renovation / waterproofing of cement corrugated …€¦ · at . contracting firms of repute,...

Ref: DGM/AFU/CGO/CIVIL/20 September 19, 2020

TENDER NOTICE

RENOVATION / WATERPROOFING OF CEMENT CORRUGATED SHEETS ROOF AT AFU CARGO WAREHOUSE AT OLD TERMINAL - KAP

PIA intends Renovation of Office Block & Waterproofing of Cement Corrugated Sheets Roof at AFU Cargo Warehouse at Old terminal -KAP. Contracting firms of repute, registered with Pakistan Engineering Council for the year 2019-2020 in C-6 (Civil) category may apply. Submission of Bids: The bidding process shall be carried out on “Single Stage, Two Envelop” basis as per PPRA rules # 36(a). The interested parties can download detail bid documents from PIA/PPRA website, and submit the same along with Rs. 5,000.00 (Non-refundable) Pay Order with sealed Technical Bid and 02% of bid value (refundable) with sealed Financial Bid documents in the shape of Pay Order/Bank Draft or unconditional Bank Guarantee by any Scheduled Bank of Pakistan, in favor of PIACL. Sealed separate envelops of Technical and Financial bids should be sent by 06-10-2020 by 14:00 Hours to General Manager Facilities Management Division or dropped in tender box placed in account section works. The bids will be opened on the same day at 14:30 Hours in the office of General Manager Facilities Management Division, 1st Floor, Flight Operation Building, PIA Head Office, Karachi Airport - Karachi.

PIA reserves the right to reject anyone or all bids as per PPRA rules # 33.

On the face of envelop reference must be written DGM /AFU/CGO/CIVIL/20

DY. GENERAL MANAGER (MAINTENANCE) (FACILITIES MANAGEMENT DIVISION) 1ST FLOOR, FLIGHT OPERATION BUILDING PIA HEAD OFFICE. Tel: 021-99043037 Email: [email protected]

mailto:[email protected]

Seal & Signature For: Pakistan International Airlines Of the contractor


INVITATION TO BID


PIA intends Renovation of Office Block & Waterproofing of Cement Corrugated Sheets Roof at AFU Cargo Warehouse at Old terminal -KAP. Contracting firms of repute, registered with Pakistan Engineering Council for the year 2019-2020 in C-6 (Civil) category may apply. The interested Contractors are requested to send their applications to the Office of undersigned along with following details:

Name & year of establishment of firm, registered address and Fax / telephone numbers / Email.

Valid Certificate of Pakistan Engineering Council, registered in minimum C- 6 Category. Financial status with Bank Certificate. Latest bank statement with 03 years history. Valid NTN certificate. Details of dispute / arbitration / litigation, if any. All mandatory documents mentioned in check list.

Submission of Bids: The bidding process shall be carried out on “Single Stage, Two Envelop” basis as per PPRA rules # 36(a). The interested parties can download detail bid documents from PIA/PPRA website, and submit the same along with Rs. 5,000.00 (Non-refundable) Pay Order with sealed Technical Bid and 02% of bid value (refundable) with sealed Financial Bid documents in the shape of Pay Order/Bank Draft or unconditional Bank Guarantee by any Scheduled Bank of Pakistan, in favor of PIACL. Sealed separate envelops of Technical and Financial bids should be sent by 06-10-2020 by 14:00 Hours to General Manager Facilities Management Division or dropped in tender box placed in account section works. The bids will be opened on the same day at 14:30 Hours in the office of General Manager Facilities Management Division, 1st Floor, Flight Operation Building, PIA Head Office, Karachi Airport - Karachi.

PIA reserves the right to reject anyone or all bids as per PPRA rules # 33.





DATA SHEET

1. The name of the Assignment is: RENOVATION / WATERPROOFING OF CEMENT CORRUGATED SHEETS ROOF AT AFU CARGO WAREHOUSE AT OLD TERMINAL - KAP

2. The name of the Client is: Pakistan International Airlines Corporation Limited (PIACL)

3. The description and the objectives of the assignment are: RENOVATION / WATERPROOFING OF CEMENT CORRUGATED SHEETS ROOF AT AFU CARGO WAREHOUSE AT OLD TERMINAL - KAP

4. Phasing of the Assignment (if any): No

5. Pre-Proposal Conference: Pre Proposal Meeting held date: 29-09-2020 at 15:00 Hrs in the office of General Manager Facilities Management 1ST FLOOR, FLIGHT OPERATION BUILDING PIA HEAD OFFICE. Tel: 021-9904640 Email: [email protected]

6. The name(s) and address(es) of the Client’s Official(s) is (are): DY. GENERAL MANAGER (MAINTENANCE) (FACILITIES MANAGEMENT DIVISION) 1ST FLOOR, FLIGHT OPERATION BUILDING PIA HEAD OFFICE. Tel: 021-99043037 Email: [email protected]

7. The Client shall provide the following inputs: All Data and Reports available with Client

8. Association with other Firms/JV : PROOF DOCUMENTS REQUIRED 9. The number of copies of the Financial Proposal required are:

Original Only 10. The address for writing on the proposal is


11. Date and time of proposal submission is before06-10-2020at 14:00 Hours. 12. Date and time of opening of Proposal is 06-10-2020at 14:30 Hours. 13. Validity period of the proposal is:






120 Days (Day 1 counts from tender opening day)

14. Assignment Completion Period a. Construction and Furnish 03 months



DOCUMENTS CHECK LIST Date:__________


M/s._______________________________________________________________________

BIDS DOCUMENTS TICK APPROPRIATE BOX

S.NO. DOCUMENTS AVAILABALITY

1

Sealed Envelop of Bid. Separate sealed envelope with the name “Technical Proposal” and separate sealed envelope with the name “Financial Proposal”

Yes

No

2 Name & year of establishment of firm, registered address and Fax / telephone numbers / Email.

Yes No

3 If any job carried out earlier in PIA, a certificate of recommendation is required from concerned Deputy General Manager.

Yes

No

4 Valid Certificate of Pakistan Engineering Council for the year 2019-2020, registered in minimum C-6 (Civil) Category.

Yes No

5 Financial status with Bank Certificate. Yes No

6 Latest bank statement with 03 years history. Yes No

7 Valid NTN certificate and FBR certificate Yes No

8 Details of dispute / arbitration / litigation, if any. Affidavit or Non litigation certificate / non Black listing Certificate duly signed

Yes No

9 Pay Order of Rs. 5,000/- (nonrefundable) Earnest Money 2% - (Refundable)

Yes No

All documents stated in checklist are mandatory. If any requirement stated above (1-9) is not marked, the bid will be turned down and will not be considered in the competition.



SIGNATURE OF CONTRACTOR CHECKED & VERIFIED BY

DY.GENERAL MANAGER (MAINTENANCE)

GENERAL MANAGER (FACILITIES MANAGEMENT)



TENDER FORM

M/s._______________________________________________________________________

DESCRITION OF WORK: -

RENOVATION / WATERPROOFING OF CEMENT CORRUGATED SHEETS ROOF AT AFU CARGO WAREHOUSE AT OLD TERMINAL – KAP

Dear Sir,

Please send not later than 06-10-2020 you’re sealed quotations for the items mentioned in the attached sheet as per following terms and condition.

1. PIA reserves the right to accept or reject any quotations without assigning any reason. 2. An earnest-money of 2% in the shape of pay-order/Bank Draft in favor of PIA is to be

attached with quotation as earnest money. 3. Tender will be opened by on 06-10-2020 at 14:30 Hours by the under signed in presence of

the contractors who care to attend. 4. Your quotation should remain valid up to Four Months. 5. Period required for completion of project is Three months. 6. All works/sample/design will be executed / approved by the engineer on duty. 7. PIA reserves the right to cancel the work order at any stage of the work without assigning

any reason as per PPRA RULE # 33. 8. PIA accepts only standard materials original manufacturer strictly in accordance with the

specifications. Any inferior or sub-standard materials, if used, shall be rejected out-right. 9. PIA shall have the option to increase or decrease the quantity of any item mentioned in the

quotation / work order. 10. The firm to whom the contract is awarded shall have to abide by the rules and regulations

mentioned in the work order and as well as the all rules & regulations of PIA. 11. No excuse of non – availability of materials or fluctuation in the market rates etc. shall be

accepted after the work order is issued. 12. Security deposit 10% will be deducted from each running bill and same will be returned after

six months. In case of any discrepancy found, the same will be withheld without prior notification.

13. If the work is delayed after given time period, Rs. 2000 / day will be deducted, up to max. 10% of total project cost.

14. Award of purchase order will be issued strictly on the technical qualification as per evaluation criteria attached / financial evaluation and meeting all mandatory requirements. On acceptance of the bids the successful bidder will provide “Samples” of the items and will be liable to supply the items of the approved quality during the specified period.

15. Payment will be released minimum after 21 days of receipt of Bill from contractor. 16. Scope of Work as per attached BOQ. 17. Proposal evaluation will be carried out on procedure mentioned below:



Technical Proposal The evaluation committee appointed by the CLIENT shall carry out Technical Proposal Evaluation, applying the evaluation criteria and point system specified in the Data Sheet. Each responsive proposal shall be attributed a technical score. Firms scoring less than seventy five (70) percent points shall be rejected and their financial proposal shall be returned unopened. Financial Proposal The financial proposals of the technically qualified consulting firms on the basis of evaluation of technical proposals shall be opened in the presence of the representatives of these firms, who shall be invited for the occasion and care to attend. Client shall inform the technically qualified firms regarding the date and time for opening the financial proposals. The total cost of each proposal shall be publicly announced to the attending representatives of the firms. The evaluation committee shall determine whether the financial proposals are complete and without computational errors. The lowest financial proposal among all the technically qualified bidders will be awarded the job.

18. FIDIC / PEC Standards should be followed in letter and spirit.

19. The attached Performa of permit to work is mandatory job to be followed at the time of award of work. Annexure ‘A’



TECHNICAL EVALUATION CRITERIA WORK EXPERIENCE

S.No. Description Marks (max)

Explanation of Marks Obtain

01 Similar nature of Work during last 05 years 30 05 marks will be given against each project of 1 Million If the contractor executed 04 or more similar nature of work 30 marks will be given

02 Supply of Office Furniture 5 01 marks will be given against every project

Total Marks 35

ENLISTMENT AND REGISTRATION

S.No. Description Marks (max)


01 Registration with PEC 10 C4 =10 Marks

C5=09 Marks

C6=08 Marks

02 Registration with FBR and NTN Number 5

03 Enlistment with any Government Organization 5 For every enlistment 02 Marks will be given

Total 20

PROFESSIONAL CAPABILITIES

S.No. Description Marks Assigned


01 B.SC / B.E. (Civil) Engineer Registered with PEC 10 05 Marks will be given against every registered Engineer and 10 will be given to Professional



Engineer

02 Associate Engineer Civil 5 03 Marks for experience of 03 years or more

01 marks for each DAE associate Civil

Total Marks 15

EQUIPMENT CAPABILITIES

S. No. Description Marks Assigned

01 Grinders / Cutters /Loaders / Dumpers / Scaffolding pipes/ Shuttering/ Tractor with trolleys/ Transport Vehicles

10

Total 10

FINANCIAL STATEMENT

S.No. Description Marks Assigned


01 Bank Statement for last one year Transaction 10 For every 01 Million Transaction 02 Marks will be given

02 Closing Bank Balance 05 For every 1 Million 01 Marks will be given

Total Marks 15

GENERAL REQUIREMENTS

S. No. Description Marks Assigned


01 Litigation Certificate 2.5 In case of contractor have any litigation no marks will be given

02 Blacklisting 2.5 In case of any blacklisting no marks will be given to firm or JV.



Total Marks 05

Total Marks 100

Qualifying Marks 70



QUOTATION


SNO DESCRIPTION QTY UNIT RATE AMOUNT

1 Demolishing/removal of old damaged wooden partition and throughout removal of debris away from PIA premises.

1000 SFT

2 Providing & fixing of Aluminum sliding window with netting (deluxe model) anodized aluminum extruded section including glass complete fitting (material lucky or equivalent) as desired by concerned Engineer.

160 SFT

3 Providing & fixing of Granite slab with cutting & proper fixing as desired by concerned Engineer.

21 SFT

4 Providing & fixing of square corrugated sheets 22 gauge with purlin/framing and riveting complete work with painting as desired by concerned Engineer.

750 Sft

5 Supply and fix, Gypsum Ceiling 600mm x 600mm x 7.5mm thick, incl Aluminum Tee & Aluminum angle, 25mm x 25mm x 1mm, incl hanger clips, jointing clips and 14 SWG, GL wire with proper levelling etc. as per standard and specification. As Desire by Engineer.

750 Sft

6 Providing and laying, white / light colour Porcelain (24X24/20X20) on walls and floors, set in neat cement and joints grouted with white / coloured cement complete all as specified imported asian origin (China, Malaysia or equivalent).

79.30 Sqm

6 02 Coats of painting on new or old work such as walls with Matt Emulsion paint including scraping and filling properly.

2068.79 Sqm

7 19mm thick Cement plaster 1:4, finished as specified.

450 Sqm

8 Providing and laying of PCC Solid Blocks,(1ftx5inchx8inch) for non-load bearing walls, as specified in building blocks walls, incl setting and jointing in CM 1:3 up to GF

17 Cum



roof level.

9 02 coats of Weather Resistant paint on exterior wall on new surface or old surface with scraping and filling complete work

371.6 Sqm

10 02 coats of painting on new or old work such as doors of any type and description with Synthetic Enamel paint including scraping and filling.

525.99 Sqm

11 Supply and fix, holds fast, guard bars, straps tor wooden trusses, holding down bolts with washers, ladders, railing, brackets pipe supports, tie rods and balusters, chimney bars, chains rings shackles, hinges any type gratings or gullies, etc incl forging, letting into stone or brick work etc. complete by welding in lieu of riveting / bolting etc.

3364 Kg

12 Supply and fix, joist, channel, angle or tee sections, fixed independently without connecting plates etc, cut to ordinary length.

112 Kg

13 Providing & fixing of aluminum door (deluxe model) anodized aluminum extruded section including glass complete fitting (material lucky or equivalent)

114 SFT

14 P/F fix grill partition with open able grill gate using 3/8” dia bars complete i/c painting works.

120 Sft

15 Supply and fix, Low down plastic flushing cistern, white colour, 13 lit capacity with connection to flushing pipe etc, complete.

03 Each

16 Pillar cock single 15 mm dia with high neck brass material best quality supply and fixing

02 Each

17 Bib cock 15 mm dia best quality supply and fixing

04 Each

18 Supply and fix, WC apparatus European pattern, complete, comprising closet, 13 lit flushing cistern, glazed, low down, flush pipe, seat cover etc in special colour (IFO pattern or equivalent, width not less than 380mm), fixed to concrete, brick, stone or wood work, best quality, pak made.

01 Each

19 S/F toilet shower best quality, pak 02 Each



made,15mm dia,

20 Supply and fix Urinal apparatus, basin/stall pattern white colour, complete comprising basin, flushing cistern flush pipe etc, flat back fixed to concrete, brick stone or wood work, best quality pak made

01 Each

21 Water tank, made of Fibre glass, capacity 500 gallons, supply and fixing

01 Each

22 Providing and Laying CC type ‘B’ (1:2:4) using shingle or gravel in roof slabs, landings, walls, plinth beams and band etc as specified requiring shuttering.

6 Cum

Total Amount

Electrical work

S. NO.

DESCRIPTION UNIT QTY RATE(PKR) AMOUNT

1 P/F of one point wiring controlled by one switch wiring complete with pvc sheathed single core cable 1.5mm2 in concealed conduit.

EACH 50

2 P/f of wiring in conduit surface concealed flame proof with single core pvc insulated cable installed at connected complete 06mm cable

MTR 220

3 P/f of wiring in conduit surface concealed flame proof with single core pvc insulated cable installed at connected complete 04mm cable

MTR 260

4 P/f of wiring in conduit surface concealed flame proof with single core pvc insulated cable installed at connected complete 2.5mm cable

MTR 200

5 P/f of pvc conduit 25mm dia complete with all band, tees, boxes, saddles etc for surface wiring

MTR 220

6 P/f of pvc conduit 20mm dia complete with all band, tees, boxes, saddles etc for surface wiring

MTR 180

7 p/f of switch socket make akai 13amp EACH 20

8 p/f of One gang switch 08 gang way 10Amp EACH 10

9 p/f of One gang switch 06 gang way 10Amp EACH 10



10 P/f of MCCB Single phase 06 to 63 Amp (Breaking 06kA)

EACH 7

11 P/f of single phase steel box 15Amp to 60Amp EACH 7

12 P/f of ceiling fan 2x2 (voldam or equivalent) EACH 10

13 P/f of 2’ x 2’ LED light panels 12 watts (Sogo, Unilux or Equivalent with one year warranty)

EACH 25

TOTAL

Furniture


1 03 seater steel cushion chairs 12 Each

2 High back revolving chair with cushion seats master or Equivalent

03 Each

3 Low back revolving chair with cushion seats master or equivalent

03 Each

4 Officer table approved design size (72’’x30’’x30’’) Top made of ¾ ‘’ thick commercial veneered board 700 densities with plastic laminate texture and veneer side drawer case made in board 700 density chipboard pressed with plastic laminate on all exposed surface. Rail 3’’x 1’’ thick of marsa wood. All edges covered with ½ ‘’ thick marsa wood beading. Drawer side and back of 11mm thick lasani wood board with high quality drawer channel. Lock china KGI and recessed handles. Imported ball caster in the drawer box. Providing and laying clear glass imported 5 mm thick with finish edges on the top of table. Complete in all respects and as desired by Engineer.

04 Each

Total Amount



Waterproofing of roof


1.

Removing of Old Bitumen Coating, Cleaning of Roof, and Un Loading / unloading of Garbage from Roof and dump the debris away from PIA premises. Repair all cracks / joints of roof with chemical then apply Ever seal Chemical coating with canvas fabric cloth up to 1.5 mm to 2 mm thick on GI corrugated sheets. Fill all potholes with proper chemical treatment to stop the leakage of water, complete in all respect. Replace the damaged/ broken sheets where ever required, as desired by concerned Engineer. (5 yr warranty required, during 5 yrs all repair work must be done by contractor)

20000

SFT

TOTAL AMOUNT

Total Consolidated amount = ___________

Note: All items required prior approval by providing samples at the cost borne by the

contractor. Beside general sales taxes (G.S.T) all other applicable taxes are considered to be

included in the quoted price. It is MANDATORY for contractors to ensure prior visit of site before submitting the

tender, for assessment of job.

Vendor List S.

No. Items Description 1 Paint Nippon, Jotun, Gobis or Equivalent as approved by Engineer. 2 Porcelain tiles Master or Equivalent brand as approved by Engineer. 3 Water closet Porta design or equivalent as approved by Engineer.

4 Plumbing items e.g bib cock, pillar cock, taps, mixers e.t.c are of Master, Sonex or Equivalent as approved by engineer.

5 PPR Pipe of Dadex /Plastherm or equivalent as approved by Engineer.



6 Electrical wiring Pakistan cables, AGS, Fast or equivalent as approved by Engineer.

7 Breakers of Hager, Schneider or equivalent as approved by Engineer. 8 Electrical sheets of Clipsal or equivalent as approved by Engineer. 9 Furniture Master or Equivalent.



LAYOUT OF AFU CARGO - KAP



ANNEXURE ‘A’

PERMIT TO WORK

PERMIT TO WORK (PTW) HSE-F-07A

Ed-2 (Rev # 00) January 2017

_____________________________________________________________________________ Controlled Document – Do not reproduce without permission

Date Permit Valid from: To Permit No: Area Authority (AA) (where work is performed) Executing Department (ED)(who orders

work. Contractor /Operator (CO) (who undertakes the task)

1. ED Describe work to be undertaken:

2. ED defines Location of Work (site/ equipment/ vessel etc.)

3. ED defines Type of work/s (tick mark one or more of following) Construction Maintenance burning welding cutting grinding dry grit/ shot blasting working on gas pipe lines

electrical chilled water energized systems temporary electrical arrangement hazardous chemicals handling/transporting/generating hazardous wastes Excavation/trenching Using a gas, diesel, LP (propane) powered engine indoors Operating a powered or self-propelled work platform handling asbestos radiography working on fire protection/detection systems working on security/ safety systems compressed air/gases

heating, ventilation, or air conditioning equipment Working with chemicals, polishing or grinding Working at heights of more than 6 feet/ roofs

Working in confined spaces lifting heavy materials or hoisting with cranes or hoists Moving machinery Electrical Hazards Hazardous fumes Working on any hazardous equipment other…………………………………………………………………

4. ED defines Equipment/ Tools to be used:

5. ED and AA jointly define Personal Protective Equipment Required:

Hard Hat Safety Shoes Rubber Boots Protective Clothing

Ear Plug Ear Muffs Dust Mask Face Shields

Safety Belt/ Harness Full Face Mask Safety Goggles Leather/ Rubber Gloves

Heat Resistant Gloves Breathing Apparatus Others…………………….. Others……………………..

6. ED and AA jointly define Fire Fighting Measures Fire Fighting Team required Yes No N/A Fire Extinguisher Yes No N/A details………………………………………………………….. Fire Hose Yes No N/A details………………………………………………………….. 7. ED, AA and CO jointly Identify Operation Controls ( tick mark appropriate columns at para 11 and state further specific to job operational controls in this column).

a.

b. c.

Action in case of Emergency: 8. CONFIRMATION (to be filled by ED) I HAVE INSPECTED THE EQUIPMENT & AREA AND VERIFIED THAT OPERATIONAL CONTROLS (Ref. Para 3,4,5,6,7 and 11) ARE IN PLACE FOR SAFE EXECUTION OF JOB. Issued by: __________________________________________Sign: __________________Date& Time: ______________

9. ACCEPTANCE (AA where work is performed and CO who perform the work)

I HAVE UNDERSTOOD THE PTW AND SHALL IMPLEMENT OPERATIONAL CONTROLS (Ref. Para 3, 4,5,6,7 and 11) WHILE PERFORMING THE WORK. AA nominated incharge for work: _________________________ Sign:____________ Date & Time: ____________

Contractor / Operator performing the work: _________________ Sign:______________ Date & Time: ______________

10. Verification after completion of work

Work Completed Yes No If No, Permit Extended from …………………. to ………………………………….

Site cleared for Normal Operation Yes No Work Completion date & time: …………………………………………

Area Authority (AA): ___________________________________Signature: __________________Date& Time: ____________

Contractor/Operator who performed the work: _________________________

Signature: ____________Date & Time: ______




11. ED, AA and CO jointly Identify Operational Controls and ensure implementation (these are in addition to Para 3 ,4, 5, 6, and 7)

Electrical Work/ Moving Machinery Equipment electrically Isolated/ Mechanically disconnected Safety tags/ Caution Signs placed

Yes No N/A Yes No N/A

Responsibility Area Auth

ED Contractor/ operator

Construction / Maintenance

Barricade area / Place ‘ work in progress. sorry for inconvenience’ boards Safety hats, safety Shoes Scaffolding / ladders in good condition Safety harness used when working above 6 ft. height Waste Collection areas defined. Waste disposal defined. Fire arrangements in place / Extinguisher assessable Electrical / gas connections disconnected and made safe

Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A

Welding/ Cutting/ Brazing/ Burning

Flash Back Arrestor installed at Oxygen and Acetylene Cylinders Pressure Gauges on Gas Cylinders are available and Functional Electric Arc Welding leads are completely insulated Area clear of explosive/ flammable materials Area cordoned off Fire Extinguisher assessable

Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A

Lifting, Loading & unloading

Fork Lift/Carne/Chain block has appropriate loading capacity Load testing of Carne/Chain block done Crane/ Fork Lift Operator has Authorization/ valid Driving License Load Cart available in Crane Wire ropes suitably sized and strong Area cordoned off

Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A

Handling/ Storage of Chemicals Drains plugged to prevent spillage going into sewerage Spill prevention controls in place Spill response equipment available Availability and understanding of MSDS

Yes No N/A Yes No N/A Yes No N/A Yes No N/A

Working at Height

Ladder/ Scaffolding/ platform properly placed, stable and well tied PPEs(shoes, dress, are worn) Scaffolding planks are tied Arrangement available for anchoring safety belt/harness

Barrication of surrounding area Structure is safe and sound for climbing Operator trained and fit to climb

Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A

Radiography

Area cordoned off & Caution Sign displayed License available Radiation Testing Done

Yes No N/A

Yes No N/A Yes No N/A

Confined Space Inlet & Outlet Valves properly closed

Yes No N/A




Vessel/ line de-pressurized & earthed

Vessel/ pipeline flushed and free from toxic/ flammable/ corrosive vapors

Vessel/ Temperature Suitable for Entry

Adequate Mechanical/ Natural ventilation provided

Yes No N/A

Yes No N/A

Yes No N/A

Yes No N/A

Gas Test Results after isolation and ventilation: Time ____________ Oxygen __________% >19.5 % Explosive _______% L.E.L < 10% Toxic ___________PPM <10PPM H2S Testers signature: _____________________________ Periodic atmospheric tests:

Time _______ O2 %: ______________ LEL %: __________ Toxic(ppm) _______

Time _______ O2

No of persons entering into the Confined Space __________________

Names i. _________________ ii. _______________

iii. _________________iv. _______________

Name of standby person out side the confined space ________________________ %: ______________ LEL %: __________ Toxic(ppm) _______

Time _______ O2 %: ______________ LEL %: __________ Toxic(ppm) _______

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