name of each member in JV] 3. Tenderer's actual or intended country of registration [insert actual or intended country of registration] 4. Tenderer's year of registration [insert Tenderer's year of registration] 5. Xxxxxxxx's Address in country of registration [insert Tenderer's legal address in country of registration] 6. Xxxxxxxx's Authorized Representative Information Name [insert Authorized Representative's name] Address [insert Authorized Representative's Address] Telephone [insert Authorized Representative's telephone/fax numbers] Email Address [insert Authorized Representative's email address] 7. Attached are copies of original documents of [check the box(es) of the attached original documents] i) Legal and financial autonomy ii) Operation under commercial law iii) Establishing that the Tenderer is not under the supervision of the agency of the Procuring Entity A current tax clearance certificate or tax exemption certificate in case of Kenyan tenderers issued by the KenyaRevenue Kenya Revenue Authority in accordance with ITT 4.14. 8. Included are the organizational chart, a list of Board of Directors, and the beneficial ownership. TENDER-SECURING DECLARATION FORM [The Bidder shall complete this Form in accordance with the instructions indicated] Date [insert date(as day, month and year) of Tender Tender No [insert number of tendering process] To [insert complete name of 1. I We understand that, according to your conditions, bids must be supported by a Tender-Securing Declaration.