application form Word, 286KB - Melbourne Emergency Response and

By Gregory Cooper,2014-03-02 19:51
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Online and Web Analyst. Senior Online and Web Analyst. Manager, IT OperationsSenior Business Analyst. Project Manager. Senior Project Manager. IT Data


    MUL ID:

    ICT services

Multi-Use List for Information and Communication

    Technology (ICT) Services

    Part B Application Form

    All sections of the application form must be completed as well as a Schedule for each Service

    Type your organsiation seeks to provide under the MUL arrangement.

Company Details

    Organisation Name/Trading Name:

    Australian Business Number (ABN):

    Postal Address:

    Street Address:

    Small to Medium Enterprise (SME)?

    Indicate here whether the Applicant is an Australian or New Zealand firm with fewer than 200 full time equivalent employees.

    Any related companies within the meaning of Section 50 of

    the Corporations Act 2001 (Cth)?

    Primary Contact Details






    Postal Address:

    Page 1 of 9

In the last five years, have you or any of the directors of the company (if applicable):

    ; been declared bankrupt or had bankruptcy proceedings brought against YES NO


    ; been a director of any business that has failed, e.g. gone into YES NO

    liquidation, voluntary administration or receivership?

    ; been convicted of an offence against a Commonwealth, State or YES NO

    Territory law resulting in a custodial sentence?

    ; been convicted of an offence against a Commonwealth, State or YES NO

    Territory law involving dishonesty?

    ; failed to perform any substantive requirement or obligation under any YES NO

    prior grant funding agreement or contract with the Australian


    ; been a director of an organisation or a business that has failed to YES NO

    perform any substantive requirement or obligation under any prior

    grant funding agreement or contract with the Australian government?

    If “yes”, please provide details.

Financial Viability

    Briefly describe your organisation’s corporate history. If your organisation has been involved in significant litigation, real or possible organisational change or disruption (past, present or

    pending), or any other activity which may be of interest to AUSTRAC, please provide details.

Core Business Activity

    Provide a statement that outlines the core business activity of your organisation. You should

    highlight your organisation’s specialised skills and previous experience in providing services similar to those required under this MUL. You should list the geographic locations in which

    your organisation can provide the Services.

    Page 2 of 9

Capacity to provide Services

    Please indicate the Services your organisation wishes to provide to AUSTRAC under the

    MUL arrangement. Note that for each Service type you select you will need to complete a

    separate Schedule in the template format of the Schedule to this Part B, describing your

    organisation’s expertise and specialist ability in that specific Service area. The Schedule(s) are

    to be attached to your Application. The full description of the Services required for each

    Service type can found at Part A - Attachment A.

Service Type Indicate Yes/No

    Help Desk Analysts

    Desktop Support Analysts

    Senior Desktop Support Analysts

    Desktop Support Team Leader

    Manager, IT Service Desk and Support

    Windows Systems Engineer

    Senior Windows Systems Engineer

    Team Leader, Windows Systems

    Windows Systems Architect

    Manager, Windows Systems

    Communications and Security Engineer

    Senior Communications and Security Engineer

    Team Leader, Communications and Security

    Manager, Communications and Security

    UNIX Administrator

    Senior UNIX Administrator

    UNIX and Security Administrator

    Senior UNIX and Security Administrator

    UNIX and Security Architect

    Team Leader, UNIX and Security

    Manager, UNIX and Security

    Database Administrator

    Senior Database Administrator

    Team Leader, Database Administration

    Manager, Database Administration

    Page 3 of 9

    Service Type Indicate Yes/No

     Online and Web Analyst

    Senior Online and Web Analyst Manager, IT Operations Senior Manager, IT Operations Director, IT Operations IT Administrator IT Security Advisor Director, IT Security Test Analyst Senior Test Analyst Manager, Testing and Quality Assurance Senior Manager, Testing and Quality Assurance Director, Testing and Quality Assurance Business Analyst Senior Business Analyst Project Manager Senior Project Manager IT Data Architect IT Systems Architect Enterprise Architect Director, IT Architecture Documentation Analyst Development Database Administrator Release Manager Analyst Programmer Senior Analyst Programmer Team Leader, IT Systems Manager, IT Systems Senior Manager, IT Systems Director, IT Systems Chief Information Officer

    Page 4 of 9

Conflict of Interest

    Applicants must declare any real or perceived conflicts of interest that exist or may exist in the provision of these Services.

Statement of Non-Compliance

    If Applicants are non-compliant with any requirement of Part A of the MUL they must state their non-compliances in accordance with the Statement of Non-Compliance format table below. Failure to list all non-compliances will render an Applicant ineligible for the MUL.

     Reference Comments

    (e.g. clause 3.26) (Note 1)


    Attachment A Statement of


    Attachment B MUL Rules

    Note 1:

    If the Appliant does not comply with a particular requirement, the Applicant is to state the extent, justification and impact of non-compliance and details of any alternative clause.

    Page 5 of 9

Declaration by Applicant

    Conflict of Interest

    The Applicant represents, after having made all reasonable enquiries, that it either does not have any actual or potential conflicts of interest in respect of the MUL, its Application or the provision of the Services, or it has declared all such actual or potential conflicts as part of Part B Application Form.

    The Applicant undertakes to advise AUSTRAC in writing of all actual or potential conflicts of interest in respect of the MUL, its application or the provision of the Services immediately upon becoming aware of the same.

    Employee entitlements

    The Applicant declares that, having made all reasonable enquiries as at the date of this declaration, there are no unsettled judicial decisions against the Applicant (not including decisions under appeal) relating to unpaid employee entitlements.

YES, I declare that there are no unsettled NO, I do not declare that there are no

    judicial decisions against the Applicant unsettled judicial decisions against the

    relating to unpaid employee entitlements. Applicant relating to unpaid employee


    Equal opportunity for women

    The Applicant declares that it is not currently named by the Equal Opportunity for Women in the Workplace Agency (EOWWA) as not complying with the Equal Opportunity for Women in the

    Workplace Act 1999 (EOWW Act).

YES, I declare that the Applicant is not NO, I do not declare that the Applicant is not

    named by the EOWWA. named by the EOWWA.

    Further Representations and Acknowledgements

    The Applicant makes the following further representations to AUSTRAC:

    ; it has examined the MUL documentation and any other documents referenced or referred to in

    the MUL documentation, and any other information made available by AUSTRAC for the

    purposes of submitting their application;

    ; it has read, taken appropriate advice on and fully understood the MUL and its requirements;

    ; it has sought and examined all necessary information which is obtainable by making reasonable

    queries relevant to the risks and other circumstances which may have an effect on its


    ; it has satisfied itself as to the correctness and sufficiency of its Application; and

    Page 6 of 9

    ; it has accepted and has fully complied with the provisions of the MUL, including the terms and

    conditions in the MUL (except where otherwise stated).

    The Applicant acknowledges that:

    ; AUSTRAC will be relying on all of the information contained in, and all of the representations

    made in, the application and any subsequent written and/or verbal clarifications; ; AUSTRAC may exercise any of its rights set out in the MUL, at any time;

    ; the statements, opinions, projections, forecasts or other information contained in the MUL may


    ; neither the lodgement of the MUL nor the acceptance of any application, nor any agreement

    made subsequent to the MUL, will imply any representation from or on behalf of AUSTRAC

    that there has been no material change since the date of the MUL or since the date as at which

    any information contained in the MUL is stated to be applicable;

    ; except as required by law and only to the extent so required, neither AUSTRAC, nor its

    respective officers, employees, advisers or agents will in any way be liable to any person or

    body for any loss, damage, cost or expense of any nature arising in any way out of or in

    connection with any representations, opinions, projections, forecasts or other statements, actual

    or implied, contained in or omitted from the MUL;

    ; the Applicant will be responsible for all costs and expenses related to:

    o the preparation and lodgement of its Application;

    o any subsequent negotiations;

    o any other action or response in relation to this MUL; and

    o where the Applicant has sought its own professional advice as appropriate and has not

    construed the MUL as investment, legal, tax or other advice.


    The Applicant acknowledges that AUSTRAC may disclose, and consents to AUSTRAC disclosing, any

    information provided by the Applicant, whether confidential or not:

    ; to its employees and contractors solely in order to evaluate or otherwise assess the MUL; ; to its internal management personnel solely in order to evaluate or otherwise assess the MUL; ; to the responsible Minister;

    ; in response to a request by a House or a Committee of the Parliament of the Commonwealth of


    ; to another agency, where this serves the legitimate interests of the Commonwealth; ; where the information is authorised or required by law to be disclosed;

    ; where the information is in the public domain otherwise than by AUSTRAC’s disclosure; and

    Page 7 of 9

    ; where the disclosure is required to meet AUSTRAC’s reporting or accountability requirements,

    including, without limitation:

    o under the Financial Management and Accountability Act 1997;

    o to the Australian National Audit Office or any other auditor appointed by the AUSTRAC;

    o in accordance with the provisions that require notification of agency contracts on


    o in accordance with the Requirements for agency annual reports (published by the

    Department of the Prime Minister and Cabinet); and

    o to the Commonwealth Ombudsman.

    The Applicant acknowledges that AUSTRAC has received this application in reliance on this Declaration. The Applicant acknowledges that AUSTRAC may suffer loss if any of the representations, undertakings, consents or other statements in this Declaration or the Applicant’s Application are

    misleading or deceptive.


Duly Authorised to Sign Application for and on Behalf of (state full name of Applicant)

Signature of Applicant’s Representative

Name if Representative

Position of Representative

Signature of Witness Address of Witness

Refer Enquiries in relation to this application to Telephone no.

    Page 8 of 9

Schedule to MUL Application

    Template for Response

    Note to Applicants: You must complete a separate Schedule for each Service Type your organisation proposes to provide to AUSTRAC under the Multi-Use List arrangement. For each Schedule, please indicate which Service Type you propose to provide and include responses to the questions outlined below.

    Service Type:

    1. Expertise and Specialist Skills

    Outline your organisation’s expertise and specialised skills in providing the Service

    Type you have nominated in Part B Capacity to Provide Services.

    Page 9 of 9

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