SPD Prequalification Doc Health Sector Goods July 2023

STANDARD PROCUREMENT
DOCUMENT
Prequalification
Document
Health Sector Goods
(Pharmaceuticals, Vaccines and Condoms)
(For use with a Request for Bids process)
July 2023
This document is subject to copyright.
This document may be used and reproduced for non-commercial purposes only. Any commercial
use, including without limitation reselling, charging to access, redistribute, or for derivative
works such as unofficial translations based on this document is not allowed.
i
Revisions
July 2023
A few editorial enhancements have been made.
June 2021
This version includes provisions to ensure that a firm disqualified by the Bank for non-
compliance with SEA/SH obligations is not awarded a contract. A few editorial enhancements
have also been made.
October 2017
This revision dated October 2017 incorporates new provisions on beneficial ownership.
January 2017
In this revision dated January 2017 a few editorial enhancements have been made.
July 2016
This revision dated July 2016 incorporates a number of changes reflecting the Procurement
Regulations for IPF Borrowers, July 2016.
ii
Foreword
The Prequalification Document (PD) for procurement of Health Sector Goods (Pharmaceuticals,
Vaccines and Condoms) shall be used by the Borrower with minimum changes as may be
necessary, and acceptable to the Bank, when a Prequalification process takes place prior to the
bidding process for procurement of Health Sector Goods through Request For Bids (RFB)
procedure in projects that are financed, in whole or in part, by the World Bank.
This Standard Procurement Document (SPD) has been updated to reflect the World Bank’s
Procurement Regulations for IPF Borrowers,(“Procurement Regulations”), July, 2016 as
amended from time to time. This SPD is applicable to the Prequalification of suppliers for Health
Sector Goods funded by IBRD or IDA-financed projects whose Legal Agreement makes
reference to the Procurement Regulations.
Those wishing to submit comments or questions on these documents or to obtain additional

information on procurement under World Bank-financed projects are encouraged to contact:
Chief Procurement Officer

The World Bank
1818 H Street, N.W.
Washington, D.C. 20433 U.S.A.
http://www.worldbank.org
iii
Summary
Specific Procurement Notice - Invitation for Prequalification

The template attached is the Invitation for Prequalification. This is the template to be used by the
Borrower.
Prequalification Document: Procurement of Health Sector Goods

[Insert type of health goods, e.g. Pharmaceuticals, Vaccines and
Condoms]
PART 1 – PREQUALIFICATION PROCEDURES
Section I - Instructions to Applicants (ITA)
This Section provides information to help the Applicants in preparing and

submitting their Applications for Prequalification (“Applications”). Information is
also provided on opening and evaluation of Applications. Section I contains
provisions that are to be used without modification.
Section II - Prequalification Data Sheet (PDS)
This Section includes provisions that are specific to each Prequalification and
supplement Section I, Instructions to Applicants.
Section III - Qualification Criteria and Requirements
This Section specifies the methods, criteria, and requirements to be used to

determine how Applicants shall be prequalified and later invited to bid.
Section IV - Application Forms
This Section includes the Application Submission Form and other forms required to
be submitted with the Application.
Section V - Eligible Countries
This Section contains information regarding eligible countries.

iv
Section VI - Fraud and Corruption
This Section provides the Applicants with the reference to the Bank’s policy in
regard to Fraud and Corruption applicable to the Prequalification process.
PART 2 -- SUPPLY REQUIREMENTS
Section VII - Scope of Supply
This Section includes a summary description, delivery and completion schedules,

and Site and other Data of the Supply of the Health Sector Goods subject of this
Prequalification.
v
Specific Procurement Notice

Template
Invitation for Prequalification

Health Goods
Country: ____________________________________________________________
Name of Project: _____________________________________________________
Contract Title: _______________________________________________________
Loan No./Credit No./Grant No.:_________________________________________
Prequalification Reference No.:[as per the Procurement Plan]__________________
1. The [insert name of Borrower/Beneficiary/Recipient] [has received/has applied for/intends

to apply for] financing from the World Bank toward the cost of the [insert name of project
or grant], and intends to apply part of the proceeds toward payments under the contract 1for
[insert title of contract]2.
2. The [insert name of implementing agency] intends to prequalify suppliers for [insert contract
number and/or name, a brief description of the type(s) of health goods to be provided,
including quantities, location and other information necessary to enable potential Bidders to
decide whether or not to respond to this Prequalification. This information may include the
essential items listed in the Prequalification Document and also any important or
specialized prequalification requirements]. It is expected that the Request for Bids will be
made in [insert month and year].
3. Prequalification will be conducted through the procedures as specified in the World Bank’s
Procurement Regulations for IPF Borrowers - Procurement in Investment Projects
Financing” [insert date of applicable Procurement Regulations edition as per legal
agreement] (“Procurement Regulations”), and is open to all eligible Applicants as defined in
the Procurement Regulations.
1
If Prequalification is being invited for more than one contract, describe each contract and indicate whether
Applications may be made for Prequalification for one or more of the contracts
2
Insert if applicable: “This contract will be jointly financed by [insert name of cofinancing agency]. Procurement
process will be governed by the World Bank’s Procurement Regulations.”
vi
4. Interested eligible Applicants may obtain further information from the [insert name of
agency] at the address below [insert address at end of document] during office hours [insert
office hours if applicable, e.g. 0900 to 1700 hours]. A complete set of Prequalification
Documents in [insert name of language] may be purchased by interested Applicants on the
submission of a written Application to the address below and upon payment of a
nonrefundable fee of [insert amount in local currency] or [insert amount in specified
convertible currency, e.g. US$]. The method of payment will be [insert method of payment].
The document will be sent by [insert delivery procedure].
5. Applications for Prequalification should be submitted in clearly marked envelopes and

delivered to the address below by [insert time] on [insert date]. Electronic Applications will
[will not] be permitted3. Late Applications may be rejected.
[Insert name of office]

[Insert name of officer and title]
[Insert postal address and/or street address, postal code, city and country]
[Insert telephone number, country and city codes]
[Insert facsimile number, country and city codes]
[Insert email address]
[Insert web site address]
3
The delivery procedure is usually airmail for overseas delivery and surface mail or courier for local delivery. If
urgency or security dictates, courier services may be required for overseas delivery. With the agreement of the World
Bank, documents may be distributed by e-mail, downloaded from authorized web site(s) or electronic procurement
system. PQ document (in Read Only form) should be posted on the Purchaser’s web page for inspection by prospective
Applicants.
Prequalification Document
Health Goods
Procurement of:
[Insert type of Goods, e.g. Pharmaceuticals, Vaccines, Condoms]
Invitation for Prequalification No: [insert reference from Procurement Plan]

Project: [insert name of project]
Purchaser: [insert the name of the Purchaser’s agency]
Country: [insert country where Prequalification Document is issued]
Issued on: [insert date when Prequalification Document was issued to Applicants]
(This Prequalification Document is for use with a Request for Bids process)
1
Standard Procurement Document

Table of Contents
PART 1 – Prequalification Procedures........................................................................................3

Section I - Instructions to Applicants..............................................................................................5
Section II - Prequalification Data Sheet (PDS).............................................................................19
Section III - Qualification Criteria and Requirements...................................................................23
Section IV - Application Forms.....................................................................................................33
Section V - Eligible Countries.......................................................................................................48
Section VI - Fraud and Corruption................................................................................................49
PART 2 – Scope of Supply..........................................................................................................51
Section VII - Scope of Supply.......................................................................................................53
Part 1 – Prequalification Procedures 3
PART 1 – Prequalification Procedures

Section I – Instructions to Applicants (ITA)
Section I - Instructions to Applicants

Table of Contents
A. General........................................................................................................................................7
1. Scope of Application........................................................................................................7
2. Source of Funds.................................................................................................................7
3. Fraud and Corruption........................................................................................................7
4. Eligible Applicants............................................................................................................8
5. Eligibility........................................................................................................................10
B. Contents of the Prequalification Document..............................................................................10
6. Sections of Prequalification Document...........................................................................10
7. Clarification of Prequalification Document and Pre-Application Meeting......................11
8. Amendment of Prequalification Document.....................................................................11
9. Cost of Applications........................................................................................................12
10. Language of Application.................................................................................................12
11. Documents Comprising the Application..........................................................................12
12. Application Submission Letter.......................................................................................12
13. Documents Establishing the Eligibility of the Applicant...............................................13
14. Documents Establishing the Qualifications of the Applicant.........................................13
15. Signing of the Application and Number of Copies........................................................13
D. Submission of Applications......................................................................................................13
16. Sealing and Identification of Applications.....................................................................13
17. Deadline for Submission of Applications.......................................................................14
18. Late Applications............................................................................................................14
19. Opening of Applications.................................................................................................14
E. Procedures for Evaluation of Applications...............................................................................14
20. Confidentiality...................................................................................................................14
21. Clarification of Applications..........................................................................................15
22. Responsiveness of Applications.....................................................................................15
23. Margin of Preference.....................................................................................................15
24. Sub-contractors...............................................................................................................15
F. Evaluation of Applications and Prequalification of Applicants................................................15
25. Evaluation of Applications.............................................................................................15
26. Purchaser’s Right to Accept or Reject Applications......................................................16
27. Prequalification of Applicants........................................................................................16
28. Notification of Prequalification......................................................................................16
29. Request for Bids.............................................................................................................16
30. Changes in Qualifications of Applicants........................................................................17
31. Procurement Related Complaint.....................................................................................17
Section I - Instructions to Applicants

A. General
1. Scope of 1.1 In connection with the Invitation for Prequalification indicated in
Application Section II, Prequalification Data Sheet (PDS), the Purchaser, as
defined in the PDS, issues this Prequalification Document
(“Prequalification Document”, “PD”) to prospective applicants
(“Applicants”) interested in submitting applications
(“Applications”) for Prequalification to bid for the of supply Health
Sector Goods and Related Services incidental thereto as specified
in Section VII, Scope of Supply. In case the Health Sector Goods
are to be Bid as individual contracts (i.e. the slice and package
procedure), these are listed in the PDS. The Request for Bids
(RFB), number corresponding to this is also provided in the PDS.
2. Source of Funds 2.1 The Borrower or Recipient (hereinafter called “Borrower”)
indicated in the PDS has applied for or received financing
(hereinafter called “funds”) from the International Bank for
Reconstruction and Development or the International Development
Association (hereinafter called “the Bank”) towards the cost of the
project named in the PDS. The Borrower intends to apply a portion
of the funds to eligible payments under the contract(s) resulting
from the bidding for which this Prequalification is conducted.
2.2 Payment by the Bank will be made only at the request of the
Borrower and upon approval by the Bank, and will be subject, in all
respects, to the terms and conditions of the Loan (or other
financing) Agreement. The Loan (or other financing) Agreement
prohibits a withdrawal from the loan (or credit) account for the
purpose of any payment to persons or entities, or for any import of
goods, equipment, plant or materials, or services if such payment
or import, to the knowledge of the Bank, is prohibited by a decision
of the United Nations Security Council taken under Chapter VII of
the Charter of the United Nations. No party other than the Borrower
shall derive any rights from the loan (or other financing) agreement
or have any claim to the proceeds of the loan (or credit).
3. Fraud and 3.1 The Bank requires compliance with the Bank’s Anti-Corruption
Corruption Guidelines and its prevailing sanctions policies and procedures as
set forth in the WBG’s Sanctions Framework, as set forth in
Section VI, Fraud and Corruption.
3.2 In further pursuance of this policy, Applicants shall permit and
shall cause their agents (where declared or not), subcontractors,
subconsultants, service providers, suppliers, and personnel, to
permit the Bank to inspect all accounts, records and other
documents relating to any initial selection process, prequalification
process, bid submission (in case prequalified), proposal
submission, and contract performance (in the case of award), and
to have them audited by auditors appointed by the Bank.

4. Eligible 4.1 Applicants shall meet the eligibility criteria as per ITA 5.1.
Applicants
4.2 An Applicant may be a firm that is a private entity, a state-owned
enterprise (subject to ITA 4.8), or any combination of such entities in
the form of a joint venture (“JV”) under an existing agreement or with
the intent to enter into such an agreement supported by a letter of
intent. In the case of a joint venture, all members shall be jointly and
severally liable for the execution of the entire Contract in
accordance with the Contract terms. The JV shall nominate a
Representative who shall have the authority to conduct all business
for and on behalf of any and all the members of the JV during the
Prequalification process, Bidding (in the event the JV submits a
Bid) and during contract execution (in the event the JV is awarded
the Contract). Unless specified in the PDS, there is no limit on the
number of members in a JV.
4.3 A firm may apply for Prequalification both individually, and as

part of a joint venture, or participate as a subcontractor. If
prequalified, it will not be permitted to bid for the same contract
both as an individual firm and as a part of the joint venture or as a
subcontractor. However, a firm may participate as a subcontractor
in more than one Bid, but only in that capacity. Bids submitted in
violation of this procedure will be rejected.
4.4 A firm and any of its affiliates (that directly or indirectly control, are
controlled by or are under common control with that firm) may
submit its Application for Prequalification either individually, as joint
venture or as a sub-contractor among them for the same contract.
However, if prequalified only one prequalified Applicant will be
allowed to bid for the same contract. All Bids submitted in
violation of this procedure will be rejected.
4.5 An Applicant may have the nationality of any country, subject to the
restrictions pursuant to ITA 5.1. An Applicant shall be deemed to
have the nationality of a country if the Applicant is constituted,
incorporated or registered in and operates in conformity with the
provisions of the laws of that country, as evidenced by its articles of
incorporation (or equivalent documents of constitution or association)
and its registration documents, as the case may be. This criterion also
shall apply to the determination of the nationality of proposed
specialized sub-contractors or suppliers for any part of the Contract
including related Services.
4.6 Applicants shall not have a conflict of interest. Applicants shall be

considered to have a conflict of interest, if they participated as a
Section I – Instructions to Applicants (ITA) 9
consultant in the preparation of the design or technical

specifications or have been hired or proposed to be hired by the
Purchaser or Borrower for contract implementation of the Health
Sector Goods that are the subject of this Prequalification . In
addition, Applicants may be considered to have a conflict of
interest if they have a close business or family relationship with a
professional staff of the Borrower (or of the project implementing
agency, or of a recipient of a part of the loan) who:
(a) are directly or indirectly involved in the preparation of the

Prequalification Document or bidding document or
specifications of the Contract, and/or the Bid evaluation
process of such Contract; or
(b) would be involved in the implementation or supervision of
such Contract, unless the conflict stemming from such
relationship has been resolved in a manner acceptable to the
Bank throughout the Bidding process and execution of the
Contract.
4.7 An Applicant that has been sanctioned by the Bank, pursuant to

the Bank’s Anti-Corruption Guidelines, and in accordance with its
prevailing sanctions policies and procedures as set forth in the
WBG’s Sanctions Framework, as described in Section VI,
paragraph 2.2 d. shall be ineligible to be prequalified for, initially
selected for, bid for, propose for, or be awarded a Bank-financed
contract or benefit from a Bank-financed contract, financially or
otherwise, during such period of time as the Bank shall have
determined. The list of debarred firms and individuals is available
at the electronic address specified in the PDS.
4.8 Applicants that are state-owned enterprises or institutions in the
Purchaser’s Country may be eligible to participate only if they can
establish, in a manner acceptable to the Bank, that they:
(a) are legally and financially autonomous;
(b) operate under commercial law, and
(c) are not under supervision of the Purchaser.
4.9 An Applicant shall not be under suspension from bidding by the

Purchaser as the result of the execution of a Bid/Proposal–Securing
Declaration.
4.10 An Applicant shall provide such documentary evidence of eligibility
satisfactory to the Purchaser, as the Purchaser shall reasonably
request.
4.11 A firm that is under a sanction of debarment by the Borrower from

being awarded a contract is eligible to participate in this
procurement, unless the Bank, at the Borrower’s request, is
satisfied that the debarment:
(a) relates to fraud or corruption; and
(b) followed a judicial or administrative proceeding that afforded
the firm adequate due process.
5. Eligibility 5.1 Firms and individuals may be ineligible if they are nationals of
ineligible countries as indicated in Section V. The countries,
persons or entities are ineligible if:
(a) as a matter of law or official regulations, the Borrower’s
country prohibits commercial relations with that country,
provided that the Bank is satisfied that such exclusion does not
preclude effective competition for the supply of goods or the
contracting of works or services required; or
(b) by an act of compliance with a decision of the United Nations
Security Council taken under Chapter VII of the Charter of the
United Nations, the Borrower’s country prohibits any import of
goods or contracting of works or services from that country, or
any payments to any country, person, or entity in that country.
B. Contents of the Prequalification Document

6. Sections of 6.1 This Prequalification Document consists of Parts 1 and 2 which
Prequalification comprise all the sections indicated below, and which should be read
Document in conjunction with any Addendum issued in accordance with ITA 8.
PART 1 Prequalification Procedures
 Section I - Instructions to Applicants (ITA)

 Section II - Prequalification Data Sheet (PDS)
 Section III - Qualification Criteria and Requirements
 Section IV - Application Forms
 Section V - Eligible Countries
 Section VI - Fraud and Corruption
PART 2 Supply Requirements

 Section VII - Scope of Supply
6.2 Unless obtained directly from the Purchaser, the Purchaser accepts
no responsibility for the completeness of the document, responses to
requests for clarification, the minutes of the pre-Application
meeting (if any), or Addenda to the Prequalification Document in

accordance with ITA 8. In case of any discrepancies, documents
issued directly by the Purchaser shall prevail.
6.3 The Applicant is expected to examine all instructions, forms, and
terms in the Prequalification Document and to furnish with its
Application all information or documentation as is required by the
Prequalification Document.
7. Clarification of 7.1 An Applicant requiring any clarification of the Prequalification
Prequalification Document shall contact the Purchaser in writing at the Purchaser’s
Document and address indicated in the PDS. The Purchaser will respond in writing
Pre-Application to any request for clarification provided that such request is received
Meeting no later than fourteen (14) days prior to the deadline for submission
of the Applications. The Purchaser shall forward a copy of its
response to all prospective Applicants who have obtained the
Prequalification Document directly from the Purchaser, including a
description of the inquiry but without identifying its source. If so
indicated in the PDS, the Purchaser shall also promptly publish its
response at the web page identified in the PDS. Should the
Purchaser deem it necessary to amend the Prequalification Document
as a result of a clarification, it shall do so following the procedure
under ITA 8 and in accordance with the provisions of ITA 17.2.
7.2 If indicated in the PDS, the Applicant’s designated representative is

invited at the Applicant’s cost to attend a pre-Application meeting at
the place, date and time mentioned in the PDS. During this pre-
Application meeting, prospective Applicants may request
clarification of the project requirement, the criteria for qualifications
or any other aspects of the Prequalification Document.
7.3 Minutes of the pre-Application meeting, if applicable, including the

text of the questions asked by Applicants, including those during the
meeting (without identifying the source) and the responses given,
together with any responses prepared after the meeting will be
transmitted promptly to all prospective Applicants who have
obtained the Prequalification Document. Any modification to the
Prequalification Document that may become necessary as a result of
the pre-Application meeting shall be made by the Purchaser
exclusively through the use of an Addendum pursuant to ITA 8.
Non-attendance at the pre-Application meeting will not be a cause
for disqualification of an Applicant.
8. Amendment of 8.1 At any time prior to the deadline for submission of Applications, the
Prequalification Purchaser may amend the Prequalification Document by issuing an
Document Addendum.
8.2 Any Addendum issued shall be part of the Prequalification

Document and shall be communicated in writing to all Applicants

who have obtained the Prequalification Document from the
Purchaser. The Purchaser shall promptly publish the Addendum at
the Purchaser’s web page identified in the PDS.
8.3 To give Applicants reasonable time to take an Addendum into

account in preparing their Applications, the Purchaser may, at its
discretion, extend the deadline for the submission of Applications in
accordance with ITA 17.2.
C. Preparation of Applications
9. Cost of 9.1 The Applicant shall bear all costs associated with the preparation and
Applications submission of its Application. The Purchaser will in no case be
responsible or liable for those costs, regardless of the conduct or
outcome of the Prequalification process.
10. Language of 10.1 The Application as well as all correspondence and documents
Application relating to the Prequalification exchanged by the Applicant and the
Purchaser, shall be written in the language specified in the PDS.
Supporting documents and printed literature that are part of the
Application may be in another language, provided they are
accompanied by an accurate translation of the relevant passages in
the language specified in the PDS, in which case, for purposes of
interpretation of the Application, the translation shall govern.
11. Documents 11.1 The Application shall comprise the following:

Comprising the
Application (a) Application Submission Letter, in accordance with ITA 12.1;
(b) Eligibility: documentary evidence establishing the
Applicant’s eligibility, in accordance with ITA 13.1;
(c) Qualifications: documentary evidence establishing the
Applicant’s qualifications, in accordance with ITA 14; and
(d) any other document required as specified in the PDS.
11.2 The Applicant shall furnish information on commissions and
gratuities, if any, paid or to be paid to agents or any other party
relating to this Application
12. Application 12.1 The Applicant shall complete an Application Submission Letter as
Submission provided in Section IV, Application Forms. This Form must be
Letter completed without any alteration to its format.
13. Documents 13.1 To establish its eligibility in accordance with ITA 4, the Applicant
Establishing the shall complete the eligibility declarations in the Application
Eligibility of the Submission Letter and Form ELI-1.1 (eligibility), included in Section
Applicant IV, Application Forms.

14. Documents 14.1 To establish its qualifications to perform the contract(s) in
Establishing the accordance with Section III, Qualification Criteria and
Qualifications Requirements, the Applicant shall provide the information
of the Applicant requested in the corresponding Information Sheets included in
Section IV, Application Forms.
14.2 Wherever an Application Form requires an Applicant to state a
monetary amount, Applicants should indicate the USD equivalent
using the rate of exchange determined as follows:
(a) for turnover or financial data required for each year -
Exchange rate prevailing on the last day of the respective
calendar year (in which the amounts for that year is to be
converted).
(b) value of single contract - Exchange rate prevailing on the
date of the contract.
14.3 Exchange rates shall be taken from the publicly available source
identified in the PDS. Any error in determining the exchange rates
in the Application may be corrected by the Purchaser.
15. Signing of the 15.1 The Applicant shall prepare one original of the documents
Application and comprising the Application as described in ITA 11 and clearly mark
Number of it “ORIGINAL”. The original of the Application shall be typed or
Copies written in indelible ink and shall be signed by a person duly
authorized to sign on behalf of the Applicant. In case the Applicant is
a JV, the Application shall be signed by an authorized representative
of the JV on behalf of the JV and so as to be legally binding on all the
members as evidenced by a power of attorney signed by their legally
authorized signatories.
15.2 The Applicant shall submit copies of the signed original
Application, in the number specified in the PDS, and clearly mark
them “COPY”. In the event of any discrepancy between the original
and the copies, the original shall prevail.
D. Submission of Applications
16. Sealing and 16.1 The Applicant shall enclose the original and the copies of the
Identification of Application in a sealed envelope that shall:
Applications
(a) bear the name and address of the Applicant;
(b) be addressed to the Purchaser, in accordance with ITA 17.1; and
(c) bear the specific identification of this Prequalification process
indicated in the PDS reference ITA 1.1.

16.2 The Purchaser will accept no responsibility for not processing any
envelope that was not identified as required in ITA 16.1 above.
17. Deadline for 17.1 Applicants may either submit their Applications by mail or by
Submission of hand. Applications shall be received by the Purchaser at the address
Applications and no later than the deadline indicated in the PDS. When so
specified in the PDS, Applicants have the option of submitting
their Applications electronically, in accordance with electronic
Application submission procedures specified in the PDS.
17.2 The Purchaser may, at its discretion, extend the deadline for the
submission of Applications by amending the Prequalification
Document in accordance with ITA 8, in which case all rights and
obligations of the Purchaser and the Applicants subject to the
previous deadline shall thereafter be subject to the deadline as
extended.
18. Late 18.1 The Purchaser reserves the right to accept Applications received after
Applications the deadline for submission of Applications, unless otherwise
specified in the PDS.
19. Opening of 19.1 The Purchaser shall open all Applications at the date, time and
Applications place specified in the PDS. Late Applications shall be treated in
19.2 Applications submitted electronically, if permitted pursuant to ITA

17.1, shall be opened in accordance with the procedures specified
in the PDS.
19.3 The Purchaser shall prepare a record of the opening of Applications

to include, as a minimum, the name of the Applicants. A copy of
the record shall be distributed to all Applicants.
E. Procedures for Evaluation of Applications

20. Confidentiality 20.1 Information relating to the Applications, their evaluation and
results of the Prequalification shall not be disclosed to Applicants
or any other persons not officially concerned with the
Prequalification process until the notification of Prequalification
results is made to all Applicants in accordance with ITA 28.
20.2 From the deadline for submission of Applications to the time of
notification of the results of the Prequalification in accordance with
ITA 28, any Applicant that wishes to contact the Purchaser on any
matter related to the Prequalification process may do so only in
writing.
21. Clarification of 21.1 To assist in the evaluation of Applications, the Purchaser may, at its
Applications discretion, ask an Applicant for a clarification (including missing
documents) of its Application, to be submitted within a stated
reasonable period of time. Any request for clarification from the
Purchaser and all clarifications from the Applicant shall be in writing.
21.2 If an Applicant does not provide clarifications and/or documents
requested by the date and time set in the Purchaser’s request for
clarification, its Application shall be evaluated based on the
information and documents available at the time of evaluation of the
Application.
22. Responsiveness 22.1 The Purchaser may reject any Application which is not responsive to
of Applications the requirements of the Prequalification Document. In case the
information furnished by the Applicant is incomplete or otherwise
requires clarification as per ITA 21.1, and the Applicant fails to
provide satisfactory clarification and/or missing information, it may
result in disqualification of the Applicant.
23. Margin of 23.1 Unless otherwise specified in the PDS, a margin of preference shall
Preference not apply in the Bidding process resulting from this
Prequalification.
24. Sub-contractors 24.1 Subcontractors’ qualification and experience will not be considered
for evaluation of the Applicant. The Applicant on its own (without
taking into account the qualification and experience of the
Subcontractor) should meet the qualification criteria.
F. Evaluation of Applications and Prequalification of Applicants

25. Evaluation of 25.1 The Purchaser shall use the factors, methods, criteria, and
Applications requirements defined in Section III, Qualification Criteria and
Requirements, to evaluate the qualifications of the Applicants, and
no other methods, criteria, or requirements shall be used. The
Purchaser reserves the right to waive minor deviations from the
qualification criteria if they do not materially affect the technical
capability and financial resources of an Applicant to perform the
contract.
25.2 Subcontractors proposed by the Applicant shall be fully qualified
for their parts of the Scope of Supply and Related Services of the
Health Sector Goods.
25.3 In case of multiple contracts, Applicants should indicate in their

Applications the individual contract or combination of contracts in
which they are interested. The Purchaser shall prequalify each
Applicant for the maximum combination of contracts for which the
Applicant has thereby indicated its interest and for which the
Applicant meets the appropriate aggregate requirements. The

Qualification Criteria and Requirements are mentioned in Section
III.
25.4 Only the qualifications of the Applicant shall be considered. The

qualifications of other firms such as the Applicant’s subsidiaries,
parent entities, affiliates, subcontractors or any other firm(s)
different from the Applicant shall not be taken into consideration
in determining the qualifications of the Applicant.
26. Purchaser’s 26.1 The Purchaser reserves the right to accept or reject any Application,
Right to Accept and to annul the Prequalification process and reject all Applications
or Reject at any time, without thereby incurring any liability to the
Applications Applicants.
27. Prequalification 27.1 All Applicants whose Applications substantially meet or exceed the
of Applicants specified qualification requirements will be prequalified by the
Purchaser.
27.2 An Applicant may be “conditionally prequalified,” that is, qualified
subject to the Applicant submitting or correcting certain specified
nonmaterial documents or deficiencies to the satisfaction of the
Purchaser.
27.3 Applicants that are conditionally prequalified will be so informed
along with the statement of the condition(s) which must be met to the
satisfaction of the Purchaser before or at the time of submitting their
Bids.
28. Notification of 28.1 The Purchaser shall notify all Applicants in writing of the names of
Prequalification those Applicants who have been prequalified or conditionally
prequalified. In addition, those Applicants who have been
disqualified will be informed separately.
28.2 Applicants that have not been prequalified may write to the Purchaser
to request, in writing, the grounds on which they were disqualified.
29. Request for 29.1 Promptly after the notification of the results of the Prequalification,
Bids the Purchaser shall request Bids from all the Applicants that have
been prequalified or conditionally prequalified.
29.2 Bidders may be required to provide a Bid Security or a Bid-
Securing Declaration acceptable to the Purchaser in the form and an
amount to be specified in the bidding document.
29.3 The successful Bidder shall be required to provide a Performance
Security as specified in the bidding document.
29.3 If required in the bidding documents, the successful Bidder shall
provide additional information about its beneficial ownership using

the Beneficial Ownership Disclosure Form included in the bidding
document.
29.4 Prior to Contract award, the Purchaser will verify that the
successful Bidder (including each member of a JV) is not
disqualified by the Bank due to noncompliance with contractual
SEA/SH prevention and response obligations. The Purchaser will
conduct the same verification for each subcontractor proposed by
the successful Bidder. If any proposed subcontractor does not meet
the requirement, the Purchaser will require the Bidder to propose a
replacement subcontractor.
30. Changes in 30.1 Any change in the structure or formation of an Applicant after being
Qualifications prequalified in accordance with ITA 27 and invited to bid
of Applicants (including, in the case of a JV, any change in the structure or
formation of any member thereto) shall be subject to the written
approval of the Purchaser prior to the deadline for submission of
Bids. Such approval shall be denied if:
(a) a prequalified Applicant proposes to associate with a
disqualified Applicant or in case of a disqualified joint
venture, any of its members;
(b) as a consequence of the change, the Applicant no longer
substantially meets the qualification criteria set forth in
Section III, Qualification Criteria and Requirements; or
(c) in the opinion of the Purchaser, the change may result in a
substantial reduction in competition.
30.2 Any such change should be submitted to the Purchaser not later than
fourteen (14) days after the date of the RFBs.
31. Procurement 31.1 The procedures for making a Procurement-related Complaint are
Related as specified in the PDS.
Complaint
Section II – Prequalification Data Sheet (PDS) 19
Section II - Prequalification Data Sheet (PDS)

A. General
ITA 1.1 The identification number of the Invitation for Prequalification is: [insert number]
The Purchaser is: [insert full name, including name of Project Officer, and address]
The list of contracts is: [insert number, names and identification numbers. If the
Health Sector Goods have not been divided into contracts, add the name of
the Health Sector Goods]
ITA 2.1 The name of the Borrower is: [insert name of Borrower]
The name of the Project is: [insert name of Project]
ITA 4.2 Maximum number of members in the JV shall be: [insert a number or insert “not
limited”]
ITA 4.7 A list of debarred firms and individuals is available on the Bank’s external website:
http://www.worldbank.org/debarr.
B. Contents of the Prequalification Document

ITA 7.1 For clarification purposes, the Purchaser’s address is:
[insert information or state “same as in ITA1.1 above”]
Attention: [insert name and room number of Project Officer]
Address: [insert street name and number]
[insert floor and room number, if applicable]
City: [insert name of city or town]
ZIP Code: [insert postal (ZIP) code, if applicable]
Country: [insert name of country]]
Telephone: [insert telephone number including country and city codes]
Facsimile number: [insert fax number including country and city codes]
Electronic mail address: [insert e-mail address of Project Officer]
ITA 7.1 & 8.2Web page: [In case used, identify the widely used website or electronic portal of
free access where Prequalification information is published]
ITA 7.2 Pre-Application Meeting will be held: [Yes/No]

[If Yes, please add the address, date and time of the meeting]
C. Preparation of Applications
ITA 10.1 This Prequalification document has been issued in the [Insert “English” or
“French” or “Spanish”] language.
Note: In addition to one of the above languages, and if agreed with the Bank, the
Borrower has the option to issue translated versions of the Prequalification
document in another language which should either be: (a) the national
language of the Borrower; or (b) the language used nation-wide in the
Borrower’s country for commercial transactions. In such case, the following
text shall be added:]
“In addition, the Prequalification document is translated into the [insert national or
nation-wide used] language [if there are more than one national or nation-
wide used language, add “and in the ____________” [insert the second
national or nation-wide language].
Applicants shall have the option to submit their Prequalification Application in any
one of the languages stated above. Applicants shall not submit Applications in
more than one language.]”
All correspondence exchange shall be in ____________ language.
The Application as well as all correspondence shall be submitted in ______
[Insert the language of the Prequalification document in case of one language]
Note: If the Prequalification document is issued in more than one language, the
following text shall be inserted above: “in one of the above languages”]
Language for translation of supporting documents and printed literature is
_______________________. [Specify one language]
ITA 11.1 (d) The Applicant shall submit with its Application, the following additional documents:
[insert list of additional documents]
ITA 14.2 The source for determining exchange rates is [insert a publicly available source]
ITA 15.2 In addition to the original, the number of copies to be submitted with the Application
is: [insert number of copies]
D. Submission of Applications
ITA 17.1 The deadline for Application submission is:
Date: [insert date]
Time: [insert time]
[The time allowed for preparation and submission of the Prequalification Document
should be sufficient for Applicants to gather all the information required—
preferably eight weeks, but in any case not less than six weeks after the date
when the documents are available for distribution or the date of the
advertisement, whichever is later. This period may be longer for very large
projects, where time should be allowed for the formation of joint ventures and
assembly of the necessary resources.]
For Application submission purposes only, the Purchaser’s address is:
[insert information requested below or insert “Purchaser’s address is the same as
that indicated in 1.1]
Attention: [insert name and room number of Project Officer]
Address: [insert street name and number]
[insert floor and room number, if applicable]
City: [insert name of city or town]
ZIP Code: [insert postal (ZIP) code, if applicable]
Country: [insert name of country]
Telephone: [insert telephone number including country and city codes]
Facsimile number: [insert fax number including country and city codes]
Email address: [insert e-mail address of Project Officer]
Applicants [insert “shall” or “shall not”] have the option of submitting their
Applications electronically.
The following provision should be included and the required corresponding
information inserted only if Applicants have the option of submitting their
Applications electronically. Otherwise omit.]
The electronic Application submission procedures shall be: [insert a description
of the electronic Application submission procedures.]
ITA 18.1 [Choose one of the two options below:]

Late Applications will be returned unopened to the Applicants.
[or]
The Purchaser reserves the right to accept or reject late Applications.
ITA 19.1 The opening of the Applications shall be at [Insert date, time and address]
ITA 19.2 [The following provision should be included and the required corresponding
information inserted only if Applicants have the option of submitting their
Applications electronically. Otherwise omit.]
The electronic Application opening procedures shall be: [insert a description of
the electronic Application opening procedures.]
E. Procedures for Evaluation of Applications

ITA 23.1 [The following provision should be included and the required corresponding
information inserted only if the Procurement Plan authorizes the
Application of a margin of preference and the Purchaser intends to apply
it to the subject contract. Otherwise omit]
A margin of domestic preference [insert either “shall” or “shall not”]
___________apply
ITA 31.1 The procedures for making a Procurement-related Complaint are detailed in
the “Procurement Regulations for IPF Borrowers (Annex III).” If an
Applicant wishes to make a Procurement-related Complaint, the
Applicant should submit its complaint following these procedures, in
writing (by the quickest means available, that is either by email or fax),
to:
For the attention: [insert full name of person receiving complaints]
Title/position: [insert title/position]
Purchaser : [insert name of Purchaser]
Email address: [insert email address]
Fax number: [insert fax number] delete if not used
In summary, at this stage, a Procurement-related Complaint may challenge
any of the following:
1. the terms of the Prequalification Documents; and
2. the Purchaser’s decision not to prequalify an Applicant.
Section III – Qualification Criteria and Requirements 23
Section III - Qualification Criteria and

Requirements
This Section contains the methods, criteria, and requirements that the Purchaser shall use to
evaluate Applications. The information to be provided in relation to each requirement and the
definitions of the corresponding terms are included in the respective Application Forms.
Contents
1. Eligibility..................................................................................................................................24
2. Historical Contract Non-Performance..................................................................................24
3. Financial Situation and Performance....................................................................................26
4. Experience................................................................................................................................27
Eligibility and Qualification Criteria Compliance Requirements Documentation
Joint Venture (existing or intended)

All Members Each One Member Submission
No. Subject Requirement Single Entity
Combined Member Requirements
1. Eligibility
1.1 Nationality Nationality in accordance Must meet Must meet Must meet N/A Forms ELI – 1.1
with ITA 4.5 requirement requirement requirement with attachments
1.2 Conflict of No conflicts of interest in Must meet Must meet Must meet N/A Application
Interest accordance with ITA 4.6 requirement requirement requirement Submission
Letter
1.3 Bank Eligibility Not having been declared Must meet Must meet Must meet N/A Application
ineligible by the Bank, as requirement requirement requirement Submission
described in ITA 4.7 and Letter
5.1
1.4 State-owned Meet conditions of ITA Must meet Must meet Must meet N/A Forms ELI – 1.1
enterprise of the 4.8 requirement requirement requirement with attachments
Borrower
country
1.5 United Nations Not having been excluded Must meet Must meet Must meet N/A Forms ELI – 1.1
resolution or as a result of prohibition in requirement requirement requirement with attachments
Borrower’s the Borrower’s country
country law laws or official regulations
against commercial
relations with the
Applicant’s country, or by
an act of compliance with
UN Security Council
resolution, both in
accordance with ITA 5.1
and Section V.
2. Historical Contract Non-Performance
2.1 History of Non- Non-performance of a Must meet Must meet Must meet N/A Form PER-1
Performing contract4 did not occur as a requirement2 requirements requirement5
4
Non performance, as decided by the Purchaser, shall include all contracts where (a) non performance was not challenged by the Supplier, including through
referral to the dispute resolution mechanism under the respective contract, and (b) contracts that were so challenged but fully settled against the Supplier. Non
performance shall not include contracts where Purchaser’s decision was overruled by the dispute resolution mechanism. Non performance must be based on all
information on fully settled disputes or litigation, i.e. dispute or litigation that has been resolved in accordance with the dispute resolution mechanism under the

Contracts result of Supplier’s default
since 1st January [insert
year].
2.2 Suspension Not under suspension Must meet Must meet Must meet N/A Application
Based on based on execution of a requirement requirement requirement Submission
Execution of Bid/Proposal Securing Letter
Bid/Proposal Declaration pursuant to
Securing ITA 4.9.
Declaration by
the Purchaser
2.3 Pending Applicant’s financial Must meet N/A Must meet N/A Form PER-1
Litigation position and prospective requirement requirement
long term profitability still
sound according to criteria
established in 3.1 below
and assuming that all
pending litigation will be
resolved against the
Applicant
2.4 Litigation No consistent history of Must meet Must meet Must meet N/A Form PER-1
History court/arbitral award requirement requirement requirement
decisions against the
Applicant since 1st January
[insert year]6
2.5 Bank’s SEA At the time of Contract Must meet N/A Must meet N/A Application
and/or SH Award, not subject to requirement requirement Submission
Disqualification disqualification by the (including each (including Letter, Form
Bank for non-compliance subcontractor) each PER-2
subcontractor
respective contract and where all appeal instances available to the Applicant have been exhausted.
5
This requirement also applies to contracts executed by the Applicant as JV member.
6
The Applicant shall provide accurate information on the Application Submission Form about any litigation or arbitration resulting from contracts completed or
ongoing under its execution over the last five years. A consistent history of court/arbitral awards against the Applicant or any member of a joint venture may
result in disqualifying the Applicant.

with SEA/ SH obligations proposed by
the Applicant)
3. Financial Situation and Performance

3.1 Financial The audited balance sheets Must meet N/A Must meet N/A
Capabilities or, if not required by the requirement requirement
laws of the Applicant’s
country, other financial
statements acceptable to
the Purchaser, for the last
[insert number] years shall
be submitted and must
demonstrate the current
soundness of the
Applicant’s financial
position and indicate its
prospective long-term
profitability.
3.2 Average Annual Average annual turnover Must meet Must meet N/A N/A Form FIN – 3.2
Turnover (Average Annual Sales requirement requirement
Revenue) from supply of
Health Sector Goods of
US$ [insert amount in
US$ equivalent in words
and figures], calculated as
total certified payments
received for contracts in
progress and/or completed
during the last three years.
[Insert a figure which is at
least five times the
estimated contract
amount]
3.3 Current The Applicant shall also Form CON -1

Commitments demonstrate, to the
satisfaction of the
Purchaser, that it has
adequate sources of
finance to meet the cash
flow requirements on
contracts currently in
progress and for future
contract commitments.
4. Experience
4.1 General Experience in supply of Must meet N/A Must meet N/A Form EXP –1
Experience Health Sector Goods for at requirement requirement
least the last three years
4.2 (a) Specific (i) Documentary Must meet Must meet N/A Must meet
Experience evidence of the requirement requirement requirement
Applicant’s
qualifications to
perform the Contract
in accordance with 4.2
(b)(i) below Must meet Must meet N/A Must meet
(ii) Technical and requirement requirement requirement
Production Capability
in accordance with
4.2(b)(ii) as below. Must meet Must meet N/A Must meet
requirement requirement requirement
(iii) Experience on
Packaging,
Distribution in Must meet Must meet Must meet Must meet
accordance with requirement requirement requirement requirement
4.2(b)(iii) below.
(iv) Registration
Requirement in
accordance with 4.2(b)
(iv) below.

4.2 (b) See below for details
Specific Experience Requirements
The Specific Experience Requirements under 4.2 (b) are as follows:
4.2 (b)(i) Documentary evidence

The following documents must be included with the Application:
Documentary evidence of the Applicant’s qualifications to perform the Contract if its Bid is
accepted:
(i) that, in the case of an Applicant offering to supply Goods under the Contract that the
Applicant manufactures or otherwise produces (using ingredients supplied by primary
manufacturers) that the Applicant:
(a) is incorporated in the country of manufacture of the Goods;
(b) has been licensed by the regulatory authority in the country of manufacture to
supply the Goods;
(c) has manufactured and marketed the specific goods covered by this Prequalification
Document, for at least two (2) years, and for similar Goods for at least five (5) years;
(d) has received a satisfactory GMP inspection certificate in line with the WHO
certification scheme on pharmaceuticals moving in International Commerce from
the regulatory authority (RA) in the country of manufacture of the goods or has
been certified by the competent authority of a member country of the
Pharmaceuticals Inspection Convention (PIC), and has demonstrated compliance
with the quality standards during the past two years prior to Application
submission;
(ii) that, in the case of an Applicant offering to supply Goods under the Contract that the
Applicant does not manufacture or otherwise produce,
(a) that the Applicant has been duly authorized by a manufacturer of the Goods that
meets the criteria under (i) above to supply the Goods in the Purchaser’s Country
using the Manufacturer Authorization Form; and
(iii) the Applicant shall also submit the following additional information:
(a) a statement of installed manufacturing capacity;
(b) details of on-site quality control laboratory facilities and services and range of
tests conducted;
(c) list of major supply contracts conducted within the last three years.
4.2(b)(ii) Technical and Production Capability

The Applicant shall provide evidence that it has the technical, and production capability
necessary to perform the Contract:
(i) that it has successfully completed or substantially completed at least [insert number] similar
contracts for supply of the goods and within the last five years. [The number of similar
contracts required should be not less than three and not more than five (normally four),
depending on the size and complexity of the subject contract].] Similar contracts are those of
approximately the same size and that includes comparable products, e.g., capsules, tablets,
vaccines.
The goods may have been supplied by the Applicant as a manufacturer or by its agent, with
references being submitted to confirm satisfactory performance,
(ii) that it has achieved an annual average production rate of _________[The annual production
rate required should be at least three times the quantities specified under the contract]
during the last three years
4.2 (b)(iii) Experience on Packaging, Distribution and Transportation
The Applicant should provide proof of experience with and knowledge of modes of packing,
distribution, and transportation of pharmaceuticals similar to those subject to bidding under
logistical and climatic conditions similar to the ones in the purchaser’s country. It should provide
names of countries to which the Applicant has supplied (including packaged, distributed, and
transported) products worth at least the amount [insert the amount] within the past three years.
4.2(b)(iv) Registration Requirements
The Goods to be supplied under the Contract shall be registered with the relevant authority in the
Purchaser’s country. An Applicant who has already registered its Goods by the time of
Prequalification should submit a copy of the Registration Certificate with its Application (subject
to subsequent confirmation at Bid submission). An Applicant who has not registered its goods
subject of Bidding and wishes to commence the process of registration, should refer to the
agency and contact person identified below.[insert name, address, telephone, e-mail address,
and contact persons for registration offices, i.e., Pharmaceutical registration, Pharmacological
committee of Ministry of Health, Pharmacopoeia committee of Ministry of Health, Department
of governmental control for quality, efficiency and safety of pharmaceuticals and medical
equipment ]
If Registration is a requirement in the country of the Purchaser, the bidding document for the
Procurement of Health Sector Goods stipulates that:
A Bidder who has already registered the goods by the time of Bidding should submit a copy of
the Registration Certificate with its Bid.
Otherwise, the successful Bidder, by the time of Contract signing, shall submit to the Purchaser
either:
(a) a copy of the Registration Certificate of the Goods for use in the Purchaser’s country, or, if
such Registration Certificate has not been obtained;
(b) evidence establishing to the Purchaser’s satisfaction that the Bidder has complied with the
following documentary requirements in order to register the Goods to be supplied under the
Contract: [insert documentary requirements]
Section IV - Application Forms
Table of Forms
Application Submission Letter....................................................................................................................

Applicant Information Form........................................................................................................................
Financial Situation and Performance...........................................................................................................
Average Annual Turnover (Annual Sales Value)........................................................................................
Historical Contract Non-Performance, Pending Litigation and Litigation History .....................................
Sexual Exploitation and Abuse (SEA) and/or Sexual Harassment Performance Declaration.....................
Manufacturer’s Authorization......................................................................................................................
Information Form
Application Submission Letter
Date: [insert day, month, and year]
PD No. and title: [insert PD number and title]
To: [insert full name of Purchaser]
We, the undersigned, apply to be prequalified for the referenced PD and declare that:
(a) No reservations: We have examined and have no reservations to the
Prequalification Document, including Addendum(s) No(s), issued in accordance
with Instructions to Applicants (ITA) 8: [insert the number and issuing date of each
addendum].
(b) No conflict of interest: We have no conflict of interest in accordance with ITA 4.6;
(c) Eligibility: We (and our subcontractors) meet the eligibility requirements as stated ITA 4.1,
we have not been suspended by the Purchaser based on execution of a Bid/Proposal
Securing Declaration in accordance with ITA 4.9;
(d) Suspension and Debarment: We, along with any of our subcontractors, suppliers,
consultants, manufacturers, or service providers for any part of the contract, are not
subject to, and not controlled by any entity or individual that is subject to, a
temporary suspension or a debarment imposed by the World Bank Group or a
debarment imposed by the World Bank Group in accordance with the Agreement for
Mutual Enforcement of Debarment Decisions between the World Bank and other
development banks. Further, we are not ineligible under the Purchaser’s country
laws or official regulations or pursuant to a decision of the United Nations Security
Council;
(a) Sexual Exploitation and Abuse (SEA) and/or Sexual Harassment (SH): [select the
appropriate option from (i) to (v) below and delete the others].
We [where JV, insert: “including any of our JV members”], and any of our
subcontractors:
(i) [have not been subject to disqualification by the Bank for non-compliance
with SEA/ SH obligations.]
(ii) [are subject to disqualification by the Bank for non-compliance with SEA/
SH obligations.]
(iii) [had been subject to disqualification by the Bank for non-compliance with
SEA/ SH obligations. An arbitral award on the disqualification case has been
made in our favor.]
(e)
(f) State-owned enterprise or institution: [select the appropriate option and delete the
other] [We are not a state-owned enterprise or institution] / [We are a state-owned
enterprise or institution but meet the requirements of ITA 4.8];
Section IV – Application Forms
(g) Commissions, gratuities, fees: We declare that the following commissions,

gratuities, or fees have been paid or are to be paid with respect to the
Prequalification process, the corresponding bidding process or execution of the
Contract:
Name of Recipient Address Reason Amount
[insert full name [insert street/ [indicate reason] [specify amount

for each number/city/country] currency, value,
occurrence] exchange rate and
US$ equivalent]
________________ ________________ ________________ ________________
________________ ________________ ________________ ________________
________________ ________________ ________________ ________________
________________ ________________ ________________ ________________
[If no payments are made or promised, add the following statement: “No commissions or
gratuities have been or are to be paid by us to agents or any third party relating to this
Application]
(h) Not bound to accept: We understand that you may cancel the Prequalification
process at any time and that you are neither bound to accept any Application that you
may receive nor to invite the prequalified Applicants to bid for the contract subject of
this Prequalification process, without incurring any liability to the Applicants, in
(i) True and correct: All information, statements and description contained in the
Application are in all respect true, correct and complete to the best of our knowledge and
belief.
Signed: [insert signature(s) of an authorized representative(s) of the Applicant]

Name: [insert full name of person signing the Application]
In the capacity of: [insert capacity of person signing the Application]
Duly authorized to sign the Application for and on behalf of: [insert full name of the
Applicant or the name of the JV]
Address: [insert street number/town or city/country address]
Dated: [insert date the document is signed i.e. day number] day of [insert month], [insert
year]
[For a joint venture, either all members shall sign or only the authorized
representative, in which case the power of attorney to sign on behalf of all members
shall be attached]
Form ELI -1.1

Applicant Information Form
Date: [insert day, month, year]

Page [insert page number] of [insert total number] pages
Applicant's name
[insert full name]
In case of Joint Venture (JV), name of each member:
[insert full name of each member in JV]
Applicant's actual or intended country of registration:
[indicate country of Constitution]
Applicant's actual or intended year of incorporation:
[indicate year of Constitution]
Applicant's legal address [in country of registration]:
[insert street/ number/ town or city/ country]
Applicant's authorized representative information
Name: [insert full name]
Address: [insert street/ number/ town or city/ country]
Telephone/Fax numbers: [insert telephone/fax numbers, including country and city codes]
E-mail address: [indicate e-mail address]
1. Attached are copies of original documents of
 Articles of Incorporation (or equivalent documents of constitution or association), and/or
documents of registration of the legal entity named above, in accordance with ITA 4.5.
 In case of JV, letter of intent to form JV or JV agreement, in accordance with ITA 4.2.
 In case of state-owned enterprise or institution, in accordance with ITA 4.8 documents
establishing:
 Legal and financial autonomy
 Operation under commercial law
 Establishing that the Applicant is not under supervision of the Purchaser
2. Included are the organizational chart, a list of Board of Directors, and the beneficial ownership.
In case of JV, the Applicant’s information shall include information on each JV member and
letter of intent to form JV or JV agreement, in accordance with ITA 4.2
Form ELI -1.1 (continued)

Applicant Information Form

1. Applicant’s name
2. 2. Street Address: Postal Code: City: Country:
3. P.O. Box and Mailing Address:

4. Telephone Number:
5. Fax Number:
6. E-mail Address:
7. Web Site:
8. Contact Name:
9. Contact Title:
10. Type of Business:
11. If Other, specify:
12. Nature of Business:
13. Year Established:
14. Dates, Numbers, and Expiration Dates of Current Licenses and Permits:
15. Current health authority registration information:
16. Proof of product and facility registrations with purchaser’s country regulatory authority and
international agencies (e.g., WHO Certification Scheme, GMP)
17. Name of government agency(ies) responsible for inspecting and licensing of facilities in the
country of origin of the raw material and or processing of the goods:
Date of last inspection:

18. Quality Assurance Certification

(Please include a copy of your latest certificate
with the PQ Application):
19. Production capacity: [insert peak and average production capacity over the last three years
in units/day or units/month, etc.]
20. List of names and addresses of sources of raw material and what products they will be used
in:
21. List product recalls linked to defects during the last 36 months. Include reason and date of
recall.
22. Are technical documents available in: [Purchaser should insert language]
Yes No
Form FIN – 3.1

Financial Situation and Performance
[ The following table shall be filled in for the Applicant and for each member of a Joint Venture]
Applicant’s Name: [insert full name]

Joint Venture Member Name: [insert full name]
1. Financial data
Type of Financial information Historic information for previous _[insert number] years,
in [insert in words]
(currency) (amount in currency, currency, exchange rate*, USD
equivalent)
Year 1 Year 2 Year 3
Statement of Financial Position (Information from Balance Sheet)
Total Assets (TA)
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
* Refer ITA 14 for the exchange rate
3. Financial documents
The Applicant and its parties shall provide copies of financial statements for [number] years
pursuant Section III, Qualifications Criteria and Requirements, Sub-factor 3.1. The financial
statements shall:
(a) reflect the financial situation of the Applicant 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 statements0 for the [number] years required above; and
complying with the requirements
0
If the most recent set of financial statements is for a period earlier than 12 months from the date of
Application, the reason for this should be justified.
Form FIN - 3.2

Average Annual Turnover (Annual Sales Value)
[The following table shall be filled in for the Applicant and for each member of a Joint
Venture]

Annual turnover data

Year Amount Exchange rate* USD equivalent
Currency
[indicate [insert amount and indicate
calendar currency]
year]
Average Annual
Turnover **
* Refer ITA 14 for date and source of exchange rate.

** Total USD equivalent for all years divided by the total number of years. See Section III,
Qualification Criteria and Requirements, ITA 3.2.
Current Contract Commitments / Contracts in Progress

Form CON-1
1. Name of Contract(s)
2. Purchaser Contact Information [insert address, telephone, fax, e-mail address]
3. Value of outstanding contracts [current US$ equivalent]
4. Estimated delivery date
5. Average monthly invoices over the last six months (US$/mon.)

Form- EXP-1
44. Contracts over [insert amount] during the last three years:
Purchaser Value Year Goods/Services Supplied Country of
Destination
Form- PER 1
Historical Contract Non-Performance, Pending Litigation

and Litigation History
[The following table shall be filled in for the Applicant and for each member of a Joint Venture]
Non-Performed Contracts in accordance with Section III, Qualification Criteria and
Requirements
 Contract non-performance did not occur since 1st January [insert year] specified in, Sub-Factor
2.1.
 Contract(s) not performed since 1st January [insert year] specified in Sub-Factor 2.1
Year Non- Contract Identification Total Contract
performed Amount (current
portion of value, currency,
contract exchange rate
and US$
equivalent)
[insert [insert amount Contract Identification: [indicate complete contract [insert amount]
year] and percentage] name/ number, and any other identification]
Name of Purchaser: [insert full name]
Address of Purchaser: [insert street/city/country]
Reason(s) for nonperformance: [indicate main
reason(s)]
Pending Litigation, in accordance with Section III, Qualification Criteria and Requirements
 No pending litigation in accordance with, Sub-Factor 2.3
 Pending litigation in accordance with Sub-Factor 2.3 as indicated below.
Year of Amount in dispute Contract Identification Total Contract
dispute (currency) Amount
(currency), USD
Equivalent
(exchange rate)
[insert year] [insert amount] Contract Identification: [indicate complete [insert amount]
contract name, number, and any other
identification]
Address of Purchaser: [insert
street/city/country]
Matter in dispute: [indicate main issues in
dispute]
Party who initiated the dispute: [indicate
“Purchaser” or “Supplier”]
Status of dispute:
Litigation History in accordance with Section III, Qualification Criteria and
Requirements
 No consistent history of court/arbitral award decisions in accordance with , Sub-Factor 2.4.
 Consistent history of court/arbitral award decisions in accordance with Sub-Factor 2.4 as
indicated below.
Year of Outcome as Contract Identification Total Contract
award percentage of Net Amount
Worth (currency), USD
Equivalent
(exchange rate)
[insert year] [insert percentage] Contract Identification: [indicate complete [insert amount]
contract name, number, and any other
identification]
Address of Purchaser: [insert
street/city/country]
Matter in dispute: [indicate main issues in
dispute]
Party who initiated the dispute: [indicate
“Purchaser” or “Supplier”]
Reason(s) for Litigation and award decision
[indicate main reason(s)]
Form PER – 2
Sexual Exploitation and Abuse (SEA) and/or Sexual

Harassment Performance Declaration
[The following table shall be filled in by the Applicant, each member of a Joint Venture and each
subcontractor proposed by the Applicant]
Joint Venture Member’s or Subcontractor’s Name: [insert full name]
SEA and/or SH Declaration

in accordance with Section III, Qualification Criteria, and Requirements
We:
 (a) have not been subject to disqualification by the Bank for non-compliance with SEA/ SH obligations
 (b) are subject to disqualification by the Bank for non-compliance with SEA/ SH obligations
 (c) had been subject to disqualification by the Bank for non-compliance with SEA/ SH obligations An
arbitral award on the disqualification case has been made in our favor.
[If (c) above is applicable, attach evidence of an arbitral award reversing the findings on the issues
underlying the disqualification.]
Period of disqualification: From: _______________ To: ________________

Manufacturer’s Authorization
[The Applicant shall require the Manufacturer to fill in this Form in accordance with the
instructions indicated. This letter of authorization should be on the letterhead of the
Manufacturer and should be signed by a person with the proper authority to sign documents
that are binding on the Manufacturer.]
Date: [insert date (as day, month and year) of Application Submission]
PD No.: [insert number]
To: [insert complete name of Purchaser]
WHEREAS
We [insert complete name of Manufacturer], who are official manufacturers of [insert type
of goods manufactured], having factories at [insert full address of Manufacturer’s factories],
do hereby authorize [insert complete name of Applicant] to submit a Prequalification
Application and submit a Bid the purpose of which is to provide the following Goods,
manufactured by us [insert name and or brief description of the Goods], and to
subsequently negotiate and sign the Contract.
We hereby extend our full guarantee and warranty in accordance with the General
Conditions of Contract, with respect to the Goods offered by the above firm.
Signed: [insert signature(s) of authorized representative(s) of the Manufacturer]
Name: [insert complete name(s) of authorized representative(s) of the Manufacturer]
Title: [insert title]
Dated on ____________ day of __________________, _______ [insert date of signing]

Section V - Eligible Countries 49
Section V - Eligible Countries

Eligibility for the Provision of Goods, Works and Services in Bank-Financed
Procurement
In reference to ITA 5.1, for the information of the Applicants, at the present time firms and
individuals, supply of goods, or contracting of works or services, from the following countries are
excluded from this Prequalification process:
Under ITA 5.1 (a): [insert a list of the countries following approval by the Bank to apply the
restriction or state “none”]
Under ITA 5.1 (b): [list the countries or state “none”]
Section VI – Fraud and Corruption 51
Section VI - Fraud and Corruption

(This Section VI shall not be modified)
1. Purpose
1.1 The Bank’s Anti-Corruption Guidelines and this annex apply with respect to procurement
under Bank Investment Project Financing operations.
2. Requirements
2.1 The Bank requires that Borrowers (including beneficiaries of Bank financing); bidders
(applicants/proposers), consultants, contractors and suppliers; any sub-contractors, sub-
consultants, service providers or suppliers; any agents (whether declared or not); and any of
their personnel, observe the highest standard of ethics during the procurement process,
selection and contract execution of Bank-financed contracts, and refrain from Fraud and
Corruption.
2.2 To this end, the Bank:

a. Defines, for the purposes of this provision, the terms set forth below as follows:
i. “corrupt practice” is the offering, giving, receiving, or soliciting, directly or
indirectly, of anything of value to influence improperly the actions of another
party;
ii. “fraudulent practice” is any act or omission, including misrepresentation, that
knowingly or recklessly misleads, or attempts to mislead, a party to obtain
financial or other benefit or to avoid an obligation;
iii. “collusive practice” is an arrangement between two or more parties designed to
achieve an improper purpose, including to influence improperly the actions of
another party;
iv. “coercive practice” is impairing or harming, or threatening to impair or harm,
directly or indirectly, any party or the property of the party to influence improperly
the actions of a party;
v. “obstructive practice” is:
(a) deliberately destroying, falsifying, altering, or concealing of evidence
material to the investigation or making false statements to investigators in
order to materially impede a Bank investigation into allegations of a
corrupt, fraudulent, coercive, or collusive practice; and/or threatening,
harassing, or intimidating any party to prevent it from disclosing its
knowledge of matters relevant to the investigation or from pursuing the
investigation; or
(b) acts intended to materially impede the exercise of the Bank’s inspection
and audit rights provided for under paragraph 2.2 e. below.
Section VI – Fraud and Corruption 52
b. Rejects a proposal for award if the Bank determines that the firm or individual
recommended for award, any of its personnel, or its agents, or its sub-consultants, sub-
contractors, service providers, suppliers and/ or their employees, has, directly or
indirectly, engaged in corrupt, fraudulent, collusive, coercive, or obstructive practices
in competing for the contract in question;
c. In addition to the legal remedies set out in the relevant Legal Agreement, may take
other appropriate actions, including declaring misprocurement, if the Bank determines
at any time that representatives of the Borrower or of a recipient of any part of the
proceeds of the loan engaged in corrupt, fraudulent, collusive, coercive, or obstructive
practices during the procurement process, selection and/or execution of the contract in
question, without the Borrower having taken timely and appropriate action
satisfactory to the Bank to address such practices when they occur, including by
failing to inform the Bank in a timely manner at the time they knew of the practices;
d. Pursuant to the Bank’s Anti-Corruption Guidelines, and in accordance with the Bank’s
prevailing sanctions policies and procedures, may sanction a firm or individual, either
indefinitely or for a stated period of time, including by publicly declaring such a firm
or individual ineligible (i) to be awarded or otherwise benefit from a Bank-financed
contract, financially or in any other manner; 0 (ii) to be a nominated0 sub-contractor,
consultant, manufacturer or supplier, or service provider of an otherwise eligible firm
being awarded a Bank-financed contract; and (iii) to receive the proceeds of any loan
made by the Bank or otherwise to participate further in the preparation or
implementation of any Bank-financed project;
e. Requires that a clause be included in request for bid/request for proposals documents
and in contracts financed by a Bank loan, requiring (i) bidders (applicants/proposers),
consultants, contractors, and suppliers, and their sub-contractors, sub-consultants,
service providers, suppliers, agents, personnel, permit the Bank to inspect 0 all
accounts, records and other documents relating to the procurement process, selection
and/or contract execution, and to have them audited by auditors appointed by the
Bank.
0
For the avoidance of doubt, a sanctioned party’s ineligibility to be awarded a contract shall include, without limitation, (i)
applying for pre-qualification, expressing interest in a consultancy, and bidding, either directly or as a nominated sub-contractor,
nominated consultant, nominated manufacturer or supplier, or nominated service provider, in respect of such contract, and (ii)
entering into an addendum or amendment introducing a material modification to any existing contract.
0
A nominated sub-contractor, nominated consultant, nominated manufacturer or supplier, or nominated service provider
(different names are used depending on the particular bidding document) is one which has been: (i) included by the bidder in its
pre-qualification Application or bid because it brings specific and critical experience and know-how that allow the bidder to meet
the qualification requirements for the particular bid; or (ii) appointed by the Borrower.
0
Inspections in this context usually are investigative (i.e., forensic) in nature. They involve fact-finding activities undertaken by
the Bank or persons appointed by the Bank to address specific matters related to investigations/audits, such as evaluating the
veracity of an allegation of possible Fraud and Corruption, through the appropriate mechanisms. Such activity includes but is not
limited to: accessing and examining a firm's or individual's financial records and information, and making copies thereof as
relevant; accessing and examining any other documents, data and information (whether in hard copy or electronic format)
deemed relevant for the investigation/audit, and making copies thereof as relevant; interviewing staff and other relevant
individuals; performing physical inspections and site visits; and obtaining third party verification of information.
Part 2 – Scope of Supply 53
PART 2 – Scope of Supply

Section VII – Scope of Supply 55
Section VII - Scope of Supply

[Insert name of goods]
Contents
1. Scope of Supply.................................................................................................................54
2. Delivery Schedule..............................................................................................................55
1. Scope of Supply
2. Delivery Schedule

SPD Prequalification Doc Health Sector Goods July 2023

Uploaded by

Copyright:

Available Formats

SPD Prequalification Doc Health Sector Goods July 2023

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

SPD Prequalification Doc Health Sector Goods July 2023

Uploaded by

Copyright:

Available Formats

STANDARD PROCUREMENT

Those wishing to submit comments or questions on these documents or to obtain additional

Chief Procurement Officer

Specific Procurement Notice - Invitation for Prequalification

Prequalification Document: Procurement of Health Sector Goods

PART 1 – PREQUALIFICATION PROCEDURES

Section I - Instructions to Applicants (ITA)

This Section provides information to help the Applicants in preparing and

Section II - Prequalification Data Sheet (PDS)

Section III - Qualification Criteria and Requirements

This Section specifies the methods, criteria, and requirements to be used to

Section IV - Application Forms

Section V - Eligible Countries

This Section contains information regarding eligible countries.

Section VI - Fraud and Corruption

PART 2 -- SUPPLY REQUIREMENTS

Section VII - Scope of Supply

This Section includes a summary description, delivery and completion schedules,

Specific Procurement Notice

Invitation for Prequalification

1. The [insert name of Borrower/Beneficiary/Recipient] [has received/has applied for/intends

5. Applications for Prequalification should be submitted in clearly marked envelopes and

[Insert name of office]

Invitation for Prequalification No: [insert reference from Procurement Plan]

Standard Procurement Document

PART 1 – Prequalification Procedures........................................................................................3

PART 1 – Prequalification Procedures

Section I - Instructions to Applicants

Section I - Instructions to Applicants

to have them audited by auditors appointed by the Bank.

4.3 A firm may apply for Prequalification both individually, and as

4.6 Applicants shall not have a conflict of interest. Applicants shall be

consultant in the preparation of the design or technical

(a) are directly or indirectly involved in the preparation of the

4.7 An Applicant that has been sanctioned by the Bank, pursuant to

(a) are legally and financially autonomous;

(b) operate under commercial law, and

(c) are not under supervision of the Purchaser.

4.9 An Applicant shall not be under suspension from bidding by the

4.11 A firm that is under a sanction of debarment by the Borrower from

B. Contents of the Prequalification Document

PART 1 Prequalification Procedures

 Section I - Instructions to Applicants (ITA)

PART 2 Supply Requirements

meeting (if any), or Addenda to the Prequalification Document in

7.2 If indicated in the PDS, the Applicant’s designated representative is

7.3 Minutes of the pre-Application meeting, if applicable, including the

8.2 Any Addendum issued shall be part of the Prequalification

Document and shall be communicated in writing to all Applicants

8.3 To give Applicants reasonable time to take an Addendum into

11. Documents 11.1 The Application shall comprise the following:

Applicant IV, Application Forms.

indicated in the PDS reference ITA 1.1.

19.2 Applications submitted electronically, if permitted pursuant to ITA

19.3 The Purchaser shall prepare a record of the opening of Applications

E. Procedures for Evaluation of Applications

F. Evaluation of Applications and Prequalification of Applicants

25.3 In case of multiple contracts, Applicants should indicate in their

Applicant meets the appropriate aggregate requirements. The

Period of disqualification: From: _ To: __