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Management Procedure for Procurement Error! Unknown document property name.

Appendix C – QAP-007-01-Approval Form for Short listed Tenderers

Approval Form for Short listed Tenderers

Name of Project SINOHYDRO BATANG TORU HEPP PROJECT File No:

Tender Invitation Date 2015.5.2 Tender Closing Date 2015.6.20

Estimated Value 4,500,000,000 Date Prepared

Scope of work:

a. Survey and setting-out of drill aera

b. Hole diameter, while diameter of f at beginning will be determined by drilling personnel inished hole is 75mm.

c. In the process of taking core sample out of coring pipe, in order to ensure intactness of the core sample, it is
forbidden to knock the coring pipe with vigorously.

d. Hore samples shall be placed in core box in upper-and-lower order. Serial numbers must be marked with red
paint in Arabic numbers for samples over 5cm. At the frontage of core box, it is to indicate “---Area, XX hole,
Box No., Serial No., Hole depth”.

Contract Requirements:

After the sub-contract become into effective, all the works under this subcontract must be completewithin 90
calendar days.

For each hole, the minimum core recovery should reach 95%for integrate stratum and 85% for weak interlayer
and crushed zone.

Short listed
Name of Tenderers Evaluation Result
Yes or No

PT ARBICO KARYA MANDIRI OK NO

PT CAHAYA INDO PRIMA OK NO

PT Geo ACE OK NO
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CV.SINAR ANGEL EMAS OK NO

Prepared by Approved by

Signature

Name

Designation

Date

Appendix D – QAP-007-02-Sub-Contractor/ Supplier Evaluation Form

Sub-Contractor / Supplier Evaluation Form

SECTION File No.:

1.0 COMPANY BACKGROUND


Management Procedure for Procurement Error! Unknown document property name.

1.1 Company Name: PTGeo ACE

1.2 Address:JI.Soekarno Hatta 544 BANDUNG, 40286 INDONESIA

1.3 Telephone No:(022)-7504196, 7504202

1.4 Fax No:(022)-7563022

1.5 e-mail:elboens@geoace.co.id

1.6 Name/Title of Contract Person Not provided

1.7 Parent of Holding Company:Not provided

Address(if applicable) Not provided

1.8 Type of Company: Private Limited/Sole proprietor/Partnership/Public Listed/Others

(please specify)

1.9 Place of incorporation: Not provided

1.10 Years of incorporation: Not provided

1.11 Registration No: Not provided

1.12 Services or products offered by company.Provide copies of Company/product brochures

Not provided

Delete whichever not applicable


Management Procedure for Procurement Error! Unknown document property name.

SECTION B

FINANCIAL BACKGROUND

1.1 Provide copies of audited financial statements for the last 3 yearsNot provided

1.2 Provide a copy of most recent Company Annual ReportNot provided

1.3 Bankers/financiers

Name of Bank/financial Institution Max overdraft allowed

(a) Not provided Not provided

(b)

(c)

1.4 List of Major Shareholders/Directors

Name %Equity Designation

Not provided
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SECTION C

1.0 EXPERIENCE

1.1 Major projects completed in the last 5 yearsNot provided

Job Title Client Value Year Completed


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1.2 Major projects currently in hand:Not provided

Job Title Client Value Year Completed

SECTION D

1.0 PERSONNEL
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1.1 Summary of Company Personnel : Not provided

Total Number of Staff : Not provided

No. of Management Staff : Not provided

No. of Quality Staff : Not provided

No. of Administrative Staff : Not provided

Others : Not provided

1.2 Attach Company organization chart and state key full time staff employed by the company

Not provided

SECTION E
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1.0 PERSONNEL

1.1 Listed the major equipment owned by the company

Description of Equipment Qty Capacity/Model Owned/Leased

Not provided
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SECTION F

1.0 QUALITY SYSTEM

1.1 Is the company ISO9001 certified? If yes, attach a copy of the ISO 9001 certificate

□ Yes □ NoNot provided

1.2 Has the company been award with any special recognition for quality, productivity or safety
(e.g. certified product,quality award and safety recognition)

□Yes □ NoNot provided

If yes,provide the detail,Attach supporting documents

SECTION G

1.0 SAFETY & HEALTH

1.3 Does the company have any safety management system in place? If yes,attach a copy of Safety
Plan or Certificate.

□Yes □ NoNot provided

1.4 Has any major occupational Safety & Health incident occurred in the company in the last 3
years?

□Yes □ NoNot provided

If yes, please provide details of incidents.


Management Procedure for Procurement Error! Unknown document property name.

SECTION H

FOR OFFICE USE ONLY

1) Document submitted

a) Company Profile□ Not provided

b) Annual Report□ Not provided

c) Audited Accounts□Not provided

d) ISO9001 Certifiacte□ Not provided

e) Other relevant supporting document□ Not provided

2) Evaluation Score

Sub-contractor/Supplier

Area evaluated Remarks

Track Record score

Financial Strength (1-5)

Management (1-5)

Technical Competence (1-5)

Quality System (1-5)

Equipment Availability (1-5)

Manpower Availability (1-5)

Safety Aspects (1-5)


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Total Score:

Average Score:

Grade:

3) Result of Evaluation:

The sub-contractor/supplier is recommended to be included in the Approved


YES/NO
Vendor List

Evaluated by: Signature Name Designation Date

Approved by: Signature Name Designation Date

Notes:

1) Areas not evaluated shall not be given a score.

2) Company certified to ISO9001 shall be given a minimum score of 4.0 for Quality System.

3) Evaluation criteria.

5 - Excellent demonstrate high capability

4 - Goods, minor improvemental can result in performance


improvement
Score
3 - Average, improvement needed

2 - Weak, major improvement needed

1 - Vert weak critical deficiencies observed

A - Excellent(Average score 4.0 above)


Grade
B - Good(Average score 3.5 to below 4.0)
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C - Average(Average score 3 to below 3.5)

B - Weak(Average score 2.0 to below 3.0)

B - Unacceptable(Average score 2.0 below)


Management Procedure for Procurement Error! Unknown document property name.

Appendix E: QAP-007-03-Approved Vendor List

APPROVED VENDOR LIST

Name of contract Type of


Name of Company Address Telephone E-mail Grade
person work