IT-APP A-1

APPENDIX A

NOT USED

CONTRACT RD276
 IT-APP B-1

APPENDIX B
LAND TRANSPORT AUTHORITY

DECLARATION OF GST STATUS OF THE TENDERERS FIRM/JOINT VENTURE

Contract RD276

Tenderers Name : _________________________________________________

Address : _________________________________________________

The tenderer hereby declares that as of this tender date the GST (Goods & Services
Tax) Status of the Firm/Joint Venture as follows:-

Confirm GST STATUS YES/NO

Either Taxable under the GST Act

Or Non-taxable under the GST Act

If declared as taxable under the GST Act, the tenderer shall provide the following
details:-

GST Registration No.: ___________________________

___________________ ____________________ __________________

COMPANY STAMP NAME / DESIGNATION SIGNATURE / DATE

CONTRACT RD276
 IT-APP C-1

APPENDIX C

Declaration of Tax-Residency Status of Tenderer (For Individuals)

(i) Name of Person : ________________________________________________

(ii) NRIC No. ( Pink / Blue* ) / Passport No.* :_______________________________

(iii) I confirm that I am / am not* a tax-resident in Singapore for income tax purposes.

(iv) I confirm that I am a Singapore Citizen / Singapore Permanent Resident / Others

(please state nationality)
______________________________ *
(v) For Singapore Permanent Resident / Others Only

I confirm that :
[Please tick the appropriate box(es)]

I have been residing in Singapore since ___________ (month & year) and my
absences from Singapore, if any, is temporary.

I have been / expect to be* physically present in Singapore for 183 days or more
in a single calendar year for :
(a) the past years from ____________ to _____________ ,
(b) the current year _______ , and
(c) the future years from ___________ to ______________.
I have been / expect to be* employed in Singapore for 183 days or more in a
single calendar year for :
(a) the past years from ____________ to _____________ ,
(b) the current year __________ , and
(c) the future years from ___________ to ______________.
(vi) I understand that the above information may be used for all existing and future
contracts that I may have with LTA. I confirm that I shall notify LTA immediately if
there is any change to the above information.

_____________________________________
Name & Signature

Date :

Document to be attached :
Photocopy of NRIC / Passport(particulars page)

CONTRACT RD276
 IT-APP C-2
APPENDIX C
Declaration of Tax-Residency Status of Tenderer
Please fill in the appropriate column.
Note : If Tenderer is a registered joint-venture/consortium, complete one Declaration for the joint-venture/consortium
If Tenderer is a non-registered joint-venture/consortium, each joint-venture/consortium partner shall have to complete one Declaration.

For Companies For Businesses

(i.e. Sole proprietorship/ Partnership)

Name of Company : ____________________________________________ Name of Business : ____________________________________________

Incorporation No. (given by ACRA#) : ________________________________ Registration No. (given by ACRA#) : ________________________________

We confirm that the Company is / is not* a tax-resident in Singapore for We confirm that the Business is / is not* a tax-resident in Singapore for
income tax purposes. income tax purposes.

We confirm that the control and management of the Company is / is not* We confirm that we have / do not have* a branch/office* in Singapore to carry
exercised in Singapore. on the business activities in Singapore.

We understand that the above information may be used for all existing and We understand that the above information may be used for all existing and
future contracts that we may have with LTA. We confirm that we would notify future contracts that we may have with LTA. We confirm that we would notify
LTA immediately if there is any change to the above information LTA immediately if there is any change to the above information

___________________________________ _______________ ___________________________________ _____________

Name & Signature of Authorised Person Company Stamp Name & Signature of Authorised Person Company Stamp

Date : _________________ Date : __________________

Document to be attached : Document to be attached :

Certificate of Incorporation issued by ACRA Certificate of Registration issued by ACRA

#
Company and Businesses Registration No.
* delete as appropriate

CONTRACT RD276
 IT-APP D1-1

APPENDIX D1
LAND TRANSPORT AUTHORITY

SCHEDULE OF CONTRACTS CURRENTLY EXECUTED BY TENDERER

Contract RD276

Tenderers Name : _________________________________________________

Address : _________________________________________________

The tenderer shall furnish hereunder the particulars of all work/services currently
executed by him for the private sector, government and statutory bodies.

Details of Client Total Value

Percentage of Expected
Contracts Reference of
work completed Date of
Executed Address and Consultancy
as at Tender Date Completion
Contact Nos. Contract

I/We hereby confirm that the contracts embodied in the above schedule are the only
projects currently executed by us (if space is insufficient, please continue on separate
sheet).

___________________ ____________________ __________________

COMPANY STAMP NAME / DESIGNATION SIGNATURE / DATE

CONTRACT RD276
 IT-APP D2-1

APPENDIX D2
LAND TRANSPORT AUTHORITY

SCHEDULE OF CONTRACTS PREVIOUSLY EXECUTED BY TENDERER

Contract RD276

Tenderers Name : _________________________________________________

Address : _________________________________________________

The tenderer shall furnish hereunder the particulars of all work/services previously
executed by him for the private sector, government and statutory bodies.

Client Reference
Details of Contracts Total Value of Date of
Address and
Executed Consultancy Completion
Contact Nos.
Contract

I/We hereby confirm that the contracts embodied in the above schedule are the only
projects previously executed by us (if space is insufficient, please continue on
separate sheet).

___________________ ____________________ __________________

COMPANY STAMP NAME / DESIGNATION SIGNATURE / DATE

CONTRACT RD276
IT-APP E-1

APPENDIX E

NOT USED

CONTRACT RD276
 IT-APP F-1

APPENDIX F
LAND TRANSPORT AUTHORITY

DECLARATION OF COMPANYS DIRECTORS / PARTNERSHIP

AND PRINTOUT FROM ACRA WITH THE LIST OF DIRECTORS

Contract RD276

Tenderers Name : _________________________________________________

Address : _________________________________________________

Business Registration No. : ___________________________________________

I hereby certify that as of this date the equity participation of the Companys Director /
Partnership are as follows :

Name of NRIC / % of
S/no Directors / Nationality Passport Appointment Share
Partners No Holding

________________ ___________________ _________________

COMPANY STAMP NAME / DESIGNATION SIGNATURE / DATE

CONTRACT RD276
 IT-APP G-1

APPENDIX G
UNDERTAKING TO SAFEGUARD OFFICIAL INFORMATION
FOR CONTRACT RD276
(TO BE SUBMITTED WITH TENDER SUBMISSIONS)

To: Land Transport Authority of Singapore (the Authority)

1. My attention has been drawn to the Official Secrets Act (Chapter 213, Revised
Edition 2012) and in particular to Section 5 thereof which relates to the
safeguarding of official information.

2. I understand and agree that the information acquired or to be acquired by me in

the course of my participation in/work for the above Contract and/or the tender
therefor, includes official information falling within the ambit of the Official Secrets
Act which is strictly confidential in nature and is not to be published or
communicated by me to any unauthorised person in any form at any time,
without the official sanction of the Authority and even then, strictly on a "need-to-
know" basis and only for participating in/performing the work for the above
Contract and/or the tender therefor.

3. I shall ensure that any other person who is authorised by me to have access to
any official information shall similarly sign an undertaking to safeguard such
official information on the same terms.

4. I undertake to return any document received from the Authority, and any copies
made or reproduced from the whole or any part of such document, whenever
required by the Authority.

5. I further understand and agree that any breach or neglect of this undertaking may
render me liable to prosecution under the Official Secrets Act, in addition to any
other remedies available to the Authority under any cause of action.

_______________________ __________________________
Signature Full Name in BLOCKS

_______________________ __________________________
Designation NRIC/Passport No.

_______________________ __________________________
Name of Company Date

_______________________ __________________________
Signature of Witness Full Name in BLOCKS

_______________________ __________________________
Designation NRIC/Passport No.

_______________________ __________________________
Name of Company Date
CONTRACT RD276
 IT-APP L-1

APPENDIX L

LETTER OF UNDERTAKING FROM PROSPECTIVE PARENT COMPANY

(On corporate guarantor's letterhead)

Date

Land Transport Authority of Singapore

(address)
Attention:

Dear Sir/Madam

CONTRACT RD276
APPOINTMENT OF QUALIFIED PERSON (SUPERVISION) FOR PRPOPOSED
BUS DEPOT AT LOYANG

We, [ name of corporate guarantor ] of [ address ] undertake to

sign execute and deliver a guarantee in the format as shown in Appendix __ of ____
and in accordance with Clause [ ] of the Conditions of Contract in the event that [
name of tenderer ] is awarded Contract _____.

Yours faithfully,

(signature, name of authorised signatory, designation & company stamp)

CONTRACT RD276
 IT-APP N1-1

APPENDIX N1
ORIGINAL
(On Company letterhead)

Date: (dated as per your Form of Tender) Ref No.(Companys)

Land Transport Authority

1 Hampshire Road
Block 2A
Level 1
Singapore 219428

Dear Sir

CONTRACT RD276
APPOINTMENT OF QUALIFIED PERSON (SUPERVISION) FOR PRPOPOSED
BUS DEPOT AT LOYANG

Letter of Certification

I, [name of authorized person], for and on behalf of [name of company] hereby certify
that all copies submitted are identical to and processed from the originals submitted.

Yours faithfully,

[Signature of Authorised Signatory in blue ink]

Name and designation of Authorised Signatory

CONTRACT RD276
 IT-APP N2-1

APPENDIX N2
ORIGINAL

(Companys original letterhead)

Date: (dated as per your Form of Tender)

Land Transport Authority

1 Hampshire Road
Block 2A
Level 1
Singapore 219428

Dear Sir

CONTRACT RD276
APPOINTMENT OF QUALIFIED PERSON (SUPERVISION) FOR PRPOPOSED
BUS DEPOT AT LOYANG

TENDER INVENTORY

Package 1 Financial Proposal (1 Original & XX Copies)

(a) Xxxxxxxxxxxxxxxxxxx
(b) Xxxxxxxxxxxxxxxxxxxxx
(c) Xxxxxxxxxxxxxxxxxxxxxxx (Please list down the main items submitted & list of
CDs as applicable)

Package 2 Quality / Technical Proposal (1 Original & XX Copies)

(a) Xxxxxxxxxxxxxxxxxxx
(b) Xxxxxxxxxxxxxxxxxxx
(c) Xxxxxxxxxxxxxxxxxxx (Please list down the main items submitted & list of CDs
as applicable. For the items on Technical Proposal, the items submitted in
Package 2 should be listed).*

Yours faithfully,

[Signature of Authorised Signatory in blue ink]

Name and designation of Authorised Signatory

*Please refer to Section 6.2 of the Instructions to Tenderers and amend accordingly.

CONTRACT RD276
 IT-APP N3-1
APPENDIX N3
CONTACT DETAILS
CONTRACT RD276
APPOINTMENT OF QUALIFIED PERSON (SUPERVISION) FOR PRPOPOSED BUS
DEPOT AT LOYANG

For correspondence during tender clarification and evaluation, the following are
our contact details:

Name of Tenderer(s)* :

Address :

Facsimile Number :

Contact Person (1) :

Contact Number(s) :

Email Address :

Contact Person (2) :

Contact Number(s) :

Email Address :

Contact Person (3) :

Contact Number(s) :

Email Address :
*please indicate all names of members of JV or consortium as appropriate

__________________________________________________
COMPANY STAMP & AUTHORISED SIGNATORY

CONTRACT RD276