Waha Oil Company
Contractor Pre-Qualification Questionnaire
‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
Pre- qualification questionnaire for contractors (please fill in the blanks)
Company name
Date
-This Questionnaire was filled in (please “”)
On Waha Oil Co. Request for the updating of Waha Vendors' List
On Waha Oil Co. Request for the inclusion in Waha Oil Co. Bidders' List
Subsequent to Contractor / Supplier's Application.
This pre- qualification questionnaire is intended to collect technical, financial and organizational data on
the supplier of services and / or products for the oil and gas industry, for the purpose of evaluating the
supplier to be included in the pre – qualified suppliers’ list for Waha Oil Company.
Instructions for the data/ information entry:
No.
1.
2.
3.
4.
5.
Instruction
Detailed information on partners, affiliates, etc shall be specified with
appropriate attachments.
Sections not applicable should be annotated “N/A”
Duplicate if necessary and attach any additional information, data sheets,
catalogues, brochures, etc as appropriate.
“Company” Means your Company, “Unit” means any departmental / divisional
section of your Company
For any clarification, please contact Waha Oil Company Pre-qualification
Committee on Tel No 00(218) 21-4 811852 Fax No 00(218) 21-4 811852
Persons involved in this Questionnaire compilation
Compiler of the questionnaire and authorized contact for follow – up (please fill in the blanks)
Name
Position
Telephone
No.
Email
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Unit/ Department
fax No.
Rev(0) June 2012
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‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
Contents
1. Company General Information .................................................................................................................. 3
1.1- Registration and Authorization........................................................................................................ 3
Company Primary Business Activities: ...................................................................................................... 4
2. Manpower Resources ............................................................................................................................... 4
2.1- Organization structure....................................................................................................................... 4
2.2-Permanent Staff & Craft ................................................................................................................. 5
3. Financial information ................................................................................................................................. 6
4. Insurance .................................................................................................................................................. 6
5. Relevant Company Experience ................................................................................................................ 6
6. Workload ................................................................................................................................................... 7
Future Projects ....................................................................................................................................... 8
7. Engineering Capability .............................................................................................................................. 8
8. Procurement .............................................................................................................................................. 8
9. Quality Assurance ..................................................................................................................................... 9
10. Project Management Systems ................................................................................................................ 9
11. Health, Safety & Environmental (HSE) ................................................................................................... 9
12. Environmental Compliance ................................................................................................................... 10
13. Professional and Business Standing .................................................................................................... 11
14. Declaration ............................................................................................................................................ 12
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Rev(0) June 2012
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‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
1. Company General Information
Company Name
Telephone
Registered Office address
Fax
Company Origin
Mailing address
Legal representatives’ Name
e- mail
Telephone
Fax
Parent Company/Previous Business Names
Telephone:
Fax:
website
Enquiries to be Sent to
Company Registration No
Company type
Date of Registration
Partnership
Public Limited
Private Limited
Other
Country of registration
Under Present Ownership since:
Names of Owner(s)
Contact for insurance information
1.1- Registration and Authorization
Yes
Yes
Yes
No
Yes
No
Yes
No
Yes
No
Does your company have any previous experience with Waha oil company
Yes
No
If Yes, please attach details.
Yes
No
Does your company have any previous experience in Libya
Yes
No
If Yes, please attach details.
Yes
No
Fully Libyan Company ( if Yes attach details ) .
Foreign Company Officially Registered in Libya (If yes attach details)
During the last five years has your organization been in bankruptcy or statutory
reorganization
During the last five years has your organization been Abandoned work on any contract prior
to it’s’ completion?
During the last five years has your organization been a defendant in any court action alleging
breach of contract?
If any individual or entity owns legally or beneficially more than thirty percent (30%) of your organization,
give name and address of such individual entity.
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Rev(0) June 2012
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‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
Company Primary Business Activities:
Main Business Activity:
Work normally Subcontracted:
List manufacturers for whom you are a licensed distributor / supplier (please attach copy of license)
1.
2.
3.
4.
5.
6.
2. Manpower Resources
2.1- Organization structure
(Please fill the following table)
No.
Key Position
Available
1.
Chairman /CEO
Yes
No
2.
General Manager
Yes
No
3.
Finance Manager
Yes
No
4.
Accounting Manager
Yes
No
5.
Sales Manager
Yes
No
6.
Technical Manager
Yes
No
7.
Operation Manager
Yes
No
8.
Procurement Manager
Yes
No
9.
Quality Manager
Yes
No
10.
Safety Manager
Yes
No
11.
Other
Yes
No
Full Name
Please attach the current organization chart of the company (if the company is part of
group please provide organization chart indicating the relevant position).
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Rev(0) June 2012
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‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
2.2-Permanent Staff & Craft
Please indicate the core staff and craft that you consider as permanent manpower and include the average years of
continuous employment with your company (please add to table as required) Also please indicate which works /
disciplines that you would normally subcontract .In addition to the table below, please supply a manpower histogram
to reflect permanent manpower resources covering the previous 2 years.
Number of Personnel
Total
Staff
Junior
Senior
Principal
Available
Combined
years of
experience
Project Management
Engineering
PDDM (Document Control)
Quality
HSE
Project Controls
Procurement
Construction Management & supervisor
Training
Finance
Contracting
IT
Craft
Civil
Mechanical
Electrical
Instrumentation
Others
2.31
2
Please answer the following (Yes / No )
Has any of your personnel ever been employed by Waha Oil Co
Company? If Yes, attach details.
Have any of your key personnel been involved in any firm, which
has been bankrupt, liquidated or gone into receivership? If Yes,
attach details.
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Yes
No
Yes
No
Rev(0) June 2012
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‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
3. Financial information
Last year
Second year
Third year
$
$
$
Turnover Value
Has your company met the terms of its banking facilities and loan arrangements during
the past year? If “No” please explain why.
Yes
No
Has your company met all its obligations to pay creditors and staff during the past
year? If “No” please explain why.
Yes
No
What is the name and address of your bankers (who could provide a reference)
Bank Name----------------------------- Branch address ------------------------------------ Contact person--------------------------------------Telephone No-------------------------------------------------- Email--------------------------------------------------------
Please attach the following:
1- Copy of the organizations audited financial statement including cash & Funds flow for the last
three years.
2- Written authorization to contact the bank indicated for verification of references.
3- Declaration that no arbitration and /or litigation with client or supplier (s) exist.
4- A statement of your cash flow forecast for the current year and a bank letter outlining the current
cash and credit position.
4. Insurance
Please provide details of your current insurance cover for the following :1
Employers Liability
Value in USD
Public Liability
Value in USD
Other (please specify)
Value in USD
2
3
5. Relevant Company Experience
Please list up to all Oil & Gas contracts still current or completed in the last three years, under the following headings
(substitute your own schedules if you wish and give as much detail as is relevant to undertaking for future
opportunities):
Please ensure that under the headings of “type of work” and “value” the description and amount given is that for the
actual Contract scope undertaken by your Company. "Type of work" should indicate whether your Company was
performing FEED, EPC, PMC or other functions, and whether your Company was the main contractor, or a subcontractor.
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Rev(0) June 2012
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‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
Current Contracts/ Projects.
Client/location
Type of work
Value in
USD
Start date
Customer contact
telephone
Previous Contracts / projects in the last three years
Client/location
type of work
Value in
USD
Customer contact
telephone
Preferred Job Cost Range
Minimum Value
Banking References
6. Workload
Present a listing that details current Projects (backlog) with information as shown below. Please supply
Backlog curves to support the data (if available)
Current Projects:
The following data for projects currently in hand in contractor’s office (only projects of over USD 5 million budget):

Client

Project Type/Location Of Project

Project planned & actual Start Date

Scheduled Completion Date

Installed cost/ approx. value of work performed

Nature of services/work performed

Performed as main or sub-contractor

Management services

Name of Client Representative (may be used for obtaining references)

Telephone / contact details of Client Representative

What percentage of your current workload comprises projects of less than USD 5 million?
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Rev(0) June 2012
7
‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
Future Projects
For new projects that can be expected in the near future, please supply projected staffing / craft levels. Please complete the table
below
Type of projects
Number of Indirect
Number of Directs
Expected Man-hours
General Contracting
Civil
Mechanical / Piping
Electrical / Instrumentation

Provide an indication, preferably in graphical form, for the next three years and expressed in staff hours per month
of:
o
current workload
o
expected workload
o
total productive capacity
o
total staff month capacity
7. Engineering Capability
Please indicate any Engineering capability that your company has. This should include design, drafting and shop detailing services if
applicable. (Please add to table as required)
Engineering Type
Design
Drafting
Shop Detailing
Civil / Structural / Architectural
Piping
Mechanical
Electrical
Instrumentation
Others
8. Procurement
Does your company have any experience with procurement of
materials?
Does your company have an electronic materials management
system?
Yes
No
Yes
No
If not then advise what systems are in place within your company to control requisitioning, purchasing,
expediting, logistics management, warehousing and material control.
Please supply USD value details of procurement that your company has undertaken in the previous 3 years
Year
Last year
Second year
Third year
Total value
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Rev(0) June 2012
8
‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
9. Quality Assurance
Is your company certified to ISO 9001?
Yes
No
Yes
No
If yes, please submit a copy of the Certificate from the certifying institute
If not certified, does your company have another Quality
Control System?
If yes, please provide a short description of this system or attach the relevant documentation.
Name(s) of Company QA Representative(s)
Contact details
10. Project Management Systems
Does your company use electronic Planning and Scheduling
systems? If yes, state name and type of software
Does your company use electronic Cost / Time Control systems? If
yes, state name and type of software
Does your company use CAD or other drafting systems? If yes, state
name and type of software
Does your company use electronic Purchasing and Material Control
systems? If yes, state name and type of software
Does your company use a electronic Document Control system? If
yes, state name and type of software
Dose the above mentioned systems are to be collaborated on line
system base?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
11. Health, Safety & Environmental (HSE)
Does your company have a HSE Mission Statement, vision or
Policy document on safety?
If yes please attach a copy of the cover and index pages
Does your company have a HSE Program or Safety Management
System? If Yes, Please provide a copy of the primary document Table of
Contents
Are there Company procedures for storing and handling hazardous
substances? If yes, provide details.
Does your company have a Safety Orientation Program for new
hires?
Does your company have a Safety Training Program for
Construction Supervision?
Does your company hold regular workplace HSE meetings for
supervisors?
Does your company hold employee ‘toolbox’ HSE meetings on site?
If yes, at what
frequency?
Daily
Weekly
Biweekly
Does your company conduct HSE pre-task assignment meeting
with employees?
Monthly
Yes
No
Yes
No
If yes please attach a copy of notes from a recent pre-task assignment
Does your company conduct workplace HSE inspections?
If yes, at what
frequency?
Daily
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Weekly
Biweekly
Monthly
Rev(0) June 2012
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‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
Please list below the requested HSE statistics (as per OSHA definitions) for your company for the
last three years in (Libya & worldwide).
Last year
Second year
Third year
Number of OSHA Recordable Cases
Number of Lost Workdays
Number of Restricted Workdays
Number of Fatalities
Number of Man-Hours Worked
Lost time incident rate per 200,000 man-hours
worked
Total recordable incident rate per 200,000
man-hours worked
Number of Vehicle accidents
If you record data in a different format please attach detail
Have any notices been served upon your company with respect to Health,
Safety or Environmental incidents?
Does your company carry out random testing for alcohol and/or drug
abuse?
Does your company have an equipment Safety Inspection procedure?
Does your company have a behavioral safety management system in
place? If yes please attach a flow chart (or other) detailing this
Do your employees / sub-contractors read, write and understand English
such that they can perform their job tasks safely without an interpreter?
Do you 'Safety Qualify' your sub-contractors?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
12. Environmental Compliance
During the last five years, has your company/firm received a violation/fine/penalty for non-compliance involving any
of the following?
Improper disposal/dumping of hazardous waste or hazardous
materials on land or in water.
Yes
No
Discharging oil, an oil byproduct, or other hazardous substances to
land, water, or air.
Yes
No
Release of oil or hazardous waste during transport of hazardous
materials and/or hazardous waste.
Yes
No
If you answered yes to any of the questions above, please provide an explanation of the circumstances surrounding
the violation.
What is your company’s normal ratio of site HSE supervisors to the workforce?
1:50
1:200
1:150
1:100
Other
Please supply of listing of other HSE related training programs that your company implements
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Rev(0) June 2012
10
‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
13. Professional and Business Standing
Do any of the following apply during last 5 years to your company or to (If any) the Director(s) /Partner(s)/
Proprietor(s) :-
1
2
3
4
5
Was in a state of bankruptcy, insolvency, compulsory
winding up, and receivership or subject to relevant
proceedings?
Has been convicted of criminal offence related to
business or professional conduct?
Has committed an act of grave misconduct in the course
of business?
Has not fulfilled obligations related to payment of taxes?
Is not in possession of relevant licenses or membership of
an appropriate professional body where required by law?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
6
Would your organization be prepared to offer a bid or
performance Bond if required?
Yes
No
7
Has your organization ever had a contract terminated under the
terms of the contract?
Yes
No
Yes
No
8
Has your organization ever been unable to renew a contract for
failure to perform to the terms of the original contract
If yes to any of the above questions, please attach details.
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Rev(0) June 2012
11
‫شركة الواحة للنفط‬
Waha Oil Company
Contractor Pre-Qualification Questionnaire
14. Declaration
I declare that the answers submitted in this supplier questionnaire and any supporting documents are
correct. I understand that the information will be used in the evaluation process to assess my
organization’s suitability to be invited to tender for the Waha Oil Company’s requirements.
1
Form completed by :
2
Name:
3
Position/Job Title:
4
Date :
5
Telephone No:
6
Signature :
Address 4.5 Km, Tripoli Int - Airport
Road
P.O Box: 395 Tripoli – Libya
Tel: + 218 21 3337161
Fax: +218 21 3337169
Rev(0) June 2012
12