CONTRACTOR QUESTIONNAIRE
SECTION 1 :- CONTRACTOR PRE-QUALIFICATION QUESTIONNAIRE
DECLARATION (CONTRACTOR)
We hereby declare and undertake that all the information/documents provided are under our full legal responsibility and confirm that we indemnify and hold ADMA-OPCO harmless against any claim or liability arising from the acceptance or use of such information/documentation whatever the source of such claim or liability.
We also authorize ADMA-OPCO to verify and seek any way of confirmatory of such information/documents.
We acknowledge that submission of this Questionnaire does not give us any right whatsoever to be invited to tender for any work being so tendered by ADMA-OPCO.
We undertake to inform Company of any changes and will periodically update/confirm (at least yearly) all items of supplied information.
SignatureFull Name
Designation
On Behalf Of
Date
Stamp
Note: Official Authorization /Power of Attorney from the owner to the above signed should be attached.
CHECK LIST (CONTRACTOR)
S.No. / DESCRIPTION / CONTRACTOR’S CONFIRMATIONCompulsory Attachments / Confirmation
1. / Covering letter from Local Contractor along with copy of their
- Abu DhabiMunicipality Trade License
- Abu DhabiMunicipality Trade Registration Certificate
- Abu Dhabi Chamber of Commerce & Industry (ADCCI)
(Above Certificates must contain classification for Oil & Gas Field Services).
- “To Whom It May Concern Certificate” from ADCCI stating % of ownership.
Note: Attach copy of above License/Certificates and the official English translation of the ADCCI membership registration certificate /
2. / Latest Balance Sheets/Annual Reports for last 3 years duly audited & certified by chartered accountant for the last year only. /
3. / Worldwide & local experiences list including Name of Client, Scope of Work, Value & Year of Project along with the relatedFinal Acceptance / Provisional Acceptance Certificatesas applicable for the experiences entered within the Contractor's screen (copies of contract to be attached) /
4. / Company profile outlining key areas (1 or 2 pages). /
5. / List of personnel under your company's visa issued by Ministry of Labour of UAE Government, Abu Dhabi. /
6. / Power of Attorney (authorization for signee) for signature in the company declaration. /
Additional Attachments, If Applicable to your Activities
7. / Letters of approval from major international oil & gas producers /
8. / Copy of QA/QC manual along with implementation forms, check lists & certificates applicable to QA/QC Management System /
9. / Copy of HSE Manual along with implementation forms, check lists & certificates /
10. / Contractor Classification from Planning Department, Abu Dhabi. /
11. / Copy of ISO 9001 certification from an international certifying agency. /
12. / Company organization charts with brief CVs and roles & responsibilities. /
13. / Company catalogues/brochures, if any. /
Optional Documents
14. / Bankers reference letter(s). /
15. / Customer reference letters. /
16. / Any other documents which you wish to enclose in support of this pre-qualification
(Please list below): /
Confirm that all Sections / Sub-sections applicable to you have been filled.
Notes:
Item Nos. 1 to 6 are compulsory for Contractors.
Item Nos. 7 to 13 are compulsory for Contractors, if applicable to the nature of work.
Item No. 14 onwards – optional.
PRE-QUALIFIED WITH ADNOC GROUP OF COMPANIES (CONTRACTOR)
If your company is pre-qualified with any of ADNOC group of companies, please fill the following information and provide supporting documents:
S.No. / ADNOCCOMPANY NAME / REGISTRATION No. / DETAILS OF / SERVICES PREQUALIFIED
HUMAN RESOURCES (CONTRACTOR)
List below, by category of specialization, the number of personnel employed, indicating whether they represent core “permanent” employees or “hired” ones.
Please attach list of personnel under your company's visa issued by Ministry of Labour of UAE Government, Abu Dhabi.
Permanent: Under your Abu Dhabi Company's visa
Hired: Not under your Abu Dhabi Company’s visa in Abu Dhabi.
CATEGORY OF SPECIALIZATION / TOTAL NUMBER / PERMANENT / HIREDArchitects
Chemical Engineers
Civil Engineers & Supervisors
Coded Welders (for Pressure Welding)
Commissioning Engineers
Contract / Project Management
Design / Drawing Personnel
Electrical Engineers
Estimating Engineers
Instrument Engineers
Machinery Engineers
Mechanical Engineers
Metallurgists
Production / Control Engineers
Purchasing Personnel
QA / Inspection & Test Personnel
Research & Development Personnel
Safety Personnel
Sales Personnel
Valves & Piping Engineers
Welding Engineers
OTHERS: (Please specify)
Please enclose the following Organization Charts:
- Organization Chart for your Local Office in Abu Dhabi
- Organization Chart for your Corporate Office
- Organization Chart for your Home Office
- Please mention the number of UAE nationals permanently employed by your company and confirm it with evidence documents issued or endorsed by the UAE Governmental Authority which to be linked under linked documents screen:
INFRASTRUCTURE (CONTRACTOR)
Please enclose the following document and tick the box to confirm:
(i)SPACE (Please specify the space occupied, in square meters)Offices / Warehouses / Workshops/Plants
Showrooms / Laboratories / Others
(ii)COMPUTERS/OFFICE AUTOMATION (Please specify the Facilities available)
No. Of Computers / No. of other Hardware such as Printers/Plotters, etc.
Do you use AUTOCAD or similar program? / YES / NO
Please list application software used/available with you including the ones for Project Planning/ Control functions and for Engineering Design:
Please describe very briefly, communication network(s)/facilities available, such as Modems, Electronic Mail, Telefax, etc.:
PLANT AND EQUIPMENT (CONTRACTOR)
Summarize your fixed/mobile Plant and Equipment in U.A.E. which are in good working order and provide a similar list for Plant and Equipment outside U.A.E., as a separate attachment.
S. No. / PLANT/EQUIPMENT ANDITS MANUFACTURER/MAKE / QTY. / CAPACITY / YEAR OF MFR. / LOCATION / OWNED/ HIRED / REMARKS
LICENSOR POSITION (CONTRACTOR)
To be completed only if your company is a process licensor. Please list processes relevant to the Hydrocarbon/Petrochemical/General Chemical/Process Industry for which your organization holds proprietary rights available to ADNOC under a licensing arrangement:
PROCESS (NAME) / PURPOSE / No. OF UNITSON STREAM / TYPICAL CAPACITY
TECHNICAL RESOURCES (CONTRACTOR)
(A)Please provide a brief write-up on how Planning, Procurement, Construction and Management of client projects are handled, emphasizing on Procurement, Personnel planning and their deployment, Project monitoring & control, Quality Control and Safety aspects.
Notes:
To be provided by Companies seeking pre-qualification for Project Engineering, Project Management and similar jobs/services.
(B) BACK-UP SERVICES:
Please summarize all back-up services you have, to support your prime business
ENGINEERING & DESIGN / WORKSHOPS & FABRICATION / TESTING, COMMISSIONING & OTHER SPECIALIZED SERVICESSECTION 2 :- CONTRACTOR HSE QUESTIONNAIRE
Contractors’ services Work Groups are classified into 9 groups as follow:
Group #1:Projects and consultancy engineering services
Group #2: Major projects construction
Group #3:Plants operations and maintenance
Group #4:Information technology
Group #5:Exploration and production studies / services
Group #6:Manpower supply
Group #7:Finance and legal
Group #8:Marketing
Group #9:Administration and general services
Contractors prequalification is usually achieved by issuing a standard and comprehensive HSE Pre-qualification format questionnaire document for the Contractor to complete, supported where necessary by historical performance records.
When pre-qualifying new or unknown Contractors, under group 1 to 3 above, it is recommended to arrange for inspection visits to the Contractor's base site (with particular emphasis being placed on ensuring that the Contractor has the resources and management structure to meet the ADNOC group of companies HSE standards). The Contractor's existing sites should be audited to verify that he could achieve the HSE standards proposed for the Pre-qualification.
For Contractors with services groups 4 to 9 above, it is not mandatory to conduct inspection visits to Contractors base site, however this will be left to the HSE Assessor to decide on case by case basis.
Section - 3 provides a typical questionnaire document for Contractor’s under group 4 to 9 to fill.
Section - 4 provides a comprehensive HSE pre-qualification questionnaire for Contractors under groups 1 to 3 to fill. This questionnaire is to be verified and scored by the HSE Assessor during the site verification visit. This questionnaire is directed towards establishing the status of the Contractor's HSEMS.
Section - 5 provides guidelines for a points evaluation system, which minimizes subjective judgment, to be used by the HSE Assessor to evaluate Contractors' submissions during the inspection visit. Contractors who achieve a predefined acceptable score will then be judged to have met the HSE Pre-qualification requirements.
Contractors’ submission and audit rating:
- Preferred: 85 -100% (Pre-qualified. Re-assessment to be made after three years if not awarded any job during this period).
- Acceptable: 65 – 84% (Pre-qualified. Re-assessment to be made after two years if not awarded any job during this period).
- Failed: 31-64% (Not Pre-qualified but might be re-evaluated after 6 months)
- Unacceptable: 0-30% (Rejected and not to be considered)
The HSE scoring of 65% and above to be transferred as 10 marks and above to the Contractor’s HSE evaluation criteria with a maximum of 15 marks for 100%.
Contractors scoring under 65% or under 10 marks are knocked out.
Contractors scoring zero in any of the HSE elements will be also knocked out, even if the overall score is more than 65%.
CONTRACTOR HSE PRE-QUALIFICATION QUESTIONNAIRE (GROUPS 4 – 9)
Please tick the appropriate box and provide required information:
Name and address of premises to which this HSE questionnaire applies: -
Name and title of Management Representative responsible for your HSE Management System.
- Do you have a formally documented HSE Management System?
- Do you have a HSE Manual / HSEMS Procedures?
If yes, provide copy of HSEMS manual & list of HSEMS procedures.
- Since when HSEMS implemented in your company?
- Does your HSE Management System meet the requirements of ISO 14000 Series / OHSAS 18000 series / other internationally recognized HSE System?
If yes, specify National/International Standard to which It is developed
- Is your HSE Management System approved by any inspection/certifying agency Or by any large well-known company, viz. Lloyds, BV, DNV, TUV, etc. or a major oil company?
If yes, specify which one and provide last certification or surveillance audit report and copy of the certificates.
- Can you provide training facilities at site?
If yes, please describe briefly
Please summarize HSE accreditations of your Company and its Associate companies, if any:
NAME OF COMPANY AND ITSASSOCIATED COMPANIES / ISO OR EQUIVALENT STANDARDS
(Please Specify)
Note: Please attach copies of HSEMS, HSE Certificate(s) and HSE Manual(s).
If your Company is not certified yet, but is going through the certification process, specify the name of Agency employed, if any, and approximate certification completion time:
(Please attach a letter from the Agency confirming the above).
Questionnaire completed by:-
Name:
Position:
Signature with Date:
Official Stamp
CONTRACTOR HSE PRE-QUALIFICATION QUESTIONNAIRE (GROUPS 1-3)
TO BE COMPLETED BY THE CONTRACTOR AND VERIFIED/SCORED BY THE HSE ASSESSOR DURING THE SITE VERIFICATION:
Name of the Company / :Address
Name of the Person
(Including position, title & e-mail address) completing this Checklist: / :
Nature of Business / :
Telephone # / :
Fax # / :
Statement: I, certify that the details provided in this assessment are true and correct to the best of my knowledge.
Signature with Date / :
CONTRACTOR HSE QUESTIONNAIRE
S.No. / EVALUATION FACTORS / CONTRACTOR’S RESPONSE / MAX SCORE / SCORE AWARDED / REMARKS / AREA OF IMPROVEMENT1 / LEADERSHIP AND COMMITMENT
1.1 / Commitment to HSE through Leadership
Are senior managers personally involved in HSE management?
Is there evidence of commitment at all levels of the organization?
Is there a positive culture towards HSE matters?
2 / HSE POLICY AND STRATEGIC OBJECTIVES
2.1 / HSE Policy documents
Does your company have an HSE Policy document? (If yes please attach a copy).
Who has overall and final responsibility for HSE in your organization?
Who is the most senior person responsible for this policy being implemented at premises/ sites where his employees are working? (Provide name, title and experience).
2.2 / Availability of Policy statements to employees
Itemize the methods by which you have drawn your HSE Policy statement to the attention of all your employees?
What are the arrangements for advising employees of changes in the HSE Policy?
3 / ORGANIZATION, RESOURCES AND COMPETENCE
3.1 / Organization - commitment & communication
How is management involved in HSE activities, objective setting and monitoring?
How is your company structured to manage and communicate HSE matters effectively?
What provision does your company make for internal HSE communication meetings?
3.2 / Competence and training of managers/ supervisors/ senior site staff/ HSE advisors
Have the managers and supervisors at all levels who will plan, monitor, oversee and carry out the work received formal HSE training in their responsibilities to conducting work to HSE requirements.
If YES please give examples. Where the training is given in-house please describe the content and duration of courses.
3.3 / Competence and general HSE training
What arrangements does your Company have to ensure new employees have knowledge of basic industrial HSE, and to keep this knowledge up to date?
What arrangements does your Company have to ensure new employees have knowledge of your HSE policies and practices?
What arrangements does your Company have to ensure new employees have been Instructed and given information on specific hazards arising out of the work being undertaken? What training do you provide to ensure that all employees are aware of Group company requirements?
What arrangements does your Company have to ensure existing staff HSE knowledge is up to date?
(If training is provided in-house please give details of content)
3.4 / Specialized Training
Have you identified areas of your Company where specialized training is required to deal with potential dangers? (If YES please itemize and provide details of training given)
If the specialized work involves radioactive, asbestos removal, chemical or other occupational health hazards, how are the hazards identified, assessed and controlled?.
3.5 / HSE qualified staff – additional training
Does your company employ any staff who possesses HSE Qualifications that aim to provide training in more than the basic requirements?
3.6 / Assessment of suitability of Sub-contractors / other companies
How do you assess:
HSE competence
HSE record of the subcontractors and companies with whom you place contracts?
Where do you spell out the standards you require to be met?
How do you ensure these are met and verified?
4 / RISK EVALUATION AND MANAGEMENT
4.1 / Hazards and effects assessment
What techniques are used within your Company for the identification, assessment, control and recovery of HSE hazards and effects?
4.2 / Exposure of the workforce
Do you have in place any systems to monitor the exposure of your workplace to hazards like chemicals or physical agents?
4.3 / Handling of chemicals
How is your workforce advised on the hazards encountered in the course of their work?
4.4 / Personal protective equipment
What arrangements does your company have for provision and maintenance of PPE both standard issue and that required for specialized activities?
4.5 / Waste Management
Does your company have in place systems for identification, classification and management of waste?
5 / PLANNING, STANDARDS AND PROCEDURES
5.1 / HSE or Operations Manuals
Do you have a company HSE manual (or Operations Manual with relevant sections on HSE), which describes in detail your Company approved HSE working practices relating to your work activities?
(If the answer is YES please attach a copy)
How do you ensure that the working practices and procedures used by your employees on-site are consistently in accordance with your HSE policy objectives and arrangements?
5.2 / Equipment control & Maintenance
How do you ensure that plant and equipment used by your employees within your premises, on-site, or at other locations, is correctly managed and maintained in a safe working condition?
5.3 / Standards
Where do you spell out the standards you require to be met?
How do you ensure these are met and verified?
Is there an overall structure for producing, updating and disseminating standards?
5.4 / Road Safety Management
How is road safety managed and what arrangements does your company have for combating road and vehicle incidents?
6 / IMPLEMENTATION AND MONITORING
6.1 / Management and performance monitoring of work activities
What arrangements does your company have for supervision and monitoring of HSE performance?
What type of performance criteria is used in your company; give examples?
What arrangements does your company have for communicating the results and findings of this supervision and monitoring to your management and employees?
6.2 / HSE performance achievement awards
Has your Company received any award for HSE achievement?
6.3 / Statutory Notified incidents / dangerous occurrences
Has your company suffered any statutory notified incidents in the last three years (safety, occupational health and environmental)? Answer with details including dates, most frequent types, causes and follow-up preventative measures taken.
6.4 / Improvement requirement and Prohibition Notices
Has your company suffered any improvement requirement or prohibition notices by the relevant national body, regulatory body for HSE or other enforcing authority or been prosecuted under any HSE legislation in the last three years? (If your answer is YES please give details.)?
6.5 / HSE performance records
Have you maintained records of your incidents and HSE performance for the last five years?
(If YES, please give following details for each year, number of Lost Time Injuries, number and type of other injuries e.g. MTC, RWC, F.A., total hours worked by workforce for each corresponding year, frequency rates, your company definition of a Lost Time incident).
How is health performance recorded?
How is environmental performance recorded?
How often is HSE performance reviewed? By whom?
6.6 / Incident investigation and reporting
Who conducts incident investigations?
How are the findings of an investigation, or from a relevant incident occurring elsewhere, communicated to your employees?
Are near misses reported?
7 / AUDIT AND REVIEW
7.1 / Auditing
Do you have a written procedure on HSE auditing and how does this procedure specify the schedules and standards for auditing (including unsafe act auditing)?
Does your company HSE Plans include schedules for auditing and what range of auditing is covered?
How the effectiveness of auditing is verified and how does management report and follow up audits?
8 / HSE MANAGEMENT -ADDITIONAL FEATURES
8.1 / Memberships of Associations
Does your Company hold HSE membership of, or actively support any industry or trade organization?
8.2 / Additional features of your HSE Management
Does your Company have any other HSE features or arrangements not described elsewhere in your response to the questionnaire?
SECTION 3 :- CONTRACTOR QUALITY QUESTIONNAIRE