call for service reference: cfs1 - western cape the nurse is prescribing. 6. ... biovac stock order...

VERSION 2: DECEMBER 2012

CALL FOR SERVICE BID NUMBER: WCDOH381/12

CALL FOR THE PROVISION OF HEALTH CARE SERVICES BY PRIVATE SERVICE PROVIDERS OR

NON GOVERNMENTAL ORGANISATIONS SITUATED WITHIN THE METRO DISTRICT

YOU ARE HEREBY INVITED TO SUBMIT YOUR APPLICATION IN RESPONSE TO THIS CALL FOR

SERVICE TO THE DEPARTMENT OF HEALTH: WESTERN CAPE GOVERNMENT

INITIAL CLOSING DATE: 15 JANUARY 2013 CLOSING TIME: 11H00

THE WESTERN CAPE GOVERNMENT HEALTH DEPARTMENT IN CONJUNCTION WITH THE CITY

OF CAPE TOWN, CALL ON PRIVATE HEALTH SERVICE PROVIDERS WITHIN THE METRO

DISTRICT, WITH RELEVANT SKILLS, EXPERIENCE AND FACILITIES TO SUBMIT THEIR

APPLICATIONS TO RENDER FAMILY PLANNING AND/OR IMMUNISATION SERVICES ON

BEHALF OF THE WESTERN CAPE GOVERNMENT.

The successful applicant will be required to complete and sign a written Contract Form

(WCBD 1-4)

APPLICATION DOCUMENTS MAY BE

POSTED TO:

APPLICATION DOCUMENTS MAY BE DEPOSITED

IN THE BID BOX MARKED ‖DEPARTMENT OF

HEALTH‖ SITUATED AT:

Ref: BID NUMBER

PO BOX 2060

CAPE TOWN

8000

The Foyer

Corner of Dorp and Keerom Streets (Entrance

under arches)

Provincial Building, Tower Block

Cape Town

8001

Please note the following important requirements:

1. Bids may be posted or submitted via the Department of Health Bid Box.

2. All bids must be submitted on the official forms as per the Annexures to this

document – (not to be re-typed) and only originally signed documents will be

considered.

3. The following contact details should be attached: Addressed to the Business

Development Unit, Bid number, contact name, contact title, company name,

address, telephone number, cellular number and email.

Please refer all technical/specification enquiries to H Moeng Tel: (021) 713 7669 or R

Mitchell 021 483 2644 / 3362.

Call for Service

Reference: CFS1

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PURPOSE

To enhance the current Primary Health Care network through partnership with the Private

Sector, thereby increasing quality and access to care available to citizens of the Western

Cape.

BACKGROUND

There are multiple historical arrangements that have arisen over the past 15-20 years, in

terms of provision of state stock for family planning methods and vaccines to private

practitioners, the City of Cape Town and non-governmental providers (including NPO’s)

in the Cape Metro. It is intended that all providers who receive state stock will comply

with a uniform policy.

OBJECTIVE

The intent of such a policy(s) is to address the following standard items, amongst others;

1.1 Ordering and supply of stock e.g. inventory, medicines and medical

supplies

1.2 Management of state stock (medicines and medical supplies)

1.3 Management of seconded personnel (as applicable)

1.4 Provision of services (including referrals)

1.5 Monitoring and evaluation of performance of providers

1.6 Adverse Events

1.7 Confidentiality of information

1.8 Risk management

1.9 Copyright and intellectual property rights

1.10 Payment of fees and expenses (where applicable)

1.11 Public Liability & Indemnity Cover

The following highlighted concerns will expressly be addressed in the aforementioned

policy(s);

1.12 Wastage and expired stock: - more strict stock control measures

1.13 Fees: - specify conditions under which fees and/or service fees may be

levied by providers;

1.14 Stricter criteria and clear guidelines for monitoring and evaluation of the

various Providers;

1.15 The introduction of a revised standard contract which comprehensively

addresses the Supply Chain Management requirements for all providers.

1.16 Control, prescribing, dispensing and administering of medicines and

medical supplies required to provide the service.

CRITERIA FOR APPLICATION

In order to be considered, applicants must comply with criteria as per Annexure A to this

document. Applicants will also be subject to a vetting and approval process as well as a

site inspection. Application approval will be based on the district’s need for such a

service among other criteria. The rendering of family planning services is subject to

authorisation in terms of the Nursing Act 33 of 2005, section 56(6).

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Call for Service

Reference: CFS1

BID NUMBER: WCDOH381/12

ANNEXURE A: APPLICATION CRITERIA

Applicants that have submitted complete forms and passed the initial screening evaluation will

be issued with a reference number via post or email. Applications must include the following

documents (including this Annexure A) to be considered for further processing:

Item

no

Description Yes No Comments

1

Applications must be properly received (fully completed and signed)

in a sealed envelope indicating the application name, Bid reference

number and Call for Service reference number

2 Declaration of interest form must be properly received on the

application, properly and fully completed and signed (Annex G)

3 Submission of certified copy/copies of ID documents or passports

4 Certified copy of proof of Registration

5 Certified copy of proof of payment of annual fee for current year –

pharmacy, hospital, etc.

6 Certified copy of relevant permits (Annexure B)

7

Motivational letter (to include estimate of number of patients

currently making use the facility, as well as estimated future patient

demand for baby vaccinations and family planning consultations

respectively.)

8 Section 56(6) authorisation (Nursing Act) or proof that application for

authorisation has been made.

9

Evidence of current competence e.g. CPD activities, proof of

attendance of courses for updates within last 3 years, Family Planning

course, Expanded child immunization programme

10 Copy of the Registration Certificate(s) of organisation

11 A valid original Tax Clearance Certificate issued by the South African

Revenue Service (SARS)

12

Cold Chain:

Is the refrigerator only used for vaccines?

Is a functional continuous electronic monitoring device used to

record temperatures in the fridge and is correctly placed?

Does the fridge have a dedicated plug with a warning notice?

Disclaimer 1. Applications that do not meet the requirements as set out in Annexure A or do not have the

specified supporting documents will not be accepted;

2. The Department may request additional information and conduct such enquiry in order to finalise its

decision in relation to the application;

3. The Department may at its sole discretion decline any application for whatsoever reason/s. The

Department shall however inform applicants in writing thereof provided that the applicant has

passed the initial screening evaluation;

4. Applicants that have not received any correspondence or reference numbers within 30 days may

consider their application to be unsuccessful.

I, _____________________(Full name) ,____________________(Position) hereby certify that the

information, representations and documents attached to this application is true and correct at

the time of completion, and that I am duly authorised to furnish this application on behalf of the

organisation.

_______________________________ (Signature) ___________________________ (Date)

ANNEXURE B: DOCUMENTATION REQUIRED

PRIVATE PROVIDER

DOCUMENTATION REQUIRED

P

ha

rma

cy

lic

en

se

fro

m

ND

OH

Ce

rtific

ate

o

f re

co

rdin

g

of

ph

arm

ac

y w

ith

SA

PC

(20

12

/ 2

01

3)

Pro

of

of

pa

ym

en

t o

f

an

nu

al

fee

s fo

r c

urr

en

t

ye

ar

for

ph

arm

ac

y

(20

13

)

ID

do

c.

of

Re

spo

nsi

ble

Ph

arm

ac

ist

+

pro

of

of

reg

istr

atio

n

/ p

ay

me

nt

of re

g. fe

es

(20

13)

ID o

f p

ers

on

/s r

en

de

rin

g

the

se

rvic

e

Pro

of

of

reg

istr

atio

n

&

pro

of

of

pa

ym

en

t o

f

an

nu

al f

ee

s o

f p

ers

on

/s

ren

de

rin

g t

he

se

rvic

e

Ev

ide

nc

e

of

cu

rre

nt

co

mp

ete

nc

y

e.g

. C

PD

ac

tiv

itie

s,

pro

of

of

att

en

da

nc

e

of

co

urs

es

or

up

da

tes

with

in l

ast

3

ye

ars

Se

ctio

n

22

A(1

5)

pe

rmit

in

term

s o

f th

e

Me

dic

ine

s a

nd

R

ela

ted

Su

bst

an

ce

s A

ct

10

1

of

19

65

Pro

of

of

de

sig

na

tio

n b

y

the

D

G

of

org

an

isa

tio

n

pe

rfo

rmin

g

a

he

alth

serv

ice

(S

ec

t 5

6(6

) o

f

Nu

rsin

g A

ct

33

of 2

00

5

Au

tho

risa

tio

n o

f n

urs

e/s

pro

vid

ing

th

e s

erv

ice

in

term

s o

f Se

c

56(6

) o

f

Nu

rsin

g A

ct

33

of 2

00

5

Dis

pe

nsi

ng

lic

en

se

Pharmacist rendering

immunisation or family planning

service

X X X X X X X

X (if products

above S2 are

supplied)

Nurse rendering an

immunisation service in a

pharmacy (employed)

X X X X X X X

Nurse rendering a family

planning service in a pharmacy

(employed)

X X X X X X X X X

Nurse rendering an

immunization & family planning

service in a pharmacy

X X X X X X X X X

Nurse rendering an

immunisation service in a private

organization

X X X X

Call for Service

Reference: CFS1


R

e

f

e

r

e

n

c

e

:

C

F

S

1


of 30

PRIVATE PROVIDER

DOCUMENTATION REQUIRED

Ph

arm

ac

y

lic

en

se

fro

m

ND

OH

Ce

rtific

ate

o

f re

co

rdin

g

of

ph

arm

ac

y w

ith

SA

PC

(20

12

/ 2

01

3)

Pro

of

of

pa

ym

en

t o

f

an

nu

al

fee

s fo

r c

urr

en

t

ye

ar

for

ph

arm

ac

y

(20

13

)

ID

do

c.

of

Re

spo

nsi

ble

Ph

arm

ac

ist

+

pro

of

of

reg

istr

atio

n

/ p

ay

me

nt

of re

g. fe

es

(20

13)

ID o

f p

ers

on

/s r

en

de

rin

g

the

se

rvic

e

Pro

of

of

reg

istr

atio

n

&

pro

of

of

pa

ym

en

t o

f

an

nu

al f

ee

s o

f p

ers

on

/s

ren

de

rin

g t

he

se

rvic

e

Ev

ide

nc

e

of

cu

rre

nt

co

mp

ete

nc

y

e.g

. C

PD

ac

tiv

itie

s,

pro

of

of

att

en

da

nc

e

of

co

urs

es

or

up

da

tes

with

in l

ast

3

ye

ars

Se

ctio

n

22

A(1

5)

pe

rmit

in

term

s o

f th

e

Me

dic

ine

s a

nd

R

ela

ted

Su

bst

an

ce

s A

ct

10

1

of

19

65

Pro

of

of

de

sig

na

tio

n b

y

the

D

G

of

org

an

isa

tio

n

pe

rfo

rmin

g

a

he

alth

serv

ice

(S

ec

t 5

6(6

) o

f

Nu

rsin

g A

ct

33

of 2

00

5

Au

tho

risa

tio

n o

f n

urs

e/s

pro

vid

ing

th

e s

erv

ice

in

term

s o

f Se

c

56(6

) o

f

Nu

rsin

g A

ct

33

of 2

00

5

Dis

pe

nsi

ng

lic

en

se

Nurse rendering a family

planning service in a private

organization

X X X X X X

Nurse rendering an

immunization & family planning

service in a private organisation

X X X X X X

Nurse rendering immunisation

service in a private hospital (as

part of the hospital ward)

(employed)

X X X X X X X

Medical officer (doctor)

immunization services

X X X

Medical officer (doctor) family

planning services (includes

dispensing of medicines)

X X X X

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NOTES

1. Pharmacists can provide immunization and family planning if they can prove competence. A Section 22A(15) permit will be required if pharmacist

supplies any medicine which falls above S2 (to check latest scheduling of vaccines).

2. If a nurse in a pharmacy is not an employee of the pharmacy, she will be treated the same as a nurse in a private organization.

3. Where a nurse is providing immunization or family planning services in a pharmacy, a Section 22A(15) permit is not required to enable possession of the

medicine as the pharmacy is entitled by law to keep medicine .

4. In cases where a nurse supplies immunization in a private organization, she/he does not require authorization in terms of Section 56(6) as the nurse is not

making a cognitive choice as to what to use but simply following the EPI guidelines. A Section 22A(15) permit is required.

5. In cases where a nurse supplies family planning in a pharmacy or private organization she/he requires authorization in terms of Section 56(6) as in this

case the nurse is prescribing.

6. In cases where organizations need to be designated by the DG of the NDOH as organizations providing a health service in order to provide services on

behalf of the province, the applications for such designation must be submitted to NDOH by the province. NDOH consults with SAPC. Proof must be

provided by the organisation of the medical practitioner who will take responsibility for the actions of the nurses.

7. The designated organization must employ a medical practitioner who will then authorize nurses to prescribe and be responsible for their supervision

(such medical practitioner must not be in the employ of the province).

8. In all cases where a patient leaves a facility with medicine e.g. oral contraceptives supplied by a nurse or medical practitioner a dispensing license is

required.

Call for Service

Reference: CFS1


ANNEXURE C: APPLICATION PROCESS

Application Process

Business

Development

(BDU)

District

committee

(evaluation)

Delegated

Authority

SLA

Private Provider Complete applications together with

supporting documents submitted via Post

Box or Department of Health Bid Box

Initial screening and evaluation

Refer to applicable district committee

Safekeeping of all documents and records

Evaluation panel to scrutinise the

application and supporting documentation

against established criteria

Premises inspection by authorised

personnel using a structured checklist

Recommendation made to District

Manager or Chief Director to approve

Reasons for unsuccessful decision taken to

be communicated to the applicant

SLA to be signed by District Manager or

Chief Director

All parties informed and documentation

updated by information management

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Call for Service

Reference: CFS1


ANNEXURE D: ORDERING PROCESS

Stock Process Flow

RDM

District office

Vaccine Orders

DDV from

Biovac

Delivery to

Private Provider

Private Provider

All Private Providers will be registered as

CMD demanders.

Designated person with appropriate

qualifications must sign responsibility of

orders.

Orders placed by Private Provider

electronically via fax/email using a

standardized DOH order format.

Delegated District / Sub-structure

Pharmacist responsible for confirming,

vetting and capture on RDM

Pharmacist to confirm whether relevant

reporting data has been submitted before

approving order.

The cold chain must be maintained both

during the transportation and storage of

the medicines

Medicines will be delivered directly to the

Private Provider

A delivery note must accompany each

delivery

Family Planning

orders

Stock order

from CMD

De

liv

ery

Pro

ce

ss

Ord

erin

g P

roc

ess

Private provider to confirm receipt of order

as per SOP within 2 business days from the

date of signing delivery note.

Private provider to report discrepancies

within 2 business days from the date of

signing delivery note.

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Call for Service

Reference: CFS1


ANNEXURE E: PRIVATE PROVIDER AUDIT TOOL

Please note this is the rapid monitoring tool once approval has been granted, and is not the initial inspection

tool. This tool is subject to change and merely serves as a guideline. Compliance to Good Pharmacy

Practice (GPP) will also be taken into consideration.

Immunisation practices Yes No Comment Notes for supervisor

Can the immunizer indicate how and when the

Rotavirus vaccine is administered? Also indicate

the maximum age at which the Rotavirus vaccine

can be given?

Given as liquid drops per

mouth at 6 and 14 weeks.

RV cannot be given after

24 weeks of age

Can the immunizer name the injection sites of the

Pentaxim Vaccine?

Intramuscularly in left thigh

at 6,10 & 14 weeks & in the

left arm at 18 months

Is there an emergency tray with at least

Adrenaline, Promethazine and hydrocortisone

injections?

Check that none of the

drugs have expired

Is the emergency procedure displayed in the

immunization room?

Is there a private consultation room appropriate

for the administration of immunisations?

As per minimum standards

in GPP

Are infection control measures observed?* Hand washing between

patients, etc.

Is there a sharps container for the appropriate

disposal of used needles and syringes?

Is the RTHB checked and correctly completed?* Observe

Stock Management* Yes No Comment Notes for supervisor

Is there an up-to-date, completed stock card for

all vaccines, diluents and family planning?

Stock cards must reflect

name of medicine,

expiry date, quantity

received, batch number,

pack size/presentation, min

/ max levels (status of temp

regulatory devices in the

case of vaccines must also

be recorded)

Have any of the following items been out of stock

(check stock cards):

Nur-Isterate

Hepatitis B vaccine

2ml syringes

Pentaxim vaccine

of 30

Does the number of measles vials equal the

number of measles vaccine diluent?

Number of vaccine vials

must be equal to the

number of vaccine diluents

Is stock rotated and FEFO (First Expiry First Out)

principles adhered to.

Note: VVM status must also

be considered

EPI Disease Surveillance Yes No Comment Notes for supervisor

Are there Case Investigation Forms for all 4

conditions (AFP, Measles, NNT, AEFI)?

Cold Chain Management Yes No Comment Notes for supervisor

Are there sufficient cooler boxes and ice bricks?

Are there any vaccines with expired VVMs?* The square must be lighter

than the surrounding circle

Is a contingency plan in place to maintain the

cold chain should current measures fail?

Cooler box:

Are there any frozen icepacks?* Icepacks must not be

frozen solid, but must be

conditioned

Is a functional continuous electronic monitoring

device used to record temperatures in the cooler

box?

Check if this has been

activated and is working

properly. Also check that

temperatures have not

gone below 2 degrees

Celsius

Multi Dose Vial Policy (MDVP): Check the

following*

Measles Vaccine- vial has the opening date and

time printed on the vial

Reconstituted Measles

vaccine must be used

within 6 hours of opening

Td (Diftavax)- vial has opening date printed on

the vial

Opened Td must be used

with 4 weeks of opening

Needles/syringes should not be left inserted in vials

This contrary to MDVP and

must be discarded

immediately

Vaccine Fridge:

Are the fridge temperature records completed

twice daily and appropriate action taken if

temperature excursions occur?

Temperatures must be

plotted twice a day. Check

that temperature

excursions have not

occurred in succession

Is the fridge only used for vaccines? No food, or other drugs

stored in the vaccine fridge

Is a purpose-built fridge is used to store the

vaccines?

Note: Freezer and

refrigerator compartments

must each have separate

external doors and its own

thermostat controls

Is the fridge able to maintain temperature

between 2-8°C?

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Is the fridge large enough to hold 1 month's stock

without crowding?

Vaccines are not stored

against unit walls or coils.

Vaccines are stored in their

original packaging

Is a functional continuous electronic monitoring

device used to record temperatures in the fridge

and is it correctly placed?

Check that the device is

activated and placed near

the vaccines in the middle

of the fridge

Has there been any temperature excursions

recorded in the last 30 days (check logger and

temp records)?

Does the fridge have a dedicated plug with a

warning notice?

Is the layer of ice in the freezer less than 0.5cm?

Have any vaccines frozen in the last month?* Check stock records,

temperature monitors. Also

check for physical signs of

freezing such as wet

packaging, ice around

vials, etc.

Is there any reconstituted Measles vaccine in the

fridge?*

Discard immediately

Human Resources Date Comment Notes for supervisor

State the date of the last EPI course that the

immunizer been on

Contract only valid if

competency training done

in the last 3 years

State the date of the last cold chain training the

immunizer received

Immunizer wears a name badge

Documentation Yes No Comment Notes for supervisor

Is there a copy of the following documents:

The Cold Chain Operations Manual (Sep 2003)

The New Vaccine Guidelines (Oct/Nov 2009)

The Vaccinators Manual (April 2005)

The EPI Disease Surveillance Field Guide (Oct

1998)

National Contraception Policy Guidelines

National Contraception Service Delivery

Guidelines

Reporting document for AEF Contraceptive

method

Medicine Control Procedure

Reports on audits conducted

Certificate in family planning course and updates

Proof of annual registration with regulatory body

and any other documentation required by law to

carry out family planning and immunisation

services

Healthcare professional

and service site

Additional Yes No Comment Notes for supervisor

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Electronic patient record database e.g. Excel or export file

Prices of services and a notice indicating DoH

stock availability is placed in a prominent place

Applicable to the private

sector only

* Only applicable to sites that are already

receiving vaccines

Call for Service: CFS1

ANNEXURE F: APPLICATION FOR THE PROVISION OF HEALTH CARE SERVICES BY PRIVATE

SERVICE PROVIDER OR NON GOVERNMENTAL ORGANISATIONS

SERVICE PROVIDER INFORMATION Notes Taken? Name and Address PLEASE NOTE:

1. A separate form must be completed for each facility / premises from which the service(s) is (are) provided.

2. Approval of applications is subject to proof of documentation, evaluation of need, audit of premises and the

acceptance of the conditions of the service level agreement.

Only applications for the Metro District will be considered with this Call for Service.

The application process for other districts will be communicated in due course.

DATE OF APPLICATION DATE OF RECEIPT (Office use only)

PROVIDER ADDRESS: CONTACT PERSON:

Name of private facility: Contact person:

Name of private practitioner: Telephone:

Physical Address: Fax number:

Postal Address: Email address:

Note: All correspondence (if any) will be via email or post

SERVICESTO BE PROVIDED: (please indicate with an X)

PHC license number (if applicable):

Family planning services

Immunisation services

Geographical area where service/s will be offered:

District Yes/No Suburb/Town District Yes/No Suburb/Town District Yes/

No

Suburb/Town

Metro Overberg West Coast Eden Winelands Karoo Type of service provider: (please indicate with an X) Pharmacist

in private

community

Pharmacy

Registered

Nurse in

private

community

pharmacy

Medical

practitioner

registered

with HPCSA

Private

Hospital

Pharmacy

Registered

Nurse in terms

of Section

22A permit

Other Private

clinic

Doctors

rooms

Specify days of operation &

hours of operation

per weekdays, weekends &

public holidays

(Give full details)

Estimated number of clients to be

serviced on average per month

of 30

PHC license number (if applicable):

PROFESSIONAL DETAILS:

Professional details of person(s) responsible for issuing medicine(s) or medical product(s) :

Please submit certified copies of current registration certificates, permits and licences (as applicable), and proof of good

standing with professional body

Name Qualification Professional Body

E.g. SA Pharmacy Council

Ordering

Dispensing

Provision of

Service

Registration number

Courses attended which render the applicant competent to provide service(s): Note that for current competence course

must have been completed within past 3 years:

Name Name of course Service provider Date of successful completion

If a service is currently being rendered on behalf of WCGH or City of Cape Town, please provide details thereof including:

Type / nature of service, Period of time (months or years) over which service has been offered, Extent of service i.e.

average number of clients per month:

REGISTRATION OF PREMISES:

Pharmacy registration number: (Y Number )

FOR OFFICE USE ONLY:

Sent to District

Sign and date

Received at District

Sign and date

Audit of facility

Sign and date

Outcome of facility audit: attach

copy of report & recommendations

APPROVED / REJECTED

Date of re-audit as applicable Outcome of re-audit of facility as

applicable

Date of approval Date of renewal/reapplication

Demander number

of 30

ANNEXURE G: WCBD FORMS

WCBD 1

of 30

WCBD 2

of 30

TCC 001

of 30

WCBD 4

DECLARATION OF INTERESTS, BIDDERS PAST SCM PRACTICES AND INDEPENDENT BID

DETERMINATION

1. To give effect to the following legislative requirements:

Act No 8 of 2010: Western Cape Procurement (Business Interest of Employees)Act, 2010,

National Treasury Practice Note 4 of 2006: Declaration of Bidders Past SCM Practices-(SBD8),

National Treasury Instruction Note 33 of 2011: Enhancing Compliance Monitoring and

Improving Transparency and Accountability in Supply Chain Management: Declaration of

Interest (SBD4) ,

National Treasury Practice Note 2010: Prohibition of Restrictive practices (SBD9),

Section 4 (1) (b) (iii) of the Competitions Act No. 89 of 1998 as amended together with its

associated regulations,

Act No 12 of 2004: Prevention and Combating of Corrupt Activities and

Regulations pertaining to the tender defaulters register, Paragraph 16A9 of the National

Treasury Regulations and/or any other applicable legislation.

2. Please note that all prospective bidders intending to do business with the Western Cape Provincial

Government must be registered on the Western Cape Supplier Database by 1 April 2012.

3. Definitions

“Bid” includes a price quotation, advertised competitive bid, limited bid or proposal

“Bid rigging (or collusive bidding)‖ occurs when businesses, that would otherwise be expected to

compete, secretly conspire to raise prices or lower the quality of goods and / or services for

purchasers who wish to acquire goods and / or services through a bidding process. Bid rigging is,

therefore, an agreement between competitors

„„business interest‟‟ means —

(a) a right or entitlement to share in profits, revenue or assets of an entity;

(b) a real or personal right in property;

(c) a right to remuneration or any other private gain or benefit, and includes any interest

contemplated in paragraphs (a), (b) or (c) acquired through an intermediary and any

potential interest in terms of any of those paragraphs;

“Consortium or Joint Venture” means an association of persons for the purpose of combining their

expertise, property, capital, efforts, skill and knowledge in an activity for the execution of a

contract;

„„employee‟‟ means a person employed by the Institution, whether permanently or temporarily,

including —

(a) an employee as contemplated in section 8 of the Public Service Act;

(b) a person appointed in terms of section 12A of the Public Service Act;

(c) a person transferred or seconded to the Institution or a provincial public entity in terms of

section 15 of the Public Service Act; and

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(d) an educator as defined in the Employment of Educators Act, 1998 (Act 76 of 1998), and

includes a member of the board or other controlling body of a provincial public entity;

„„entity‟‟ means any —

(a) association of persons, whether or not incorporated or registered in terms of any law,

including a company, corporation, trust, partnership, close corporation, joint venture or

consortium; or

(b) sole proprietorship;

„„entity conducting business with the Institution‟‟ means an entity that contracts or applies or tenders for

the sale, lease or supply of goods or services to the Province

“Family member” means a person’s —

(a) spouse; or

(b) child, parent, brother or sister, whether such a relationship results from birth, marriage or

adoption;

„„intermediary‟‟ means a person through whom an interest is acquired, and includes—

(a) a person to whom is granted or from whom is received a general power of attorney; and

(b) a representative or agent;

―Institution‖ means —

Provincial Government of the Western Cape

“Provincial Government Western Cape (PGWC)” means

(a) the Institution of the Western Cape, and

(b) a provincial public entity;

“RWOPS” means — Remunerative Work Outside the Public Service

„„spouse‟‟ means a person’s —

(a) partner in marriage;

(b) partner in a customary union according to indigenous law; or

(c) partner in a relationship in which the parties live together in a manner resembling a marital

partnership or customary union;

4. Any legal person, including persons employed by the Institution, or their family members, may

make an offer or offers in terms of this invitation to bid. In view of possible allegations of favouritism,

should the resulting bid, or part thereof, be awarded to persons employed by the PG, or to their

family member, it is required that the bidder or his/her authorised representative declare his/her

position in relation to the evaluating/adjudicating authority where the bidder is employed by the

Institution; and/or

5. The bid of any bidder may be disregarded if that bidder or any of its directors have abused the

institution’s supply chain management system; committed fraud or any other improper conduct in

relation to such system; or failed to perform on any previous contract.

6. Section 4 (1) (b) (iii) of the Competition Act No. 89 of 1998, as amended, prohibits an agreement

between, or concerted practice by firms, or a decision by an association of firms, if it is between

parties in a horizontal relationship and if it involves collusive bidding (or bid rigging). Collusive bidding

is a pe se prohibition meaning that it cannot be justified under any grounds.

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7. Communication between partners in a joint venture or consortium will not be construed as collusive

bidding

8. In addition and without prejudice to any other remedy provided to combat any restrictive practices

related to bids and contracts, bids that are suspicious will be reported to the Competition

Commission for investigation and possible imposition of administrative penalties in terms of section 59

of the Competition Act No 89 of 1998 and or may be reported to the National Prosecuting Authority

(NPA) for criminal investigation and or may be restricted from conducting business with the public

sector for a period not exceeding ten (10) years in terms of the Prevention and Combating of

Corrupt Activities Act No 12 of 2004 or any other applicable legislation.

SECTION A: DETAILS OF THE ENTITY

A1. Name of the Entity

A2. Entity registration Number

(where applicable)

A3. Entity Type

A4. Tax Reference Number

A5.Full details of directors, shareholder, member, partner, trustee, sole proprietor or any persons

with a right or entitlement to share in profits, revenue or assets of an entity, of the entity should be

disclosed in the Table A below.

TABLE A

FULL NAME DESIGNATION

(Where a

director is a

shareholder,

both should be

confirmed.)

IDENTITY NUMBER PERSONAL TAX

REFERENCE NO.

PERCENTAGE

INTEREST IN

THE ENTITY

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SECTION B: DECLARATION OF THE BIDDER‟S INTEREST

To disclose relationships between the bidding entity and persons listed in Table A and

any employees of the Institution; and to restrict business interest of Institution employees’

according to section 2 (1) of the Western Cape Procurement (Business Interest of

Employees) Act of 2010, bidding entity must give the following details. An Institution

employee taking remunerative work outside public enterprise should first obtain

necessary approval (RWOP), failure to submit proof of such authority, where applicable,

may result in the disqualification of the bid.

B1. Are any persons listed in Table A employees of the Institution?

(If yes, complete Table B and attached “RWOP”)

NO YES

B2. Are any employees of the entity also employees of the Institution?

(If yes complete Table B and attached “RWOP”)

NO YES

B3.

Are any family members of the persons listed in Table A employees of the

Institution?

(If yes complete Table B)

NO YES

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TABLE B

Details of persons connected with the bidder who are employees of the Institution as defined

should be disclosed in Table B below.

FULL NAME OF

INSTITUTION

EMPLOYEE

IDENTITY

NUMBER

PROVINCIAL

DEPARTMENT/

ENTITY OF

EMPLOYMENT

DESIGNATION /

RELATIONSHIP

TO BIDDER**

INSTITUTION

EMPLOYEE

NO./PERSAL

NO.(Indicate if

not known)

PERCENTAGE

INTEREST

SECTION C: PERFORMANCE MANAGEMENT AND BIDDER‟S PAST SUPPLY CHAIN

MANAGEMENT PRACTICES

To enable the prospective bidder to provide evidence of past and current performance with the

Institution.

C1. Did the entity conduct business with the Institution in the last twelve months?

(If yes complete Table C)

NO YES

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C2. Table C

Complete the below table to the maximum of the last 5 contracts.

NAME OF

CONTRACTOR

PROVINCIAL

DEPARTMENT

OR

PROVINCIAL

ENTITY

TYPE OF SERVICES

OR COMMODITY

CONTRACT /

ORDER NUMBER

PERIOD OF

CONTRACT

VALUE OF

CONTRACT

C3.

Is the entity or its principals listed on the National Database as companies or

persons prohibited from doing business with the public sector?

NO YES

C4.

Is the entity or its principals listed on the National Treasury Register for Tender

Defaulters in terms of section 29 of the Prevention and Combating of

Corrupt Activities Act (No. 12 of 2004)?

(To access this Register enter the National Treasury’s website,

www.treasury.gov.za, click on the icon “Register for Tender Defaulters”

or submit your written request for a hard copy of the Register to

facsimile number (012) 3265445.)

NO YES

C5.

If yes to C3 or C4, were you informed in writing about the listing on the

database of restricted suppliers or Register for Tender Defaulters by National

Treasury?

NO YES

C6.

Was the entity or persons listed in Table A convicted for fraud or corruption

during the past five years in a court of law (including a court outside the

Republic of South Africa)?

NO YES

http://www.treasury.gov.za/

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SECTION D: DULY AUTHORISED REPRESENTATIVE TO DEPOSE TO AFFIDAVIT

The form should be signed by a duly authorised representative of the entity before a

commissioner of oaths.

I, ..…………………………………………………......................................... hereby swear/affirm;

i. that the information disclosed above is true and accurate;

ii. that I understand the content of the document;

iii. the entity undertakes to independently arrive at any offer at any time to the

Institution without any consultation, communication, agreement or

arrangement with any competitor. In addition, that there will be no

consultations, communications, agreements or arrangements with any

competitor regarding the quality, quantity, specifications and conditions or

delivery particulars of the products or services to the Institution.

iv. that the entity or its representative are aware of and undertakes not to disclose

the terms of any bid, formal or informal, directly or indirectly, to any competitor,

prior to the awarding of the contract.

__________________________________

DULY AUTHORISED REPRESENTATIVE’S

SIGNATURE

I certify that before administering the oath/affirmation I asked the deponent the following

questions and wrote down his/her answers in his/her presence:

1.1 Do you know and understand the contents of the declaration?

ANSWER: ……………………

1.2 Do you have any objection to taking the prescribed oath?

ANSWER: ……………………..

1.3 Do you consider the prescribed oath to be binding on your conscience?

ANSWER: …………………….

1.4 Do you want to make an affirmation?

ANSWER: …………………….

2. I certify that the deponent has acknowledged that he/she knows and understands the

contents of this declaration, which was sworn to/affirmed before me and the deponent’s

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signature/thumbprint/mark was place thereon in my presence.

………………………………………………………………………………….

SIGNATURE FULL NAMES

Commissioner of Oaths

Designation (rank) ………………………….ex officio: Republic of South Africa

Date: ………………………………Place ………………………………

Business Address: …………………………………………………………………

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ANNEXURE H: APPLICATION FOR AUTHORISATION|NURSING ACT 33 OF 2005, SECTION 56(6)

First of all it is important to note that although the Act commenced on 16 December 2006, section 56 of the

Act only came into operation on 17 March 2008. Section 56(6) deals with the requirements for nurses, in

various fields to, inter alia, keep, supply and administer medicines.

The relevant parts of section 56(6) of the Act, read as follows:

“(6) Despite the provisions of this Act, the said Medicines and Related Substances Act, 1965, the

Pharmacy Act, 1974 (Act 53 of 1974), and the Health Professions Act, 1974 (Act 56 of 1974), a nurse who is in

the service of-

…

(d) an organisation performing any health service designated by the Director- General after

consultation with the South African Pharmacy Council referred to in section 2 of the Pharmacy Act, 1974,

and who has been authorised by the … the medical practitioner in charge of such organisation, … may in

the course of such service perform with reference to-

…

(iii) the keeping of prescribed medicines and their supply, administering or prescribing on the prescribed

conditions,

any act which the said … medical practitioner … may, after consultation with the Council, determine in

general or in a particular case or in cases of a particular nature, if the services of a medical practitioner or

pharmacist, as the circumstances may require, are not available.”

It follows that the requirements for a nurse in private practice (or organisation as the Act refers to) to keep,

supply, administer or prescribe on prescribed conditions, medicine is as follows:

1. The nurse should be part of an organisation which performs a health service designated by the

Director-General of the National Department of Health, after consultation with the SA Pharmacy

Council;

2. the medical practitioner in charge of the organisation may authorise the nurse to perform any act in

general or in particular, but only after consultation with the Nursing Council; and

3. the nurse may not perform such authorised acts if the services of a medical practitioner or

pharmacist, as the circumstances may require, are available.

Furthermore the steps to obtain Authorisation are as follows:

1. The private party need to apply to the National DG to be recognized as an organization designated

to perform a health service, after consultation with the Pharmacy Council (the DG of the National

Department of Health);

2. The organization(private party) then approve/authorize their own staff to perform the service, only

after consultation with the Nursing Council;

3. The person within the organization who authorizes the staff must be a medical practitioner;

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ANNEXURE I: ADVERTISEMENT

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ANNEXURE J: CAPE TOWN METRO DISTRICT

Please note that this Call for Service only applies to service providers situated within the

Metro District.

call for service reference: cfs1 - western cape the nurse is prescribing. 6. ... biovac stock order...

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