Tender Schedule EC1
Claims History Information
C7810.EC1
Name of Tenderer:
Contract Number:
Part A
Provide details in the table below of your organisation's last three Road Infrastructure Projects for the Department of Transport and Main Roads within the [Type here] Region
where the contract value is greater than $2 million. If no projects have been completed within the [Type here] Region, then Tenderers shall submit information for projects
outside the Region the tender refers to.
Project
Project name and brief description
Start and finish dates
Client
*Client Representative and contact details
Start:
1
Finish:
Start:
2
Finish:
Start:
3
Finish:
*Note: Principal may contact these references to obtain further information.
Part B
Provide the following claims information for projects listed under Part A.
Project 1
Original Tendered Value:
Number of claims referred to the Principal
Number of these claims determined by the Principal
Number of claims referred to a third party
Number of claims determined by a third party
Transport Infrastructure Contract, Transport and Main Roads, April 2015
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Tender Schedule EC1
Claims History Information
C7810.EC1
Name of Tenderer:
Contract Number:
Complete the following tables for the specific claim types listed below.
Delay/disruption
claims for Project 1
(list each claim)
Claimed value at
initial submission
Was claim notified
within contractual
obligations?
Y/N
Was claim resolved
prior to issue of
Final Certificate?
Y/N
Settled value
against the
claim
No. of months taken to
resolve after the issue
of Final Certificate
(if applicable)
Comments
Latent condition
claims for Project 1
(list each claim)
Claimed value at
initial submission
Was claim notified
within contractual
obligations?
Y/N
Was claim resolved
prior to issue of
Final Certificate?
Y/N
Settled value
against the
claim
No. of months taken to
resolve after the issue
of Final Certificate
(if applicable)
Comments
Omitted items
claims for Project 1
(list each claim)
Claimed value at
initial submission
Was claim notified
within contractual
obligations?
Y/N
Was claim resolved
prior to issue of
Final Certificate?
Y/N
Settled value
against the
claim
No. of months taken to
resolve after the issue
of Final Certificate
(if applicable)
Comments
Transport Infrastructure Contract, Transport and Main Roads, April 2015
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Tender Schedule EC1
Claims History Information
C7810.EC1
Project 2
Name of Tenderer:
Contract Number:
Original Tendered Value:
Number of claims referred to the Principal
Number of these claims determined by the Principal
Number of claims referred to a third party
Number of claims determined by a third party
Complete the following tables for the specific claim types listed below.
Delay/disruption
claims for Project 2
(list each claim)
Claimed value at
initial submission
Was claim notified
within contractual
obligations?
Y/N
Was claim resolved
prior to issue of
Final Certificate?
Y/N
Settled value
against the
claim
No. of months taken to
resolve after the issue
of Final Certificate
(if applicable)
Comments
Latent condition
claims for Project 2
(list each claim)
Claimed value at
initial submission
Was claim notified
within contractual
obligations?
Y/N
Was claim resolved
prior to issue of
Final Certificate?
Y/N
Settled value
against the
claim
No. of months taken to
resolve after the issue
of Final Certificate
(if applicable)
Comments
Transport Infrastructure Contract, Transport and Main Roads, April 2015
3 of 5
Tender Schedule EC1
Claims History Information
C7810.EC1
Name of Tenderer:
Contract Number:
Was claim notified
within contractual
obligations?
Y/N
Omitted items
claims for Project 2
(list each claim)
Claimed value at
initial submission
Project 3
Original Tendered Value:
Was claim resolved
prior to issue of
Final Certificate?
Y/N
Settled value
against the
claim
No. of months taken to
resolve after the issue
of Final Certificate
(if applicable)
Comments
Was claim resolved
prior to issue of
Final Certificate?
Y/N
Settled value
against the
claim
No. of months taken to
resolve after the issue
of Final Certificate
(if applicable)
Comments
Number of claims referred to the Principal
Number of these claims determined by the Principal
Number of claims referred to a third party
Number of claims determined by a third party
Complete the following tables for the specific claim types listed below.
Delay/disruption
claims for Project 3
(list each claim)
Claimed value at
initial submission
Was claim notified
within contractual
obligations?
Y/N
Transport Infrastructure Contract, Transport and Main Roads, April 2015
4 of 5
Tender Schedule EC1
Claims History Information
C7810.EC1
Name of Tenderer:
Contract Number:
Latent condition
claims for Project 3
(list each claim)
Claimed value at
initial submission
Was claim notified
within contractual
obligations?
Y/N
Was claim resolved
prior to issue of
Final Certificate?
Y/N
Settled value
against the
claim
No. of months taken to
resolve after the issue
of Final Certificate
(if applicable)
Comments
Omitted items
claims for Project 3
(list each claim)
Claimed value at
initial submission
Was claim notified
within contractual
obligations?
Y/N
Was claim resolved
prior to issue of
Final Certificate?
Y/N
Settled value
against the
claim
No. of months taken to
resolve after the issue
of Final Certificate
(if applicable)
Comments
Authorisation
For and on behalf of the Tenderer
Name/Position
Signature
Date
Name of Tenderer
The Department of Transport and Main Roads collects personal information on this form so that you may authorise the Tender for and on behalf of the Tenderer. The information on this form is
accessible by authorised departmental officers and external personnel who are engaged to assess Tenders and if your organisation is the successful Tenderer, the Department may from time to
time disclose your contact details to third parties as a point of contact.
Transport Infrastructure Contract, Transport and Main Roads, April 2015
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