JOINT VENTURE VERIFICATION AFFIDAVIT
UNDERTAKING BY THE REPRESENTATIVE OF THE ENTITY (THIS MUST BE SIGNED FOR EACH COMPANY FOR BY AN
AUTHORISED REPRESENTATIVE
WE, the undersigned,
Joint Venture Agreement Name: ___________________________________________________
JV Tender Number: ___________________________________________________
Participating Entity Name: ___________________________________________________
Participating Entity Name: ___________________________________________________
Participating Entity Name: ___________________________________________________
WE HEREBY STATE UNDER OATH / SOLEMNLY AFFIRM:
1. We are party to a Joint Venture Agreement and are authorised to sign on behalf of the above entities for
the purpose of a Joint Venture Agreement B-BBEE Verification.
2. I hereby declare that the shareholding structure of this entity is as listed below:
Organization Shareholders Percentage
Holding BEE Rating
Operational Involvement
Voting Rights
Name % Level Yes/No %
Total Holdings %
4. We hereby declare that the information supplied in this affidavit is true and correct to the best of our
knowledge. We understand that providing false information or failing to provide the information required
constitutes a misrepresentation. We agree and accept that HARVEST CHARTERED ACCOUNTANTS may wish to
verify the correctness of the information we have provided.
SIGNED AT ________________ON THIS THE _________DAY OF__________________20____.
REPRESENTATIVE NAME: ____________________________ SIGNATURE: _______________________________________________
REPRESENTATIVE NAME: ____________________________ SIGNATURE: _______________________________________________
REPRESENTATIVE NAME: ____________________________ SIGNATURE: _______________________________________________
COMMISSIONER OF OATHS
I HEREBY CERTIFY that the representative has acknowledged that he knows and understands the contents of this
Affidavit.
Commissioner of Oaths: ___________________________________________
Place of signing: ___________________________________________ Date: ____________________________
