E.

Financial Information Form

[To be completed by the Bidder and by each member of the Bidder’s JV]

Bidder’s Name: Prezzo Shed Investments Limited

Date: 23-05-2022
JV Member’s Name: [Insert or state “None” if the Bidder is not a Joint Venture]
ICB No.: [201265198_2021_ICB_DGMT_CCE_RT]
Page [Insert] of Insert] pages

Financial Data

Historic information for last available three (3) years1

Type of Financial Information
(amount in Bidder’s home-currency, exchange rate, €-
in [Naira]
equivalent)
[2019] [2020] [2021]
Statement of Financial Position (Information from Balance Sheet)
[Insert value in [Insert value in [Insert value in
Bidder’s home Bidder’s home Bidder’s home
currency] currency] currency]
Total Assets (TA) [Insert exchange [Insert exchange [Insert exchange
rate] rate] rate]
[Insert €-equivalent] [Insert €-equivalent] [Insert €-equivalent]

Total Liabilities (TL)

Total Equity/Net Worth (NW)

Current Assets (CA)

Current Liabilities (CL)

Working Capital (WC)

Information from Income Statement

Total Revenue (TR)

Profits Before Taxes (PBT)

Cash Flow Information

Cash Flow from Operating
Activities

1
[In circumstances where it is of utmost importance that Bidders have a longer company history, this
requirement may be increased to up to five (5) years; if such a longer period is chosen, please amend the
revised number of years throughout this table].
B Medical Systems S.à r.l. 17, op der Hei L - 9809 Hosingen Luxembourg | T +352 9207 311 | F +352 9207 31 300 |
ww w.bmedicalsystems.com | VAT NO. LU 105 180 71 | REG. NO. RC Luxembourg B 91535
 Annual Turnover Data
Year Currency & Amount Exchange €-equivalent
Rate

Average Annual
Turnover2

Financial Documents

The Bidder and its parties shall provide copies of financial statements for the last available
three (3) years pursuant Section I ITB point 11 sub-point (vi)The financial statements shall:

(a) Reflect the financial situation of the Bidder or in case of JV member, and not an
affiliated entity (such as parent company or group member);

(b) Be independently audited or certified in accordance with local legislation;

(c) Be complete, including all notes to the financial statements;

(d) Correspond to accounting periods already completed and audited.

 Attached are copies of financial statements3 for the last available three (3) years
required above and complying with the requirements.

Title of the person signing the Bid [Insert complete title of the person signing the Bid]

Signature of the person named above [Signature of the person named above]

Date signed [Insert date of signing] day of [Insert month] [Insert year]

Title of the person signing the Bid [Insert complete title of the person signing the Bid]

Signature of the person named above [Signature of the person named above]

Date signed [Insert date of signing] day of [Insert month] [Insert year]

2
See Section III, Qualification and Evaluation Criteria, Qualification, Sub-Factor 3.2
3
If the most recent set of financial statements is for a period earlier than 12 months from the date of bid,
the reason for this should be justified.
B Medical Systems S.à r.l. 17, op der Hei L - 9809 Hosingen Luxembourg | T +352 9207 311 | F +352 9207 31 300 |
ww w.bmedicalsystems.com | VAT NO. LU 105 180 71 | REG. NO. RC Luxembourg B 91535