section xii - qualification questionnaire

7/29/2019 Section XII - Qualification Questionnaire

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Ethiopian Roads Authority Section XII Qualification Questionnaire

Section XII Qualification Questionnaire

Addis Ababa - Adama Road Project, Tender Documents i


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Technical Proposal

- SCHEDULE 1 Site Organization- SCHEDULE 2 Method Statement- SCHEDULE 3 Major Items of Construction Plant

a) Construction Plant and Equipment (Own Stock)

b) Construction Plant and Equipment (Purchase)

c) Construction Plant and Equipment (Hire)

- SCHEDULE 4 Subcontractors- SCHEDULE 5 Senior Site Personnel

- SCHEDULE 6 Technical Details

- SCHEDULE 7 Mobilisation and Performance Programme

- Others

Addis Ababa - Adama Road Project, Tender Documents 1


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SCHEDULE 1 Site Organization



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SCHEDULE 2 Method Statements



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SCHEDULE 3: MAJ OR ITEMS OF CONSTRUCTION PLANT (Form EQU)The Bidder shall provide adequate information to demonstrate clearly that it has the capability to meetthe 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 belowthe types and makes which you would use, age and state condition:

a) Items which would be immediately available from your own stocks:

Capacity

Description(Type, Model, Make) No.

Year ofManufacture

EstimatedUse

(hr, km)

EstimatedC.I.F. Value

*

PowerRating

t m

* Bidder should state Port of Entry.

b) Items which you would propose to purchase for the Contract together with expected deliveryperiods:



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Year ofManufacture

EstimatedUse


PowerRating

Capacity

(hr, km) * t m




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c) List below any items of plant which you would propose to hire:


Year ofManufacture

EstimatedUse


PowerRating

Capacity

(hr, km) * t m




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SCHEDULE 4: SUBCONTRACTORS

If you intend to sublet part of the Works, indicate the sections for which a subcontractor is proposedtogether with the name and address of the proposed subcontractor. Enter a statement of similarworks previously executed by the proposed subcontractor, including description, location and valueof work, year completed and name and address of employer.

Notwithstanding such information, the bidder, if awarded the Contract, shall remain entirely andsolely responsible for the satisfactory completion of the Works.

Item Section of Work ApproximateValue

Name and Address ofSubcontractor

Statement ofSimilar Works

PreviouslyExecuted



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SCHEDULE 5: SENIOR SITE PERSONNEL (Form PER-1)Set out below is a table showing the bidders proposed senior personnel for assignment to theproject site. Bidders should provide the names of suitably qualified personnel to meet the specifiedrequirements 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 ofhis 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).



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Form PER-2: Resume of Proposed Personnel

(a) Name of Bidder:(b) Position:

(d)

Name: (e)

Date of Birth:(c)

PersonnelInformation(f) Professional Qualifications:(g)(i) Name of Employer(j) Address of Employer(k) lawyer(l) Telephone (m) Contact (Manager /

Personnel Officer)

(n) Fax (o) Email

(h) PresentEmployment

(p) J ob title (q) Years with presentemployer

(r)(s) Summarize professional experience over the last 20 years, in reverse chronologicalorder. Indicate particular technical and managerial experience relevant to the project

(t) From (u) To (v) Company / Project / Position/ Relevant technicaland management experience

(w) (x) (y)(z) (aa) (bb)(cc) (dd) (ee)(ff) (gg) (hh)(ii) (jj) (kk)Name of authorized representative: --------------------------------------------------------Signature of authorized representative: ---------------------------------------------------

The bidder shall attach a staff assignment schedule for the above listed senior personnel showingtheassignment periods on siteduring the various stages of the project.



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SCHEDULE 6: TECHNICAL DETAILS

The Clauses below summarise required technical details, which the contractor shall include in hisbid. The numbering refers to Section IV, Technical Specifications, of the Bidding Documents, andthe Clauses or extract of the Clauses below shall be read in conjunction with the said TechnicalSpecifications.

1205 StandardsTrade Names

Where trade names or manufacturers catalogue reference numbers are mentioned in theTechnical Specifications or the Bill of Quantities, they are intended only to serve as a guideto the type of article or material required. The Contractor may use any article or materialsimilar and equal to those specified subject to approval of the Engineer. The bidder shallgive identifying details of proposed alternative products in the Bill of Quantities.

1302 General Requirements, (a) Camps, equipment and testing facilitiesThe 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, theworkshop, 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 theEngineer's office and housing accommodation including lay-out plan(s) for his proposeddesign and method of construction of the buildings. He shall state any proposed deviationfrom the outline of the Bidding Document.

1406 VehiclesThe Contractor shall submit with his bid detailed specifications and description of allvehicles 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) MillingThe Contractor shall submit with his bid detailed specifications and description of hismilling plant/equipment which he intends to provide including a list of reference projectswhere he has successfully performed milling works.

6404 Plant and Equipment, (a) GeneralThe Contractor shall submit with his bid detailed specifications and description includingemission 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 ControlThe Contractor shall submit with his bid detailed specifications and descriptionincluding brand and type/model of the laser speed measuring equipment which heintends to provide.

9902 Traffic Safety, (b) Weight ControlThe Contractor shall submit with his bid detailed specifications and descriptionincluding brand and type/model of the weigh bridge equipment which he intends toprovide.



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SCHEDULE 7: MOBIL ISATION 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. forthe 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 projectroad, if any;

a traffic management plan including proposed closing of sections of the road where the Worksshall be executed, showing the respective sections/sub-sections and the duration of the proposedclosing, if any;

a description of organisation and methodology proposed for the performance of the variousworks items of the Project;

in sufficient detail to demonstrate the adequacy of the Bidders proposals to meet theTechnical Specifications and the completion time referred to the bidding documents.



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Bid FormsForm 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 ofconstitution

Bidder's authorized representative(name, address, telephone numbers, faxnumbers, 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 entitynamed 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.



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Form ELI 1.2: J V Information Sheet

Each member of a JV must fill in this form

J V/ Specialist Subcontractor Information

Bidder's legal name

JV Partner's orSubcontractor's legal name

JV partner's orSubcontractor's year ofconstitution

JV Partner's or

Subcontractor's year ofconstitution

JV partner's orSubcontractor's legal addressin country of constitution

JV partner's orsubcontractor's authorizedrepresentative information(name, address, telephonenumbers, fax numbers, e-mailaddress)

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.



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Form CON 2

Historical Contract Non-Performance

[The following table shall be filled in for the Bidder and for each partner of a J oint 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, QualificationCriteria and Requirements, requirement 2.2.1

Year

Nonperformedportion ofcontract

Contract Identification

Total contractAmount

(current value,US$ equivalent)

[insert year] [insert

amount andpercentage]

Contract Identification: [indicate complete contract

name/ number, and any other identification]

Name of Employer: [insert full name]

Address of Employer; [insert full name]

Reason(s) for non performance: [indicate mainreason(s)]

[insert amount]



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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 AssetsTotal LiabilitiesNet worthCurrent AssetsCurrent 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 incomestatements) 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 notsister 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).



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Form FIN 3.2: Average Annual Construction Turnover


Annual Turnover Data for the Last 3 Years (construction only)Year

AmountCurrency

ExchangeRate

US$Equivalent

Average Annual Construction Turnover

The information supplies should be the Annual Turnover of the Bidder or each member of a JV interms of the amounts billed to clients for each year for work in progress or completed, converted toUS$s at the rate of exchange at the end of the period reported.



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Form FIN 3.3 (a): Financial Resources

Specify proposed sources of financing, such as liquid assets, unencumbered real assets, lines ofcredit, and other financial means, net of current commitments, available to meet the totalconstruction cash flow demands of the subject contract or contracts as indicated in Section III

(Evaluation and qualification Criteria).

Financial Resources

No. Source of financing Amount (US$ equivalent)

1

2

3



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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 allcontracts that have been awarded, or for which a letter of intent or acceptance has been received, orfor contracts approaching completion, but for which an unqualified, full completion certificate hasyet to be issued.

Current Contract Commitments

No. Name of contractEmployer's contactAddress, Tel, Fax

Value ofoutstanding

Work[current US$Equivalent]

Estimatedcompletion

Date

Average monthlyInvoicing OverLast six Months

[US$/month]

1

2

3

4

5



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Form EXP 4.1: General construction Experience


General Construction Experience

StartingMonthYear

EndingMonthYear

Years

Contract Identification and NameNam and Address of Employer

Brief Description of the Works Executed bythe Bidder

Role ofBidder



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Form EXP 2.4.2(a): Specific Construction Experience

Fill up one (1) form per contract.

Contract of Similar Size and NatureContract No.. of... Contract Identification

Award Date Completion Date

Role in Contract Contractor Management Contractor Subcontractor

Total contract Amount US$

If partner in a JV or

subcontractor, specify

participation of total contractamount

Percent of Total 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



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Form EXP 2.4.2 (b) Specific Construction Experience in Key Activities

Fill up one (1) form per contract

Contract with Similar key ActivitiesContract No.. of... Contract Identification

Award Date Completion Date

Role in Contract Contractor Management Subcontractor

Contractor

Total contract Amount US$

If partner in a JV or

subcontractor, specifyparticipation of total

contract amount

Percent of Total 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



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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)

Year Matter in Dispute

Value ofPendingclaim in US$Equivalent

Value ofPendingclaim as aPercentageof net

Worth



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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 bidguarantee.

At the request of the Bidder, we ____________________ [name of Bank] hereby irrevocablyundertake to pay you any sum or sums not exceeding in total an amount of ___________ [amountin figures] (____________) [amount in words] upon receipt by us of your first demand in writingaccompanied 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 Bidderin the Form of Bid; or

(b) having been notified of the acceptance of its Bid by the Employer during the period ofbid validity, (i) fails or refuses to execute the Contract Agreement or (ii) fails orrefuses to furnish the performance security, in accordance with the ITB.

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 ofthe Bidder; and (b) if the Bidder is not the successful Bidder, upon the earlier of (i) our receipt of acopy your notification to the Bidder of the name of the successful Bidder; or (ii) twenty-eight daysafter the expiration of the Bidders bid.

Consequently, any demand for payment under this guarantee must be received by us at the office onor before that date.

This guarantee is subject to the Uniform Rules for Demand Guarantees. ICC Publication No.

458._____________________________

[signature(s)]