PARTICULARS OF CONTRACTOR

1.1 Name of construction company ( as registered by NCA) : ……………………………….......………..

1.2 Postal Address : ………………............… Tel No. : ………………………………….........................

E-mail : ………………………………...............................…................................................................

1.3 Name, designation and phone number of company’s contact person when further details are required :

………………………………....……………………………….............……………………….................

…………………………………………………………………........................................................…...…

1.4 (i)Business registration number : ……………………………………………………………………….....

(ii)Date of registration : …………………………………………………………………………..........….

1.5 Nature of construction firm : Sole proprietor Partnership

Limited Liability Co. State Agency

Joint Venture

APPLICATION FORM

Best Civil Engineering Works Contractor

Best Mechanical Engineering Services Contractor

Best Electrical Engineering Services Contractor

Best Building Works Contractor

I wish to be considered for the Award of Best Contractor,

Women, Youth and Persons with Disability (attach AGPO

certificate).

*Note that this category is optional.

Class of Works

*Special Category Yes No

NCA 1-4 NCA 5-8

CONTRACTOR OF THE YEAR

1.0 Tick where appropriate the award you are applying for. If you wish to submit an application under more than one category, use separate application forms for each.

Category of Registration

Civil Engineering Works

Mechanical Engineering Services

Electrical Engineering Services

Building Works

Category of Registration Class of Works 1 2 3 4 5 6 7 8

*To input subcontractor details (where applicable), use the form labelled Annexe 1

1.6 NCA registration number. : ……………………….

NCA registration particulars (Place check mark where applicable)

DETAILS OF PROJECT

2.0 Title of Project : …………………………………………………………………………………………

…………………………………………………………………………………………………………….

2.2 Project Registration Number :……………………………………………………………...........................

2.3 Type of Project (eg Road, Dam, Building etc): …………………………………………………………....

2.4 Physical Location : ………………………………………………………………..........................

2.5 Name & contact number of the client: ……………………………………………………………………...

……………………………………………………………...…………………………………………………

2.6 Date of commencement : ………………………........................................................……..…..

2.7 Contract document (to be attached) : …………………………………………………………..…............

2.8 Contract Sum (Kshs.) ....................................................................................................................................

2.9 Project Procurement Method : …………………………………………………………..…............

2.9 Form of Contract 1. JBC FIDIC EPC

Other ……………....………………....……………....……………..…..........

Note: don’t forget to enclose the following documents (copies, not originals):

a. Valid Kenya Revenue Authority tax compliance certificate, an authenticated Certificate of Incorporation

or Business Name Registration, and an authenticated County Business Permit

b. Set of fully approved and authenticated architectural, structural, civil, electrical and mechanical drawings

c. Geotechnical report (where applicable)

d. Signed contract agreement

e. Programme of Works

f. A list of workers working on the site (list full names and accreditation numbers)

g. Approved safety management framework or policy authenticated by a relevant consultant

Name of Consultant Type of consultant e.g architect, engineer etc

Registration Number

Phone Number

Email Address

2.10 Name & Contact of the Consultants Engaged in the Project, eg Architect, Quantity Surveyor etc

ANNEXE 1

SUB-CONTRACTORS DETAILS

Name of Construction firmName and designation

of contact person

NCA Registration

Number

Phone Number Email Address