سند پیش ارزیابی 2 ) E4 پروژه طرح جامع برق )پروژه
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1 E4
2 2
3 .1.1 E4 EPC 3
4 Project Manager and Supervisor department Client Project Consultant Applicant Unincorporated Joint Venture/Consortium Joint and Several Responsibility 4
5 Project E4 Bidder Reference to Similar Industrial Project Reference to Other Industrial work Project Description
6 Summary of Scope of Work
7
8
9 HSE QA/QC.1.1 9
10
11 CD
12
13
14 04
15 E4 05
16 06
17 : -1 NA 1 Not Applicable 07
18 -1-1 Form 1 General Information Legal Status Registered Name: Date & Place of Registration: Principal Place of Business: Registered Number: Type of Company: Latest Registered Capital: 08
19 Subject of activity: Name of the shareholders and share structure: Particulars, Educational-Executive Experiences of the BOD members and the managing director/ceo,..: Branch offices (If any) a) In Iran b) In other countries Subsidiaries (If any) a) In Iran b) In other countries -1-1 Minimum Required Evidence: 1- Iranian companies should provide and submit a copy of their Articles of Association and a copy of the Official Gazette(s) evidencing above information. 2- Non-Iranian companies should prepare documents and evidences proving above information in English and should have the same confirmed by the Chamber of Commerce of their subject country. Form 2 Specialty Capabilities Form 2-1- Reference to Other Industrial Projects completed during last ten (10) years: Name of the Project Description of the Project Client Value of the Contract Awarded Your Role of the Project Management Contractor Designer Consultant & Supervisor Main Contractor (Independently or In the form of a JV 09
20 Subcontractor In case your involvement has been as the contractor, please determine your share in the works of the relevant project: Design Procurement Civil and Structure Works Installation & Commissioning Training and Operation Value of your Share of the works Contractual Dates of Commencement and Expiration Actual Dates of Commencement and Completion Client Contact Details Minimum Required Evidence: 1- A copy of the concluded contract showing the above information to be provided 2- A copy of the "Completion Certificate" issued by the pertinent client 3- A copy of the "Good Performance Certificate" issued by the pertinent client to be provided Form 2-2- Reference to Other Industrial Projects in Progress Name of the Project: Description of the Project: Client: Value of the Contract Awarded: Your Role of the Project: Management Contractor Designer Consultant & Supervisor Main Contractor (Independently or In the form of a JV/ ) Sub Contractor 21
21 In case your involvement has been as the contractor, please determine your share in the works of the relevant project: Design Procurement Civil and Structure Works Installation & Commissioning Training and Operation Value of your Share of the works: Contractual Dates of Commencement and Expiration: Actual Date of Commencement: Progress percentage (Planned): Progress percentage (Actual): Client Contact Details: Minimum Required Evidence: 1- A copy of the concluded contract showing the above information to be provided 2- Documents showing the project's progress status report as confirmed by the relevant client -1-1 Form 2-3- Reference to Similar Industrial Projects: Name of the Project: Description of the Project: Client: Value of the Contract Awarded: Your Role of the Project: Management Contractor Designer Consultant & Supervisor Main Contractor (Independently or In the form of a JV/ ) Sub Contractor If your involvement has been as the designer, please determine in which stage and discipline you have been involved: Process (details to be included): Main Equipment (Particulars to be indicated): 20
22 Others (details to be included): In case your involvement has been as the contractor, please determine your share in the works of the relevant project: Design Procurement (list of the vendors and suppliers of main equipment to be included Civil and Structure Works Installation & Commissioning Training and Operation Value of your Share of the works: Contractual Dates of Commencement and Expiration Actual Dates of Commencement and Completion Client Contact Details: Minimum Required Evidence: 1- A copy of the concluded contract showing the above information to be provided 2- A copy of the "Good Performance Certificate" issued by the relevant client to be provided 3- Documents showing the project's progress status report as confirmed by the relevant client to be provided, in case the project is not finished yet Form 3- Organization Chart & Personnel Form 3-1- Top Organization Chart Item Full Name Position Education Work Experience Period of cooperation with company 22
23 Minimum Required Evidence: Organization chart, educational and executive background evidences of the key personnel and chief officers (engineering, procurement, executive, quality control, financial and contracts, planning and project control departments) named above must be submitted. 23
24 Form 3-2:List of Subcontractors for Performance of the Project Item Name of Company Subject of Activity Nationality Remarks -1 Minimum Required Evidence: 1- Submission of a framework agreement (or any other agreement) between the parties or a subcontractor readiness notification (in writing) is necessary. 2- Utilization by the Applicant of such subcontractors which are recognized by the Client as being competent, in the process of tender or during project performance, is a must. Form 4- Resources and Facilities Form 4-1 : Construction Equipment, Machinery and Tools 24
25 ) No. Facilities Description Quantity Manufacturer Date of Manufacture (Year) Power or Capacity Operation Condition Minimum Required Evidence: Applicant s ownership documents must be submitted. Form 4-2: Office, Workshop, Warehouse,... ) ) No. Facilities Description Area (m2) Location Type of Ownership (Rented or owned) Minimum Required Evidence: Applicant s ownership documents / lease agreement must be submitted. Form 4-3: Computer Hardware Facilities No. Facilities Description Number Model Remark 25
26 PC. Printer Scanner Plotter Minimum Required Evidence: Form 4-4: Main Software Facilities (Engineering, Procurement, Construction, Management and Project Planning & Control ) No. Subject Name of Software Ver. Remark Minimum Required Evidence: Form 5- Applicant s Financial Status Form 5-1- Turn-Over (For the Last Three Years) Please specify the total value of annual turn- over of the Applicant, in terms of works billed to clients during last three (3) years. 26
27 Actual Turn-Over Fiscal Year First Year Second Year Third Year Minimum Required Evidence: Applicant is required to submit supporting documents issued from its banks or confirmed by the Chamber of Commerce of its subject country. Form 5-2- Assets and Liabilities (For the Last Three Years) ) Please specify summaries of assets and liabilities for the previous three ( 3 ) ears. Third Year Second Year First Year Description Total assets Current assets Total liabilities Current liabilities Minimum Required Evidence: Applicant s annual balance sheet or tax return or other documents confirmed by the Chamber of Commerce of Applicant s subject country must be submitted. Form 6- Procedure and Technical Standards Description Standard or Procedure Name Quality Assurance / 27
28 Project Management / ISO / Heath, Safety and Environment (HSE) / Civil & Structure / Mechanical / Electrical / Control & Instrumentation / Piping / Minimum Required Evidence: Certificates issued by competent certifying authorities, where applicable, must be submitted. Form 7- Litigation History Applicants should provide information on any history of litigation or arbitration resulting from contracts executed in the last five ( 5 ) years or currently under execution. 28
29 Year Award for or against Applicant Name of client, cause of litigation, and matter in dispute Disputed amount FORM 8: TYPE AND MAKER OF THE EQUIPMENT 29
30 FORM 9: TYPE TESTS CERTIFICATES FOR EQUIPMENTS FROM ACCREDITED LABORATORY 31
31 30
32 32
33 MVA KA : ( ) 33
34 ( ) ( ) 8- ( ) 34
35 9- ( ) EPC 10- ( ) 11- ( ) DC 35
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