Please state which category your company would like to qualify for.
Company Name:
Qualification Category / Tick One Option Only1) System Integrator
2) Video Surveillance Subsystem (CCTV) Manufacturer
3) Radar Vehicles Detectors Manufacturer
4) Dynamic Message Signs & System Manufacturer
5) Lane and Speed Control Signs & System Manufacturer
6) ITS Communications Contractor
7) Local Electrical Contractor
Note:
Companies wishing to qualify for more than one category must complete and submit a separate application package for each additional category with appropriate qualification details.
1. Prequalification Documents;
Roads And Transport Authority has a standard prequalification Document for Consultants and Contractors prepared by Contracts & purchasing Department.
2. Method of Compiling Lists of Consultants / Contractors for prequalification
a. By advertising in the press and technical publications Advert prepared by Contracts & purchasing department inviting interested parties to apply for prequalification.
b. The concerned department in conjunction with the contracts & purchasing department prepares a list of contractors / Consultants whom invited to apply for prequalification.
3. Procedure on approved Prequalification notice;
All Contractors / Consultants who have been approved will be informed in writing by Contracts & purchasing department with a copy to concerned department.
4. Submission;
a: All formats and submitted information must be completed and filled, typed in
b: The applicant should submit this form with the attached information in a proper double binder formats (original + Copy)
c: Contractor / consultants required to submit a copy of their trade license & the Established agreement (for Partnership/ L.L.C. Companies) along with the prequalification documents
d: Uncompleted applications will not be looked at.
IMPOTANT NOTICE:
· Prequalification Package Documents can be directly downloaded from RTA's website and/or could be collected from the contracts & purchasing department at their office in the Roads and Transport Authority Headquarter Building.
· All Prequalification inquiries must be addressed to:
by e-mail to:
or by phone to: 009714 2906738
or by fax to: 009714 2065558
Standard Prequalification form for Contractors / Consultants
Notes to applicants
1 Pleases answer all questions.
2 supplementary pages may be photocopied and interested if required.
3 Please number each page in the space provided at the top of each pages.
4 Please retain a copy of your complete submission.
5 If a joint venture is proposed, all companies are to respond to all questions.
6 Project financial data is to be given in UAE Dirhams unless otherwise requested.
Standard pages
1. / Title page / 2. / Notes3. / Structure and organization 1 / 4. / Structure and organization 2
5. / Financial Statement / 6. / Audited Financial Report (3 years)
7. / Bank Statement (3 years) / 8. / Data Gathering Form for Financial Analysis
9. / Joint Venture / 10. / Resources: personnel 1
11. / Resources: personnel 2 / 12. / Resources: Plant
13. / Resources: other* / 14. / Experience: geographical
15. / Experience: relevant projects in completed / 16. / Additional information
17. / Copy of Valid Trade License / 18. / Optional: Customized Credit Rating Report or Rating Quality Label from Dubai Chamber of Commerce and Industry
19. / Declaration
Please list below additional pages attached to each standard page:
1-
2-
3-
4-
5-
6-
Structure and Organization 1
1 Name of Firm:-
Address:
Telephone number: Tele Fax Number:
Telex number:
Registered office address: e-mail address
2 Description of Firm (for example, General Civil Engineering Contractor).
3 Number of Year's experience in own country:
In G.C.C.:
Internationally:
4 Names and address of associated companies to be involved in the project – and whether parent/subsidiary/other.
5 If the Firm is a subsidiary, what involvement, if any, will the parent have in the project?
Structure and Organization 2
6 Names and addresses of any associates the Firm has in the country of the project knowledgeable in the procedures of customs, immigration etc.:
7 Please indicate here or attach an organization chart showing the Firm structure including the positions of directors and key personnel, if relevant
8 Name of person (s) authorized to reply to queries concerning this application.
Financial Statement
1. Capital:
Authorized:
Issued:
2. Annual value of construction works undertaken for each of the last five years and projected for current year:
Year / Current / 200-- / 200-- / 200-- / 200-- / 200--U.A.E
G.C.C
Abroad
3. Indicate monetary values of work in hand and the size of contract you can undertake now with consideration of present commitments:
4. Please attach copies of the Firm's previous three year's accounts (profit / loss, assets / liabilities) and other financial data which you consider to be useful. List all attachments below:
5. Name and address of bankers from who references can be obtained:
Audited Financial Report (3 years)
Bank Statement (3 years)
Data Gathering Form for Financial Analysis
The attached form has to be submitted in hard copy (signed and stamped by both company and auditor), and also as a soft copy.
Joint Venture
If the Firm intends to enter into venture for the project, please give the following information, otherwise state "not applicable".
1. Names and address of joint venture partners:
2. Name of firm leading the joint venture:
3. Name and address of bankers to the joint venture:
4. In case of the joint venture being a partnership, provide percentage holding by each partner:
5. Please attach hereto a statement indicating the section of the project to be undertaken by each of the joint venture partners:
6. In case the joint venture is to be a separate firm, provide percentage of shareholding by each Firm or person:
7. Provide any details of previous work carried out by the joint venture:
Resources: personnel 1
1. Total Number of staff: ______Technical ______Administrative_____ (Please include list of total staff available by category / trade)
2. Please list present executive directors:
Name:
Nationality:
Present position:
Years of experience:
Years with the Firm:
3. Please list information about the senior management and contract staff who are likely to be engaged on the project:
Name:
Nationality:
Present position:
Proposed position:
Years of experience:
Years with the Firm:
Major works for which responsible (type, value and location)
Linguistic ability relevant to project:
Resource: personnel 2
List information about other key personnel below: (please include C.V. of key staff only)
Name: Present position
Nationality:
Year's of experience - with the Firm:
- in construction :
Major works for which responsible (type and value):
Name: Present position
Nationality :
Year's of experience - with the Firm:
- in construction :
Major works for which responsible (type and value):
Name: Present position
Nationality :
Year's of experience - with the Firm:
- in construction :
Major works for which responsible (type and value):
Resources: Contractor's equipment (Plant)
On the basis of the information provided in the prequalification document please indicate the equipment and facilities considered by the Firm to be necessary for undertaking the project and whether this is already in the firm's ownership or will be purchased or hired:
Hired / Owned / Purchased:
Age:
QTY.:
Operating condition:
Current Location:
Note:-
Resources: other
1 If it is foreseen that any part of the contract will be subcontracted state the type of work to be undertaken by the subcontractor (S) and, if known, given the name and address of the subcontractor(S) to ber used.
2 Fabrication facilities (to be completed only if relevant to the project):
Summary:
Description:
Location:
Capacity:
Annual Production:
Experience: geographical
1 Years and place in which works similar to the ITS project has been undertaken:
2 Summary of experience of firm in the years and places of the project and/or neighboring states:
Experience: relevant projects completed
Please fill in information about the relevant ITS projects completed over the past six years
-Name of Client and address:
-Name, locatio0nj and type of project:
-Name of Contractor:
-Name of Consultants:
-Contractor price:
-Percentage of participation of Firm in project:
-Comm. Date:
-Contract Duration:
- Was contract satisfactorily completed?
Note:-
Experience: all projects in progress
Please fill in information about all ITS projects in progress, including those where the firm has received a letter of intent, but a formal contract has not yet been awarded;
-Name of Client:
-Name of Consultant:
-Name of contactor:
-location and description of the work:
-Contract Price:
-Contract Duration:
-Value completed & certified:
-Scheduled date of completed of work:
-Percentage of participation of firm in project:
Note: - Information above s
Additional information
Please add any further information which you consider to be relevant to the evaluation of your application for prequalification. If you wish to attach other document please list below,
Copy of Valid Trade License
Optional: Customized Credit Rating Report or Rating Quality Label from Dubai Chamber of Commerce and Industry.
Declaration
In the case of an application by a group of joint Venture or individual company / firm the following declaration is to be signed by all members of the group or joint Venture or individual company / firm.
I / we the undersigned, apply on behalf of the above firm, group or Joint Venture to be considered for inclusion on the list of approved consultants / Contractors for the project.
I / we submit two (2) copies of each document giving the requested information about the organization, financial status and experience for your appraisal.
I / we understand that any contract subsequently entered into will be subjected to the laws and regulations applicable in the Emirates of Dubai and the United Arab Emirates.
I / we understand that the acceptance of this application is at the sole discretion of Roads and Transport Authority.
I / we undersigned, declare that I / we am / are authorized to sign this document, on behalf of the firm named herein and that the information provided is true and correct to the best of my / our knowledge.
I / we authorize and accept that the Roads and Transport Authority may verify such statements and other information in this questionnaire and further agree to furnish any additional information that may be required.
I / we admit that there is no employment contract with RTA or blood relation with RTA's officials who are related to the contractual procedures that might be of link to our Establishment / Company / Firm activities, in accordance with the relevant articles in the Dubai Emirate Governmental Contracts Law No 6/1997 and Governmental Human Resources Law No 27/2006, or any other provisions enacted in this respect.
Firm Name:
Signature:
Name:
Position in Firm:
QFO-2.5.4.VRM1-1 / Page 2 of 14 / Issue: 1.0