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Appendix A

INFORMATION TO BE SUBMITTED BY TENDERER


FORM 1
SCHEDULE OF COMPLETED PROJECTS UNDERTAKEN BY THE FIRM AS A MAIN CONTRACTOR FOR THE LAST 3
YEARS (DO NOT INCLUDE PROJECTS COMPLETED BEFORE 1ST JAN 2007)
Note : Tenderer is required to submit the following information in the form below to ensure that all information required for the tender
evaluation is submitted.

S/N

Project Title

Name, Address, Tel & Fax


of Employer/Client
(list person/firm from
whom reference can be
obtained)

Contract Value*

Total Contract Value


*If unit of Currency is foreign, please give the equivalent in Singapore Dollars.

IST/1

Date of
Contractual
Commencement
& Completion

Actual date of
Completion

LD (days), if
any

Appendix A
FORM 2
SCHEDULE OF CURRENT PROJECTS UNDERTAKEN BY THE FIRM

S/N

Description of Project

Name, Address, Tel & Fax


of Employer/Client
(list person/firm from whom
reference can be obtained)

Contract Value*

*If unit of Currency is foreign, please give the equivalent in Singapore Dollars.

IST/2

Date of
Contractual
Commencement
& Completion

Appendix A
FORM 3
CLIENTS ASSESSMENT ON MAIN CONTRACTORS PERFORMANCE IN
PROJECT WITHIN PAST 3 YEARS
(Note : Contractor to submit forms for a minimum of but not limited to 3 projects)
Name of Contractor:
________________________________________________
Project Title:
Contract Value:
Commencement Date:
Completion Date:
Clients Particulars
Name:
Address:
Office Tel:
Email:
Name of Clients
Representative:
Designation

________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________

________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________

Assesment on performance of Contractor


No Attribute

1
2
3
4
5
6
7
8

Performance Rating (Tick where applicable)


Excellent
Good
Average
Poor
Very
Poor

Progress of Work/Delivery
Quality of Workmanship
Quality of Materials
Response to Instructions
Performance during Defects
Liability Period
Site Planning and Control
Inconvenience to
Tennant/Public
Testing & Commissioning

Client Representatives Comments:


___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Official Stamp of Client

Clients Representatives Signature/Date


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Appendix A
FORM 4
RESOURCES AND EXPERIENCE
A) Tenderer to submit organization chart showing site organization set-up

B) DETAILS OF PROPOSED SITE MANAGEMENT TEAM FOR THIS PROJECT

S/N

Designation

Name

Qualification

Project
Manager

(recognized
degree)

M&E
Coordinator

(recognized
diploma)

Workplace
Safety &
Health Officer

(qualifications
approved by
MOM)

Site Safety
Coordinator

(qualifications
approved by
MOM)

Years of
experience

Years with
the firm

Tenderer to submit curriculum vitae of each of the above site management team to be
deployed on this project. The information shall include :
1) Name
2) NRIC/Passport No
3) Nationality
4) Present position
5) Qualifications
6) Years of experience
7) Projects handled including project value and role undertaken

IST/4

Experience
in NUS
projects
(Yes/No)
eg. yes

Appendix A
FORM 5
FINANCIAL STANDING
1)

Name of Bankers
_____________________________________________________________________
_____________________________________________________________________

2)

Financial Background
Note : Tenderer must complete the form below in addition to submission of
the audited financial reports.

YEAR

200_

200_

200_

Ave (3 Years)

Net Tangible Worth


Revenue, Turnover, Sales
Current Assets
Current Liabilities
Current Ratio :
Current Assets .
Current Liabilities
Net Profit after Tax
Net Profit Margin :
Net Profit After Tax
Sale
Net Operating Income
Long Term Liabilities
Shareholders Equity
Gearing Ratio (%):
Long Term Liabilities
Shareholders Equity x 100

3.

Financial Statement
Tenderer to submit statement of Profit and Loss Account for the preceding 3 years
certified by Accountants and a certified copy of latest audited Financial Report.
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Appendix A
FORM 6
DECLARATION ON LEGAL STANDING

DETAILS OF LEGAL ISSUES (LITIGATION, ARBITRATION, ETC) THAT


THE FIRM IS INVOLVED CURRENTLY
S/N

Name of Project

Client/ SubContractor

IST/6

Details of legal issue

Appendix A
FORM 7
SAFETY PERFORMANCE
1) MOM SAFETY RECORD
Has the firm been involved in projects that have accumulated demerit points for
safety violation by MOM in the last 3 years?

Yes

No

If yes, please provide details of the safety violation and the parties involved. Please
also advise on the number of such projects and the number of such occurrences.
Year
Project Title
Demerit Points
Safety Violation
Description

Please state demerit points accumulated in MOM record


_______Points

IST/7

Appendix A
DECLARATION
The undersigned hereby certify that to the best of my knowledge, the particulars
given in the tender forms are true and correct. The Employer, or its representative, is
authorized to make direct enquiries, request for information and make references to
any person, firm, public official or organization named in the forms to verify the
information submitted herein or regarding the competence and general reputation of
the undersigned.
Dated this ________________ day of ________________________ 20 ___________
Signature : __________________________________________________
Name : ____________________________________________________
In the capacity of
____________________________________________________________________
duly authorised to sign tenders for and on behalf of __________________________
____________________________________________________________________
(IN BLOCK LETTERS)
Address: _____________________________________________________________
____________________________________________________________________
Signature of Witness: __________________________________________________
Name of Witness: _____________________________________________________
Address: _____________________________________________________________
____________________________________________________________________
Occupation: __________________________________________________________

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