| Ghana Forestry Commission |
| Application
for Pre-qualification to bid for Timber Utilisation
Contracts |
Non-disclosure notice: All information provided by the applicant with
this application form will be held confidential
by the Timber Resource Evaluation Committee,
unless it was previously in the public domain
or unless it is required to be disclosed
pursuant to law, in which case the Timber
Resource Evaluation Committee will give
the applicant reasonable notice of the required
disclosure. |
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Please read all instructions carefully: |
Please use
CAPITALS |
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1. Applicant
organisation |
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Write
the full name of the organisation applying
to pre-qualify. |
1.1 Applicant’s registered
name: |
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Write the applicant’s
business registration number.
Please attach a certified
copy of the applicant’s current
business certificate. |
1.2 Applicant’s registration
number: |
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Date of registration: |
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Month: |
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Year: |
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Describe the exact nature
of the applicant’s current business
activities |
1.3 Nature of applicant’s
current business: |
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Please tick the appropriate
box and for each box you have ticked, attach
a certificate from the Internal Revenue
Service or the Social Security and National
Insurance Trust showing that the applicant
has no payments outstanding which are required
to have been made by the application date. |
1.6 Has the applicant fully paid
the following? |
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2. Forest
utilisation record |
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List
all agreements to utilise forest resources
including licences, leases, permits and contracts
that are currently held or have been held
by the applicant organisation in the past
10 years. Provide the total area in square
km, the date when the agreement was issued
and, if not current, the expiry date. |
2.1 Forest utilisation agreements |
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Name |
Area (km2) |
Date Issued |
Date Expired |
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Add
up the areas of all agreements currently held: |
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Total
area of current agreements (km2): |
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Tick
Yes if the applicant has no outstanding
fees other than those within the period allowed.
Attach certification from the
Forest Services Division and/or the Timber
Industry Development Division stating that
there are no outstanding fees.Tick No
if the applicant has any outstanding charges
such as stumpage fees, rents, levies. Please
attach a list of outstanding fees showing
type, amount and date due. |
2.2 Forest industry chargesAre all the applicant’s forest
or wood industry charges paid up to date? |
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Tick
No only if the applicant has
not been convicted of or admitted to any breach
of any forest or timber industry law or regulation
in the last 2 years. Attach certification
from the Forest Services Department stating
that there have been no breaches.Tick Two
or more if the applicant has been convicted
of or has admitted to committing 2 or more
breaches of any forest or timber industry
law or regulation in the last 2 years. |
2.3 Compliance with forest regulationsHas
the applicant been convicted of or admitted
to any breach of forest laws or regulations
in the last 2 years? |
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No breaches |
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Only one breach |
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Two or more breaches |
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Describe
briefly the nature of the breach (e.g. illegal
logging), and state the date of conviction
or administrative sanction and the sanction
imposed (e.g. amount of fine) |
If you did not tick
the first box (no breaches), please list all
breaches that the applicant has been convicted
of or has admitted to in the two years preceding
this application: |
| Breach |
Date |
Sanction imposed |
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3. Financial
capability |
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Calculate the applicant’s
average sales over the last 5 accounting
periods as shown in the audited income statements
and tick the appropriate box.
This will determine whether
the applicant is categorised as “small”,
“medium” or “large”.
Please attach the audited
accounts showing both profit and loss
and income statements. |
3.1 Annual turnover
What was the applicant’s
average annual turnover during the last
five accounting periods? |
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Less than US$500,000 (Small)
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Between US$500,000
– $4,999,999 (Medium) |
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US$5 million or more (Large) |
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If you have ticked the first
box in Question 3.1 (Turnover less than
US$500,000) go directly to Section 5.
If you have ticked the second
or third box, please continue to Section
4. |
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4. Downstream processing
and value added |
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Tick Yes if the applicant
operates any log processing facility such
as a sawmill or veneer plant, or further
downstream processing such as manufacture
of plywood, mouldings or furniture. |
4.1 Current processing capacity |
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Does the applicant have installed
wood processing capacity? |
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If you ticked Yes to
Question 3.1, describe all the downstream
processing operated directly by the
applicant. |
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4.2 Existing processing facilities |
| Location |
Type |
Capacity (m3) |
Employees |
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If you ticked No to
Question 3.1, state whether the applicant
has an application for investment in wood
processing that has been recommended by
the Forestry Commission and approved by
the Minister of Lands and Forests as qualifying
for the incentives described in Act
617?
If you tick yes please
attach a copy of the approval. |
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4.3 Approved investment application |
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If No, does the applicant
have an approved application to invest in
a wood product processing? |
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4. Declaration |
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I hereby certify that I am
authorised to sign this application on behalf
of the applicant organisation.
I further certify that all
statements made in this application are
to the best of my knowledge true and accurate.
I understand that the Timber
Resource Evaluation Committee may independently
check any records or conduct such audits
that it considers warranted to verify the
accuracy of any statement made in this application
and may take appropriate action against
me personally, including criminal proceedings
for fraud, should any statement made be
shown to be intentionally false or misleading. |
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For and on behalf of: |
| Applicant: |
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| Signature: |
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| Name: |
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| Date: |
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| Position: |
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5. Attachments |
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Please tick each box to ensure
the following documents are attached with
your application.
Include your application
fee in cheque or cash as follows depending
on size category:
Small: ˘100,000
Medium: ˘250,000
Large: ˘500,000 |
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Current business certificate |
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Income tax clearance certificate |
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Social security clearance certificate |
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VAT clearance certificate |
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FSD certificate of
no outstanding forest fee payments,
or list of outstanding fees |
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FSD certificate of
no breaches of forest laws or regulations
in last 2 years, or list describing
breaches |
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Audited financial accounts for each of last 5 years |
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If a “Large”
or “Medium” sized organisation,
and not a current processor, a copy
of approved investment application |
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For
TREC use only |
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Date received: |
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Registration: |
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Category: |
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Financial capacity: |
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Financial compliance: |
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Legal compliance: |
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Decision: |
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Signature: |
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Chairman, Timber Resource
Evaluation Committee |
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