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Individual Consultants: Expression of Interest

This document is an Expression of Interest form for an individual consultant for an ADB project. It includes: 1) Basic project information including the project number, name, and country. 2) The consultant's personal information including name, nationality, address, email, and ADB registration number. 3) A section for the consultant to provide their qualifications and experience relevant to the assignment. 4) An eligibility declaration where the consultant certifies that they meet ADB requirements for eligibility including not being employed by the executing or implementing agency, not being part of the terms of reference writing team, not being sanctioned by ADB or other MDB, and understanding the consequences of any misrepresentations.

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Chandeshwor Shah
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462 views

Individual Consultants: Expression of Interest

This document is an Expression of Interest form for an individual consultant for an ADB project. It includes: 1) Basic project information including the project number, name, and country. 2) The consultant's personal information including name, nationality, address, email, and ADB registration number. 3) A section for the consultant to provide their qualifications and experience relevant to the assignment. 4) An eligibility declaration where the consultant certifies that they meet ADB requirements for eligibility including not being employed by the executing or implementing agency, not being part of the terms of reference writing team, not being sanctioned by ADB or other MDB, and understanding the consequences of any misrepresentations.

Uploaded by

Chandeshwor Shah
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Expression of Interest

Individual Consultants
A. Project Data
Project Number
Project Name
Project Country
B. Consultant Data (pre!populated from C"# re$istration%
Name
Country of Nationality
Address of consultant
E-mail of consultant
ADB-CMS No.
Assi$nment #pecific &ualifications and Experience
Assignment Specific Experience (Proide information demonstrating your a!ility" s#ills
and experience to underta#e adertised assignment and delier inputs$ outputs re%uired under
t&e '()*
(t&er +nformation (if t&is E(+ is filled on t&e !asis of simplified CMS registration" please
proide summary of your %ualifications and attac& your C, to your CMS registration*
C. Eli$ibility Declaration
I, the undersigned, certify to the best of my knowledge and belief
My CMS registration contains current contact details
The CV I attached to my CMS registration correctly describes my qualifications and
my experience
I am not employed by the Executing or the Implementing Agency
I am not part of the team who wrote the terms of reference for this consulting
serices assignment!
I am not sanctioned "not eligible for engagement# by A$% or another M$%!
I have not been convicted of an offense or crime related to theft& corruption or fraud!
I understand that it is my obligation to notify A$% should I become ineligible to
wor' with A$% or another M$%& or should I be conicted of an offense related to
theft& corruption or fraud!
I understand that any misrepresentations that knowingly or recklessly mislead, or attempt to
mislead may lead to the automatic rejection of the proposal or cancellation of the contract, if
awarded, and may result in further remedial action, in accordance with ADBs Anticorruption
Policy
Completed by
(Name'Position%
Date (dd'mm'yyyy%
E(+-indiiduals
Dec -./.

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