Section A Details of the Consortium

A1 To be completed on behalf of all Member Organisations making up the Consortium

Consortium Name:
Address:
Telephone:
Fax:
E-mail:

Consortium Authorized Representative (Person for contact purposes)

Consortium Name:
Address:
Telephone:
Fax:
E-mail:

Declaration that must be signed by the Consortium is at the end of the document in Section E

A2 Status of Consortium

(a)

Single Candidate

Consortium

Other joint venture

(b)

Already a
Limited
Company

To be incorporated

Not to be incorporated

A3 Where Consortium is already a limited company:

Registered Name:
Current Trading Name:
Previous Trading Names (if different):
Registered Address (if different to A1):
Telephone (if different to A1):
Fax (if different to A1):
E-mail (if different to A1):
Registered No:
Year of Registration:
Country of Registration:

A4 Indicate the Relevant Organisations that will undertake the following roles on the Project

Role	Complete Section	Name of organisations (full title)
Shareholding Companies	A
Construction Contractor	B
"Hard" FM Service Provider(s)	C
"Soft" FM Service Provider(s), including Third Party Income Service Provider(s)
Equipment Provider(s)
IM&T Provider(s)
Designer(s) and Technical Adviser(s), including IM&T	D
Legal Adviser
Financial Adviser
Other Adviser(s)

A5 Provide an organisation chart showing internal relationships between the Consortium and Member and Relevant Organisations. State whether membership, roles and responsibilities will change during the PFI procurement, design, construction and operational phases of the contract and how appropriate transitions will be managed and by who.

A6 Provide a statement that there are no grounds applicable to any Relevant Organisation pursuant to which a Bidder may be rejected under Regulation 14 of the Public Services Contracts Regulations 1993.

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