Application Form
Prequalification of Consultants
for
Engineering Projects
Applies to Consultants, Local Government and Government Design
Units wishing to make competitive offers for Engineering Projects
Form C7512
March 2015
Application Form
Prequalification of Consultants for Engineering Projects
Department of Transport and Main Roads
THIS APPLICATION IS FOR THE PREQUALIFICATION OF
A CONSULTANT ORGANISATION
WITH A LOCAL DELIVERY CAPABILITY
Name of Applicant
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Postal Address for Correspondence
................................................................................................................................................
Address:
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Telephone No: ...................................................
Facsimile No: .................................
Email: ....................................................................................................................................
Contact Name: ......................................................................................................................
Note: All applicants: All sections of this application must be completed and the original signed application
to be sent to the address below.
Section
Address Application to:
Title
Senior Program Support Officer
Infrastructure Delivery Services
Program Management & Delivery
Department of Transport &
Main Roads
G.P.O. Box 1549
Bisbane Qld 4001
A
Organisation Details
B
RPEQ Details
C
Organisation Experience and
Current Technical Resources
D
Current Projects
E
Past Experience
F
Technical Experience of Personnel
Floor 18, 313 Adelaide Street
Brisbane Qld 4000
G
Project Size Capability
H
Geographic Area(s) of Operation
I
Engineering Software
J
Organisational History
K
Insurance
L
Quality System Details
M
Consultant Certification
Show Qualification Levels Requested (X)
Official Use
Discipline
Assessors
BD1
BD2
BD3
ES1
ES2
ES3
Attachment A Current Projects
FC1
FC2
FC3
Attachment B
GE1
GE2
GE3
Attachment C Bridge Planning & Design Expertise
HE1
HE2
HE3
Attachment D Economic Studies Expertise
HD1
HD2
HD3
Attachment E Financial/Commercial Expertise
TE1
TE2
TE3
Attachment F Geotechnical Expertise
TP1
TP2
TP3
Attachment G
Assessment Results
notified to applicant
and included in the Signed: …………….. Date: ……………
Prequalification
Register Database
Relevant Projects Completed in the
Last (3) years
Highway Engineering Planning &
Design Expertise
Attachment H Hydraulic Design
Attachment I Traffic Engineering Expertise
Attachment J Transport Planning Expertise
Page 1 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalification of Consultants for Engineering Projects
A.
Organisation Details (please
Individual
Application Form
appropriate box)
Partnership
Company
Trust
Authority
Other .............................................................................................................
Australian Business Number (ABN)
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Full Name (as registered with the Australian Securities Commission)
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Company and Business only – provide your Australian Company Number (ACN)
or Australian Registered Body number (ARBN) or Registered Business Number
(RBN)
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Address of Registered Office
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Provide a brief description of the present organisation structure, including names of
Principals, etc.
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Page 2 of 23
C7512
March 2015
Application Form
Prequalification of Consultants for Engineering Projects
B.
Department of Transport and Main Roads
Registered Professional Engineer of Queensland (RPEQ) Details
Provide details of how the requirements of Clause 3.4 Registered Professional Engineers
(C7511 Information Brochure) will be addressed.
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Page 3 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalification of Consultants for Engineering Projects
Application Form
Full Name, address (of office where individual is employed), RPEQ number and Discipline
of each nominated person.
Name
Page 4 of 23
C7512
March 2015
Address / office
RPEQ Number
Discipline
Application Form
Prequalification of Consultants for Engineering Projects
C.
Department of Transport and Main Roads
Organisation Experience and Current Technical Resources
Experience of Organisation seeking Prequalification;
DISCIPLINE
YEARS OF
EXPERIENCE
AS A
CONSULTANCY
SIZE OF CURRENT
WORKFORCE
(TECHNICIANS &
ENGINEERS)
LOCAL DELIVERY CAPABILITY LOCATION & CAPACITY
Bridge Design
Economic
Studies
Financial/
Commercial
Geotechnical
Engineering
Highway
Engineering
Hydraulic
Design
Traffic
Engineering
Transport
Planning
D.
Current Projects for this Organisation
Please list on Attachment A the commissions your organisation is presently
undertaking, and, if applying for extension of your prequalification registration,
commissions carried out since the last Application.
E.
Past Experience of this Organisation
Please list on the attached Attachment B, commissions completed in the last three
years. Attach copies of detailed planning / design layouts relating to these
commissions.
F.
Technical Experience of Personnel in this Organisation
Please set out on the attached Attachments C to I, as relevant, the experience of
the nominated members of your organisation, including detailed evidence of
work done by each nominated member.
Please include CVs of personnel.
Page 5 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalification of Consultants for Engineering Projects
G.
Application Form
Project Size Capability for this Organisation
Size of commissions this organisation can predictably produce.
What size of commission can this
organisation predictably produce?
FEES UP TO
$250,000
H.
FEES UP TO
$500,000
Comments
FEES OVER
$500,000
Geographic Area(s) of Operation
In which areas of the state does this organisation wishes to provide engineering
consultant services?
Note: To be successful you will need to demonstrate your understanding and
experience of local conditions and Transport and Main Roads local requirements for
each centre nominated by attaching supporting evidence. However, local suppliers
will be given preference in line with Queensland Procurement Policy Guidelines.
Transport & Main Roads Office
Barcaldine
Brisbane
Bundaberg
Cairns
Cloncurry
Emerald
Gympie
Mackay
Nerang
Roma
Rockhampton
Toowoomba
Townsville
Warwick
Page 6 of 23
C7512
March 2015
Yes
No
Application Form
Prequalification of Consultants for Engineering Projects
I.
Department of Transport and Main Roads
Engineering Software
Please indicate the software and version number in use by your organisation.
Software Description
Indication Box
Planning and Design
A Roundabout Numerical Design Tool (ARNDT)
Culvert 5.1 (or higher) *
TMR 12D Customisation *
12D Model V9C2d *
Roadside Impact Severity Calculator (RISC)
OSRoad
AutoCAD 2010 (or higher) *
AutoCAD MAP 2010 (or higher) *
TMR AutoCAD Customisation *
Version No.
..............
..............
..............
..............
.............
..............
..............
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* Mandatory software required for Transport and Main Roads projects includes:


12D Model with Transport and Main Roads 12D Customisation and Culvert. 
AutoCAD 2000 or AutoCAD Map 2000 with Transport and Main Roads AutoCAD
Customisation
Works Management System (WMS) 
The Department of Transport and Main Roads has adopted the 12D Model Road Design Software for all
road planning and design projects. Culvert is to be used for 3D modelling of culvert structures.
Consultants requiring prequalification in HE1, HE2 or HE3 categories must have 12D Model Road Design
Software. Specific approval on a project by project basis is required to use alternative software.

Estimating
EXPERT ESTIMATION
Works Management System (WMS)* - Estimating
Module
SMART COST (database)
@ RISC
..............
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..............
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Prequalified consultants will be required to enter into a Licence Agreement prior to the installation and
use of WMS. No charge will apply to the Licence Agreement at this time.

Bridge Design
ACES Bridge Analysis System
SpaceGASS
Microstran
Steel Schedule Program
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Page 7 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalification of Consultants for Engineering Projects
Application Form
Engineering Software (continued)
Geotechnical Engineering
SLOPE/W (for Levels 1, 2 & 3)
PLAXIS-2D (for Levels 2 & 3)
Holebase or any industry accepted
software compatible with Holebase,
example GINT Pro (for Levels 2 & 3)
Hydraulic Design
PC Drain
HEC-RAS
MIKE 11
XP-EXTRAN / XP-SWMM / XP-UDD
Other hydraulic or culvert packages (please specify)
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2D Hydraulic Design
MIKE 21
DELFT-FLS
DELFT-3D
SOBEK
MIKE FLOOD
TU FLOW
Other 2D model packages (please specify)
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Hydrology
RORB
URBS
XP-RAFTS
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Traffic Analysis
SIDRA INTERSECTION
TRARR
TRANSYT – 7F
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Micro Modeling
AIMSUM2
PARAMICS
VISIM
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Page 8 of 23
C7512
March 2015
Application Form
Prequalification of Consultants for Engineering Projects
Department of Transport and Main Roads
Engineering Software (continued)
Traffic Network Modeling
CUBE
VISUM
OMNITrans
SATURN
TRIPS
EMME2
QRS
TRANSCAD
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Roadway Lighting
Perfect Lite
Perfect Lite AutoCAD Interface
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Signs
Signs
TraSiS
TriaSiCAD
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Vehicle Path Analysis
Autoturn
Autotrack
Vehicle Path
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Miscellaneous
Folder Creation Utility
MapInfo
SPSS
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Please indicate any additional software not listed
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Page 9 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalification of Consultants for Engineering Projects
J.
Application Form
Organisational History
Has your organisation ever had a design contract determined or taken over?
Yes
No
If Yes, give details:
.....................................................................................................................................
.....................................................................................................................................
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Have you, your business organisation or your company been declared bankrupt,
entered into receivership, management, agreement, scheme or composition pursuant
to the Bankruptcy Act or the Companies Code? If so, give details.
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K.
Insurance
The applicant must provide the following information in relation to its current insurance
under the following headings:
1.
Workers Compensation
Policy Number
Expiry Date
Such insurance must comply with Clause 8.1 – General Conditions of Contract
Consultants for Engineering Projects.
2.
Public Liability
Insurer
Policy Number
Expiry Date
Maximum Amount for any
one claim/aggregate amount
Deductible Amount (Excess)
Page 10 of 23
C7512
March 2015
$
Application Form
Prequalification of Consultants for Engineering Projects
Department of Transport and Main Roads
The Applicant may be required to provide a copy of any Public Liability insurance policy
to Transport and Main Roads on request. It is important that such policy/ies comply
with Clauses 8.3 and 8.4 – General Conditions of Contract - Consultants for
Engineering Projects.
3.
Professional Indemnity (PI)
The Applicant’s current PI insurance must comply with Clauses 8.2 – General
Conditions of Contract Consultants for Engineering Projects unless otherwise agreed in
writing with Transport and Main Roads.
The Applicant must provide the following information:
Insurer
Policy Number
Expiry Date
Rating
Maximum Amount for any
one claim/ aggregate amount
Deductible Amount (Excess)
$
Jurisdictional and Territorial
Limits
The Applicant must include with the submission of this application:

a "Certificate of Currency" that the consultants insurance policy meets the
requirements of the General Conditions of Contract (Form 7545).
The Applicant, if successful in its application and subsequently being contracted to
provide consultant services, will be required by Transport and Main Roads to give an
undertaking that it will continue its PI insurance for 7 years (unless otherwise specified)
after Practical Completion of any resulting road transport infrastructure.
Page 11 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalification of Consultants for Engineering Projects
L.
Application Form
Quality System Details
For engineering consultants prequalified in the categories of Bridge Design,
Geotechnical Engineering, Highway Engineering, Hydraulic Design, Traffic Engineering
and Transport Planning, it is a mandatory requirement to hold third party certification to
the relevant Australian Standard from a JAS-ANZ accredited organisation. Self
assessed systems are not acceptable.
The capability statement on the quality certification certificate must include the areas of
Prequalification.
For consultants prequalified in the categories of Economic Studies and
Financial/Commercial, third party certification is preferable.
Controlled Self
Assessment undertaken in conjunction with the department will be accepted.
Please confirm with an ‘X’ in the box and complete particulars.
3rd Party certification from a JAS-ANZ accredited organisation has
been granted.
Please attach a copy of all pages of the Certificate and Schedule
JAS-ANZ organisation
Certificate Number
Date of Issue
/
/
Controlled Self Assessment undertaken in conjunction with the
Department of Transport and Main Roads (TMR)
Date of assessment
/
/
TMR Unit
Please include a full copy of the third party Certificate and Schedule with this
application. This is required to confirm that the capability statement on the certificate
matches the categories of Prequalification being sought.
OR
Please include full documentation supporting Controlled Self Assessment.
Page 12 of 23
C7512
March 2015
Application Form
Prequalification of Consultants for Engineering Projects
M.
Department of Transport and Main Roads
Consultant Certification
I hereby certify that I have made all reasonable endeavors to ensure that the
information provided is correct.
...................................................................
Signed:
Date: …........./........./..........
on behalf of
........................................................................................................………...................
The Department of Transport & Main Roads collects personal information on this form so that you may authorise the
application for and on behalf of the Applicant. The information on this form is accessible by authorised officers and
external personnel who are engaged to assess applications. Consultant organisational details will be made available on the
Department's website in accordance with Clause 5 of the Information Brochure for the Prequalification of Consultants for
Engineering Projects.
Page 13 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
Application Form
CURRENT PROJECTS
Project
Name
Prequalification
Level of Project
Brief Description of Work
(including Estimated Construction Cost)
Cost of
Consultant
Service
Estimated
Date of
Completion
Client
(including contact name
& telephone number)
ATTACHMENT A
Page 14 of 23
C7512
March 2015
Application Form
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
1. PROJECT COMPLETED SINCE LAST APPLICATION OR
2. PAST THREE YEARS EXPERIENCE (new Applicants Only)
Project
Name
Prequalification
Level of Project
Brief Description of Work
(including Estimated Construction Cost)
Cost of
Consultant
Service
Estimated
Date of
Completion
Client
(including contact name
& telephone number)
ATTACHMENT B
Page 15 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
Application Form
TECHNICAL EXPERIENCE OF PERSONNEL
(MATCHED TO THE QUALIFICATION LEVELS FOR BRIDGE DESIGN)
Name
Technical
Qualifications
Present
Office
Position in
Location in
Organisation Organisation
Relevant Expertise and Experience
(Description of Individuals Key Skills matched to the relevant
Qualification Levels i.e. Class of Work Descriptions)
Client
(include contact name
and telephone number)
ATTACHMENT C
Page 16 of 23
C7512
March 2015
Application Form
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
TECHNICAL EXPERIENCE OF PERSONNEL
(MATCHED TO THE QUALIFICATION LEVELS FOR ECONOMIC STUDIES)
Name
Technical
Qualifications
Present
Office
Position in
Location in
Organisation Organisation
Relevant Expertise and Experience
(Description of Individuals Key Skills matched to the relevant
Qualification Levels i.e. Class of Work Descriptions)
Client
(include contact name
and telephone number)
ATTACHMENT D
Page 17 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
Application Form
TECHNICAL EXPERIENCE OF PERSONNEL
(MATCHED TO THE QUALIFICATION LEVELS FOR FINANCIAL/COMMERCIAL)
Name
Technical
Qualifications
Present
Office
Position in
Location in
Organisation Organisation
Relevant Expertise and Experience
(Description of Individuals Key Skills matched to the relevant
Qualification Levels i.e. Class of Work Descriptions)
Client
(include contact name
and telephone number)
ATTACHMENT E
Page 18 of 23
C7512
March 2015
Application Form
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
TECHNICAL EXPERIENCE OF PERSONNEL
(MATCHED TO THE QUALIFICATION LEVELS FOR GEOTECHNICAL ENGINEERING)
Name
Technical
Qualifications
Present
Office
Position in
Location in
Organisation Organisation
Relevant Expertise and Experience
(Description of Individuals Key Skills matched to the relevant
Qualification Levels i.e. Class of Work Descriptions)
Client
(include contact name
and telephone number)
ATTACHMENT F
TECHNICAL EXPERIENCE OF PERSONNEL
(MATCHED TO THE QUALIFICATION LEVELS FOR HIGHWAY ENGINEERING)
Page 19 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
Name
Technical
Qualifications
Present
Office
Position in
Location in
Organisation Organisation
Application Form
Relevant Expertise and Experience
(Description of Individuals Key Skills matched to the relevant
Qualification Levels i.e. Class of Work Descriptions)
Client
(include contact name
and telephone number)
ATTACHMENT G
TECHNICAL EXPERIENCE OF PERSONNEL
(MATCHED TO THE QUALIFICATION LEVELS FOR HYDRAULIC DESIGN)
Page 20 of 23
C7512
March 2015
Application Form
Name
Technical
Qualifications
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
Present
Office
Position in
Location in
Organisation Organisation
Relevant Expertise and Experience
(Description of Individuals Key Skills matched to the relevant
Qualification Levels i.e. Class of Work Descriptions)
Client
(include contact name
and telephone number)
ATTACHMENT H
TECHNICAL EXPERIENCE OF PERSONNEL
(MATCHED TO THE QUALIFICATION LEVELS FOR TRAFFIC ENGINEERING)
Page 21 of 23
C7512
March 2015
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
Name
Technical
Qualifications
Present
Office
Position in
Location in
Organisation Organisation
Application Form
Relevant Expertise and Experience
(Description of Individuals Key Skills matched to the relevant
Qualification Levels i.e. Class of Work Descriptions)
Client
(include contact name
and telephone number)
ATTACHMENT I
TECHNICAL EXPERIENCE OF PERSONNEL
(MATCHED TO THE QUALIFICATION LEVELS FOR TRANSPORT PLANNING)
Page 22 of 23
C7512
March 2015
Application Form
Name
Technical
Qualifications
Department of Transport and Main Roads
Prequalified Consultants for Engineering Projects
Present
Office
Position in
Location in
Organisation Organisation
Relevant Expertise and Experience
(Description of Individuals Key Skills matched to the relevant
Qualification Levels i.e. Class of Work Descriptions)
Client
(include contact name
and telephone number)
ATTACHMENT J
Page 23 of 23
C7512
March 2015