PREQUALIFICATION OF QUANTITY SURVEYING
FOR
CFC STANBIC BANK
REF: 2014/15-15
.
TABLE OF CONTENTS
Part 1: General Instructions
Section I
Company Profile
Section II
Financial Status of the Firm
Average Annual Construction Turnover
Financial Resources
Current Contract Commitments/Works in Progress
Section III
Office & Service Facilities
Personnel
(20 Marks)
Part 2: Key Qualification
Section IV
Firms Experience
Section V
References
Section VIII
List of Attachments to be submitted
(40 Marks)
Part 3: Personal Biodata
(10 Marks)
Part 4: Academic Qualifications
(10 Marks)
Part 5: Professional Experience
(10 Marks)
Part 6: Appendices
Declaration
Banker’s Reference
Inspection Form
Pending Litigation
Confidential Business Questionnaire
(10 Marks)
2
Ref No:
Date:
APPLICATION FORMS FOR PREQUALIFICATION OF QUANTITY SURVEYORS
A.
GENERAL INSTRUCTIONS
Dear Applicant,
Thank you for showing interest to offer construction services by procuring this application form for
Pre-qualification as Quantity Surveyor.
Before filling form you are advised to read carefully the General Conditions and Procedures for
prequalification of Contractors, which are issued with this form.
A duly filled application shall be returned together with the tender the format given.
Thanking you
Yours faithfully,
HEAD OF PROCUREMENT
CFC STANBIC BANK
3
ELIGIBILITY FOR QUALIFICATION AS AQUANTITY SURVEYOR
1.0
Qualifications
Qualifications necessary for qualification are: (a)
The applicant MUST have the minimum technical qualifications and skills prescribed.
“At least one of share holders or Partners” must have the technical qualifications and
skills set.
(b)
Necessary experience as prescribed in the field of application of which, having
satisfactorily completed a project of similar nature and magnitude within the last three
years is a MUST Ref. (Section V).
(c)
The applicant’s professional and general conduct to be such that, in the opinion of the
evaluation committee, he/she is a person fit and proper to be pre-qualified.
(d)
The applicant must have necessary Plant and Equipment for execution of the intended
works. The applicant must show proof of ownership such as vehicle logbooks, receipt
etc.
(e)
The Applicant MUST attach all documents indicated in section VII
(f)
A minimum score of at least 70% of the technical specifications given
1.1
Exception
The Committee may refuse to prequalify a person as a contractor if its opinion: (a)
1.2
Is a person whose employment shall result into conflict of interest with his employer.
Distinction of Local and Foreign Contractors
There shall be no distinction of categories of contractors, namely Local and Foreign.
4
B.
APPLICATION FORM FOR QUALIFICATION OF QUANTITY SURVEYORS
For official use only
Application received by …………………………
Receipt No. ………………………………………
Processing
Site inspection on ………………………………..
Site inspection by ……………………………….
Application submitted to the …………………….
Approved …………… Not approved …………..
Scores
Mark
Part 1: General Instructions
……………
Out Of
(20 Marks)
Part 2: Key Qualification
…………..
(40 Marks)
Part 3: Personal Bio data
…………...
(10 Marks)
Part 4: Academic Qualifications
…………….
(10 Marks)
Part 5: Professional Experience
…………...
(10 Marks)
Part 6: Appendices
…………….
(10 Marks)
__________
__________
__________
__100_____
Total
5
SECTION I: COMPANY PROFILE
1.
Company’s Name in full …………………………………………………………..
2.
Address of Head Office ……………………………………………………………
3.
(a) Telephone No. …………………………………………………………………..
(b) Fax No. ………………………………………………………………………….
(c) E-mail ………………………………………………….……………………………..
(d) Internet Website ……………………………………………………………………….
4.
5.
Banker’s Name(s) and Address(es) …………….…………………………………………
………………………………………………….………………………………………….
……………………………………………………………………………………………..
Place(s) of Business (i.e. Location of Main Branch Offices).
(Write house/Plot No. Block No. Street Name and Village/Town/City Name)
6.
Current Class …………………. Registration No. …….. Year of Registration ………….
(Attach copy of Registration Certificate)
7.
No. of Certificate of Incorporation of Business Names ……………………..……………
(Copy of Certificate required)
8.
(a) Registered Capital: …………….. (b) Paid up Capital ……………………
(Applicable to Companies, which are limited by, shares as shown in their memorandum and
Articles of Association).
9.
Names, qualifications/experience and nationality of directors or partners. Put a star (*)
against the technically qualified directors/partners.
S/No.
Name
Qualification
……..
………
…………………
……..
………
…………………
……..
………
…………………
……..
………
…………………
(Attach certified copies of share certificates)
10.
Nationality
………………
………………
………………
………………
% Shares
…………...
…………...
…………...
…………...
Current Business License (attach copy)
Number: ………………………………………………………………………………..
Date Issued: …………………………….
Place Issued: ………………………..
6
CONFIDENTIAL BUSINESS QUESTIONNAIRE
You are requested to give the particulars indicated in Part 1; either Part 2(a) , 2(b), (c) and (d)
whichever applies to your type of business;
You are advised that it is a serious offence to give false information on this form
Part 1 – General
Business Name: …………………………………………………………………………….
Location of Business Premises; County/Town………………………………………………
Plot No…………………………………Street /Road ……………………………………..
Postal Address: …………………………………Tel No……………………………………
Fax: ……………………………………………Email: ………………………………………
Nature of Business: ………………………………………………………………………….
Current Trade License No……………………..: Expiry Date……………………………….
Maximum Value of business which you can handle at any time Kshs……………………
Name of your bankers………………………………………………………………………
Branch……………………………………………………………………………………….
Part 2 (a) – Sole Proprietor
Full Name: ………………………………………. Age………………………………….
Nationality……………………………………. Country of Origin……………………….
*Citizenship details …………………………………………………………………………..
Part 2 (b) – Partneship
Give details of partners as follows :
Name in full
Nationality Citizenship details
……… …….
…………………
……………… …………………
……… ……… …………………
……… ……… …………………
………………
………………
………………
………………
7
Shares
…………...
…………...
…………...
…………...
Part 2 (c) – Registered Company
Private or Public: ……………………………………………………………………….
State the nominal and issued capital of the company:
Nominal Kshs………………………………………………………..............
Issued Kshs……………………………………………………………………
Give details of directors as follows :
Name in full
Nationality Citizenship details*
……… …….
…………………
……………… …………………
……… ……… …………………
……… ……… …………………
………………
………………
………………
………………
Shares
…………...
…………...
…………...
…………...
Part 2 (d) – Interest in the firm
Is there any person / persons in………………………… (Name of employer) who has interest in this
firm? Yes/No………………….( Delete as necessary)
I certify that the information given above is correct.
…………………………
(Title)
…………………………. ……………………
(Signature)
(Date)
*Attach proof of citizenship
8
SECTION II : FINANCIAL STATUS OF THE FIRM
Financial Data f
Financial Data for Previous 3 Years [KSH. Equivalent]
Year 1:
Year 2:
Year 3:
Information from Balance Sheet
Total Assets
Total Liabilities
Net Worth
Current Assets
Current Liabilities
Information from Income Statement
Total Revenues
Profits Before Taxes
Profits After Taxes
 Attached are copies of financial statements (balance sheets including all related notes, and income
statements) for the last three years, as indicated above, complying with the following conditions.

All such documents reflect the financial situation of the firm, and not sister or parent
companies.

Historic financial statements must be audited by a certified accountant.

Historic financial statements must be complete, including all notes to the financial statements.

Historic financial statements must correspond to accounting periods already completed and
audited (no statements for partial periods shall be requested or accepted).
9
Form FIN-2: Average Annual Construction Turnover
Each Bidder or member of a JV must fill in this form
Year
Annual Turnover Data for the Last 3 Years (Construction only)
UUS KSH.US
Amount
Exchange
KSH. Equivalent
Currency
Rate
Average Annual Construction Turnover
The information supplied should be the Annual Turnover of the Bidder or each member of a JV in
terms of the amounts billed to clients for each year for work in progress or completed. The Bidder
MUST have a minimum turnover of Kshs 5,000,000.00 (Shillings Five Million) per annum for the last
three years.
10
Form FIN-3: Financial Resources
Specify proposed sources of financing, such as liquid assets, unencumbered real assets, lines of
credit, and other financial means, net of current commitments, available to meet the total
construction cash flow demands of the subject contract or contracts as indicated.
No.
Source of financing
Amount (KSH.. equivalent)
1
2
3
11
Form FIN-4: Current Contract Commitments / Works in Progress
Bidders and each partner to a JVA should provide information on their current commitments on all
contracts that have been awarded, or for which a letter of intent or a acceptance has been received, or for
contracts approaching completion, but for which an unqualified, full completion certificate has yet to be
issued.
Name of contract
Employer,
contract
address/tel/fax
Value of
outstanding work
(current KSh.
equivalent)
1.
2.
3.
4.
5.
Etc.
12
Estimated
completion date
Average monthly
invoicing over
last six months
KSh. month)
SECTION III: OFFICE AND SERVICE FACILITIES
Established
Size (m2)
No. of
Rooms
Staff
Position
A. Office
B. Vehicles
13
No.
Installed
Facilities
Type No.
Personnel
The Bidder shall provide details of the proposed personnel and their local experience records.
PART 2: KEY QUALIFICATION
Particulars of Permanent Personnel (Including Directors/Partners, Technical and Administrative
Staff)
Name of personnel
Nationality
Academic
Qualification*
Status and
Position in
Company*
Total Work
Experience
No. of
Years With
the
Company
………………………………………………………………………………….
Signature and Official Stamp
Date
* Attach Certificate or Testimonials and CVs
** Directors/Partners should be shown clearly
14
Basic Terms of
Employment
(Permanent or
Contract)
SECTION IV: EQUIPMENT OWNED
Particulars of Construction Equipment Owned by Company
Name of
Equipment
Type/Make/Model
Date of
Manufacture
Qualification
No/Serial No/Other
Identification mark
Owned/Leased
Remarks
………………………………………………………………………………….
Signature and Official Stamp
Date
* Attach copies of license and/or any other documents as proof of ownership. If leased indicate
source and submit certified lease agreement.
15
SECTION V: FIRMS EXPERIENCE
Particulars of applicant of similar nature in hand or executed by the firm for the last three years with particular reference to Kenya including works carried out
as sub-contractor. Please give names of Main Contractors for works carried out as sub-contractor. (Evidence required for each project e.g. copies of first
pages of contract agreements up to page containing signatures and seals and appendices to the contract (Jobs without copies of Contract agreement should not
be included in this list):
Project Type
& Location
Main or
SubContractor
Client
and his
address
Consultant
and his
address
Original
contract sum
(KSH. M)
Final contract
Sum (KSH. M)
………………………………………………………………………………….
Signature and Official Stamp
Date
* Attach Certificate of Completion
** (e.g. why project delayed or not completed)
*** You may use similar table if space provided here is not sufficient
16
Month &
Year started
Month & year
completed
Extension of
time (if any)
Remarks/
Explanation
SECTION VI: REFERENCES
Names and qualifications of at least two Referees. Referees must be registered Engineers,
Architects or Quantity Surveyors. The Referee must be a person who knows and can
comment on the performance of the firm. (NB; A fellow contractor cannot be a referee, even
if he is registered.).
Name:
Qualification No.**
Postal Address
1…………………….
……………………..
…………………..
2. ……………………
……………………
…………………..
3……………………..
……………………
…………………..
*Copies of attendance certificate(s) required
** Professionals Qualification number must be given
I/We the undersigned hereby declare as follows
(i)
(ii)
(iii)
(iv)
(v)
(vi)
My/Our signing of this application form implies acceptance of responsibility for the
veracity and accuracy of all submitted therein or therewith.
The information given will be used by the evaluation Committee for the purpose of
evaluating this application for Qualification. Such Qualification will be approved at
the sole discretion of the Committee
Any employer, consultant or banker, past or present, is hereby authorized and
requested to provide information on the competence and general reputation of this
firm if so requested by the committee.
The committee is welcome to visit and physically inspect my/our establishment and
works (contracts) executed, when it deems fit to do so, in order to verify the
authenticity of the information given herein, or by our Referees, or obtained from any
other source regarding our firm.
Failure to complete any part of this application from may result in not being
registered.
My/Our firm shall not be engaged in any act of corruption in whatever forms.
Dated this …………………… day of ………………………….20……………………………
(i)
Signed by ………………………………………… (Name in Block letters)
in the capacity of …………………………………. (Status in Firm)
……………………………………………….
Signature
(ii)
Signed by …………………………………………. (Name in Block letters)
in the capacity of …………………………………. (Status in Firm)
……………………………………………….
Signature
17
SECTION VII
MANDATORY LIST OF ATTACHMENTS TO BE SUBMITTED*
A. LEGAL REQUIREMENTS
1.
2.
3.
4.
5.
6.
Copy Certificate of Registration
Copy Valid Tax Compliance Certificate
Copy of VAT certificate/
Copy of Pin certificate
Copy of NSSF certificate
Copy of shareholding and directorship page of memorandum and articles of association
B. EXPERIENCE IN SIMILAR WORKS FOR THE LAST FIVE YEARS
1. Total number of completed contracts below (10m)
2. Largest completed contracts
3. Total number of ongoing projects and their value
C. MAJOR ITEMS OF EQUIPMENTS TO CARRY OUT WORKS
1. List Of Equipments Owned
D. QUALIFICATION AND EXPERIENCE OF PERSONNEL
2. Curriculum Vitae for key personnel with supporting certificates
E. REPORT ON FINANCIAL STANDING OF THE TENDERER
1.
2.
3.
4.
5.
Evidence of adequacy of working capital
Letters of authority to seek references from bankers
Information on litigation
Audited financial statements
Sworn statements of accuracy of information given
F. DISCLOSURE OF ANY LITIGATION ISSUES IF IT EXISTS OR NOT
1. Statement of litigation history
G. REGISTRATION BY STATUTORY & PROFESSIONAL BODIES
1. Registration by BORAQS/ Engineers Registration Board/AAK/IQSK etc
H. METHODOLOGY OF CARRYING OUT THE ASSIGNMENT
Give a methodology and approach of carrying out similar assignments adopted by the firm
* Tick against those attachments you have submitted. Additional attachments may be listed separately on the
covering letter.
18
PART 3: PERSONAL BIODATA
CURRICULUM VITAE FOR SHARE HOLDERS OR PARTNERS OF QUANTITY
SURVEYING FIRM
(Each director/Partner of the Company Should fill in this Form)
1.
Names:
Surname: …………………………………………………………
First: ………………………………………………………………
Middle: ……………………………………………………………
2.
Date of Birth:
Year: ………………………………………………………………..
Month: ……………………………………………………………..
Date: ………………………………………………………………..
Place of Birth: ………………………………………………………
3.
Identification:
Nationality: ………………………………………………………….
Passport/ID No. ……………………………………………………..
Work Permit No. ……………………………………………………
Date of Expiry: ………………………………………………………
4.
Residential Address:
Street: ………………………………………………………………..
Town/City: ………………………………………………………….
Country: …………………………………………………………….
5.
Postal Address:
P.O. Box ……………………………………………………………
Town/City: …………………………………………………………
Country: ……………………………………………………………
Fax No.: ……………………………………………………………
E-mail: ……………………………………………………………..
6.
(a)
Position held …………………………………………………………………………
(b)
Number of shares held ……………………………………………………………….
(c)
Percentage of shares held …………………………………………………………….
19
PART 4: ACADEMIC QUALIFICATIONS
Name of Training Institution
Date
From
Certificate/Award
To
PART C: PROFESSIONAL QUALIFICATIONS
Name of Institution/Board
Date
From
20
Certificate/Award
To
PART 5: PROFESSIONAL EXPERIENCE
Particulars of Experience
Date
From
Employer
To
PART 6: DECLARATION
I declare that the information given above is correct.
Signed: ………………………………………………
21
Date: ………………………………………..
Ref. No.
Date
To: ……………………………………………….
…………………………………………………….
…………………………………………………….
……………………………………………………
Dear Sir,
QUALIFICATION OF CONTRACTORS
BANKER’S REFERENCE
M/S ……………………………… have applied for prequalification as Quantity Surveyors. They
have given the name of your Bank as reference to their financial standing.
We shall therefore be grateful if you would provide the necessary information regarding the financial
status of the firm in question and suggest their suitability and capability for managing projects of the
size and type being applied for.
Your recommendation shall preferably be supported by indication of the line of credit available to the
contractor and any other relevant information.
Please be assured that all information will be treated confidentially.
Yours faithfully,
HEAD OF PROCUREMENT
CFC STANBIC BANK
22
APPLICATION FOR PREQUALIFICATION OF QUANTITY SURVEYORS FOR CFC
STANBIC BANK
To:
Head of procurement
CFC Stanbic Bank
I/We wish to apply for prequalification of Quantity Surveyors for CFC stanbic bank.
Enclosed herewith, please find one set of duly filled and signed Application Form with standard
attachments as marked on the list of attachments at the end application form.
In addition I/We enclose the following attachments for your reference:
(i)
…………………………………………………………………………………………..
(ii)
…………………………………………………………………………………………..
(iii)
…………………………………………………………………………………………
(iv)
…………………………………………………………………………………………
I/We understand that the Committee reserves the right to decide in which Class my/our Firm may be
registered.
Name of Applicant: ……………………………………………………………………………
…………………………………………………………………………………
………………………………………………………………………………..
Authorized signature and official Stamp
Postal Address:
Date
………………………………………………………………………….
………………………………………………………………………….
Telephone No. ……………………………………………………………………………………
23
INSPECTION FORM
1. Name of Firm …………………………………………………………………
2. Application Ref No. …………………………………………………………
3. Office
(a) Location
Street ………………………………………………………..
Building/House No. …………………………………………
Floor ………………………………………………………...
Door Sign (if any) …………………………………………..
(b). Establishment
4. Workshop
Number of Rooms ………………………. Total size (m2) ……………….
Number of Staff ………………………………………….
Clerical …………………………………………………..
Technical …………………………………………………
Office Equipment ………………………………………...
Location ………………………………………………… Size (m2 )
Plant & Vehicles (check against submitted list and verify Qualification
particulars and make comments on separate sheet)
Staff: (a) Mechanics ……………………. (b) Others ……………………….
6. Declaration
I/We declare that the information provided above is based on my/our personal assessment not
influenced in any manner by the applicant or any other person.
Signed on this ………………. day of ………………………………………. (month & year)
Name …………………………….. Position ………………………. Signature………………
Name …………………………….. Position ………………………. Signature………………
24
Form LIT: Pending Litigation
Each Bidder or member of a JV must fill in this form
Pending Litigation

No pending litigation
 Pending litigation
Year
Matter in Dispute
25
Value of
Pending
Claim in
KSH.
Equivalent
Value of
Pending
Claim as a
Percentage
of Net
Worth