ADGAS / PRE-QUALIFICATION QUESTIONNAIRE
FOR CONTRACTORS /

CONTRACTOR

PRE QUALIFICATION

QUESTIONNAIRE

ABU DHABI GAS LIQUEFACTION COMPANY LIMITED

Pages

Contractor’s Name…………………………………………………………………….….. ...3

Guidelines………………………………………………………..……………………..………4

Check List………………………..…………………………………………………………..…5 - 6

Section 1General Information...... 7

1.1.Company Information…………………………………………………… 8

1.2.Ownership, Authorised Person(s)………………………………………9

1.3.Certificates and Licenses……………….………………………………..10

1.4.Associated Companies...... …10

1.5.Financial Information…………………………………………………… .11

Section 2Work Experience ...... 12

-Guidelines for Completing Section 2……………………………...... 13

2.1Work Categories ...... ………………………………… .14

2.2List of Experience for the last 5 Years ...... 15

2.3Licensor Position ………………………………………………………….16

Section 3Company Resources ...... 17

3.1Plant and Equipment …………………………………………………...18

3.2Technical Resources ……………………………………………….…...19

Section 4Orgainization and Quality Assurance ...... 20

4.1Organization & Human Resources……………………..…………... 21

4.2Infrastructure……………………………………………………………..22

4.3Quality Assurance Accreditions………………………………….... .23-24

Section 5Company Declaration………………………………………………....25-26

Guidelines...... 28

Contents...... 29-30

Work Category Descriptions...... 31

C O N T R A C T O R ' S N A M E

This document is considered by the Company to be a very important one for evaluating suitability of an organization as a prospective Contractor. Hence you are requested to follow these guidelines for completing the Questionnaire:

  1. Additional guidelines have been provided at the beginning of Section (2). A check list is also provided on the next page for you to ensure completeness of submittal.
  1. The term “Contractor” used in this document denotes both contractors and Consultants.
  1. All information shall preferably be typewritten and should be supported with appropriate documentation. This information is required to be updated by you every two to three years by submitting a fresh Pre-qualification Questionnaire.
  1. Please attach additional sheets if the space provided for any information is insufficient. Write your Company’s ‘Short’ Name on each additional sheet, marking it with a reference number which should be entered in the Check List.
  1. Every year copies of all renewed licenses and certificates (as per Sub-Section 1.3) must be submitted, without which your registration shall stand automatically cancelled.
  1. The Questionnaire, duly completed, may be couriered/hand delivered to:

Mr.Sultan Ebrahim A. Al-Neaimi

Head of Support Services Department

ADGAS Head Office – 12th Floor

Corniche Road

ABU DHABI – U.A.E.

All correspondence shall be addressed to Head of Support Services.

  1. In case of difficulty in filling up the Questionnaire, please contact:

Lead Support EngineerTel:02-6065618 OR

Contracts Registration OfficerTel:02-6065959

Support Services Department

Fax: 02-6061201

  1. There are 5 Sections to this Questionnaire, as under:

Section 1:General Information

Section 2:Work Experience

Section 3:Company Resources

Section 4:Organization & Quality Assurance

Section 5:Company Declaration

S.NO / DESCRIPTION / CONTRACTOR’SCONFIRMATION
1.
2.
3.
4.
5.
6.
7. / COMPULSORY ATTACHMENTS
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 (ADCC&I)
Membership Registration Certificate.
(Above Certificates must contain classification for Oil & Gas Field Services).
“To whom It May Concern Certificate” from ADCC&I stating % of ownership.
Note: Attach copy of above Licence/Certificates and their official English Translation.
Latest audited Balance Sheets/Annual Reports for last 3 years, duly certified by charted accountants.
World Wide Customer List including Name of Client, Scope of Work, Value and Year of Project.
Company Profile outlining key areas (1 or 2 pages).
Confirm that Section 2 has been fully completed i.e. including Work Groups and Work Experience (with relevant attachments).Required copies of Work Service Orders/Appreciation lettersetc. for the executed work categories along with support documents to proof experience in respective areas indicated in the pre qualification documents.
Power of Attorney of Authorized Signatory
Pre qualification acceptance letters for the relevant work categories from ADNOC group of companies. /
8.
9.
10.
11. / ADDITIONAL ATTACHMENTS, IF APPLICABLE TO YOUR ACTIVITIES
Contractor Classification from Planning Department, Abu Dhabi.
Copy of QA Certificate for ISO 9000 series from an international certifying Agency along with a copy of your QA/HSE Manual.
Company Organization charts and brief write-up as per Sections 3 and 4.
Company catalogues/brochures, if any. /
12.
13.
14. / OPTIONAL DOCUMENTS
Banker’s reference letter(s).
Customer reference letters.
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 7 are compulsory for Contractors.

- Item Nos. 8 to 11 are compulsory for Contractors, if applicable.

- Item No. 12 onwards – optionally provide useful additional information for this pre-qualification.

- The pre qualification dossier shall have all above compulsory attachments arranged in serial order, with dividers.

AUTHORISED SIGNATURES
SECTION 1
GENERAL INFORMATION

1.1COMPANY INFORMATION

1.2OWNERSHIP, AUTHORIZED PERSON(S)

1.3CERTIFICATES AND LICENSES

1.4ASSOCIATED COMPANIES

1.5FINANCIAL INFORMATION

SECTION 1
PAGE1 OF 4
FULL NAME
SHORT NAME (IF ANY)
DATE ESTABLISHED
NATIONALITY
INCORPORATED IN /
ABU DHBAI OTHER EMIRATE WITHIN U.A.E

AGCC COUNTRY OTHER COUNTRY

(AGCC = ArabGulf Cooperation Council)

ADDRESS
MAIN OFFICE
IN ABU DHABI / STREET
P.O. BOX
TEL. NO.
FAX NO. / E-MAIL:
CORPORATE HEADQUARTERS / STREET
P.O. BOX
TEL. NO.
FAX NO. / E-MAIL:
OTHER ADDRESSES / STREET
P.O. BOX
TEL. NO.
FAX NO. / E-MAIL:
HOME OFFICE (ONLY FOR CONSULTANTS/ ENGINEERS) / STREET
P.O.BOX
TEL. NO.
FAX NO. / E-MAIL:
CONTACT PERSONS: (Please include name of Chief Executive of the Company)
NAME / DESIGNATION / TEL. NO. / FAX NO. / E-MAIL
SECTION 1
PAGE 2 OF 4

(A)LOCAL COMPANY

100% OWNED BY U.A.E.NATIONAL 51% OWNED BY U.A.E. NATIONAL
NAME OF OWNER(S) / NATIONALITY / % OF OWNERSHIP

(B)FOREIGN COMPANY

Is it a Branch in Abu Dhabi?

If yes, provide the composition of Board of Directors of Parent Company:

NAME / POSITION / NATIONALITY

Or, isitaSponsored Company in Abu Dhabi?

If Yes, please provide details of your Company’s Sponsor in Abu Dhabi:

NAME(S) OF SPONSOR(S) / ADDRESS / TEL.NO. / FAX NO. / E-MAIL

(C)AUTHORISED SIGNATORIES AS PER STATUTES/ARTICLES OF ASSOCIATION

NAME(S) / DESIGNATION / SPECIMEN SIGNATURE
SECTION 1
PAGE 3 OF 4

(Please attach copies of Certificates/Licenses and their English Translation)

Classified for Oil & Gas Field Services?

(The above classification is necessary for registration as a ‘contractor’)

Trade License from Abu DhabiMunicipality
Registration No. / Date Of Registration / Registration Expiry Date
Trade Registration Certificate from Abu DhabiMunicipality
Registration No. / Date of Registration / Registration Expiry Date
Membership Regn. Certificate from Abu Dhabi Chamber Of Commerce & Industry
Registration No. / Date of Registration / Registration Expiry Date
Industrial license(s) issued from U.A.E. Authorities, if any
Issuing Authority / Registration No. / Date of Registration / Registration Expiry Date
Company classification with Planning Department, Abu Dhabi, If available
Classified For / Category of Classification / Date Issued
Name of Company / Address / Type of Association* / For ADGAS use only

*Type of Association:

W / Wholly-Owned Subsidiary Co.
P / Partially Owned Subsidiary Co.
I / Independent Co., but under same Management
SECTION 1
PAGE 4 OF 4

(All figures in Thousand Dirhams)

FULL NAME OF COMPANY
BALANCE SHEET INFORMATION (FOR THE LAST 3 YEARS) / TURNOVER (FOR LAST 3 YEAR)
YEAR / YEAR / GROSS INCOME / NET INCOME
FIXED ASSETS
CURRENT ASSETS
CURRENT LIABILITIES
PAID UP CAPITAL
LONG TERM LIABILITIES

COMPANY’S AUDITORS

NAME / ADDRESS

COMPANY’S BANKERS

Provide Main Banker’s Name, Address & Credit Facilities

BANK/INSTITUTION NAME / ADDRESS / CREDIT FACILITIES
AMOUNT / DETAILS/CONDITIONS
SECTION 2
WORK EXPERIENCE

2.1WORK GROUPS

2.2WORK EXPERIENCE

2.3LICENSOR POSITION

SECTION 2
PAGE 1 OF 4

The guidelines given below should be strictly followed in order to capture the information about your Company’s and it’s Associates’ experiences:

  1. A list of Work Categories covering current areas of ADGAS’ interest is provided at the end of this Questionnaire. Please select those Work Categories which are relevant to your Company and provide your work experiences for the selected Work Category(s).

Note: You may also include a specialized service offered by you which is not covered in the list but, in your opinion, may be of interest to ADGAS.

  1. List the Work Categories selected as per item (1) above, in sub-section 2.1.
  1. Record each of your work experiences in a separate form. A specimen form is provided in Sub-section 2.2. Use photocopies of this form and give these copies serial numbers which should be entered in the column provided in Sub-section 2.1 in order to link your supporting experiences to the relevant Work Category(s). You may fill both your “completed” as well as “current ongoing” contracts in separate forms.
  1. First record the jobs directly handled by your company. You may also record a few very important jobs handled through your Associated Companies. In such a case, in the column “Name of Contractor” in the Work Experience form, please write the name of you Associate Company instead of your Company’s name.
  1. You may record as many Work Experiences as you desire to support your application. However 4 or 5 most recent and major contracts for each ‘Work Category’, preferably from Oil & Gas Industry, will be considered the minimum requirement. Jobs with ADGAS/ADNOC Group of companies followed by those undertaken in Abu Dhabi/U.A.E. should be priority listed.
  1. The description of Work Experience must identify the key areas of the work executed by your Company and extent of your direct involvement such as:
  • Turnkey Projects including Engineering Design, Supply, Erection and Supervision.
  • Maintenance/Installation/Commissioning works including Supply of Manpower.
  • Consultancy Services, i.e. Engineering Design, Study and Reports
  • Or, Construction work only.
  1. Under ‘Contract Value’, specify the value of works executed directly by your Company including your sub-contractors.
  1. Sub-section 2.3 to be completed only if your Company is a process licensor.

SECTION 2
PAGE 2 OF 4

Please record below the Work Categories relevant to your Company’s operations as selected from a List provided at the end of this Questionnaire:

S. NO. / WORK CATEGORY NO. / NAME OF WORK CATEGORIES / WORK EXPERIENCE FORM NO.

Record any other specialized services offered, which are not included in the above List:

S.NO. / SERVICES OFFERED / REMARKS, IF ANY

Page:-1/49

ADGAS / PRE-QUALIFICATION QUESTIONNAIRE
FOR CONTRACTORS /
PROCUREMENT DIVISION
SUPPORT SERVICES DEPARTMENT - REGISTRATION
LIST OF EXPERIENCE FOR THE LAST 5 YEARS
SECTION 2
PAGE 3 OF 4
CONTRACTOR'S NAME : / CONTRACTOR REGISTRATION NO.
WORK CATEGORY (WC) DESCRIPTION / WORK CATEGORY CODE
S. NO.
1 / PROJECT TITLE
2 / CLIENT
3 / SCOPE OF WORK
4 / ROLE IN PROJECT
5 / YEAR
6 / TOTAL JOB VALUE (DHS)
7 / VALUE FOR THIS WC (DHS)
8

Column No. 8 - This value should reflect the relevant portion of the total job which relates directly to the concerned work Category/Service for which this from is being filled, e.g., if your total job value is Dhs.1 Million and out of this the relevant Work Category/Service is only Dhs.50,000 then write Dhs.50,000 in this column.

Note: Please include ongoing jobs on a separate copy of this form.

Provide relevant document (copies of Work order/ Service Order or Completion Certificate or Experience certificate) for each category.

Page:-1/49

ADGAS / PRE-QUALIFICATION QUESTIONNAIRE
FOR CONTRACTORS /
SECTION 2
PAGE 4 OF 4

Please list processes relevant to the Hydrocarbon/Petrochemical/General Chemical/Process Industry for which your organization holds proprietary rights available to ADGAS under a licensing arrangement:

PROCESS (NAME) / PURPOSE / NO. OF UNITS ON STREAM / TYPICAL CAPACITY
SECTION 3
COMPANY RESOURCES

3.1PLANT AND EQUIPMENT

3.2TECHNICAL RESOURCES

SECTION 3
PAGE 1 OF 2

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 AND ITS MANUFACTURER/ MAKE / QTY. / CAPACITY / YEAR OF MFR. / LOCATION / OWNED/HIRED / REMARKS
SECTION 3
PAGE 2 OF 2

(A)Please provide a brief write-up on how planning, Procurement, Construction and Management of client projects are handled, emphasizing on Procurement, Manpower Planning and its deployment, Project Monitoring & Control, Quality Control and Safety aspects.

NOTES:

1.To be provided by Companies seeking prequalification for Project Engineering, Project Management and similar jobs/services.

  1. Please use separate sheets and confirm by ticking the box, if attached.

(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 SERVICES
SECTION 4
ORGANIZATION AND QUALITY ASSURANCE

4.1ORGANIZATION & HUMAN RESOURCES

4.2INFRASTRUCTURE

4.3QUALITY ASSURANCE ACCREDITIONS

SECTION 4
PAGE 1 OF 4

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 your manpower under yours 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 Abu Dhabi.

CATEGORY OF SPECIALIZATION / TOTAL NUMBER / PERMANENT / HIRED
Architects
Chemical Engineers
Civil Engineers and 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 and Test Personnel
Research & Development Personnel
Safety Personnel
Sales Personnel
Valves & Piping Engineers
Welding Engineers
Others (Please Specify)
SECTION 4
PAGE 2 OF 4

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 (if different from your Corporate Office)

Please enclose the following document and tick the box to confirm:

(i)SPACE (Please specify the space occupied, in square metres)

Offices WarehousesWorkshops/Plants

Showrooms LaboratoriesOthers……

(ii)COMPUTERS/OFFICE AUTOMATION(Please specify the Facilities available)

No. of ComputersNo. of other Hardware such as Printers/Plotters, etc.

Do you use AUTOCAD or similar program?

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.:

______

______

______

______

SECTION 4
PAGE 3 OF 4

Please tick the appropriate box and provide required information:

1. Do you have a formally documented Quality System?

2.Do you have a QA Manual?

If yes, specify National/International Standard to which

It is developed.

3.Does your QA System meet the requirements of ISO 9000

Series/Bs 5750 (All Parts)/other internationally recognized

QA System?

If yes, please specify which parts, and what system.

4.Is your QA System approved by any inspection/certifying agency

Or by any large well-known company, viz. Lloyds, TUV, etc. or a

Major Oil Company?

If yes, specify which ones.

5.Do you have HSE Manual? Do your company documents &

Implement HSE System?

Does your HSE System meet the requirement of ISO 14000 or

Other internationally recognized HSE System?

  1. Specify any Engineering, Fabrication and Chemical Production

Tests/Codes/Standards employed.

7.Specify any Code Construction Authority possessed by you.

8.Can you provide training facilities at site?

If yes, please describe briefly.

SECTION 4
PAGE 4 OF 4

Please summarize QA accreditions of your Company and its Associate company, if any:

NAME OF COMPANY AND ITS
ASSOCIATED COMPANIES / ISO OR EQUIVALENT STANDARDS
(Please Specify)

NOTE: Please attach copy of QA Certificate(s) and copy of QA 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).

______

______

______

______

SECTION 5
COMPANY DECLARATION

To:Abu Dhabi Gas Liquefaction Company Limited

P.O. Box 3500,

Abu Dhabi, UAE.

Dear Sirs,

I/We solemnly declare;

-that the statements and information given in this Registration Document are authentic and true,

-that copies of enclosed supporting documents are authentic and true,

-that the completion of this form does not give me/us any right whatsoever to be invited to tender for any work being so tendered by Abu Dhabi Gas Liquefaction Company Limited (ADGAS) or having been invited to tender, any right whatsoever to claim award of a Contract.

-that we acknowledge and accept that to satisfactorily evaluate our submittal ADGAS shall have the right at its sole option, to visit our offices and works in progress with a view to auditing and verifying our financial, technical and other resources, and we shall make available to ADGAS’ representatives all facilities required by them for this purpose.

Further, I/We undertake, that following submission of this completed document, any changes in circumstance which alter or are additional to the details and information given in this document, I/We shall notify ADGAS at the earliest opportunity of these changed circumstances. Any failure to inform ADGAS of such changes or additions may jeopardise any subsequent agreement.

Signed: ______

Date: ______

Full Name: ______

Designation: ______

For and on behalf of: ______

(Company Name)

Co. Stamp: ______

Please follow the two steps given below to select Work Categories Codes to identify your company’s services for which you wish to pre-qualify:

Step – 1 Select the Main Group Number from the following table which focuses on nature of your main activities, as per your Licences:

Main Group No. / Nature of Main Activity
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0 / Consultancy/Engineering
EPC, EPCM & Construction Works for Major Projects
Minor Construction & Plant Operation/Maintenance related Works
Information Technology related Services
Personnel & Manpower Supply/Services
Finance related Services
Marketing related Services
Domestic/Building related and other General Services

Step – 2 After selecting the applicable Main Group Numbers from above table, go to the “List of Work Categories” and define your Company’s activities/specialization which can be supported with your experience/references.

Notes: 1. The term “Contractor” includes Contractor and Consultants.

GROUP / DESCRIPTION
1.0 / PROJECTS & PLANT CONSULTANCY/ENGINEERING
1.1 PROJECT CONSULTANCY/ENGINEERING
1.2 OPERATING PLANT CONSULTANCY
2.0 / CONSTRUCTION WORKS (MAJOR PROJECTS)
2.1 EPC CONTRACTS – MULTI DISCIPLINE
2.2. EPCM CONTRACTS – MULTI DISCIPLINE
2.3 CIVIL WORKS
2.4 MECHANICAL WORKS
2.5 PIPELINE WORKS
2.6 ELECTRICAL WORKS
2.7 INSTRUMENTATION & TELECOM. WORKS
2.8 GENERAL CONTRACTS (MAJOR PROJECTS)
3.0 / PLANT OPERATION & MAINTENANCE
3.1 CIVIL WORKS/MAINTENANCE