Section XII - Qualification Questionnaire

Ethiopian Roads Authority
Section XII Qualification Questionnaire
Addis Ababa - Adama Road Project, Tender Documents
Technical Proposal
SCHEDULE 1 Site Organization SCHEDULE 2 Method Statement SCHEDULE 3 Major Items of Construction Plant
a) b) c) Construction Plant and Equipment (Own Stock) Construction Plant and Equipment (Purchase) Construction Plant and Equipment (Hire)
SCHEDULE 4 Subcontractors SCHEDULE 5 Senior Site Personnel
SCHEDULE 6 Technical Details
SCHEDULE 7 Mobilisation and Performance Programme
Others
SCHEDULE 1 Site Organization
SCHEDULE 2 Method Statements
SCHEDULE 3: MAJOR ITEMS OF CONSTRUCTION PLANT (Form EQU) The Bidder shall provide adequate information to demonstrate clearly that it has the capability to meet the requirements for the key equipment listed in Section III, Evaluation and Qualification Criteria. What equipment do you intend to use on this project if the Contract is awarded to you? List below the types and makes which you would use, age and state condition: a) Items which would be immediately available from your own stocks: Description (Type, Model, Make) Year of Estimated No. Manufacture Use (hr, km) Estimated C.I.F. Value * Power Rating Capacity t m
* Bidder should state Port of Entry. b) Items which you would propose to purchase for the Contract together with expected delivery periods:
Description (Type, Model, Make)
Year of Estimated No. Manufacture Use (hr, km)
Estimated C.I.F. Value *
Power Rating
Capacity t m
* Bidder should state Port of Entry.
c) List below any items of plant which you would propose to hire:
Description (Type, Model, Make)
Year of Estimated No. Manufacture Use (hr, km)
Estimated C.I.F. Value *
Power Rating
Capacity t m
* Bidder should state Port of Entry.
SCHEDULE 4: SUBCONTRACTORS If you intend to sublet part of the Works, indicate the sections for which a subcontractor is proposed together with the name and address of the proposed subcontractor. Enter a statement of similar works previously executed by the proposed subcontractor, including description, location and value of work, year completed and name and address of employer. Notwithstanding such information, the bidder, if awarded the Contract, shall remain entirely and solely responsible for the satisfactory completion of the Works. Item Section of Work Approximate Value Name and Address of Subcontractor Statement of Similar Works Previously Executed
SCHEDULE 5: SENIOR SITE PERSONNEL (Form PER-1) Set out below is a table showing the bidders proposed senior personnel for assignment to the project site. Bidders should provide the names of suitably qualified personnel to meet the specified requirements stated in Section III. Name Nationality Date of Birth Proposed Position in Project
Using the form PER-2 provided below, the undersigned bidder attaches herewith curricula vitae of his proposed senior personnel describing details of: - Proposed position; - Name; - Date of birth; - Professional Qualifications: education and supplementary training; - Language capability; - experience record with name and address of respective previous employers including Employers person of contact with telephone/facsimile number and e-mail address; - Name and signature of person or persons authorised to sign the bid (according to Instructions to Bidders).
Form PER-2: Resume of Proposed Personnel (a) (b) Name of Bidder: Position: (d) (f) (g) (h) Present Employment (i) (j) (k) (l) (n) (p) Name of Employer Address of Employer lawyer Telephone Fax Job title (m) Contact (Manager / Personnel Officer) (o) Email Name: (e) Date of Birth:
(c) Personnel Information
Professional Qualifications:
(q) Years with present employer (r)
(s) Summarize professional experience over the last 20 years, in reverse chronological order. Indicate particular technical and managerial experience relevant to the project (t) (w) (z) (cc) (ff) (ii) From (u) (x) (aa) (dd) (gg) (jj) To (v) Company / Project / Position/ Relevant technical and management experience (y) (bb) (ee) (hh) (kk)
Name of authorized representative: -------------------------------------------------------Signature of authorized representative: ---------------------------------------------------
The bidder shall attach a staff assignment schedule for the above listed senior personnel showing the assignment periods on site during the various stages of the project.
SCHEDULE 6: TECHNICAL DETAILS The Clauses below summarise required technical details, which the contractor shall include in his bid. The numbering refers to Section IV, Technical Specifications, of the Bidding Documents, and the Clauses or extract of the Clauses below shall be read in conjunction with the said Technical Specifications. 1205 Standards Trade Names Where trade names or manufacturers catalogue reference numbers are mentioned in the Technical Specifications or the Bill of Quantities, they are intended only to serve as a guide to the type of article or material required. The Contractor may use any article or material similar and equal to those specified subject to approval of the Engineer. The bidder shall give identifying details of proposed alternative products in the Bill of Quantities. 1302 General Requirements, (a) Camps, equipment and testing facilities The Contractor shall submit with his bid a preliminary lay-out plan for his main site establishment as well as specifications and drawings of the water supply system, the workshop, the laboratory, the first aid station and the ambulance service. 1402 General (Accommodation, Services, and Attendance for the Engineer's Staff) The Contractor shall submit with his bid preliminary details and specifications of the Engineer's office and housing accommodation including lay-out plan(s) for his proposed design and method of construction of the buildings. He shall state any proposed deviation from the outline of the Bidding Document. 1406 Vehicles The Contractor shall submit with his bid detailed specifications and description of all vehicles including required equipment, etc., brand and type/model of vehicle which he intends to provide. 5114 Construction Requirements for Sub-Bases Using Reprocessed Pavement Material (c) Milling The Contractor shall submit with his bid detailed specifications and description of his milling plant/equipment which he intends to provide including a list of reference projects where he has successfully performed milling works. 6404 Plant and Equipment, (a) General The Contractor shall submit with his bid detailed specifications and description including emission standards/values of his asphalt mixing plant which he intends to provide. 9901 Lessons/Lectures The Contractor shall submit with his bid curriculum vitae / curricula vitae of the person(s) proposed to provide the traffic safety lessons/lectures. 9902 Traffic Safety, (a) Speed Control The Contractor shall submit with his bid detailed specifications and description including brand and type/model of the laser speed measuring equipment which he intends to provide. 9902 Traffic Safety, (b) Weight Control The Contractor shall submit with his bid detailed specifications and description including brand and type/model of the weigh bridge equipment which he intends to provide.
10
SCHEDULE 7: MOBILISATION AND PERFORMANCE PROGRAMME The Bidder shall submit with his Bid as a minimum: an organisation chart showing the organisation of his firm, the responsibilities of his staff etc. for the performance of the Project; a performance programme showing his planned/proposed mobilisation at the Site and duration, phasing and deadlines for completion of the various activities of the Project, etc.; a time schedule indicating the requirements for the Possession of Site to be made available by the Employer, distinguishing also between individual sections/sub-sections of the project road, if any; a traffic management plan including proposed closing of sections of the road where the Works shall be executed, showing the respective sections/sub-sections and the duration of the proposed closing, if any; a description of organisation and methodology proposed for the performance of the various works items of the Project; in sufficient detail to demonstrate the adequacy of the Bidders proposals to meet the Technical Specifications and the completion time referred to the bidding documents.
11
Bid Forms Form ELI 1.1: Bidder's Information Sheet

Bidder's Information
Bidder's legal name
In case of JV, legal name
Bidder's country of constitution
Bidder's year of constitution
Bidder's legal address in country of constitution Bidder's authorized representative (name, address, telephone numbers, fax numbers, e-mail address) Attached are copies of the following original documents. 1. In case of single entity, articles of incorporation or constitution of the legal entity
named above, in accordance with ITB 4.1 and 4.2. 2. Authorization to represent the firm or JV named in above, in accordance with ITB 20.2 3. In case of JV, letter of intent to form JV or JV agreement, in accordance with ITB 4.1. 4. In case of a government-owned entity, any additional documents not covered under 1 above required to comply with ITB 4.5.
12
Form ELI 1.2: JV Information Sheet

Each member of a JV must fill in this form JV/ Specialist Subcontractor Information Bidder's legal name JV Partner's or Subcontractor's legal name JV partner's or Subcontractor's year of constitution JV Partner's or Subcontractor's year of constitution JV partner's or Subcontractor's legal address in country of constitution JV partner's or subcontractor's authorized representative information (name, address, telephone numbers, fax numbers, e-mail address) Attached are copies of the following original documents. 1. Articles of incorporation or constitution of the legal entity named above, in accordance with ITB 4.1 and 4.2. 2. Authorization to represent the firm named above, in accordance with ITB 20.2. 3. In the case of government-owned entity, documents establishing legal and financial autonomy and compliance with commercial law, in accordance with ITB 4.5.
13
Form CON 2 Historical Contract Non-Performance

[The following table shall be filled in for the Bidder and for each partner of a Joint Venture] Bidder's Legal Name: [insert full name] Date: [insert day, month, year] Joint Venture Party Legal Name: [insert full name] ICB No. and title: [insert ICB number and title] Page [insert page number] of [insert total number] pages Non-Performing contracts in accordance with Section III, Qualification Criteria and Requirements Contract non-performance did not occur during the last Five (5) years specified in Section III, Qualification Criteria and Requirements, Sub Factor 2.2.1. Contract (S) not performed during the last Five (5) years specified in Section III, Qualification Criteria and Requirements, requirement 2.2.1 Total contract Non Amount performed Contract Identification Year (current value, portion of US$ equivalent) contract Contract Identification: [indicate complete contract [insert amount] [insert year] [insert amount and name/ number, and any other identification] percentage] Name of Employer: [insert full name] Address of Employer; [insert full name] Reason(s) for non performance: [indicate main reason(s)]
14
Form FIN 3.1: Financial Situation

Each Bidder or member of a JV must fill in this form Financial Data for previous 3 Years [US$ Equivalent] Year 1: Year 2: Year 3:
Information from Balance Sheet Total Assets Total Liabilities Net worth Current Assets Current Liabilities Information form Income Statement Total Revenues Profits Before Taxes Profits After Taxes Attached are copies of financial statements (balance sheets including all related notes, and income statements) for the last three years, as indicated above, complying with the following conditions. All such documents reflect the financial situation of the Bidder or partner to a JV, and not sister or parent companies. Historic financial statements must be audited by a certified accountant. Historic financial statements must be complete, including all notes to the financial statements. Historic financial statements must correspond to accounting periods already completed and audited (no statements for partial periods shall be requested or accepted).
15
Form FIN 3.2: Average Annual Construction Turnover

Each Bidder or member of a JV must fill in this form
Annual Turnover Data for the Last 3 Years (construction only)

Year Amount Currency Exchange Rate US$ Equivalent
Average Annual Construction Turnover
The information supplies should be the Annual Turnover of the Bidder or each member of a JV in terms of the amounts billed to clients for each year for work in progress or completed, converted to US$s at the rate of exchange at the end of the period reported.
16
Form FIN 3.3 (a): Financial Resources

Specify proposed sources of financing, such as liquid assets, unencumbered real assets, lines of credit, and other financial means, net of current commitments, available to meet the total construction cash flow demands of the subject contract or contracts as indicated in Section III (Evaluation and qualification Criteria). Financial Resources No. 1 2 3 Source of financing Amount (US$ equivalent)
17
Form FIN 3.3 (b): Current Contract Commitments/ works in Progress

Bidders and each partner to a JV should provide information on their current commitments on all contracts that have been awarded, or for which a letter of intent or acceptance has been received, or for contracts approaching completion, but for which an unqualified, full completion certificate has yet to be issued.
Current Contract Commitments

Employer's contact Address, Tel, Fax Value of outstanding Work [current US$ Equivalent] Estimated completion Date Average monthly Invoicing Over Last six Months [US$/month]
No.
Name of contract
1 2 3 4 5
18
Form EXP 4.1: General construction Experience

General Construction Experience
Starting Month Year
Ending Month Year
Years
Contract Identification and Name Nam and Address of Employer Brief Description of the Works Executed by the Bidder
Role of Bidder
19
Form EXP 2.4.2(a): Specific Construction Experience

Fill up one (1) form per contract.
Contract of Similar Size and Nature

Contract No.. of... Award Date Role in Contract Total contract Amount If partner in a JV or subcontractor, specify participation of total contract amount Employer's Name Address Telephone/Fax Number E-mail Description of the similarity in accordance with Criteria 2.4.2(a) of Section III Percent of Total Amount Contractor Contract Identification Completion Date Management Contractor US$ Subcontractor
20
Form EXP 2.4.2 (b) Specific Construction Experience in Key Activities Fill up one (1) form per contract
Contract with Similar key Activities

Contract No.. of... Award Date Role in Contract Total contract Amount If partner in a JV or subcontractor, specify participation of total contract amount Employer's Name Address Telephone/Fax Number E-mail Description of the key activities in accordance with Criteria 2.4.2(b) of Section III Percent of Total Amount Contractor Contract Identification Completion Date Management Subcontractor Contractor US$
21
Form LIT Pending Litigation

Pending Litigation
No pending litigation in accordance with Criteria 2.2.2 of Section III (Evaluation and Qualification Criteria) Pending litigation in accordance with Criteria 2.2.1 of Section III (Evaluation and Qualification Criteria) Value of Pending Value of claim as a Pending claim in US$ Percentage of net Equivalent Worth
Year
Matter in Dispute
22
Form of Bid Security

(Bank Guarantee) __________________________ [Banks Name, and Address of Issuing Branch or Office] Beneficiary: Ethiopian Roads Authority P. O. Box 1770 Addis Ababa, Ethiopia Date: __________________________ BID GUARANTEE No.: __________________________ We have been informed that __________________________ [name of the Bidder] (hereinafter called "the Bidder") has submitted to you its bid dated ___________ (hereinafter called "the Bid") for the execution of Addis Ababa - Adama Road project, under Invitation for Bids No. ___________ (the IFB). Furthermore, we understand that, according to your conditions, bids must be supported by a bid guarantee. At the request of the Bidder, we ____________________ [name of Bank] hereby irrevocably undertake to pay you any sum or sums not exceeding in total an amount of ___________ [amount in figures] (____________) [amount in words] upon receipt by us of your first demand in writing accompanied by a written statement stating that the Bidder is in breach of its obligation(s) under the bid conditions, because the Bidder: (a) has withdrawn its Bid during the period of bid validity specified by the Bidder in the Form of Bid; or having been notified of the acceptance of its Bid by the Employer during the period of bid validity, (i) fails or refuses to execute the Contract Agreement or (ii) fails or refuses to furnish the performance security, in accordance with the ITB.
(b)
This guarantee will expire: (a) if the Bidder is the successful Bidder, upon our receipt of copies of the contract signed by the Bidder and the performance security issued to you upon the instruction of the Bidder; and (b) if the Bidder is not the successful Bidder, upon the earlier of (i) our receipt of a copy your notification to the Bidder of the name of the successful Bidder; or (ii) twenty-eight days after the expiration of the Bidders bid. Consequently, any demand for payment under this guarantee must be received by us at the office on or before that date.
This guarantee is subject to the Uniform Rules for Demand Guarantees. ICC Publication No. 458._____________________________
[signature(s)]
23

Section XII - Qualification Questionnaire

Hochgeladen von

Dokumentinformationen

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Section XII - Qualification Questionnaire

Hochgeladen von

Copyright:

Verfügbare Formate

Ethiopian Roads Authority