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Project Fern - Service Provider Approvals Consulatant - Pre-Q Form Rev0.1 (10072020)
Project Fern - Service Provider Approvals Consulatant - Pre-Q Form Rev0.1 (10072020)
Project Fern - Service Provider Approvals Consulatant - Pre-Q Form Rev0.1 (10072020)
TO
PROJECT FERN
AT
MUMBAI, INDIA
July 2020
Mapletree India Holding Private Limitedon behalf of Project Company
PROJECT FERN
AT MUMBAI
CONTENTS PAGE
Page | 2
Mapletree India Holding Private Limited on behalf of Project Company
PROJECT FERN
AT MUMBAI
1.2.2 The proposed facility shall include Grade-A office buildings, car-parking
structure and supporting building services; with estimated
FSI/GFA at 1.5 mil sq ft.
1.2.3 The development aim to tap into the expansion requirements of the
commercial facility in Mumbai. Building specification shall be similar to
Mapletree’s completed work both locally and within the region.
1.2.4 The design shall be in accordance with the applicable building codes,
regulations and by-laws in reference to the relevant authority
Lump Sum
Page | 3
1.5 Submission of Application Form
(6) All costs and expenses incurred in the application shall be borne
by the applicant and no claim for costs or expenses shall be
entertained by Mapletree India Holding Private Limited .
PREQUALIFICATION OF
TO
PROJECT FERN
AT
MUMBAI, INDIA
To:
Attention: K. Saravanan
1.0 PARTICULARS OF FIRM
Name:
Date of Registration :
Mailing Address :
(if different from above)
Company PAN No
: (attach a copy)
ESI/PF Registration No :
(attach a copy)
Name:
Registered Address:
Mailing Address:
Passport Number
Name Designation Nationality
Passport Specimen
Name Designation Nationality Number Signature
Please mention the person who will be involved in the signing authority for all Contracts:
.........................................................................
1.0 PARTICULARS OF FIRM (CONT'D)
(1)
(2)
(3)
(4)
1.0 PARTICULARS OF FIRM (CONT'D)
Please furnish the following information relating to the financial position of the firm:
Annual Turnover
Current Asset
Current Liabilities
Total Assets
Total Liabilities
2.0 FINANCIAL CAPACITY (CONT'D)
A statement of Profit and Loss Account for the preceding three (3)
years certified by your Auditors
Amount of credit
Name and Address of Line of Credit Maximum available (less
Financial Institution (type) amount of credit amount drawn
line down)
Mapletree India Holding Private Limited on behalf of Project Company
PROJECT FERN
AT MUMBAI
Please provide particulars of projects executed by your firm in the last five years. The projects listed should preferably be of similar
scope and nature as the subject project.
Page | 15
Mapletree India Holding Private Limited on behalf of Project Company Page 16
PROJECT FERN
AT MUMBAI
PROJECT FERN
AT MUMBAI
Description Name and Construction Value of Type of Contract Type of Current Type of
of Project Address of Period Contract* Contract Stage(State either, Building
Client (MM/YY-MM/YY) (State Pre-Contract, (Office/IT
“Architectural” Tender, Park)
Rs
/ Construction, Post-
“Architectural, Construction)
MEP, Land”, or
“Others”; if
“Others, to
specify nature
of contract)
(state also the
form of
contract used)
STAFF HEADCOUNT
Senior Level Management
Middle Level Management
Junior Level Management
Technical Staff
Non- Technical Staff
5.2 Management and Staff Resources – Other Engineering Services (please specify each discipline)
STAFF HEADCOUNT
Senior Level Management
Middle Level Management
Junior Level Management
Technical Staff
Non- Technical Staff
PROJECT FERN
AT MUMBAI
6.1 Please state the firm’s capability and experience in delivering integrated design
services. Project reference and details to be included.
Page | 19
7.0 LITIGATION
Is your firm currently involved (or has been involved in the last 5 years) in any
arbitration/litigation or pending arbitration/ litigation relating to claims or disputes of
any sort on any contract?
Yes No
If yes, please provide a brief description of the nature of the dispute, the amount
under dispute and the parties involved.
8.0 DECLARATION
I, the undersigned, hereby certify that to the best of my knowledge the particulars given in
this form are true and correct. I authorise Mapletree India Holding Private Limited (A
Mapletree Group Company) to make direct enquiries and references to any person, firm,
public official or organisation named in this form to verify the information submitted herein or
regarding the competence and general reputation of the firm.
I understand fully that Mapletree India Holding Private Limited (A Mapletree Group
Company) reserves the sole right and discretion to select the applicants and emplace them
in the prequalified list.
Signature :
:
Name
:
Designation
:
Signature of Witness
:
Name and Designation of Witness