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