Declarations (Mandatory completion)
Please answer Y (yes) / N (no) in the right-hand column. Where the response is Y provide
additional information separately. This will be forwarded to the Head of Finance or other
independent / impartial senior person within Bloxt Limited for review.
All the questions refer to the company (or its directors or any other person who has powers
of representation, decision or control of the company).
Has the company been convicted of any of the following offences:
Mandatory Grounds
Conspiracy within the meaning of section 1 of the Criminal Law
Act 1977 where that conspiracy relates to participation in a criminal organization
as defined in Article 2(1) of Council Joint Action 98/733/JHA
Corruption within the meaning of section 1 of the Public
Bodies Corrupt Practices Act 1889 or
section 1 of the Prevention of Corruption Act 1906
The Offence of Bribery or Fraud
Where the offence relates to fraud affecting the financial interests of the European
Communities as defined by Article 1 of the Convention relating to the protection of
the financial interests of the European Union, within the meaning of:
the offence of cheating the Revenue
the offence of conspiracy to defraud.
fraud or theft within the meaning of the Theft Act 1968 and the Theft Act 1978
fraudulent trading within the meaning of section 458 of the Companies Act 1985
defrauding the Customs within the meaning of the Customs and Excise Management
Act 1979 and the Value Added Tax Act 1994
an offence in connection with taxation in the European Community within the
meaning of section 71 of the Criminal Justice Act 1993
destroying defacing or concealing of documents or procuring the extension of a
valuable security within the meaning of section 20 of the Theft Act 1968
Money laundering within the meaning of the Money Laundering Regulations 2003
Any other offence within the meaning of Article 45(1) of the
Public Sector Directive.
Discretionary Grounds
Being an individual he is bankrupt or has had a receiving order or administration
order or bankruptcy restrictions order made against him or has made any composition
or arrangement with or for the benefit of his creditors or has made any conveyance
or assignment for the benefit of his creditors or appears unable to pay or to have
no reasonable prospect of being able to pay, a debt within the meaning of section
268 of the Insolvency Act 1986, or article 242 of the Insolvency (Northern Ireland)
Order 1989, or in Scotland has granted a trust deed for creditors or become
otherwise apparently insolvent, or is the subject of a petition presented for
sequestration of his estate, or is the subject of any similar procedure under the
law
Being a partnership constituted under Scots law has granted a trust deed or
become otherwise apparently insolvent, or is the subject of a petition presented for
sequestration of its estate
Being a company or any other entity within the meaning of section 255 of the
Enterprise Act 2002 has passed a resolution or is the subject of an order by the
court for the company's winding up otherwise than for the purpose of bona fide
reconstruction or amalgamation, or has had a receiver, manager or administrator on
behalf of a creditor appointed in respect of the company's business or any part
thereof or is the subject of the above procedures or is the subject of similar
procedures under the law of any other state
Has been convicted of a criminal offence relating to the conduct of their
business or profession
Has committed an act of grave misconduct during their business or
profession
Any other offence within the meaning of Article 45(1) of the Public Sector
Directive.
Has not fulfilled obligations relating to the payment of social security
contributions under the law of any part of the United Kingdom or of the relevant
State in which the Applicant is established
Is guilty of serious misrepresentation in providing any information required by
this document
In relation to procedures for the award of a public services contract, is not
licensed in the relevant State in which he is established or is not a member of an
organization in that relevant State when the law of that relevant State prohibits
the provision of the services to be provided under the contract by a person who is
not so licensed or who is not such a member
Where applicable, it is not registered with the appropriate trade or professional
register(s) of the relevant State where it is established under the conditions laid
down by that State.
The declarations have been reviewed and answered by:
Financial
To enable payment, please complete the information below:
To avoid any delays or queries being incurred.
Please be advised handwritten invoices could cause difficulty in processing. It is preferred
that you submit invoices to us in an electronic format.
Our Rates:
Swi Under 750 - £24.00
GBIS: £22.50
Non-Solid - £12.00