ATTACHMENT – 15.

5b
Document Ref. No.
PRE-QUALIFICATION QUESTIONNAIRE FOR
SUBCONTRACTOR
Date:
PROJECT:
Sheet: Page 1 of 8 - 1 -
CONTRACT No.:

Form no: CONTRACTOR:

General guidelines for filling up the Questionnaire:

1. The concerned Subcontractor must fill up all the questions without leaving any section blank,

2. The response/answers given in this questionnaire must be applicable to the specific

company mentioned in this questionnaire. Details of parent, associate or subsidiary
companies, where relevant, shall be treated as (3) below;

3. If necessary for the purpose of supporting and clarifying answers given in respect of the
company, details of parent company, associates or subsidiary companies may be given on
separate questionnaire returns,

4. In case any question requires separate documentation or continuation sheets etc. then the
same may clearly be referenced to the relevant item numbers,

5. For any question if any element is not applicable then the same should be referred as Not
Applicable or N/A,

6. Supplier should make all supporting documents as attachments to the Pre-Qualification

Questionnaire (attachment 15.5b).
Attachment number shall be referenced chronologically in the appropriate sections of the
questionnaire.

7. The Form should be returned to:

CONTRACTOR:
 ATTACHMENT – 15.5b
Document Ref. No.
PRE-QUALIFICATION QUESTIONNAIRE FOR
SUBCONTRACTOR
Date:
PROJECT:
Sheet: Page 2 of 8 - 2 -
CONTRACT No.:

Form no: CONTRACTOR:

COMPANY DETAILS

1.1 Organizational Structure

Refer Attachment#1 for Project specific and General Organization Structure.

1.2 Summary of Services or Products and Capability

1.2.1 Please provide a summary of the services or products etc. supplied by your
Company. Also indicate the value ($) or scale of work able to be undertaken.

Refer attachment for XXXX Prime Nature of Business as Attachment #. 2

1.2.2 Please confirm / comment on your Company’s capability to produce products and /
or services that comply with the Specification(s) and / or Standard(s) as
applicable.

Refer attachment for XXXX Prime Nature of Business as Attachment #. 2

1.2.3 Please specify the list of sub-contractors, source for supply of major raw materials
with their credentials.

Refer attachment for XXXX Approved Supplier List as Attachment #. 3

1.2.4 Please provide references of major projects executed for Oil & Gas Companies,
without discrepancy in delivery / defects / poor quality or significant failure, with a
Project name & Value.

Refer attachment for reference list XXXX Products & Projects executed
a. Reference list for Pressure Vessels as Attachment #. 4
b. Reference list for Storage Tanks as Attachment #. 5
c. Reference list for Launcher/ Receivers/Scraper as Attachment #. 6
d. Reference list for Heat Exchangers as Attachment #. 7
e. Reference list for Major Fabrication works as Attachment #. 8

1.2.5 List of previous similar supplies with Project Name & Location, key data of the
supply, Client’s and End user’s details & contact point, year of supply etc.
 ATTACHMENT – 15.5b
Document Ref. No.
PRE-QUALIFICATION QUESTIONNAIRE FOR
SUBCONTRACTOR
Date:
PROJECT:
Sheet: Page 3 of 8 - 3 -
CONTRACT No.:

Form no: CONTRACTOR:

Refer attachment for reference list XXXX Products & Projects executed
a. Reference list for Pressure Vessels as Attachment #. 4
b. Reference list for Storage Tanks as Attachment #. 5
c. Reference list for Launcher/ Receivers/Scraper as Attachment #. 6
d. Reference list for Heat Exchangers as Attachment #. 7
e. Reference list for Major Fabrication works as Attachment #. 8

1.2.6 Subcontractor to duly confirm compliance that they will provide support in supply
of spare parts for the life of the equipment(s).

Not Applicable

1.3 Description of Facilities

1.3.1 Technical / Manufacturing / Workshop Floor Areas (m2)

Refer attachment for XXXX Engineering facility as Attachment #. 9

1.3.2 Installed Equipment / Plant

Refer Attachment #. 10 for XXXX Fabrication Plant List for Installed

Plant/Equipment

1.3.3 Handling / Lifting Equipment Details

Refer Attachment #. 10 for XXXX Fabrication Plant List for Handling /

Lifting Equipment Details

1.3.4 Location of Facilities executing the work in terms of their proximities with main
road, airports, railway stations, seaports etc.

Refer Attachment #. 9 for XXXX Engineering facility and Attachment #.

11 for XXXX route map

1.3.5 Location in relation to Abu Dhabi, U.A.E

 ATTACHMENT – 15.5b
Document Ref. No.
PRE-QUALIFICATION QUESTIONNAIRE FOR
SUBCONTRACTOR
Date:
PROJECT:
Sheet: Page 4 of 8 - 4 -
CONTRACT No.:

Form no: CONTRACTOR:

Refer Attachment #. 11 for XXXX facility Location Map

1.4 Details of Present Human Resources:

a) Total number of Employees: xxx

b) Number of Permanent Staff: 270
c) Number of Temporary / Casual staff: Nil
d) Maximum Permanent to Temporary staff ratio over last 5 years: Not Applicable

1.5 Please highlight Subcontractor’s knowledge about International Petroleum supply industry
codes and standards followed (API) and specific approvals like ASME “U” stamping,
certification, etc.

Refer attached XXXX certification and accreditations

ISO 9001 as Attachment #. 12
ISO 14001 as Attachment #. 13
OHSAS 18001 as Attachment #. 14
API 5CT, API 5DP, API 6A, API 7-1, API 16A as Attachment #. 15
ASME ‘U’ as Attachment #. 16
ASME ‘U2’ as Attachment #. 17
ASME ‘PP’ as Attachment #. 18
NBIB ‘R’ as Attachment #. 19
UL- 142 as Attachment #. 20
UL- 58 & 1746 as Attachment #. 21

1.6 Please provide copy of following Manuals.

Refer Attached IMS Manual as Attachment #. 22

2.0 COMMERCIAL DETAILS

2.1 Details of Ownership

Refer Attachment #. 23 for XXXX Industrial License stating the details of

Owner

2.2 Financial Data

2.2.1 Audited Accounts for Previous 3 Years
 ATTACHMENT – 15.5b
Document Ref. No.
PRE-QUALIFICATION QUESTIONNAIRE FOR
SUBCONTRACTOR
Date:
PROJECT:
Sheet: Page 5 of 8 - 5 -
CONTRACT No.:

Form no: CONTRACTOR:

To be filled in

2.2.2 Annual Turnover

To be filled-in

2.3 Company’s Bankers

To be filled-in

2.4 Insurance Details

2.4.1 Company / Corporate Insurance

Refer Attachment #. 24 for XXXX General Insurance Policy

2.4.2 Claims History (if applicable)

Nil

3.0 COMPANY EXPERIENCE

Refer Attachment #. 25 for XXXX company profile and Attachment #. 26 for list of
companies represented by XXXX

4.0 SUB-CONTRACTED / SUB-LET WORK DETAILS

No work is Sub-contracted / Sub-let by XXXX

5.0 INFORMATION TECHNOLOGY (IT) RESOURCES DETAILS

To be filled-in
 ATTACHMENT – 15.5b
Document Ref. No.
PRE-QUALIFICATION QUESTIONNAIRE FOR
SUBCONTRACTOR
Date:
PROJECT:
Sheet: Page 6 of 8 - 6 -
CONTRACT No.:

Form no: CONTRACTOR:

6.0 QUALITY MANAGEMENT DETAILS

XXXX is accredited with ISO 9001:2015 and fully complying with all QMS
requirements conforming to ISO 9001 (Refer Attachment #. 12

6.1 QMS Manuals Required

Refer attached IMS Manual as Attachment #. 22

7.0 HSE MANAGEMENT DETAILS

7.1 Statement of HSE Policy and Procedures

XXXX is accredited with ISO 14001:2015, ISO: 45001:2018 and fully complying with
all EMS, Health & Hygiene requirements.
Refer attached QHSE Policy as Attachment #. 27, Drug, alcohol & smoking Policy as
Attachment #. 28, list of System Operating Procedures as Attachment #. 29 and list
of HSE operational procedures as Attachment #. 30.

7.2 HSE Manual

Refer attached IMS Manual as Attachment #. 22

7.3 Description of HSE Management Organization

Refer attached organization chart as Attachment #. 1

7.4 Please provide a copy of HSE certification

Refer Attachment #. 13 for certificates of ISO 14001; Attachment #. 14 for ISO:45001

certificate & Attachment #. 31 for EHSMS approval certification

7.5 Safety Record

Refer attached List of HSE forms as Attachment #. 32

HIRA register as Attachment #. 33
EAI register as Attachment #. 34
HSE Statistics as Attachment #. 35
 ATTACHMENT – 15.5b
Document Ref. No.
PRE-QUALIFICATION QUESTIONNAIRE FOR
SUBCONTRACTOR
Date:
PROJECT:
Sheet: Page 7 of 8 - 7 -
CONTRACT No.:

Form no: CONTRACTOR:

8.0 ANY OTHER INFORMATION THAT MAY BE USEFUL

XXXX is fully complying with AD EHS MS requirements – refer attached AD EHSMS

compliance certificate issued by IDB as Attachment #. 31

9.0 LIST OF ATTACHMENTS AND ENCLOSURES

1. XXXX Company Profile as Attachment #. 25

2. XXXX engineering facility profile as Attachment #. 9
3. XXXX Prime nature of business as Attachment #. 2
4. XXXX Registration (01017) by ZADCO as Attachment #. 36
5. XXXX Policies – QHSE, Drug, Alcohol & Smoking Policy as Attachment #. 27 & 28
6. ISO 9001: 2008 Certificate copy as Attachment #. 12
7. ISO 14001: 2004 Certificate copy as Attachment #. 13
8. OHSAS 18001:2007 Certificate copy as Attachment #. 14
9. AD EHSMS Approval Certification for XXXX HSE Documentation as Attachment #. 31
10. Companies represented by XXXX as Attachment #. 26
11. XXXX Product Reference List
a. Reference list for Pressure vessels as Attachment #. 4
b. Reference list for Storage Tanks as Attachment #. 5
c. Reference list for Launchers/Receivers (Scraper Traps) as Attachment #. 6
d. Reference list for Heat Exchangers as Attachment #. 7
e. Reference list for Major Fabrication Works as Attachment #. 8
12. Organization chart – Project specific & General as Attachment #. 1
13. XXXX Fabrication Plant List as Attachment #. 10
14. XXXX Location Map as Attachment #. 11
15. XXXX Approved Supplier List as Attachment #. 3
16. Certificates for API 5CT, 5DP, 6A, 7-1, 16A as Attachment #. 15
17. Certificates for ASME ‘U’, ‘U2’ ‘PP’ as Attachments #. 16, 17, 18
18. Certificate for NBIB ‘R’ as Attachment #. 19
19. Certificates for UL 58, 142 & 1746 as Attachment #. 20 & 21
20. XXXX Industrial License copy as Attachment #. 23
21. XXXX IMS Manual as Attachment #. 22
22. XXXX IMS System Operating Procedure List as Attachment #. 29
23. XXXX HSE Operational Procedure List as Attachment #. 30
24. XXXX List of HSE Forms as Attachment #. 32
25. XXXX HIRA Register & EAI Register as Attachments #. 33 & 34
26. XXXX HSE Statistics as Attachment #. 35
27. Chamber of commerce certificate as Attachment #. 37
28. XXXX General Insurance Policy as Attachment #. 24
29. XXXX Work Procedure List as Attachment #. 38

10.0 LOCAL AGENT DETAILS

 ATTACHMENT – 15.5b
Document Ref. No.
PRE-QUALIFICATION QUESTIONNAIRE FOR
SUBCONTRACTOR
Date:
PROJECT:
Sheet: Page 8 of 8 - 8 -
CONTRACT No.:

Form no: CONTRACTOR:

10.1 Please provide Local Agent Details.

Not Applicable

10.2 Please provide a copy of the agreement with Abu Dhabi Company endorse by the
required UAE Statutory Authorities.

Not Applicable

10.3 Please provide the after-sales service center contact details (globally and in Abu Dhabi).

sales@XXXXuae.com

Note: Subcontractor shall provide / attach the following:

 Valid Municipality License issued by Abu Dhabi Municipality with "Oil & Gas Services" included
in the activity field. (Refer as Attachment #. 23)
 Valid Certificate issued by Abu Dhabi Chamber of Commerce with " Oil & Gas Services" included
in the activity field (Refer as Attachment #. 37)
 Valid Trade Register issued by Ministry of Economy and Commerce.

11.0 Name(s)/ Position(s) of the person(s) in the company completing this questionnaire

Signature: __ __ . Signature: _____________________

Name: __________________ __ __ Name: __ _____________________

Position: _________________ _ Position: _ ____________ ______

Date: __________ . Date: ________________________