Contractor Registration Package - Civil Works

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


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)



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.



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


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.


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.


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



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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



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:



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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



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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



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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



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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



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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



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APPLICATION NUMBER

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LICENCE NO#)

MEAN AGE


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



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APPLICATION NUMBER

FOR PSAEL USE ONLY

13




LICENCE NO#)

MEAN AGE


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



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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LICENCE NO#)

MEAN AGE


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



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APPLICATION NUMBER

FOR PSAEL USE ONLY

15




LICENCE NO#)

MEAN AGE


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



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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LICENCE NO#)

MEAN AGE


Miscellaneous

Lighting Tower

Scaffolding



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FOR PSAEL USE ONLY

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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



Rev #4: 26/04/2011

APPLICATION NUMBER

FOR PSAEL USE ONLY

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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 #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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WORK EXPERIENCE


CATEGORY CODE 1001 NAME OF SUB - CATEGORY Masonry


1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



Rev #4: 26/04/2011

APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



Rev #4: 26/04/2011

APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE


CATEGORY CODE 1001 NAME OF SUB - CATEGORY Carpentry/ Joinery


1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE


CATEGORY CODE 1001 NAME OF SUB - CATEGORY Painting


1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



Rev #4: 26/04/2011

APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE


CATEGORY CODE 1001 NAME OF SUB - CATEGORY Plumbing


1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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WORK EXPERIENCE


CATEGORY CODE 1001 NAME OF SUB - CATEGORY Fabricating and Welding


1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE


CATEGORY CODE 1001 NAME OF SUB - CATEGORY Earthworks


1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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FOR PSAEL USE ONLY

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WORK EXPERIENCE


CATEGORY CODE 1001 NAME OF SUB - CATEGORY Road Rehabilitation


1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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APPLICATION NUMBER

FOR PSAEL USE ONLY

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WORK EXPERIENCE


CATEGORY CODE 1001 NAME OF SUB - CATEGORY Drainage


1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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FOR PSAEL USE ONLY

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WORK EXPERIENCE




1 3

2 4



VALUE COMPLETION

DATE




COMPANY

DESIGNATION

CONTACT NUMBER

Office #

Mobile #

Office #

Mobile #

Office #

Mobile #



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FOR PSAEL USE ONLY

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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:

Contractor Registration Package - Civil Works

Documents

Transcript of Contractor Registration Package - Civil Works