Application to become a Rewards for Residents/Rewards for Business Discount Provider

1) Introduction

Switch Your Thinking is an initiative of the City of Armadale, City of Gosnells and the Shire of Serpentine Jarrahdale working together since 2002 as the South East Regional Energy Group (SEREG). The Switch Your Thinking programs core mission is to encourage and enable people to live and work in a way that meets their needs without jeopardising the ability of future generations to meet their own needs. The program was also devised as a means of linking seemingly disparate projects and actions under an easily recognisable brand. It has been strategically designed to engage the community in participating in our efforts to reduce regional greenhouse gas emissions.

Switch Your Thinking enters into partnerships with companies that can offer residents and businesses of participating Switch Your Thinking Councils access to goods/services at a discounted rate, which will enable them to live or operate in a more sustainable and environmentally friendly manner. This is made possible via Switch Your Thinking’s Rewards for Residents and Rewards for Business programs.

To ensure the integrity of the Program is upheld, Switch Your Thinking requires all potential business partners to complete this application form. Applications will be assessed every three months during meetings of the South East Regional Energy Group.

2) Selection Process

Potential Rewards for Residents/Rewards for Business discount providers will be selected by an Evaluation Panel comprising of up to six SEREG elected members using the information supplied both by the applicant within their applications and from external independent information sources such as the Australian Business Register, Equifax and online reviews.

Applicants who can demonstrate a commitment to the underling objectives of the Switch Your Thinking Program, the ability to supply high quality goods and services to Rewards for Residents and/or Rewards for Business program participants at an affordable price and who are considered by the evaluation panel to represent the most advantageous outcome to the program may be selected.

The evaluation panel will undertake the following comprehensive assessment:

Applications are checked for completeness and compliance. Applications that do not contain all information requested may be excluded from evaluation.
Applications are then assessed against the selection criteria contained within this application.
The most suitable applicants may be short listed and may also be required to clarify their submission, make a presentation and/or demonstrate the goods/services offered. Referees may also be contacted prior to the selection of the successful applicants.

3) Company Information

Please provide the following details...

Company Name: *

Trading Name(s) *

Australian Business Number (ABN) *

ABN/GST Status *

Australian Company Number (ACN) if any:

Yrs Business in operation *

Business Primary Telephone Number *

Business Facsimile Number

Business Primary E-mail Address *

Business Website Address *

Primary Business Address *

Street address *Street address line 2

City *

State *

Postcode *

Postal Address (If different from Primary Business Address)

Street address

City

State

Postcode

Affiliated Company's/Business Partners:

Primary Contact Name: *

Secondary Contact Name:

Primary Contact Position Title: *

Secondary Contact Position Title

Primary Contact Phone # *

Secondary Contact Phone #

Primary Contact E-mail Address *

Secondary Contact E-mail Address

4) Insurance Requirements

Please supply current copies of the following insurances with this application...

Goods/Services: offered directly to participants of the Switch Your Thinking Rewards for Residents and/or Rewards for Business program.

a) Public & Product Liability Insurance - minimum value $10,000,000 per occurence

b) Workers Compensation Insurance - $50,000,000 per in cident as per WA Health and Safety Act 2020. Note: Sole traders exempt, volunteer organisations to supply valid copy if Accident Insurance.

Professional Advice: please supply a) & b) above plus the following...

c) Professional Indeminty Insurance - minimum value of $2,000,000 per occurance.

All companies providing goods/services to participants in the Switch Your Thinking Rewards for Residents and/or Rewards for Business programs are required to supply updated copies of all insurances to Switch Your Thinking throughout the length of any agreement reached between both parties.

Please attach valid Public/Product Liability Insurance

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Please attach valid Workers Compensation Insurance (sole traders exempt)

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Please attach valid Professional Indemnity Insurance (if applicable)

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Other Insurance Certificates 1

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Other Insurance Certificates 2

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5) Selection Criteria

a) Compliance Criteria

The following criteria will not be point scored. Each application will be assessed on a Yes/No basis as to whether the criterion is satisfactorily met. An assessment of “No” against any criterion may eliminate the application from consideration.

Commitment to the Switch Your Thinking Program including the environmental objectives *

YESNO

Application signed by an authorised officer and witnessed *

YESNO

Applicant has all necessary insurance types and amounts *

YESNO

There are no conflicts of interest reasonably expected to affect the program *

YESNO

The applicant is able to pay all debts in full as and when they fall due *

YESNO

Have there been any insurance claims made against the applicant in the preceding 5 years, are the outcomes acceptable to the EP? *

YESNO

Is the applicant currently involved in any litigation and if so is the type of such that it may reasonably affect the program? *

YESNO

b) Qualitative Criteria

i) Business Information (Weighting 30%)

What is your Core business? *

How long has your company been operating in this type of business *

Less than 6 months1-2 years3-5 years5 years or more

Is your company a member of any professional or industry association(s), if so please detail? *

What accreditation(s) does your company hold? *

Has your company been a provider for the Switch Your Thinking Rewards for Residents/Rewards for Business program in the past? *

YESNO

CONFLICTS OF INTEREST

Is it likely that any actual or potential conflicts of interest will arise because of, your company becoming a provider of goods/services to participants of the Switch Your Thinking Rewards for Residents and/or the Rewards for Business program? *

YESNO

If Yes, please provide details:

SUBCONTRACTORS

Do you intend to subcontract the delivery of any goods/services to participants of the Switch Your Thinking Rewards for Residents and/or Rewards for Business program? *

YESNO

If Yes please provide the following details for each sub-contractor

Contractor/Business name:
Contact Name:
Address:
Phone:
E-mail:

Subcontractor 1 Details *

Subcontractor 2 Details

Subcontractor 3 Details

Subcontractor 4 Details

What are the goods/services that will be delivered by each subcontractor?

Goods/Services Delivered by subcontractor 1 *

Goods/Services delivered by subcontractor 2

Goods/Services delivered by subcontractor 3

Goods/Services delivered by Subcontractor 4

Please list the controls your company has in place to maintain quality in the delivery of goods/services through subcontractors.

List of controls *

QUALITY ASSURANCE

Is your company certified against any Quality Assurance Systems? *

YESNO

Please Provide Details *

ii) Key Personnel details (Weighting 10%)

Please provide details of Key company personel including...

Name
Position Title
Experience
Attach relevant qualifications

Key Personnel 1 Name: *

Key Personnel 1 Position Title: *

Key Personnel 1 Experience: *

Key Personnel 1 Qualifications *

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Key Personnel 2 Name:

Key Personnel 2 Position Title:

Key Personnel 2 Experience

Key Personnel 2 Qualifications

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Key Personnel 3 Name:

Key Personnel 3 Position Title

Key Personnel 3 Experience:

Key Personnel 3 Qualifications:

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Key Personnel 4 Name:

Key Personnel 4 Position Title

Key Personnel 4 Experience:

Key Personnel 4 Qualifications

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If possible, please attach a flow chart of your company’s organisational structure, key personnel, roles, and responsibilities.

Flow Chart of Organisational Structure

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How will you inform frontline staff about your company’s involvement in the Switch Your Thinking program, and maintain the currency of that information? *

iii) Environmental Position and Switch Your Thinking understanding and commitment (Weighting 30%)

What are your company’s environmental policy/position/objectives? *

How do you think that your business activity links in with the Switch Your Thinking program? *

iv) Proposal (Weighting 30%)

Please provide details of the goods/services your company wishes to offer through the Switch Your Thinking Rewards for Residents and/or the Rewards for Business programs by completing the table shown below. Please include details of any applicable warranty periods.

Description of Goods/Service 1: *

Details of Offer 1: *

Offer is applicable to Rewards for Residents *

YESNO

Offer is applicable to Rewards for Business *

YESNO

Warranty Period (if Applicable) *

Description of Goods/Service 2:

Details of Offer 2

Offer 2 is applicable to Rewards for Residents

YESNO

Offer 2 is applicable to Rewards for Business

YESNO

Offer 2 Warranty Period (if applicable)

Description of Goods/Service 3:

Description of Offer 3:

Offer 3 is applicable to Rewards for Residents

YESNO

Offer 3 is applicable to Rewards for Business

YESNO

Offer 3 Warranty Period (if applicable)

v) Reporting

Are you willing to provide information about your Rewards for Residents/Rewards for Business offer (e.g sales numbers) to Switch Your Thinking as requested? *

YESNO

vi) References

Reference 1 Business Name (if applicable)

Reference 2 Business Name (if applicable)

Reference 1 Business Address (if applicable)

Reference 2 Business Address (if applicable)

Reference 1 Name: *

Reference 2 Name: *

Reference 1 Position Title (if applicable)

Reference 2 Position Title (if applicable)

Reference 1 Phone: *

Reference 2 Phone: *

Reference 1 E-mail *

Reference 2 E-mail *

Reference 1 Business Website Address (if applicable)

Reference 2 Business Website Address (if applicable)

COMPLETING YOUR APPLICATION

Carefully read all parts of this document and ensure you understand the requirements.
Ensure that you have addressed all compliance criteria.
Complete and return all required qualitative criteria including the functional requirements.
Indicate any additional options and/or features your offer includes and detail these within the functional requirements.
Complete, sign and click submit.

FREEDOM OF INFORMATION

Documents and other information relevant to the contract may be disclosed when required by law under the Freedom of Information Act 1992 or under a Court order.

FORM OF OFFER

I/We agree that I am/We are bound by and will comply with this application and its associated schedules, attachments, all in accordance with the application conditions.

Signature of authorised signatory of Tenderer *

Clear

Name of authorised signatory *

Position *

Address *

Witness Signature *

Clear

Name of Witness *

Address of Witness *

Date *

Month *

Year *