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別添３成果物フォーム②入札評価
入札評価結果
(技術札･価格札)
Primary Check
On
Request for Review of Bid Evaluation Results
Country:
Loan Agreement No.:
Project Name:
Procurement Lot No. and Description:
1. Summary of Observations & Recommendations on the Bid Evaluation Results
.
Attachment-1: List of Bidders and their Evaluation Results
Attachment-2: Description and Analysis on the Bid Evaluation
(Notes) Definition of Priority Level
A Observations on issues that explicitly violate the JICA’s Guidelines of Procurement under Japanese ODA Loans.
B Observations on issues that do not explicitly violate specific cl auses of the JICA Guidelines but are not in compliance
with JICA’s principles on procurement as indicated in the Handbook for Procurement under Japanese ODA Loans etc..
C Observations on issues that do not violate JICA’s Guidelines but deviate from JICA’s Sample Documents and
undermine fairness, clarity, and transparency, including clauses that give excessive burden or risk to the
Contractor/Supplier.
E Observations on minor errors such as misspelling, grammatical errors, inadequate numbering, inappropriate terms.
? Items that are brought for JICA’s decision.
Version 4.0/January 2013
Bid Evaluation
Page 1
別添３成果物フォーム②入札評価
Primary Check on the Request for Review of Bid Evaluation Results
ATTACHMENT 1: List of Bidders and their Evaluation Results
Country:
Loan Agreement No.:
Project Name:
Procurement Lot No. and Description:
1. List of Responsive Bids
Rank
Name of Bidders
Country
Evaluated Price
as evaluated
in JPY
Bid Price
Notes
Award
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3
4
5
6
7
2. List of Disqualified/Non-Responsive Bids
Name of Bidders
Version 3.3 /January 2013
Country
Bid Price
Reasons for Disqualification
Notes
Bid Evaluation
Page 2
別添３成果物フォーム②入札評価
Primary Check on the Request for Review of Bid Evaluation Results
ATTACHMENT 2: Description and Analysis on the Bid Evaluation
Country:
Loan Agreement No.:
Project Name:
Procurement Lot No. and Description:
I.
Evaluation Organization
(e.g.)
1st Step: Evaluation by the Consultant
2nd Step: Evaluation by Tender Evaluation Committee comprised of representatives from Ministries of xxxxx, ooooo, -------, and *****, based on the evaluation by the
Consultant.
3rd Step: Evaluation by Cabinet Appointed Tender Board comprised of xxxxx, ooooo, and *****, based on the recommendations by the Tender Evaluation Committee.
II.
Evaluation Procedures
Stage
1
2
3
4
5
6
Evaluation Procedures
e.g. Tender Opening
e.g. Preliminary Examination
e.g. Technical Evaluation
e.g. Price Evaluation
(if any)
(if any)
III.
Evaluation Results
Description/Criteria
(1) Stage-1: Preliminary Examination
Name of Bidders
Evaluation Results
(2)Stage-2: Technical Evaluation
Name of Bidders
Version 3.3 /January 2013
Evaluation Results
Bid Evaluation
Page 3
別添３成果物フォーム②入札評価
Name of Bidders
Evaluation Results
(2) Stage-3: Price Evaluation
Name of Bidders
Evaluation Results
(3) Stage-4: (if any)
Name of Bidders
IV.
Evaluation Results
Observations on the Bid Evaluation
Satisfactory?
Points for Consideration
Yes
1. General
(a) Transparency / Clarity of Evaluation Process
(b) No Major Difference in Evaluations between Consultant’s
Version 3.3 /January 2013
Priority
Level
Observations and Recommendations
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No N/A
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Bid Evaluation
Page 4
別添３成果物フォーム②入札評価
Satisfactory?
Points for Consideration
Yes
and Borrower’s (Executing Agency’s)
Conformity of the Evaluation Process to the Procedures
Stipulated in the Bidding Documents
(d) Confirmation of the Acknowledgment of Compliance
(e) No Breach Factor of Cross Debarment
(f) No Factor of Conflict of Interest
(g) Inclusion of Declaration Form of the eligibility under STEP
(only applied for STEP projects)
（h） No infringe on Cross debarment by the Multi Development
Banks
2. Preliminary Examination and Technical Evaluation
(a) Appropriateness of Reasons for Disqualification in light of
the Stipulations in the Bidding Documents and International
Standards for Bidding Practice
(b) No Factor Evaluated with Advantage/Disadvantage to
Specific Firms without Any Justification
3. Price Evaluation
(a) Appropriateness of Price Adjustments in light of the
Stipulations in the Bidding Documents
(b) No Preferential Margin
(c) Predetermined Bid Price
4. Overall Observations on the Evaluation Results
(c)
Version 3.3 /January 2013
Priority
Level
Observations and Recommendations
No N/A
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Bid Evaluation
Page 5
別添４
意見提出フォーマット
（案件名）円借款事業に係る調達関連書類一次チェック業務
（公告日：2014年 11月18日）について、以下のとおり意見を提出します。
通番
1
社名
:
所在地
:〒
担当者名
:
Tel
:
E-mail
:
該当頁
該当項目
質問
2
3
4
5
6
7
8
9
10
(記入例)
P.9
第2 3.(2)③ 成果品
成果品としてCD-ROMでのデータ提出の指示があるが、何枚提出すればよいのか。
※このフォーマットで書ききれない場合には、適宜行数を増やすなどして対応願います。
※本フォーマットは電子メールで送付戴くようお願いします。(Excel形式で送付願います。）
※電子メールの送付先アドレスは「意見招請実施要領」に記載のアドレスとなります。[email protected]
※ 様式のデータは、国際協力機構ホームページ「調達情報」→「調達ガイドライン、様式」→「様式　一般競争入札：総合評価落札方式
（国内向け物品・役務等）」→「質問書（Excel)」（http://www.jica.go.jp/announce/manual/form/domestic/op_tend_price.html）より
ダウンロードしたものを、適宜修正のうえ利用頂くことも可能です。

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