Section III – Bidding Forms

Section II. Bidding Forms

Table of Forms

1. Bid / No Bid Confirmation Form

2. Check-List Form
3. Bidder Information Form
4. Joint Venture Partner Information Form
5. Bid Submission Form
6. Price Schedule Form
7. Technical Specification Form
8. Bid Security (Bank Guarantee) Form
9. Manufacturer’s Authorization Form
10. Performance Statement Form
11. No Adverse Action Confirmation Form
 Section III – Bidding Forms

1. Bid / No Bid Confirmation Form

[Complete this page and return it prior to bid opening if you do not intend to bid]

Date:

To: UN Mine Action Service Email: husseinf@unops.org

UNMISS - Tomping Camp
Hussein Fawaz
From:

Subject: ITB, UNOPS case no.: MAO/ITB/13/006 – Project no. (00086850)

YES, we intend to submit an offer.

NO, we are unable to submit a bid in response to the above mentioned invitation to bid due to the
reason(s) listed below:
() The requested products are not within our range of supply
() We are unable to submit a competitive offer for the requested products at the moment
() The requested products are not available at the moment
() We cannot meet the requested specifications
() We cannot offer the requested type of packing
() The information provided for quotation purposes is insufficient
() Your ITB is too complicated
() Insufficient time is allowed to prepare a quotation
() We cannot meet the delivery requirements
() We cannot adhere to your terms and conditions (please specify: payment terms, request for
performance security, etc)
() We do not export
() Our production capacity is currently full
() We are closed during the holiday season
() We had to give priority to other clients’ requests
() We do not sell directly but through distributors
() We have no after-sales service available
() The person handling the bids is away from the office
() Others (please specify)
() We would like to receive future ITBs for this type of goods
() We don’t want to receive ITBs for this type of goods

If UNOPS has questions to the bidder concerning this NO BID, UNOPS should contact

Mr./Ms._________________, phone/email ________________, who will be able to assist.

 Section III – Bidding Forms

2. Check-List Form
Activity Yes/No/NA Page No in your Bid Remark
Have you duly completed as all the
Bidding Forms provided in Section
II?; i.e.:
- Bid / No bid Confirmation
- Bidder Information
- Joint Venture Partner Information
and associated documents as per
Instructions to Bidders Sub Clause
4.4
- Bid Submission Form
- Price Schedule
- Technical Specification
Compliance Confirmation
(Comparative Data Table)
- Bid Security (in the correct form,
and indicating the correct amount
and correct validity period)
- Manufacturer’ Authorization
- Performance Statement
- No Adverse Action Confirmation
Form

Have you provided the information as

per Instructions to Bidders Clauses:
- 18: Documents establishing the
conformity of the Goods and
Related Services
- 38: Post-qualification of the Bidder
- Financial capability related
documents
- Experience and technical capacity
related documents
 Section III – Bidding Forms

3. Bidder Information Form

1. Expertise of Organization:
Please fill in
Organization structure (e.g. service provider,
wholesaler, trader, manufacturer)
Years of company experience

Areas of expertise of organization

Current Licenses if any, and Permits (with dates,

numbers and expiration dates)
Production Capacity

2. Quality Assurance Certification:

International Quality Management System (QMS)

List of other ISO certificates or equivalent

certificates
Presence and characteristics of in-house quality
control laboratory

3. Expertise of Staff:

Total number of staff

Number of staff involved in similar supply

contracts

4. Client Reference List:

Please provide references such as client details, commercial bank details, etc.
Name of company: Contact person: Telephone: E-mail:
1.
2.

3.

5. Contact details of persons that UNOPS may contact for requests for clarification during bid
evaluation:

Name/Surname

Tel Number (direct)

Email address (direct):

PS: This person must be available during the next two weeks following receipt of bid
 Section III – Bidding Forms

4. Joint Venture Partner Information Form

[The Bidder shall fill in this Form in accordance with the instructions indicated below].
Date: [insert date (as day, month and year) of Bid Submission]
ITB No.: MAO/ITB/13/006

Page ________ of ______ pages

1. Bidder’s Legal Name: [insert Bidder’s legal name]

2. JV’s Party legal name: [insert JV’s Party legal name]

3. JV’s Party Country of Registration: [insert JV’s Party country of registration]

4. JV’s Party Year of Registration: [insert JV’s Part year of registration]

5. JV’s Party Legal Address in Country of Registration: [insert JV’s Party legal address in
country of registration]
6. JV’s Party Authorized Representative Information
Name: [insert name of JV’s Party authorized representative]
Address: [insert address of JV’s Party authorized representative]
Telephone/Fax numbers: [insert telephone/fax numbers of JV’s Party authorized representative]
Email Address: [insert email address of JV’s Party authorized representative]
7. Attached are copies of original documents of: [check the box(es) of the attached original
documents]
 Articles of Incorporation or Registration of firm named in 2, above, in accordance with
Instructions to Bidders Sub-Clauses 4.1 and 4.2.
 JV Agreement, or letter of intent to enter into such an Agreement, signed by the legally
authorized signatories of all the parties
 Section III – Bidding Forms

5. Bid Submission Form

[The Bidder shall fill in this Form in accordance with the instructions indicated No alterations to its format
shall be permitted and no substitutions shall be accepted.]
Date: [insert date (as day, month and year) of Bid Submission]
ITB No.: MAO/ITB/13/006

To: United Nations Office for Project Services,

UN Mine Action Service
Juba, South Sudan

We, the undersigned, declare that:

(a) We have examined and have no reservations to the Bidding Documents, including Amendment No.:
______________[insert the number and issuing date of each Amendment];

(b) We offer to supply in conformity with the Bidding Documents and in accordance with the Delivery
Schedules specified in the Schedule of Requirements the following Goods and Related Services
_______________________ [insert a brief description of the Goods and Related Services];

(c) The total price of our Bid, excluding any discounts offered in item (d) below, is:
______________________________[insert the total bid price in words and figures, indicating the
various amounts and the respective currencies];

(d) The discounts offered and the methodology for their application are:

Discounts. If our bid is accepted, the following discounts shall apply._______ [Specify in detail each
discount offered and the specific item of the Schedule of Requirements to which it applies.]

Methodology of Application of the Discounts. The discounts shall be applied using the following
method:__________ [Specify in detail the method that shall be used to apply the discounts];

(e) Our bid shall be valid for the period of time specified in Instructions to Bidders Sub-Clause 20.1, from
the date fixed for the bid submission deadline in accordance with Instructions to Bidders Sub-Clause
24.1, and it shall remain binding upon us and may be accepted at any time before the expiration of that
period;

(f) If our bid is accepted, we commit to obtain a performance security in accordance with Instructions to
Bidders Clause 44 and GCC Clause 12 for the due performance of the Contract;

(g) We, including any subcontractors or suppliers for any part of the contract, have nationality from
countries________ [insert the nationality of the Bidder, including that of all parties that comprise the
Bidder, if the Bidder is a JV, and the nationality each subcontractor and supplier]

(h) We have no conflict of interest in accordance with Instructions to Bidders Sub-Clause 4.2;

(i) Our firm, its affiliates or subsidiaries—including any subcontractors or suppliers for any part of the
contract—has not been declared ineligible by UNOPS, in accordance with Instructions to Bidders Sub-
Clause 4.3;

(j) We understand that you are not bound to accept the lowest evaluated bid or any other bid that you may
receive.
 Section III – Bidding Forms

Signed:_______________ [insert signature of person whose name and capacity are shown]
In the capacity of _______[insert legal capacity of person signing the Bid Submission Form]

Name:____________ [insert complete name of person signing the Bid Submission Form]

Duly authorized to sign the bid for and on behalf of:_____ [insert complete name of Bidder]

Dated on ____________ day of __________________, _______ [insert date of signing]

 Section III – Bidding Forms

6. Price Schedule Form

The Bidder shall fill in these Price Schedule Forms in accordance with the instructions indicated. The list of
line items in column 1 of the Price Schedules shall coincide with the List of Goods and Related Services
specified by UNOPS in the Schedule of Requirements.
BIDDER’S TOTAL PRICES (Price & Currency to be entered by Bidder):
TOTAL FIRM DAP PRICE (Lot 1)
TOTAL FIRM DAP PRICE (Lot 2)
TOTAL FIRM DAP PRICE (Lot 3)
BIDDER’S PRICES FOR GOODS (Price & Currency to be entered by Bidder):
Lots DESCRIPTION QTY CURRENCY:
UNIT PRICE TOTAL PRICE
DAP DAP

Lot (1) All Terrain Vehicle (ATV) with service kit

1.1 ATV 4x4 Diesel 1
1.2 Service kit 1

Lot (2) Vehicle tyres

2.1 All Terrain tyres, for off road driving 25
2.2 All Terrain tyres, for off road driving 48

Lot (3) Vehicle Spare Parts

A-1: ENGINES: 1HZ
Timing belt (every 100.000 km),
2
Lot 3.1 HZJ78/79
Lot 3.2 Oil filter element, HZJ78/79 75
Lot 3.3 Radiator cap, HZJ78/79 1
Fan and alternator belt (one pair),
6
Lot 3.4 HZJ78/79
Lot 3.5 Thermostat, HZJ78/79 (#) 1
Lot 3.6 Exhaust pipe fixing nut on manifold,
18
HZJ78/79
Lot 3.7 Exhaust pipe fixing bolt on manifold,
18
HZJ78/79
Lot 3.8 Gasket between exhaust pipe and
3
manifold, HZJ78/79
Lot 3.9 Exhaust pipe cushion, HZJ78/79 3
Lot 3.10 Washable dry air cleaner element,
30
HZJ78/79
Lot 3.11 Oil engine sump drain plug, HZJ78/79 2
Lot 3.12 Oil sump drain plug gasket, HZJ78/79 10
 A-2 : ENGINE FUEL GROUP: HZJ 78/79
Lot 3.13 Glow plug (12 Volts), HZJ78/79 18
Fuel filter and separator element,
75
Lot 3.14 HZJ78/79
Lot 3.15 Fuel filter and separator bleed plug,
3
HZJ78/79
Lot 3.16 Fuel filter and separator bleed plug gasket
3
, HZJ78/79
A-3 : TRANSMISSION: HZJ 78/79
Lot 3.17 Clutch disk, HZJ 78/79 2
Lot 3.18 Cover clutch assembly, HZJ 78/79 2
Lot 3.19 Clutch release bearing, HZJ 78/79 2
Lot 3.20 Clutch master cylinder, HZJ 78/79 2
Lot 3.21 Clutch release cylinder, HZJ 78/79 2
Lot 3.22 Rear output propeller shaft setting bolt
48
washer, HZJ 78/79
 Section III – Bidding Forms
Lot 3.23 Front output propeller shaft setting bolt
48
washer, HZJ 78/79
Lot 3.24 Rear output propeller shaft setting bolt nut,
48
HZJ 78/79
Lot 3.25 Front output propeller shaft setting bolt
48
nut, HZJ 78/79
Lot 3.26 Front propeller shaft setting bolt in front
48
axle, HZJ 78/79
Lot 3.27 Rear propeller shaft setting bolt in rear
48
axle, HZJ 78/79
Lot 3.28 Rear propeller shaft universal joint, HZJ
6
78/79
Lot 3.29 Front propeller shaft universal joint, HZJ
6
78/79
Lot 3.30 Nipple (straight), HZJ 78/79 5
Lot 3.31 Nipple (bent), HZJ 78/79 5
Lot 3.32 Drain & filler plug for axles, gear and
10
transfer case, HZJ 78/79
Lot 3.33 Oil drain & filler plug gasket, gear and
300
transfer case
Lot 3.34 Oil drain & filler plug gasket, for Axles Fr
300
& Rr HZJ 78/79
Lot 3.35 Rear drive pignon nut , HZJ 78/79 6
Lot 3.36 Front drive pignon nut, HZJ 78/79 6
Lot 3.37 Differential oil seal, FR HZJ 78/79 6
Lot 3.38 Differential oil seal, RR, HZJ 78/79 6
Lot 3.39 Wheel bolt front & rear, HZJ 78/79 6
Lot 3.40 Wheel nut, HZJ 78/79 6
Lot 3.41 Rear and front hub oil seal, HZJ 78/79 6
Lot 3.42 Front inner wheel bearing (and rear for full
6
floating axle)
Lot 3.43 Front outer wheel bearing (and rear for full
6
floating axle)
Lot 3.44 Front axle drive shaft oil seal, HZJ 78/79 6
Lot 3.45 Rear axle drive shaft oil seal, HZJ 78/79 6
Lot 3.46 Knuckle washer for front wheel bearing
6
adjusting nut
Lot 3.47 Lock washer for front wheel bearing
5
adjusting nut
Lot 3.48 Front and rear washer cone for axle shaft,
10
HZJ 78/79
Lot 3.49 Front & rear axle outer shaft flange gasket,
6
HZJ 78/79
Lot 3.50 Cap front axle outer shaft flange 12
Lot 3.51 Front drive shaft ring, HZJ 78/79 12
Lot 3.52 Front wheel bearing adjusting nut, HZJ
12
78/79
Lot 3.53 Screw, rear axle bearing lock nut, HZJ
24
78/79
A-4: STEERING: HZJ 78/79
Lot 3.54 Steering knukle arm bearing, HZJ 78/79 15
Lot 3.55 Front hub overhaul gasket kit, HZJ 78/79 4
Lot 3.56 Shim, steering knuckle adjust, T: 0,1mm,
15
HZJ 78/79
Lot 3.57 Shim, steering knuckle adjust, T: 0,2mm,
15
HZJ 78/79
Lot 3.58 Shim, steering knuckle adjust, T: 0,5mm,
15
HZJ 78/79
Lot 3.59 Shim, steering knuckle adjust, T: 1 mm,
10
HZJ 78/79
Lot 3.60 Steering damper, HZJ 78/79 3
 Section III – Bidding Forms
A-5 : BRAKE: HZJ 78/79
Lot 3.61 Master cylinder repair kit (front disk
6
brake), HZJ 78/79
Lot 3.62 Front disk brake cylinder repair kit, HZJ
6
78/79
Lot 3.63 Front disk brake pad kit, HZJ 78/79 10
Lot 3.64 Front disk brake, shim kit anti squeak, HZJ
6
78/79
Lot 3.65 Front disk brake fitting kit, HZJ 78/79 6
Lot 3.66 Rear brake cylinder repair kit (front disk
2
brake), HZJ 78/79
Lot 3.67 Front disk brake bleeder plug, HZJ 78/79 6
Lot 3.68 parking brake cable, HZJ 78/79 6
Lot 3.69 Rear brake shoes kit, HZJ 78/79 5
Lot 3.70 Brake shoes HOLD DOWN spring, HZJ
4
78/79
Lot 3.71 Front and rear brake shoes hold down pin,
4
HZJ 78/79
Lot 3.72 Rear brake shoes hold down cup, HZJ
10
78/79
Lot 3.73 Rear brake shoes back TENSION spring
12
(the small one)
Lot 3.74 Countersunk screw for retaining front and
4
rear brake drum/disk
Lot 3.75 Rear drum brake bleeder plug , HZJ 78/79 6
Lot 3.76 Parking brake wire ( inside the rear drum),
2
HZJ 78/79
Lot 3.77 Right rear brake automatic adjusting lever,
3
HZJ 78/79
Lot 3.78 Left rear brake automatic adjusting lever,
3
HZJ 78/79
Lot 3.79 Ajuster assy shoes left, for rear brake drum
3
HZJ 78/79
Lot 3.80 Ajuster assy shoes right, for rear brake
3
drum HZJ 78/79
Lot 3.81 Parking brake hold down ring, HZJ 78/79 12
A-6: SUSPENSION: HZJ 78/79
Lot 3.82 Shock absorber, Front, Toyota HZJ 78/79
30
(one unit)
Lot 3.83 Front shock absorber bushes (one unit) 120
Lot 3.84 Retainer, cushion , N°1, for front shock
30
absorber
Lot 3.85 Retainer, cushion , N°2, for front shock
30
absorber
Lot 3.86 Nut for front shock absorber 30
Lot 3.87 Bush front stabilizer bar, HZJ 78/79 60
Lot 3.88 Cushion front stabilizer bar, HZJ 78/79 12
Lot 3.89 Bolt for cushion front stabilizer bar, HZJ
12
78/79
Lot 3.90 Spacer for cushion front stabilizer bar,
12
HZJ 78/79
Lot 3.91 Nut for cushion front stabilizer bar, HZJ
12
78/79
Lot 3.92 Right & left, front spring bumper, HZJ
12
78/79
Lot 3.93 Bolt for lower arm & rod assy for front
12
lateral control HZJ 78/79
Lot 3.94 Bushes lower arm, HZJ 78/79 12
Lot 3.95 Bolt between lower arm and chassis HZJ
12
78/79
 Section III – Bidding Forms
Lot 3.96 Washer between lower arm and chassis
12
HZJ 78/79
Lot 3.97 Nut between lower arm and chassis HZJ
12
78/79
Lot 3.98 Bolt between lower arm and Front diff
15
cover HZJ 78/79
Lot 3.99 Nut between lower arm and Front diff
15
cover HZJ 78/79
Lot 3.100 Shock absorber, Rear, Toyota HZJ 78
30
Hard Top( one unit)
Lot 3.101 Rear shock absorber bush (one unit) 120
Lot 3.102 Rear shock absorber fixing bolt, HZJ
12
78/79
Lot 3.103 Rear shock absorber washer, HZJ 78/79 12
Lot 3.104 Bush for rear spring shackle N°1, HZJ
60
78/79 (lower)
Lot 3.105 Bush for rear spring shackle N°2, HZJ
60
78/79 (upper)
Lot 3.106 Bush for rear spring pin HZJ78/79 60
Lot 3.107 Rear U-bolt for Hard Top: 8 leaves
12
(length 215 mm)
Lot 3.108 U-bolt nut, HZJ 78/79 4
Lot 3.109 U-bolt washer, HZJ 78/79 4
Lot 3.110 Rear spring center bolt for Hard Top
12
(length 105 mm) HZJ 78
Lot 3.111 Rear spring center bolt nut, HZJ 78/79 12
Lot 3.112 Cushion front stabilizer bar, HZJ 78/79 12
Lot 3.113 Bushes rear stabilizer bar, HZJ 78/79 12
Lot 3.114 Cushion rear stabilizer bar, HZJ 78/79 12
Lot 3.115 Retrainer, Cushion rear stabilizer bar, HZJ
120
78/79 (top & bottom one)
Lot 3.116 Retrainer, Cushion rear stabilizer bar, HZJ
30
78/79 (middle one)
Lot 3.117 Nut, for front stabilizer bar, HZJ 78/79 30
Lot 3.118 Bolt for cushion front stabilizer bar, HZJ
12
78/79
Lot 3.119 Socket for cushion rear stabilizer bar, HZJ
12
78/79
Lot 3.120 Rear spring bumper, HZJ 78/79 3
A-7: ELECTRICITY: HZJ 78/79
Lot 3.121 Head lamp Unit LH, HZJ 78/79 2
Lot 3.122 Head lamp Unit RH, HZJ 78/79 2
Lot 3.123 Right rear combination lamp lens for HT,
2
HZJ 78
Lot 3.124 Left rear combination lamp lens for HT,
2
HZJ 78
A-8: BODY: HZJ 78/79
Lot 3.125 Front hood bumper, HZJ 78/79 2
Lot 3.126 Fuel tank cap, Hard top, HZJ 78 1
Lot 3.127 MIRROR ASSY, OUTER REAR VIEW,
1
RH
Lot 3.128 MIRROR ASSY, OUTER REAR VIEW,
1
LH
Lot 3.129 Weather-strip windshield, HZJ 78/79 3
Lot 3.130 Bumper cushion rear door, (down),HT,
10
HZJ 78/79
Lot 3.131 Bumper cushion rear door, (Up), HT, HZJ
10
78/79
Lot 3.132 Bumper cushion front door, (up and
10
down), PZ/HZJ 78
 Section III – Bidding Forms
BIDDER’S DELIVERY DATA
Country of origin of offered products: Lot 1
Lot 2
Lot 3
Delivery time (DPA from date of order): Lot 1
Lot 2
Lot 3

BIDDER'S SIGNATURE AND CONFIRMATION OF THE ITB

PROVIDED THAT A PURCHASE ORDER IS ISSUED BY UNOPS WITHIN THE REQUIRED BID VALIDITY PERIOD , THE UNDERSIGNED HEREBY
COMMITS, SUBJECT TO THE TERMS OF SUCH PURCHASE ORDER, TO FURNISH ANY OR ALL ITEMS AT THE PRICES OFFERED AND TO
DELIVER SAME TO THE DESIGNATED POINT(S) WITHIN THE DELIVERY TIME STATED ABOVE.

Exact name and address of company

COMPANY NAME
AUTHORIZED SIGNATURE DATE

ADDRESS

NAME OF AUTHORIZED SIGNATORY (TYPE OR PRINT)

PHONE NO. FAX NO. FUNCTIONAL TITLE OF SIGNATORY

EMAIL ADDRESS OF CONTACT PERSON

OTHER EMAIL ADDRESSES WEB SITE

 Section III – Bidding Forms

7. Technical Specification Form

(Comparative Data Table)

Bidders must complete the right column of the table and the compliance confirmation statement as included
in Section III, Schedule of Requirements; Technical Specifications.
 Section III – Bidding Forms

8. Bid Security (Bank Guarantee) Form

- Not required.
 Section III – Bidding Forms

9. Manufacturer’s Authorization Form

Manufacture’s Authorisation is not required
 Section III – Bidding Forms

10. Performance Statement Form

(for the period of the last five years)

Bid no:_________ Date of Opening:_________

Name of the Firm ________________________________

Order placed Order no Description Value of Date of completion of Remarks Was the
by (Full & date & quantity of Order Delivery indicating supplies of
address of ordered items As per Actual reasons of goods
purchaser) Contract late satisfactory
delivery, if
any

Signature and seal of the Bidder

__________________________

Countersigned by and seal of Chartered Accountant ---------------------------------------------

To be attached: Documentary evidence (Client’s certificate) in support of satisfactory completion of above

orders.
 Section III – Bidding Forms

11. No Adverse Action Confirmation Form

This is to certify that [delete unwanted option]:

a. No adverse action has been taken against the Bidder [insert Bidder’s name] and the
manufacturers [insert manufacturer’s name]) whose products are being offered by the
Bidder against this Invitation to Bid, in the last 5 (Five) years.

b. The following instances of previous past performance have resulted in adverse actions taken
against the Bidder [insert Bidder’s name]) and the manufacturers [insert manufacturer’s
name] whose products are being offered by the Bidder, in the last 5 (Five) years. Such
adverse actions included:

(indicate date and reasons for adverse actions and result of adverse actions; i.e. suspension
or cancellation of manufacturing license by regulatory authorities, product recalls,
blacklisting, debarment from bidding etc.)

Signature_____________
Name__________________
Designation with stamp____
Date_______
 Section III – Schedule of Requirements

Section III. Schedule of Requirements

Contents

1. List of Goods and Delivery Schedule

2. Technical Specifications
3. Inspections and Tests
 Section III – Schedule of Requirements

1. List of Goods and Delivery Schedule

Lot Description of Goods Quantity Unit Delivery Schedule from date of

No: Contract
1.1 ATV 4x4 Diesel 1 Each 50 days
1.2 Service kit 1 Each 50 days
2.1 All Terrain tyres, for off road 25 Each 50 days
driving
2.2 All Terrain tyres, for off road 48 Each 50 days
driving
3.1-132 Spare parts See price Each 50 days
schedule
form

Consignee address and Consignee-wise Quantity distribution

Line Consignee Address Quantity Unit

Item/
Lot N

1.1 1 Each
1.2 UN Mine Action Service (UNMAS) 1 Each
2.1 UNMISS Tomping Site, 25 Each
2.2 Juba, Republic of South Sudan 48 Each
3.1-132 See price Each
schedule form
 Section III – Schedule of Requirements

2. Technical Specifications
Comparative Data Table
Bidders must complete the right column of the below table and the compliance confirmation statement:

LOT (1)

Lot No: 1.1 – All Terrain Vehicle (ATV) 4x4 Diesel, Qty. (1)
UNOPS’s minimum Technical Requirements Please fill-in Yes /No
Type: All Wheel Drive (4x4) ATV (mule) 4x4 Diesel, four seats. _____ YES _____ NO
Example: Kawasaki Mule 4010 4X4 Diesel, Polaris Ranger Crew Diesel, John
Deere XUV 855D S4 (2013), or equivalent brands from reputable
manufacturers are acceptable Please specify:
Manufactured 2013 and brand new _____ YES _____ NO
If not, please specify:
Liquid cooled 4 stroke diesel, 3-cylinder OHV, 17.7kW/24PS, 52 N-m. _____ YES _____ NO
953 cc engine capacity _____ YES _____ NO
2 speed automatic plus reverse, 4WD, front LSD, rear dual mode diff. _____ YES _____ NO
To be delivered to Juba at UNMISS Tomping camp, nearby Juba International
Airport
Delivery time: DAP (Maximum 50 days) _____ YES _____ NO
Name of manufacturer: _____ YES _____ NO
Please specify:
Model:
Origin country:

Lot No: 1.2 - Service kit

UNOPS’s minimum Technical Requirements Please fill-in Yes /No
Service kit for ATV 4x4 Diesel for 10 services.
Example: Main Air Filter, Engine Oil Filter, Diesel Fuel filter, Transmission _____ YES _____ NO
Air Filter, etc.
Delivery time: DAP (Maximum 50 days) _____ YES _____ NO
If not, please specify:
Packing, labelling and shipping must be compliant with national and _____ YES _____ NO
international standards and regulations
Name of manufacturer:
Model:
Origin country:

Lot No: 2.1 – All Terrain tyres, for off road driving
UNOPS’s minimum Technical Requirements Please fill-in Yes /No
Example: BF Goodrich All Terrain T/A, Toyo Open Country A/T II, Kumho _____ YES _____ NO
Road Venture AT, or equivalent brands from reputable manufacturers are
Please specify:
acceptable
Tyres comply with Toyota Land Cruiser Prado LJ150 _____ YES _____ NO
High quality tyre made for 4x4 vehicles, produced for driving in off-road _____ YES _____ NO
conditions
Size: 245/70-17 possible model _____ YES _____ NO
Packing, labelling and shipping must be compliant with national and _____ YES _____ NO
international standards and regulations
Ability to deliver to UNMISS camp, with offloading and transporting in the _____ YES _____ NO
final destination, UNMISS Tomping camp, Juba South Sudan
Delivery time: DAP (Maximum 50 days) _____ YES _____ NO

Please specify:
 Section III – Schedule of Requirements
Name of manufacturer:
Model:
Origin country:

Lot No: 2.2 – All Terrain tyres, for off road driving
UNOPS’s minimum Technical Requirements Please fill-in Yes /No
Example: BF Goodrich All Terrain T/A, Toyo Open Country A/T II, Kumho YES _____ NO
Road Venture AT, or equivalent brands from reputable manufacturers are
Please specify:
acceptable
Tyres comply with Ford Ranger 2.2 4WD 2012 _____ YES _____ NO
High quality tyre made for 4x4 vehicles, produced for driving in off-road _____ YES _____ NO
conditions
Size: 255/70/16 possible model _____ YES _____ NO
Packing, labelling and shipping must be compliant with national and _____ YES _____ NO
international standards and regulations
Ability to deliver to UNMISS camp, with offloading and transporting in the _____ YES _____ NO
final destination, UNMISS Tomping camp, Juba South Sudan
Delivery time: DAP (Maximum 50 days) _____ YES _____ NO

Please specify:
Name of manufacturer:
Model:
Origin country:

Lot (3) – Vehicle Spare parts

UNOPS’s minimum Technical Requirements Spare No Please fill-in Yes /No
 _____ YES _____ NO
Genuine Manufacturer spare parts (OEM)  
If not, please advise
Spare parts to comply with Toyota Land Cruiser HZJ78/79 _____ YES _____ NO
Timing belt (every 100.000 km), HZJ78/79 13568-19195 _____ YES _____ NO
Oil filter element, HZJ78/79 90915-30002 _____ YES _____ NO
Radiator cap, HZJ78/79 16401-67150 _____ YES _____ NO
Fan and alternator belt (one pair), HZJ78/79 90916-02452 _____ YES _____ NO
Thermostat, HZJ78/79 (#) 90916-03089 _____ YES _____ NO
Exhaust pipe fixing nut on manifold, HZJ78/79 90179-10070 _____ YES _____ NO
Exhaust pipe fixing bolt on manifold, HZJ78/79 90126-10006 _____ YES _____ NO
Gasket between exhaust pipe and manifold, HZJ78/79 90917-06059 _____ YES _____ NO
Exhaust pipe cushion, HZJ78/79 17567-17020 _____ YES _____ NO
Washable dry air cleaner element, HZJ78/79 ** 17801-61030 _____ YES _____ NO
Oil engine sump drain plug, HZJ78/79 90341-12026 _____ YES _____ NO
Oil sump drain plug gasket, HZJ78/79 90430-12031 _____ YES _____ NO
Glow plug (12 Volts), HZJ78/79 19850-17020 _____ YES _____ NO
Fuel filter and separator element, HZJ78/79 23390-51070 _____ YES _____ NO
Fuel filter and separator bleed plug, HZJ78/79 23388-64470 _____ YES _____ NO
Fuel filter and separator bleed plug gasket , HZJ78/79 23344-54010 _____ YES _____ NO
Clutch disk, HZJ 78/79 31250-60431 _____ YES _____ NO
Cover clutch assembly, HZJ 78/79 31210-36330 _____ YES _____ NO
Clutch release bearing, HZJ 78/79 31230-60201 _____ YES _____ NO
Clutch master cylinder, HZJ 78/79 31420-60050 _____ YES _____ NO
Clutch release cylinder, HZJ 78/79 31470-60290 _____ YES _____ NO
Rear output propeller shaft setting bolt washer, HZJ 78/79 90201-11013 _____ YES _____ NO
Front output propeller shaft setting bolt washer, HZJ 78/79 90560-10101 _____ YES _____ NO
Rear output propeller shaft setting bolt nut, HZJ 78/79 90178-11001 _____ YES _____ NO
 Section III – Schedule of Requirements
Front output propeller shaft setting bolt nut, HZJ 78/79 90178-10006 _____ YES _____ NO
Front propeller shaft setting bolt in front axle, HZJ 78/79 90105-11044 _____ YES _____ NO
Rear propeller shaft setting bolt in rear axle, HZJ 78/79 90105-11044 _____ YES _____ NO
Rear propeller shaft universal joint, HZJ 78/79 04371-36050 _____ YES _____ NO
Front propeller shaft universal joint, HZJ 78/79 04371-60070 _____ YES _____ NO
Nipple (straight), HZJ 78/79 96451-00600 _____ YES _____ NO
Nipple (bent), HZJ 78/79 90416-06004 _____ YES _____ NO
Drain & filler plug for axles, gear and transfer case, HZJ 78/79 90341-18006 _____ YES _____ NO
Oil drain & filler plug gasket, gear and transfer case 90430-18008 _____ YES _____ NO
Oil drain & filler plug gasket, for Axles Fr & Rr HZJ 78/79 12157-10010 _____ YES _____ NO
Rear drive pignon nut , HZJ 78/79 90179-22029 _____ YES _____ NO
Front drive pignon nut, HZJ 78/79 90177-22003 _____ YES _____ NO
Differential oil seal, FR HZJ 78/79 90311-41009 _____ YES _____ NO
Differential oil seal, RR, HZJ 78/79 90311-45028 _____ YES _____ NO
Wheel bolt front & rear, HZJ 78/79 90942-02083 _____ YES _____ NO
Wheel nut, HZJ 78/79 90942-01101 _____ YES _____ NO
Rear and front hub oil seal, HZJ 78/79 90311-62001 _____ YES _____ NO
Front inner wheel bearing (and rear for full floating axle) 90368-49084 _____ YES _____ NO
Front outer wheel bearing (and rear for full floating axle) 90368-45087 _____ YES _____ NO
Front axle drive shaft oil seal, HZJ 78/79 90310-35010 _____ YES _____ NO
Rear axle drive shaft oil seal, HZJ 78/79 90310-36003 _____ YES _____ NO
Knuckle washer for front wheel bearing adjusting nut 90214-42030 _____ YES _____ NO
Lock washer for front wheel bearing adjusting nut 90215-42025 _____ YES _____ NO
Front and rear washer cone for axle shaft, HZJ 78/79 42323-60030 _____ YES _____ NO
Front & rear axle outer shaft flange gasket, HZJ 78/79 43422-60070 _____ YES _____ NO
Cap front axle outer shaft flange 43423-35010 _____ YES _____ NO
Front drive shaft ring, HZJ 78/79 90521-34005 _____ YES _____ NO
Front wheel bearing adjusting nut, HZJ 78/79 43521-60011 _____ YES _____ NO
Screw, rear axle bearing lock nut, HZJ 78/79 42419-60011 _____ YES _____ NO
Steering knuckle arm bearing, HZJ 78/79 90366-20003 _____ YES _____ NO
Front hub overhaul gasket kit, HZJ 78/79 43204-60031 _____ YES _____ NO
Shim, steering knuckle adjust, T: 0,1mm, HZJ 78/79 43236-60020 _____ YES _____ NO
Shim, steering knuckle adjust, T: 0,2mm, HZJ 78/79 43233-60030 _____ YES _____ NO
Shim, steering knuckle adjust, T: 0,5mm, HZJ 78/79 43234-60020 _____ YES _____ NO
Shim, steering knuckle adjust, T: 1 mm, HZJ 78/79 43235-60020 _____ YES _____ NO
Steering damper, HZJ 78/79 45700-69175 _____ YES _____ NO
Master cylinder repair kit (front disk brake), HZJ 78/79 04493-60300 _____ YES _____ NO
Front disk brake cylinder repair kit, HZJ 78/79 04479-60070 _____ YES _____ NO
Front disk brake pad kit, HZJ 78/79 04465-60250 _____ YES _____ NO
Front disk brake, shim kit anti squeak, HZJ 78/79 04945-60030 _____ YES _____ NO
Front disk brake fitting kit, HZJ 78/79 04947-60090 _____ YES _____ NO
Rear brake cylinder repair kit (front disk brake), HZJ 78/79 04906-35130 _____ YES _____ NO
Front disk brake bleeder plug, HZJ 78/79 47547-60030 _____ YES _____ NO
parking brake cable, HZJ 78/79 46410-60840 _____ YES _____ NO
Rear brake shoes kit, HZJ 78/79 04495-60060 _____ YES _____ NO
Brake shoes HOLD DOWN spring, HZJ 78/79 90501-20012 _____ YES _____ NO
Front and rear brake shoes hold down pin, HZJ 78/79 47447-60010 _____ YES _____ NO
Rear brake shoes hold down cup, HZJ 78/79 47449-30020 _____ YES _____ NO
Rear brake shoes back TENSION spring (the small one) 90506-18031 _____ YES _____ NO
 Section III – Schedule of Requirements
Countersunk screw for retaining front and rear brake drum/disk 90113-10003 _____ YES _____ NO
Rear drum brake bleeder plug , HZJ 78/79 47547-60020 _____ YES _____ NO
Parking brake wire ( inside the rear drum), HZJ 78/79 47616-35030 _____ YES _____ NO
Right rear brake automatic adjusting lever, HZJ 78/79 47643-60010 _____ YES _____ NO
Left rear brake automatic adjusting lever, HZJ 78/79 47644-60010 _____ YES _____ NO
Ajuster assy shoes left, for rear brake drum HZJ 78/79 47062-60020 _____ YES _____ NO
Ajuster assy shoes right, for rear brake drum HZJ 78/79 47061-60030 _____ YES _____ NO
Parking brake hold down ring, HZJ 78/79 96160-00500 _____ YES _____ NO
Shock absorber, Front, Toyota HZJ 78/79 (one unit) 48511-69675 _____ YES _____ NO
Front shock absorber bushes (one unit) 90948-01004 _____ YES _____ NO
Retainer, cushion , N°1, for front shock absorber 90948-02141 _____ YES _____ NO
Retainer, cushion , N°2, for front shock absorber 48509-60040 _____ YES _____ NO
Nut for front shock absorber 94184-61200 _____ YES _____ NO
Bush front stabilizer bar, HZJ 78/79 48815-60170 _____ YES _____ NO
Cushion front stabilizer bar, HZJ 78/79 90385-13009 _____ YES _____ NO
Bolt for cushion front stabilizer bar, HZJ 78/79 90119-10765 _____ YES _____ NO
Spacer for cushion front stabilizer bar, HZJ 78/79 90560-10044 _____ YES _____ NO
Nut for cushion front stabilizer bar, HZJ 78/79 94184-01001 _____ YES _____ NO
Right & left, front spring bumper, HZJ 78/79 48304-60110 _____ YES _____ NO
Bolt for lower arm & rod assy for front lateral control HZJ 78/79 90119-16003 _____ YES _____ NO
Bushes lower arm, HZJ 78/79 48061-60050 _____ YES _____ NO
Bolt between lower arm and chassis HZJ 78/79 90105-18006 _____ YES _____ NO
Washer between lower arm and chassis HZJ 78/79 90201-19011 _____ YES _____ NO
Nut between lower arm and chassis HZJ 78/79 90170-18007 _____ YES _____ NO
Bolt between lower arm and Front diff cover HZJ 78/79 90119-16003 _____ YES _____ NO
Nut between lower arm and Front diff cover HZJ 78/79 90179-16015 _____ YES _____ NO
Shock absorber, Rear, Toyota HZJ 78 Hard Top( one unit) 48531-69855 _____ YES _____ NO
Rear shock absorber bush (one unit) 90385-19003 _____ YES _____ NO
Rear shock absorber fixing bolt, HZJ 78/79 90119-12088 _____ YES _____ NO
Rear shock absorber washer, HZJ 78/79 90948-03024 _____ YES _____ NO
Bush for rear spring shackle N°1, HZJ 78/79 (lower) 90385-18021 _____ YES _____ NO
Bush for rear spring shackle N°2, HZJ 78/79 (upper) 90385-18022 _____ YES _____ NO
Bush for rear spring pin HZJ78/79 90389-14056 _____ YES _____ NO
Rear U-bolt for Hard Top: 8 leaves (length 215 mm) 90117-14181 _____ YES _____ NO
U-bolt nut, HZJ 78/79 90179-14023 _____ YES _____ NO
U-bolt washer, HZJ 78/79 90201-15012 _____ YES _____ NO
Rear spring center bolt for Hard Top (length 105 mm) HZJ 78 48247-36200 _____ YES _____ NO
Rear spring center bolt nut, HZJ 78/79 48284-37130 _____ YES _____ NO
Cushion front stabilizer bar, HZJ 78/79 48815-60170 _____ YES _____ NO
Bushes rear stabilizer bar, HZJ 78/79 90385-11021 _____ YES _____ NO
Cushion rear stabilizer bar, HZJ 78/79 48817-30010 _____ YES _____ NO
Retrainer, Cushion rear stabilizer bar, HZJ 78/79 (top & bottom one) 90948-02126 _____ YES _____ NO
Retrainer, Cushion rear stabilizer bar, HZJ 78/79 (middle one) 90948-02127 _____ YES _____ NO
Nut, for front stabilizer bar, HZJ 78/79 90179-08062 _____ YES _____ NO
Bolt for cushion front stabilizer bar, HZJ 78/79 90101-10172 _____ YES _____ NO
Socket for cushion rear stabilizer bar, HZJ 78/79 90560-10275 _____ YES _____ NO
Rear spring bumper, HZJ 78/79 48306-60160 _____ YES _____ NO
Head lamp Unit LH, HZJ 78/79 81170-60C10 _____ YES _____ NO
Head lamp Unit RH, HZJ 78/79 81130-60C40 _____ YES _____ NO
 Section III – Schedule of Requirements
Right rear combination lamp lens for HT, HZJ 78 81551-90K09 _____ YES _____ NO
Left rear combination lamp lens for HT, HZJ 78 81561-90K09 _____ YES _____ NO
Front hood bumper, HZJ 78/79 53382-60011 _____ YES _____ NO
Fuel tank cap, Hard top, HZJ 78 77310-12150 _____ YES _____ NO
MIRROR ASSY, OUTER REAR VIEW, RH 87910-60142 _____ YES _____ NO
MIRROR ASSY, OUTER REAR VIEW, LH 87940-60372 _____ YES _____ NO
Weather-strip windshield, HZJ 78/79 56121-60120 _____ YES _____ NO
Bumper cushion rear door, (down),HT, HZJ 78/79 90541-07023 _____ YES _____ NO
Bumper cushion rear door, (Up), HT, HZJ 78/79 67293-60010 _____ YES _____ NO
Bumper cushion front door, (up and down), PZ/HZJ 78 90541-09006 _____ YES _____ NO
Packing, labelling and shipping must be compliant with national and
international standards and regulations   _____ YES _____ NO

Ability to deliver to UNMISS camp, with offloading and

transporting in the final destination, UNMISS Tomping camp, Juba   _____ YES _____ NO
South Sudan
Delivery time: DAP (Maximum 50 days) _____ YES _____ NO
 
Please specify:
Name of manufacturer:    
Model:    
Origin country:

THE OFFERED PRODUCTS ARE IN ACCORDANCE WITH THE REQUIRED SPECIFICATIONS AND
TECHNICAL REQUIREMENTS:

YES NO

(NOTE TO THE SUPPIERS)

ANY DEVIATIONS MUST BE LISTED BELOW:

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Technical Drawings
- We attach some pictures for the purpose of this truck for easy of reference.
 Section III – Schedule of Requirements

3. Inspections and Tests

The Vendor shall get the Goods inspected in the manufacturer’s works by a competent authority and submit
a test certificate and also a guarantee/warranty certificate that the Goods conform to laid down specifications.

UNOPS or its representative shall inspect and/or test any or all item of the Goods to confirm their conformity
to the Contract, prior to dispatch from the manufacturer’s premises. Such inspection and clearance will not
prejudice the right of the consignee to inspect and test the Goods on receipt at destination.

If the Goods fail to meet the laid down specifications, the supplier shall take immediate steps to remedy the
deficiency or replace the defective Goods to the satisfaction of the Purchaser .
 Section IV – General Conditions for Goods

Section IV. General Conditions for Goods

In the event of an order, the UNOPS General Conditions will apply. The conditions are available at:
http://www.unops.org/english/whatweneed/Pages/Guidelinesforsuppliers.aspx under “Guidelines to suppliers
UNOPS general conditions of contract”. If your company is unable to access the document, please send an
email request to: husseinf@unops.org and the UNOPS General Conditions will be sent to you electronically.
 Section V – Special Conditions of Contract

Section V. Special Conditions of Contract

1.Contract Price (see GCG clause 3):
The prices charged for the Goods supplied and the related Services performed shall not be adjustable.

2.Packaging of the Goods (see GCG clause 4):

The Vendor shall:
Ensure appropriate pilfer-proof export packing. All cases and crates must be wrapped inside with heavy-duty
plastic-lined paper. Each case/crate/carton must be band strapped and able to withstand tough handling.
Skids for truck handling are imperative if the gross weight is more than 30 kg.
 Ensure that the relevant shipment should be prepared according to industry standard export
protection for sea voyage. All tools, spare parts, mirrors, and other easily removable items and
manuals to be enclosed in secure pilfer-proof packaging.
 Ensure that consignment to be marked as indicated in the Contract.
 Ensure that each case/crate/carton must carry a consecutive number, dimensions, volume, and weight
(i.e. Case No. X of Y cases, A x B x C cm, E m3, D kg). Markings must be done with weatherproof
material.
 Each case/crate/carton must carry outside a copy of the packing list describing the contents of the
case/crate/carton. Outside case No. 1 should be attached a full set of invoices covering the actual
delivery. It is preferred that the accompanying papers be made out in the English language
 Ship the Goods in 20 / 40 foot containers,

3.Delivery of Goods (see GCG clause 7):

1. For DAP by air,
Immediately upon shipment a fax or e-mail must be sent to:
 UNMAS at husseinf@unops.org
 Consignee on Hussein Fawaz on husseinf@unops.org
advising: Contract Number, Project No., Number of boxes/crates, Total weight net/gross in kg, Total cubic
meters, ETD airport of shipment, Name of air line, Flight No., ETA to final destination and including a copy
of the invoice & shipping documents.
Details of Shipping and other Documents to be issued and forwarded immediately upon shipment of the
Goods, to the following address:

United Nations Mine Action Service (UNMAS)

UNMISS Tomping Site, Juba - Republic of South Sudan
Tel: +211 9200 111 06, Email. husseinf@unops.org

 Airway bill in the name of Consignee marked “CLEAN ON BOARD” and “FREIGHT PRE-PAID”.
Airway bill must carry the following text under Shipper: “ON BEHALF OF UNOPS”: 1 original &
2 copies
 Invoice in the name of UNOPS: 1 original & 2 certified copies
 Packing List: 2 copies
 Inspection Certificate issued by nominated inspection agency: 1 original & 1 copy
 Manufacturer’s Warranty’s Certificate: 1 original & 1 copy

The above documents shall be received by UNOPS well in advance of the arrival of the Goods and, if
not received, the Supplier will be responsible for any consequent expenses.

4.Inspection of the Goods (see GCG clause 8):

The inspections and tests shall be: at arrival at the destination. The Inspections shall be conducted at:
UNMAS premises, Juba, South Sudan

5.Acceptance of Goods (see GCG clause 9):

For payment purposes the following documents must be sent for DAP by air,
 Section V – Special Conditions of Contract
 Invoice in the name of UNOPS: 1 original & 2 copies
 Packing List: 1 original & 2 copies
 Airway Bill in the name of Consignee: 2 copies
 Inspection Certificate issued by nominated inspection agency: 1 original & 1 copy
 Manufacturer’s Warranty’s Certificate: 1 original & 1 copy
 Mill Test Certificate: 1 original & 1 copy
 Certificate of Origin: 1 original
 Proof of documents delivery to consignee (courier AWB No. or delivery receipt from courier): 1
copy
 Bank information: Bank name & address, account number, account title, ABA/Swift Code, IBAN
No (for European banks only).

IMPORTANT: Any change to the bank details should be notified to UNOPS immediately. Failure to do so
might lead to delay in payment, for which UNOPS will not be held responsible.

Payment will be effected within thirty (30) days of receipt of the above documents by this office, or

Above documents must be sent to:

United Nations Mine Action Service
UNMISS Tomping Site, Juba - Republic of South Sudan
Tel: +211 9200 111 06
Email. husseinf@unops.org, Attn: Hussein Fawaz, Procurement Officer

6.Performance Security (see GCG clause 12):

A Performance Security shall not be required.

7.Warranties (see GCG clause 13):

8.Liquidated Damages (see GCG clause 16):

(ATTACHED IS UNOPS GENERAL CONDITIONS).
 Section VI – Contract Forms

Section VI. Contract Forms

Table of Forms

1. Contract Form
2. Performance Security
3. Bank Guarantee for Advance Payment
4. Long Term Agreement
 Section VI – Contract Forms

1. Contract Form
In the event of a Contract, the successful Bidder shall receive this form duly filled.

Purchase Order No.:   Project No. :

 IMPORTANT: All shipments, invoices and correspondence must show PURCHASE
P.O. DATE :
ORDER and PROJECT NUMBERS.
SHIP BY:        
CONSIGNEE:   VENDOR N : o
     
Attn.:   Attn.:      
Tel.:   Tel.:      
Fax:   Fax:      
DELIVERY TERMS
         
(INCOTERMS 2000):
PAYMENT TERMS:          
UNIT TOTAL
ITEM DESCRIPTION QTY U/M
PRICE PRICE
1
2
 Special Terms and Conditions        
 A. This purchase order is subject to our Invitation to Bid, Ref. No.: XXXXX dated XXXXX and according to your offer
dated ….; B. Notify Party; C. Final Destination; D. Other information, if any:; E: Attachments: General Conditions for
Goods, Packing and Shipping Instructions, others if any.
 CURRENCY : GRAND TOTAL:
Date:
Queries should be addressed to:
Buyer: Name, Title, Tel.
ON BEHALF OF UNOPS:
Name of Procurement Authority, Title, Business Unit
ACKNOWLEDGEMENT COPY:
Vendor's Signature: Date:
UNOPS, Office, Address, Country, Tel, Fax
This Purchase Order may only be accepted by the Vendor's signing and returning the Acknowledgement Copy.
Acceptance of this Purchase Order shall effect a Contract between the Parties under which the rights and obligations of
the Parties shall be governed solely by the Conditions of this Purchase Order, including the General Conditons for
Goods of the United Nations Office for Project Services (UNOPS) and any UNOPS attachments (hereinafter
collectively referred to as "This Contract"). No additional or inconsistent provisions proposed by the Vendor shall bind
UNOPS unless agreed to in writing by a duly authorised official of UNOPS. UNOPS General Conditions for Goods are
available at UNOPS website at http://www.unops.org/english/whatweneed/Pages/Guidelinesforsuppliers.aspx under
General conditions of contract. If your company is unable to access the document, Please send an e-mail or fax request
to: insert e-mail address and fax number of contact person and the UNOPS General Conditions for Goods will be sent
to you electronically or by fax.
 Section VI – Contract Forms

2. Performance Security

- Not required.
 Section VI – Contract Forms

3. Bank Guarantee for Advance Payment

No advance payment shall be made

4. Long term Agreement

 Section VI – Contract Forms

Not applicable