ESPD

Part I: Information concerning the procurement procedure and the contracting authority or contracting entity

Information about publication

Notice number in the OJS:

National Official Journal

Identity of the procurer

Official name:

Country:

Information about the procurement procedure

Type of procedure

Title:

Short description:

File reference number attributed by the contracting authority or contracting entity (if applicable):

Part II: Information concerning the economic operator

B: Information about representatives of the economic operator #1

Where applicable, please indicate the name(s) and address(es) of the person(s) empowered to represent the economic operator for the purposes of this procurement procedure:

First name

Last name

Date of birth

Place of birth

Street and number:

Postcode:

City:

Country:

E-mail:

Telephone:

Position/Acting in the capacity of:

If needed, please provide detailed information on the representation (its forms, extent, purpose ...):

C: Information about reliance on the capacities of other entities

Does the economic operator rely on the capacities of other entities in order to meet the selection criteria set out under Part IV and the criteria and rules (if any) set out under Part V below?

Yes No

Please provide a separate ESPD form setting out the information required under Sections A and B of this Part and Part III for each of the entities concerned, duly filled in and signed by the entities concerned.
Please note that this should also include any technicians or technical bodies, not belonging directly to the economic operator's undertaking, especially those responsible for quality control and, in the case of public works contracts, the technicians or technical bodies upon whom the economic operator can call in order to carry out the work.
Insofar as it is relevant for the specific capacity or capacities on which the economic operator relies, please include the information under Parts IV and V for each of the entities concerned.

D: Information concerning subcontractors on whose capacity the economic operator does not rely

(Section to be filled-in only if this information is explicitly required by the contracting authority or contracting entity.)

Does the economic operator intend to subcontract any share of the contract to third parties?