contractor registration package - civil works
TRANSCRIPT
Head Office: #31-32 Casuarina Avenue, Pointe-a-Pierre, Trinidad W.I. Telephone: (868) 658-1739/ 4147/ 3722/ 2319
Fax: (868) 658-2585/ 1003
1001‐ GENERAL CIVIL & BUILDING MAINTENANCE
________________Directors_________________ Mr. Ashmead Ghany (Chairman), Mr. Simon Ferreira (Deputy Chairman), Mr. Nigel Alleyne, Mr. Sheldon Ganga, Mr. Ramesh Brim,
Mr. Godfrey Alexis, Ms. Nalini Balwant, Ms. Reshma Ramai, Mr. Rudra Balramsingh
PALO SECO AGRICULTURAL ENTERPRISES LIMITED
PALO SECO AGRICULTURAL ENTERPRISES LIMITED
Head Office: # 31 - 32 Casuarina Avenue, Pointe-a-Pierre, Trinidad W.I. Telephone: (868) 658-1739 / 4147 / 3722 / 2319 Fax: (868) 658-2585 / 1003
i
CONTRACTOR PRE‐QUALIFICATION
NOTES TO APPLICANTS
1. The Applicant must be a registered business entity under the Laws of the
Republic of Trinidad and Tobago e.g. Sole Proprietor with a registered business
name, partnership or limited liability company.
2. Companies/ Businesses who desire to register with Palo Seco Agricultural
Enterprises Limited MUST:
a. Purchase a prequalification package for desired category of work.
b. Complete the prequalification form provided on the compact disc using
Adobe Reader (also supplied on disc).
c. Save your completed form as your Company / Business Name to a location
on your computer by using the “File > Save As” function in Adobe Reader.
d. Using your computer’s CD Burning Application, burn the previously saved
file to the supplied compact disc.
e. Print, sign and date completed form.
f. Deposit a sealed envelope addressed to Secretary, Tenders Committee in
the specially marked box at Palo Seco Agricultural Enterprises Limited
Head Office, 31 Casuarina Avenue, Pointe‐a‐Pierre on or before 10:00a.m,
25th May 2011 containing the following:
i. Printed prequalification form as per 2.(d).
ii. Completed electronic prequalification form saved on compact
disc
iii. Signed Checklist of Attachments
iv. Copies of all supporting documents (See Note 3)
PALO SECO AGRICULTURAL ENTERPRISES LIMITED
Head Office: # 31 - 32 Casuarina Avenue, Pointe-a-Pierre, Trinidad W.I. Telephone: (868) 658-1739 / 4147 / 3722 / 2319 Fax: (868) 658-2585 / 1003
ii
NOTES TO APPLICANTS (continued)
3. Please note that the following supporting documents are to submitted along
with the prequalification form:
a. Certificate of Registration/ Incorporation/ Continuance*
b. Certificate of Income Tax Registration*
c. Certificate of Income Tax Clearance*
d. Certificate of Value Added Tax Registration *
e. Certificate of Value Added Tax Clearance*
f. National Insurance Board Registration Certificate
g. National Insurance Board Clearance Certificate
h. Audited Financial statements for the last (3) three years
i. Reference Letter from Bank/ Other Financing Institution
j. Workmen’s Compensation Insurance
k. Public Liability Insurance
l. Résumes of all Key Personnel listed in application
m. Photos of available equipment and tools
* These documents are mandatory. Failure to submit these shall result in immediate
disqualification from evaluation process.
4. The prequalification package should be completed on behalf of the Applicant
Company / Business by an officer who is knowledgeable about past and current
operations, policies and practices of the respective business entity. A response
must be provided for each question. If a particular question doesn’t apply, the
response must state “not applicable or “N/A”. Management reserves the right
to refuse registration of applications deemed unresponsive.
PALO SECO AGRICULTURAL ENTERPRISES LIMITED
Head Office: # 31 - 32 Casuarina Avenue, Pointe-a-Pierre, Trinidad W.I. Telephone: (868) 658-1739 / 4147 / 3722 / 2319 Fax: (868) 658-2585 / 1003
iii
NOTES TO APPLICANTS (continued)
5. Failure to submit the required supporting documentation will result in your
application being disqualified.
6. Immediate disqualification would result if your Company’s name is not listed as
active with Ministry of Legal Affairs.
7. Once you have been prequalified, you will be placed on PSAEL’s database for the
respective work category for which you have been prequalified to perform.
8. Prequalification in no way ensures the award of contract work and PSAEL
reserves the right to limit solicitation from bidders.
9. Clarification of Pre‐qualification Documents
Any correspondence or clarification regarding documents submitted shall be
directed to:
The Customer Service Representative Finance Department Telephone No: 658‐1739 / 3722 / 4147 / 2391 ext 304
PALO SECO AGRICULTURAL ENTERPRISES LIMITED
1
PRE‐ QUALIFICATION OF CONTRACTORS FOR WORKS / SERVICES
1001‐ GENERAL CIVIL & BUILDING MAINTENANCE Palo Seco Agricultural Enterprises Limited invites suitably qualified and experienced contractors to submit applications for performing works and services to be undertaken in its operations.
CODE 1001
General Civil & Building Maintenance
Maintenance
Masonry
Carpentry / Joinery
Painting
Plumbing
Earthworks
Fabricating & Welding
Road Rehabilitation
Drainage
Works in this category are outlined below:
WORK
SUB‐CATEGORY OUTLINE OF WORKS
Maintenance
Includes general repairs, overhauls, renovations and construction to residential and commercial buildings to include the following services: Masonry, Carpentry/Joinery, Electrical, Painting, Plumbing and all other works deemed necessary.
Masonry
Repairs, replacement, modification and extensions to building structures requiring the services of masons for concrete works including foundations, tiling and drains.
Carpentry / Joinery
Repairs, replacement, modification and extensions to building structures and all fixtures and furnishings including but not limited to doors, windows, cupboards, floors and walls which involves the work of carpenters and joiners and specialist services such as vinyl tiling and acoustic ceiling installations.
Painting
Preparation and painting which includes all finishes such as application of oil and emulsion paints, varnishes and lacquers.
Plumbing Repairs, replacement and installation of gas and plumbing fixtures and service lines thereto, including sewer systems.
PALO SECO AGRICULTURAL ENTERPRISES LIMITED
2
1001‐ GENERAL CIVIL & BUILDING MAINTENANCE (continued)
WORK
SUB‐CATEGORY CRITERIA
Earthworks
Includes one or all of the following: Land clearing, cutting, excavating, filling, and compacting. Drain digging, drain clearing, ploughing, rotovating, using mechanical earthworks equipment such as tractors, bulldozers, excavators, loaders.
Fabricating & Welding
Covers general fabrication and welding required to construct, repair or modify e.g. Burglar proof grilles, metal hand railings, gates, fences, etc.
Road Rehabilitation
Includes scarifying and re‐grading of roadway; installation of well compact base course; re‐surfing of roadway; Painting of road lines.
Drainage
Includes construction of box drains, curb & slippers, retaining walls, road crossings etc.
PALO SECO AGRICULTURAL ENTERPRISES LIMITED
3
EVALUATION CRITERIA‐ CODE 1001
NB: As part of the evaluation process, PSAEL will be carrying out random site visits to verify
information submitted by applicants. * Statutory Requirement, Financial Statements & Creditworthiness, Previous Work Experience Criteria are mandatory passing criteria. Failure to be successful in less than (4) four technical criteria results in disqualification. A minimum score of (47) forty‐seven qualifies an applicant for works valued less than TT$350,000 for the particular work sub‐category(ies) for which evidence of experience was submitted and is subjected to:
Passing Statutory and Financial Requirements
Meeting at least four (4) technical criteria
To qualify for works valued TT$350, 000 to TT$1million and/or works valued over TT$1million an applicant must:
Satisfy Statutory Requirements
Obtain a Financial Statement & Creditworthiness score that is greater than or equal to (10) ten points
Provide evidence of experience of works executed in the respective contract ranges applied for
Meet at least four (4) technical criteria
CRITERIA MAXIMUM
QUALIFYING POINTS MINIMUM
QUALIFYING POINTS STAGE 1‐ STATUTORY EVALUATION
a) Statutory Requirements * 10 7
STAGE 2‐ FINANCIAL EVALUATION
b) Financial Statements & Creditworthiness * 15 4
STAGE 3‐ TECHNICAL EVALUATION
c) Key Personnel 15 10
d) Previous Work Experience * 15 2
e) Availability of Equipment 15 5
f) Client References 5 3
g) Insurances 10 7
h) Health Safety & Environmental (HSE) Policy 15 9
TOTAL 100 47
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
4
SECTION 1: CORPORATE DATA BUSINESS NAME: _________________________________________________________________
Please be advised that, it is the responsibility of the Contractor to inform PSAEL of any change in address, phone number or any other relevant information.
REGISTERED BUSINESS ADDRESS CONTACT NUMBERS
TELEPHONE MOBILE FAX
TYPE OF BUSINESS Sole Trader Partnership Other (Please state)
Limited Liability Joint Venture
POSTAL ADDRESS
(if different from address above)
CONTACT NUMBERS
TELEPHONE MOBILE FAX
E-mail address: Website:
STATUTORY REGISTRATION (Attach copies and where applicable, Memorandum & Articles of Association )
REGISTRATION NUMBER
CLEARANCE / COMPLIANCE CERTIFICATES [for Statutory items 2 – 4]
(Attach copies not more than six months old) 1. Certificate of Registration or Certificate of
Incorporation (Certificate of Continuance as applicable)
Number Date
2. Value Added Tax Registration (where applicable)
3. Income Tax Registration
4. National Insurance Board Registration
INSURANCE- Type of coverage (Attach copies)
NAME OF INSURANCE CO.
POLICY NUMBER
LIMIT OF LIABILITY
EXPIRY DATE
Workmen’s Compensation
Public Liability
Other
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
5
LIST OF OWNERS/ SHAREHOLDERS/ PARTNERS AND DIRECTORS
NAME OF OWNERS / PARTNERS /
SHAREHOLDERS DIRECTORS
POSITION IN COMPANY
ADDRESS CONTACT NUMBER
PSAEL EMPLOYEE
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Do any of the Owners / Shareholders / Partners / Directors hold interest in any other Contractor seeking pre-qualification with PSAEL? Yes No
If yes, detail below:
NAME
COMPANY
ASSOCIATION
Is your Business registered with any of the following Companies? Please tick where applicable
Petroleum Co. of Trinidad & Tobago Ltd [PETROTRIN] The CEPEP Company Limited Rural Development Co. of Trinidad & Tobago Ltd [RDC]
Community Improvement Services Limited [CISL]
The Sports Co. of Trinidad & Tobago Ltd East Port of Spain Development Company Ltd
Education Facilities Company Limited
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
6
SECTION 2: FINANCIAL DATA
ANNUAL GROSS REVENUE (for the last three (3) years)
YEAR AMOUNT TYPE OF WORK
Audited Income & Expenditure Statements and Balance Sheets of the three (3) most recent years should be provided for applicants seeking pre-qualification in the medium and large financial ranges.
Bank or Other Financial Reference (to be provided in writing)
Has the Business ever been liable for failing to comply with the fulfillment of any Contracts?
Yes No
If Yes, give brief details including matters currently in litigation and/or arbitration
Has the Company or constituent part ever been placed in:
Receivership? Yes No Liquidation? Yes No
If Yes, give brief details:
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
7
SECTION 3: RESOURCES
PERSONNEL SUMMARY – Enter Number of PERMANENT (P) and TEMPORARY (T) Employees
P T
Architect
Civil/ Structural Engineer
Civil Engineering Technician
Draughtsman
Electrical Engineer
Electrical Engineering Technician
Mechanical Engineer
Mechanical Engineering Technician
HSE Supervisor
Building/ Land Surveyor
Quantity Surveyor
Foreman/ Site Supervisor
Electrician/ Wireman
Plumber
Mason
Tiles Person
Carpenter/ Joiner
Welder/ Fabricator
Heavy Equipment/ Machinery Operator
Unskilled Labourer
Clerical
Total
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
8
Indicate below details of the Company’s work base for handling works and services for PSAEL.
ADDRESS OF COMPANY’S MAIN WORKSHOP FACILITIES
FLOOR AREA (SQ.M) INDOOR
FLOOR AREA (SQ.M) OUTDOOR
Owned Owned
Leased Leased
REMARKS/OTHER INFORMATION
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
9
LIST OF KEY PERSONNEL RESPONSIBLE FOR WORKS / SERVICES
Provide details of key personnel who will be responsible for the works / services being applied for by the Company
NAME
NO. OF YEARS WITH
COMPANY
POSITION WITH COMPANY
TECHNICAL / PROFESSIONAL QUALIFICATION
(Attach copy of resume)
RELATED EXPERIENCE
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
10
LIST OF KEY PERSONNEL RESPONSIBLE FOR WORKS / SERVICES‐ Continued
Provide details of key personnel who will be responsible for the works / services being applied for by the Company
NAME
NO. OF YEARS WITH
COMPANY
POSITION WITH COMPANY
TECHNICAL / PROFESSIONAL QUALIFICATION
(Attach copy of resume)
RELATED EXPERIENCE
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
11
LIST OF MAJOR EQUIPMENT / TOOLS OWNED OR RENTED & READILY AVAILABLE FOR WORKS / SERVICES
For Equipment / Tools which are rented or leased, a written agreement must be provided showing arrangement for hiring. * Photos of Equipment showing serial/ registration numbers and overall view of equipment and tools must be attached to signed package
EQUIPMENT / TOOLS QTY *OWNERSHIP
(INDICATE OWNED / RENTED / LEASED)
MANUFACTURER (SERIAL#/
LICENCE NO#)
MEAN AGE
ATTACHED PHOTO REF #
Surveying
Surveyor’s Level
Laser Level
Theodolite
Total Station
Earth Moving
Backhoe
Excavator
Wheel Tractor
Bulldozer (D4-D6)
Scraper
Grader
Screed Crawler
Bob Cat/ Skid Steer
Trencher
Overloader/ Site Dumper
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
12
EQUIPMENT / TOOLS QTY *OWNERSHIP
(INDICATE OWNED / RENTED / LEASED)
MANUFACTURER (SERIAL#/
LICENCE NO#)
MEAN AGE
ATTACHED PHOTO REF #
Asphalt Paving
Asphalt Mixing Plant
Asphalt Sprayer
Asphalt Spreader
Asphalt Paver
Asphalt Roller
Asphalt/ Road Saw
Curb Slip Former
Oil Distribution Truck
Concrete
Concrete Batch Plant
Concrete Cutter/ Saw
Concrete Mixer
Concrete Breaker
Power Trowel
Terrazzo Machine
Concrete Vibrator
Concrete Buggy/ Dumper
Bulk Concrete Tanker/ Truck
Concrete Pump Truck
Concrete Scrubber
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
13
EQUIPMENT / TOOLS QTY *OWNERSHIP
(INDICATE OWNED / RENTED / LEASED)
MANUFACTURER (SERIAL#/
LICENCE NO#)
MEAN AGE
ATTACHED PHOTO REF #
Hoists and Cranes
Lifting Crane
Hiab/ Wrench
Fork Lift
Man Lift
Compacting Equipment
Roller/ Compactor
Walk Behind Roller
Plate Compactor
Trucks
Flat Bed Truck
Dump Truck
1.5 Tonne Truck
2-4 Tonne Truck
5-15 Tonne Truck
Pick-up Truck
Pump Truck
Water Truck
Tractor Truck
Bucket Truck
Cutters, Saws and Grinders
Rebar Cutter
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
14
EQUIPMENT / TOOLS QTY *OWNERSHIP
(INDICATE OWNED / RENTED / LEASED)
MANUFACTURER (SERIAL#/
LICENCE NO#)
MEAN AGE
ATTACHED PHOTO REF #
Cutters, Saws and Grinders (Continued)
Chop Saw
Chain Saw
Circular Saw
Table Saw
Pneumatic Hack Saw
Grinder
Angle Grinder
Cutting Set
Pumps
Test Pump
Trash Pump
Water Pump
Rock Breaking
Rock Breaker
Jaw Crusher
Drills and Hammers
Auger
Heavy Duty Drill
Electric Magnetic Drill
Rotary Hammer Drill
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
15
EQUIPMENT / TOOLS QTY *OWNERSHIP
(INDICATE OWNED / RENTED / LEASED)
MANUFACTURER (SERIAL#/
LICENCE NO#)
MEAN AGE
ATTACHED PHOTO REF #
Drills and Hammers (Continued)
Core Drill
Jack Hammer
Demolition Hammer
Trailers
Flat Bed Trailer
Lowboy Trailer
Pole Trailer
Goose Neck Trailer
Landscaping and Grass Cutting
Weed Wacker
Lawn Mower
Mist Blower
Blower
Welding and Fabricating
Rebar Bender
Drill Press
Welding Plant
Sand Blaster
Generator
Compressor
Pressure Washer
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
16
EQUIPMENT / TOOLS QTY *OWNERSHIP
(INDICATE OWNED / RENTED / LEASED)
MANUFACTURER (SERIAL#/
LICENCE NO#)
MEAN AGE
ATTACHED PHOTO REF #
Miscellaneous
Lighting Tower
Scaffolding
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
17
SECTION 4: CONTRACT WORKS / SERVICES
Indicate below the work sub-category(ies) and financial range(s) for which your company is applying and has the necessary resources, expertise and experience to perform. Contractors should be capable of handling several contracts simultaneously.
CODE
WORK / SERVICE SUB - CATEGORY
SMALL MEDIUM LARGE
Under $350,000.00
$350,000.00 to
$1,000,000.00
Over $1,000,000.00
1001
Maintenance Masonry
Carpentry/ Joinery
Painting
Plumbing
Fabricating and Welding
Earthworks
Road Rehabilitation
Drainage
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
18
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Maintenance
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
19
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Maintenance
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
20
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Maintenance
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
21
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Masonry
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
22
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Masonry
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
23
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Masonry
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
24
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Carpentry/ Joinery
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
25
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Carpentry/ Joinery
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
26
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Carpentry/ Joinery
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
27
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Painting
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
28
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Painting
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
29
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Painting
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
30
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Plumbing
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
31
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Plumbing
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
32
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Plumbing
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
33
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Fabricating and Welding
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
34
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Fabricating and Welding
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
35
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Fabricating and Welding
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
36
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Earthworks
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
37
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Earthworks
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
38
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Earthworks
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
39
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Road Rehabilitation
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
40
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Road Rehabilitation
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
41
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Road Rehabilitation
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
42
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Drainage
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
43
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Drainage
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
44
WORK EXPERIENCE
The following information is to be provided for pre-qualification in the following work category. (Complete this form for each additional work sub-category)
CATEGORY CODE 1001 NAME OF SUB - CATEGORY Drainage
Identify Key Personnel who were listed on pages 9 and 10, who are responsible for specified works / services.
1 3
2 4
KEY CONTRACTS EXECUTED BY THE COMPANY IN THE LAST THREE YEARS Provide details of major projects in which works / services specific to the work category was handled by the Contractor. List work undertaken as a Company.
BRIEF PROJECT DESCRIPTION CLIENT FINAL CONTRACT
VALUE COMPLETION
DATE
Additional details may be attached as necessary.
CLIENT REFERENCE [ Must be the supervising personnel for the job(s) listed above ]
SUPERVISOR’S NAME (in Block letters)
COMPANY
DESIGNATION
CONTACT NUMBER
Office #
Mobile #
Office #
Mobile #
Office #
Mobile #
PALO SECO AGRICULTURAL ENTERPRISES LIMITED CONTRACTS DEPARTMENT
CONTRACTOR PRE-QUALIFICATION PACKAGE
Rev #4: 26/04/2011
APPLICATION NUMBER
FOR PSAEL USE ONLY
45
SECTION 5: SAFETY INFORMATION
YES NO
1 a) Does contractor have a safety program?
b) Has the Contractor been HSE certified in accordance to OSHA standards? (Certification documents must be provided)
c) Does contractor have a “New Employee Orientation Program?”
2. a) Does contractor conduct on-site safety inspections?
b) If YES who conducts these inspections (Safety qualification of inspector additional to below to be submitted)
c) Frequency of on-site inspections
3.a) Frequency of Contractor Employee Safety Meetings Weekly
Fortnightly
Monthly
Other
QUALITY ASSURANCE
Has your company established, documented and implemented a quality assurance system?
Yes No
If ‘yes’ please attach details (copy to be submitted) Date Implemented (DD/MM/YY) / /
Have you ever applied for Registration before? Yes No
If yes, state Trade Name and Date of Application
GENERAL DECLARATION
I (Contractor Name) hereby certify that the information provided herein
is true and correct. It is expressly understood, that if any of the information provided herein is found to be false or misleading,
PSAEL may take such action, as it deems necessary.
Name Of Official: (BLOCK LETTERS)
Position In Company: (BLOCK LETTERS)
Signature:
Date: