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TENDER SUBMISSION FORM

Please familiarise yourself with the information contained in the Invitation to Tender before completing this form.

Name of Provider

In a few words, what activities are you proposing to carry out?

How much is your tender?

Please return this form and any supporting documents by e-mail to claire.riley@communitylincs.com

The deadline for submissions is 12pm on Friday 14th April 2017. Bids received after the deadline may not be considered.

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SECTION A

Q1 ORGANISATIONAL DETAILS 1.1 Name of the

Organisation submitting the bid

1.2 Contact name:

1.3 Address:

1.4 Telephone number:

1.5 E-mail address:

1.7 Date of registration or incorporation:

1.8 Company Registration number (ifapplicable):

1.9 Registered charity number (if applicable)

Q 2 FINANCIAL CAPABILITY TO DELIVER THE SERVICE

2.1 Please provide the name and address of your banker:

Bank:

Address

Post Code

Account number:

Sort Code:

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2.2. The most recent audited accounts for my organisation are available on the Charity Commission website:

Yes / No (please delete as appropriate)If No is selected, please include the following in your application:

a) A copy of the most recent audited accounts for your organisation for the most recent full year of service delivery or

b) If none of the above is available, please state the reason below:

Q3 LEGAL AND POLICY COMPLIANCE TO DELIVER THE SERVICE

3.1Please confirm below if your organisation has in place, or can comply with the following. T.E.D. will ask to see some or all of the following from selected delivery partners before issuing a contract:

Constitution/Articles of Association/other Governance document for the organisation

Vulnerable Adults Safeguarding Policy

Health & Safety Policy

Equalities Policy

Does your organisation have a Volunteers Policy?

User Engagement Policy: Does your organisation have an Older People Involvement/Service User Participation Policy.

Data Protection: Does your organisation have a Data Protection Policy?

Insurance : Can you confirm that the insurance levels listed below will be in place before a contract for this service is signed

Employers Liability being not less than £5 million Public Liability being not less than £5 million Public liability insurance commensurate with the risk £1 million

minimum

DBS: Can you confirm that all staff and volunteers involved in the delivery of the service in roles which are eligible for DBS checks hold up to date enhanced DBS certificates?

Complaints: Does your organisation have a Complaints Policy?

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If you have answered NO to any of the above please provide an explanation in the box below.

SECTION B: QUESTIONNAIRE

1. Please type your response to each question in the box below, not exceeding the word count. In the case of partnership bids, it will be the lead provider who will complete the questionnaire making the contribution of partners clear, with regard to each question.

2. All responses will be scored using the evaluation weighting listed with each individual question and in accordance with the evaluation model.

3. Please ensure that the declaration at the end of the questionnaire is completed.

Q1: Please provide a description of your organisation’s experience of delivering services to older people and similar to those described by the Tender Specification.

Word limit: 400 Words

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Q2: Please provide a description of how your organisation will deliver the objectives as set out in the Tender Specification?

Word limit: 1000 Words.

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Q3: How will the activity contribute to the overarching outcomes of T.E.D. in East Lindsey?

More older people will be better connected with volunteering, social, leisure and health improving activities leading to an enhanced quality of life

More older people in East Lindsey will report that they do not feel lonely or isolated More older people in East Lindsey will feel positive about the opportunities that getting older presents Older people in East Lindsey will have more opportunities to influence the design and delivery and evaluation of services

and businesses available to them.

Word limit: 400 Words.

Q4: Please attach an Action Plan showing tasks, responsibilities and clear timelines for

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delivery.

Q5: Please describe the proposed referral process in detail.

Word limit: 400 Words.

Q6: How will you involve older people in the design and delivery of your activity?

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Word limit 200 Words

Q7: What key partners have you identified to assist with the delivery of the Hub?

Word limit 150 Words

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Budget Pro-forma

Please note that the maximum available investment for this service is £40,000. Your budget proposal must be submitted on this pro-forma and in the format set out below. You may add explanatory notes if you wish.

Budget Items (add additional rows as required) Year 1

Direct Service Costs (see Note 1)

£

£

£

£

£

£

£

Indirect Service Costs (see Note 2) £

£

£

£

£

Total Service Costs £

TOTAL COST to T.E.D. £

Note 1: Direct costs are specific costs relating directly to the delivery of services under the funded project. (e.g. salary, transport and travel, premises, running costs, supplies and services, consultation and service access).

Note 2: Indirect costs are apportioned for the service from the overhead costs of the organisation as a whole. These could, for example, include a proportionate share of premises and office costs, management costs, management committee costs, professional fees. This is to enable all providers to recover the full cost of delivering the service.

Breakdown of Salary Costs

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Job Title Hours Annual salary

Pension

Employer NI

Total Cost to T.E.D.

Please attach a draft Job Description for each post identified

Additional Information:

BID SUBMISSION FORM DECLARATION

I certify that the information supplied is accurate to the best of my knowledge.

Printed Name*:

Name of Organisation/Lead Partner

Email address

Job title or position in organisation :

Date:

* Please type the name of the appropriate signatory and e mail this form to claire.riley@communitylincs.com. A handwritten signature is not required.