Standard
Prequalification Form
for Project Management
Name and address of the Consultant:
Date :
NB: form to be typed not handwritten
Prequalification form
Consultant:
Notes to applicants
1. Please answer all questions in English.
2. It is expressly required that responses be provided on the forms included.
2. Supplementary pages may be photocopied and inserted if required.
3. If a Co Lead Consultant Co proposes to engage Sub-Consultant for specialist design,
otherwise provide information regarding in house capabilities.
4. Project financial data is to be given in UAE Dhs. unless otherwise requested.
Standard pages
A Title page
H Resources Sheet 2: equipment/facilities
B Notes
I Experience: geographical
C Structure and organisation Sheet 1
J Experience: relevant projects completed
D Structure and organisation Sheet 2
K Experience: projects in progress
E Financial statement
L Additional information Sheet 1
F Joint Venture
M Additional information Sheet 2
G Resources Sheet 1: personnel
Please list below any additional pages attached to each standard page:
Page C
Prequalification form
Consultant:
Structure and Organisation Sheet 1
1.
Name of Consultant:
Address:
Telephone number:
Fax number:
Registered office address:
2. Description of company
a) Main field of activity (e.q. Project Management, Cost Consultant etc.)
b) Other fields of activity (Specify)
3. Number of years experience in Project Management in
UAE :
Gulf :
International:
4. Number of years experience as a Sub-Consultant - in
UAE :
Gulf :
International:
5. Details of trade licences, names and addresses of associated companies to be
involved in projects - and whether parent/subsidiary/other:
6. If the company is a subsidiary, what involvement, if any, will the parent company
have in the projects?
Page D
Prequalification form
Consultant:
Structure and Organisation Sheet 2
7. List here and give details of all main Sub-Consultants regularly used for project work.
8. Please indicate here or attach an organisation chart showing the company structure
including the positions of directors and key personnel.
Page E
Prequalification form
Consultant:
Financial statement
1.
Capital:
Authorised:
Issued:
2. Annual value of work undertaken for each of the last three years and projected for current
year in Dhs. Millions (attach a separate sheet showing the type and value of work, clearly
identifying whether Building, Civil, Electrical or Mechanical, etc. and the relevant values of each
type of work:
Year
Current
2011
2010
2009
Home
Abroad
3. Approximate value of work in hand in Dhs.:
4. Please attach copies of the company’s previous three years’ accounts (profit/loss,
assets/liabilities) and other financial data which you consider to be useful.
List all attachments below:
5. Name and address of bankers from whom references can be obtained:
6. List here all company insurances held including Liability Professional Indemnity.
Page F
Prequalification form
Consultant:
Joint Venture
If the company intends to enter into a joint venture for the project(s), please give the
following information, otherwise state “not applicable”:
1. Names and addresses of joint venture partners:
2. Name of company leading the joint venture:
3. Name and address of bankers to the joint venture:
Page G
Prequalification form
Consultant:
Resources Sheet 1 : personnel
1. Number of staff: Technical: Administrative:
2. Please list present Senior personnel, administrative & technical and attach resumes.
Name
Present
Position
Qualifications
Experience in
UAE
Total
Experience
Page H
Prequalification form
Consultant:
Resources Sheet 3 : Consultant’s Drafting,
Planning Equipment and Systems
Please provide a list of relevant software and facilities system used by Consultant.
Page I
Prequalification form
Consultant:
Experience : Geographical
1. List major projects undertaken with location in UAE and Value.
2. List most important projects undertaken with overseas location and Value.
Prequalification form
Page
of
total pages
Consultant:
Experience : Relevant Projects Completed
Give information about all recent major projects/completed.
Name of employer
Page J
Name, location and type of project
Name of (consulting) engineer
responsible for supervision
Contract price and
date
Percentage of
participation of
company in
project
Was contract satisfactorily
completed to cost, quality & time
provision
Prequalification form
Consultant:
Experience : all projects in progress
Give information about all projects in progress, including those where the company has received
a letter of intent, but a formal contract has not yet been awarded.
Name of employer
Page K
Name, location and
type of project
Name of (consulting)
engineer responsible for
supervision
Value of contract
Value completed
and certified
Percentage of
participation of
company in project
Percentage of
practical completion
Schedule date of
completion of work
Prequalification form
Consultant:
Additional Information Sheet 1
1 Consultant’s quality assurance system: (Give details and provide QA manual)
2 Consultant’s Environmental Policy:
3 Consultant’s Safety Policies (Give details and provide Safety Manual)
4 Compliance with Etihad HSE Manual
5 Consultant’s history of litigation or arbitration from contracts executed in the last six years or
currently under execution. Please indicate for each case year, name of employer, cause of
litigation, matter in dispute, and whether the award was for or against company.
6 State project value range for which you wish to be considered.
Page L
Prequalification form
Consultant:
Additional Information Sheet 2
7 Measures for identifying and Mitigating risk’s.
8 Value Engineering exercise carried out.
9 Consultant’s planning/ programming and scheduling resources system in maintaining master
program include examples of overruns and reasons if any.
10 Understanding of Estidama requirements (give examples where participated)
Please add any further information which you consider to be relevant to the evaluation of
your application for prequalification. If you wish to attach other documents and list these
below.
Page M