Prequalification Form

SAUDI RAILWAY COMPANY

PROCUREMENT & CONTRACTS DEPARTMENT

Prequalification form

(Request for Information)

RFI

Remember to attach:

1. Commercial Registration Copy.

2. Chamber Of Commerce Membership Copy.

3. Zakat and income certificate.

4. Saudization certificate.

5. GOSI certificate (General Organization Saudi Insurance).

6. Trade license Copy.

7. Quality Management System Certificate Copy.

8. Products Catalos (Original)

9. Company profile including (organizational chart ,history of company)

10. Financial statement last 3 years

11. Reference list last 5 years

Table of Contents

Remember to attach: 1

1. Company Information 3

1.2. Business information 4

1.3. Company overview 4

1.4 Executive management 5

1.6. Affiliate companies 5

1.7. Declaration of potential conflict of interest* 5

1.8. Insurance policies 6

1.9. Insurance firm information 6

1.10. Payment terms 6

2. Performance record 6

2.1. Contracts overview 6

2.2. Details of large supplies contracts executed* 6

2.3. Details of large customers served 7

2.4. Prior product liabilities 8

3. Corporate policies 9

3.1. Quality policy 9

3.2. Contact person within your organization for this policy 9

3.3. Other policies 9

4. Products and capabilities brief 9

4.1. Products 9

4.2. IT Capabilities 10

4.3. Warehouse 10

4.6. Distribution system 11

5. Detailed product information 11

5.1. Manufacturer information 11

5.2. Catalogue for supplies 11

5.3. Service capabilities 11

1. Company Information

Company name*
Commercial registration number*
Chamber of Commerce Membership (Grade)*

Head office / registered address and phone

Address line 1*
Address line 2
P.O. Box
City*
Zip code
Province
Country*
Head office phone (no space between digits)*
Head office fax (no space between digits)*
Website address (if any)

Contact person (2 person authorized representative of the company)

Full name* / Full name*
Job title* / Job title*
Telephone/
Extension / Telephone/ Extension
Mobile phone / Mobile phone
Fax number / Fax number
Email address* / Email address
Address line 1* / Address line 1
Address line 2 / Address line 2
P.O. Box / P.O. Box
City* / City
Zip code / Zip code
State /
Province / State / Province
Country* / Country

1.2. Business information

Type of products*
(multiple choices allowed) / Services Consumables Equipment
Other
Type of business*
(multiple choices allowed) / Manufacturer Agent Wholesaler
Retailer Other
Manufacturer represented by your company
(manufacturer names, separated by semi-colons)
Trade license
(upload a copy of it: PDF, JPG, PNG or BMP format)
List of major private sector organizations that you serve in Saudi Arabia
( organization names separated by semi-colons)

1.3. Company overview

Date of establishment*
Number of employees*
Type of company* / Public Private Others
(Please specify if others)______
Principal activities*
(Please describe all the key activities of the company)

1.4 Executive management

Names and designations of key officers in the company*

Title / Name / Mobile number

1.5. Shareholding structure (if your company shareholder fill it)

Names and ownership stakes of major shareholders* (>10% stake)

Name / Ownership stake (%)

1.6. Affiliate companies (if your company shareholder fill It. Also if your company part of group provide group name)

Names and relationship of affiliated companies*

Name of affiliate / Relation to company
(subsidiary/sister company/associate companies/ other)

1.7. Declaration of potential conflict of interest*

Name of person / Role in company
(Provide designation if the person is an officer/Mention shareholder and provide % stake if the person is a shareholder) / Role in SAR/
(Provide designation)

1.8. Insurance policiesDoes your company have any insurance policies *? Yes No

Insurance policy information

Type of policy*
(Please list only business/operational policies and not employee insurance policies)
Coverage areas*
Coverage value*
Policy number*
Expiry date*

1.9. Insurance firm information

Name of insurance company*
Address line
P.O. Box
City*
Zip code
State / Province
Country*

1.10. Payment terms

Will your company be willing to accept SAR payment terms of %100 Net 90 days?

Yes No Specify:

2. Performance record

2.1. Contracts overview

Number of supplies contracts executed in last 10 year*
Value of largest supplies contract executed in last 10 year* (in USD)
Total value of supplies contracts executed in last 10 year*.
.(in USD)

2.2. Details of large supplies contracts executed*

Provide details of three largest Rail supplies contracts you have executed in the last 10 years.

Contract 1: (provide copy)

Name of Institution
Value of contract (in USD)
Year of execution
Major categories included / Services Consumables Equipment
Major activities performed in the contract

Contract 2: (provide copy)

Name of Institution
Value of contract (in USD)
Year of execution
Major categories included / Services Consumables Equipment
Major activities performed in the contract

Contract 3: (provide copy)

Name of Institution
Value of contract (in USD)
Year of execution
Major categories included / Services Consumables Equipment
Major activities performed in the contract

2.3. Details of large customers served

Provide details of the three largest customers you have served in the last 10 years. Provide location

Customer 1: (provide copy)

Name of Institution
Aggregate value of supplies purchased in one year (in USD)
Year of execution
Major categories included / Services Consumables Equipment
Other
Major activities performed in the contract

Customer 2: (provide copy)

Customer 3: (provide copy)

2.4. Prior product liabilities

Has your company been involved in any product withdrawals, contract terminations or litigations in the past 10 years? Yes No

Type of liability / Withdrawal Contract termination Litigation
Please specify if others)______
Name of product
Manufacturer of the product
Key component of product
Year(s) of liability
Details of liability
(Give a brief description of the circumstances surrounding the liability and the outcome)

3. Corporate policies

3.1. Quality policy

Does your organization have a quality policy*? Yes No

Has your organization received any certification for quality*?

Certification / Certification authority / Upload the certificate
(jpeg or PDF format only)
ISO
GMP
(Good Manufacturing Practice)
Other Specify ……………………

3.2. Contact person within your organization for this policy

Full name*
Job title*
Telephone / Ext
Mobile phone
Fax number
Email address*

3.3. Other policies

Does your organization have a risk mitigation policy? Policy Certificate None

Does your organization have an environmental policy? Policy Certificate None

Does your organization have a standardization policy? Policy Certificate None

Does your organization have a Social Responsibility policy? Policy Certificate None

4. Products and capabilities brief

4.1. Products

Service / Consumables / Equipment
What are the major products that you provide for each category in KSA*?
(Please list all major products separated by commas)
What are the major companies that you represent in KSA*?
(Please list all major companies separated by commas)
Are you the exclusive provider for any items in any of the categories in KSA*? / Yes No / Yes No / Yes No
List the exclusive products that you provide for each category in KSA
(Please list all exclusive products separated by commas)

4.2. IT Capabilities

Does your organization have an IT system for business processes*? Yes No

How would you categorize your IT system*?

Full-fledged ERP system

Independent software automating business processes with interconnectivity

Independent software automating business processes without interconnectivity

Do you have an inventory management system*? Yes No

Do you have an order acceptance system*? Yes No

Name of IT system(s)

4.3. Warehouse

Warehouse location in KSA
(List all localities, city where the warehouse is located separated by ;)
Products stored in this warehouse / Services Consumables Equipment
Size of warehouse (in. sq. m.) / Consumables : ______
Equipment : ______
Automation level / Full Partial None
Temperature control / Yes No
Humidity control / Yes No
Pest control system / Yes No

Has this warehouse received any form of certification for quality? Yes No

4.4. Certificate details

Type of certification*
Year of certification*
Certificate number*
Areas covered by certification

4.5. Certifying organization details

Name of certifying organization*
Address line
P.O. Box
City*
Zip code
State / Province
Country*

4.6. Distribution system

Fleet size
Ownership / Owned Outsourced Leased
Name of fleet manager if outsourced
Locations served in KSA
( List All if you serve all cities in KSA)
Products delivered by the distribution system / Services Consumables Equipment
Temperature control / Yes No
Humidity control / Yes No
Fleet tracking system / Yes No

5. Detailed product information

5.1. Manufacturer information

Name of manufacturer*
Location of manufacturing*
Is this manufacturing location authorized by any regulator/certifying body to manufacture this supply?* / Yes No
Please provide the name of the regulator/certifying body *

5.2. Catalogue for supplies

Do you have a Catalogue/e-Catalogue for the supplies that you provide? Yes No

(If yes need an attached)

5.3. Service capabilities

Is the servicing/maintenance/repairing of this equipment carried out by your own organization or is it outsourced? / Own Outsourced
Locations of service organization
(list all locations separated by commas)
Are your service capabilities certified by the original manufacturer? / Yes No