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INDUS MOTOR COMPANY

CONTRACTOR PREQUALIFICATION FORM Page: 1 of 8

GENERAL PRE-QUALIFICATION QUESTIONNAIRE

Vendor’s Name : _________________________________

Recommended by (Department) : _________________________________

Date : ______________________

Contractor Code (IT assigned) : ______________________

This document is the Intellectual Property of Indus Motor Company. Any unauthorized use, including the modification and
reproduction of the content is strictly prohibited. © Copyrights Ordinance 2002, All Rights Reserved.
INDUS MOTOR COMPANY
CONTRACTOR PREQUALIFICATION FORM Page: 2 of 8

To be Filled by Contractor

1. Scope of work / project interested to be qualified for:

____________________________________________________________________

2. Trade Name of the Concern: ____________________________________________

3. Business Address (Head Office): _________________________________________


____________________________________________________________________
Telephone No. (with area code): __________________________________________
Fax No.: ____________________________ Cell No.: ________________________
E-Mail: _________________________ Web Address: _______________________

4. Names and Contact Numbers of Proprietors / Directors:


1. _____________________________ 2. _____________________________
3. _____________________________ 4. _____________________________

5. Person(s) to be contacted (mention Cell Number as well):


1. _____________________________ 2. _____________________________

6. Type of Concern (Please tick box):

a. Sole proprietor b. Partnership

c. Private d. Public Ltd

7. Nature of the Business (Please tick box):

7.1 CIVIL

Dewatering Experience (Years): ________


Earthwork Experience (Years): ________
General Civil Works Experience (Years): ________
Geotechnical Investigation Works Experience (Years): ________
Piling Works Experience (Years): ________
Pre-stress Concrete Experience (Years): ________
Public Health Works Experience (Years): ________
This document is the Intellectual Property of Indus Motor Company. Any unauthorized use, including the modification and
reproduction of the content is strictly prohibited. © Copyrights Ordinance 2002, All Rights Reserved.
INDUS MOTOR COMPANY
CONTRACTOR PREQUALIFICATION FORM Page: 3 of 8

RCC Structure Works Experience (Years): ________


Roads & Bridges Experience (Years): ________
Slip Forming Experience (Years): ________
Steel Structure Experience (Years): ________
Survey Works Experience (Years): ________
Water Proofing Experience (Years): ________
Any Other - Please specify Experience (Years): ________

7.2 ELECTRICAL & INSTRUMENTATION

Cable Laying & Termination Experience (Years): ________


Electrical Equipment Installation Experience (Years): ________
Field Test Calibration Experience (Years): ________
Instrument Calibration & Testing Experience (Years): ________

7.3 ENGINEERING SERVICES

Basic Engineering Experience (Years): ________


Detailed Engineering Experience (Years): ________

7.4 MECHANICAL

a) Fabrication & Erection

Boiler Experience (Years): ________


Duct Experience (Years): ________
Fired Heater Experience (Years): ________
Grating Experience (Years): ________
HVAC Experience (Years): ________
Passivation Experience (Years): ________
Pipe Experience (Years): ________
Re-tubing Heat Exchanger Experience (Years): ________
Rotary Experience (Years): ________
Sheet Rolling Experience (Years): ________
Stack Experience (Years): ________
Stationer Experience (Years): ________
Steel Structure Experience (Years): ________
Tank & Vessels Experience (Years): ________
Any Other - Please specify Experience (Years): ________
This document is the Intellectual Property of Indus Motor Company. Any unauthorized use, including the modification and
reproduction of the content is strictly prohibited. © Copyrights Ordinance 2002, All Rights Reserved.
INDUS MOTOR COMPANY
CONTRACTOR PREQUALIFICATION FORM Page: 4 of 8

b) Inspection Service

IMTE Calibration Experience (Years): ________


NDT Experience (Years): ________

c) Insulation & Cladding (Piping, Equipment)

Cold Insulation Experience (Years): ________


Duct Insulation Experience (Years): ________
Hot Insulation Experience (Years): ________

d) Piping (Fabrication & Erection)

Cross Country Piping Experience (Years): ________


Cross Piping Experience (Years): ________
Utility & Offsite Piping Experience (Years): ________

e) Surface Treatment (Piping & Equipment)

Coating & Wrapping Experience (Years): ________


Galvanizing Experience (Years): ________
Internal Lining Experience (Years): ________
Painting Experience (Years): ________
Sand Blasting & Priming Experience (Years): ________
Shot Blasting Experience (Years): ________

7.5 OTHERS

a) Forwarding, Loading / Unloading, Transportation, etc.

Custom Clearance Experience (Years): ________


Freight Forwarder Experience (Years): ________
Light Transportation Experience (Years): ________
Heavy Transportation Experience (Years): ________

b) Manpower Supply

Supervisory Staff Experience (Years): ________


Skilled Staff Experience (Years): ________
Unskilled Staff Experience (Years): ________
This document is the Intellectual Property of Indus Motor Company. Any unauthorized use, including the modification and
reproduction of the content is strictly prohibited. © Copyrights Ordinance 2002, All Rights Reserved.
INDUS MOTOR COMPANY
CONTRACTOR PREQUALIFICATION FORM Page: 5 of 8

c) Rental Equipment

Drilling Machines Experience (Years): ________


Earth Moving Equipment Experience (Years): ________
Power Generator Experience (Years): ________
Welding Equipment Experience (Years): ________
Vehicles Experience (Years): ________
Others Experience (Years): ________

8. Date of Registration: _________________________________________________

9. Factory Address and Telephone Nos. (if applicable): __________________________


____________________________________________________________________

10. Details / Addresses of Offices outside Karachi / Pakistan (if applicable):


a. ________________________________________________________________
________________________________________________________________
b. ________________________________________________________________
________________________________________________________________
c. ________________________________________________________________
________________________________________________________________

11. Name of Sister Concerns (if applicable):


(Please tick the relevant box) Yes No

a. _______________________________ Registered with IMC

b. _______________________________ Registered with IMC

12. Manpower Qualification (Optional):


Graduate Skilled
Engineers Semi-Skilled

13. Number of staff employed:


Office Factory

This document is the Intellectual Property of Indus Motor Company. Any unauthorized use, including the modification and
reproduction of the content is strictly prohibited. © Copyrights Ordinance 2002, All Rights Reserved.
INDUS MOTOR COMPANY
CONTRACTOR PREQUALIFICATION FORM Page: 6 of 8

14. Detail of Works / Jobs already completed

Sr. Work / Job Location Customer Contract Contract Date of Actual


No. Description Value Duration Commencement Completion
Date

Please attach details if necessary.

15. Detail of Works / Jobs In Hand

Sr. Work / Job Description Location Customer Contract Value Contract Duration Date of
No. Commencement

Please attach details if necessary.

16. Did you go on litigation against any Customer? Yes No


If yes, give detail and reasons of going in litigation _____________________________
_____________________________________________________________________
_____________________________________________________________________

17. How do you control quality at site? Please describe ____________________________


_____________________________________________________________________
_____________________________________________________________________

18. Do you have any documented procedure for Quality Control? Yes No

If yes, please mention ___________________________________________________

19. Is your company ISO 9001-2008 / ISO 14001 certified? Yes

Note: In case NO; the Contractor shall follow IMC QHSE Policy and No
Procedures during execution the work / job.

20. Upto what extent, do you have know-how about ISO 9001 Quality Management
System:
Little Low Medium High Very High

21. Upto what extent, do you have know-how about ISO 14001 Environmental
Management System
Little Low Medium High Very High

This document is the Intellectual Property of Indus Motor Company. Any unauthorized use, including the modification and
reproduction of the content is strictly prohibited. © Copyrights Ordinance 2002, All Rights Reserved.
INDUS MOTOR COMPANY
CONTRACTOR PREQUALIFICATION FORM Page: 7 of 8

22. Please provide following details about your Health, Safety & Environment (HSE)
System:
a. HSE Organization Chart.
b. List of HSE experienced key personnel.
c. How would you manage HSE during execution of work?
d. Do you have written procedure for emergency handling.
e. Please give the injuries frequency rates of last three years.

23. Please submit the following along with this PQ Form:


- HSE Organization Chart
- Assets / Liabilities Statement
- List of Major Equipment
- List / CV of Key Personnel with Past Experience
- Renewed Registration with Pakistan Engineering Council
- Income Tax Statement (last three years)

24. Please provide a copy of your company profile (Optional): Enclosed

Not Enclosed

25. Sales Tax registration number (if registered):


(Please provide a copy of the certificate)

26. National Tax Number:

27. Annual Turnover for the last 3 years and paid up capital (Optional):

Turn over Paid up Capital

Year ______

Year ______

Year ______

28. Bank Details:


a. Name of the Bank: _______________________________________________
b. Branch Address: _______________________________________________
c. Account No.: _______________________________________________
d. Branch Code: _______________________________________________
Note: Please also provide a banker’s certificate in original.
This document is the Intellectual Property of Indus Motor Company. Any unauthorized use, including the modification and
reproduction of the content is strictly prohibited. © Copyrights Ordinance 2002, All Rights Reserved.
INDUS MOTOR COMPANY
CONTRACTOR PREQUALIFICATION FORM Page: 8 of 8

DECLARATION

I, Mr. ___________________________ of ________________________ (company) hereby


solemnly declare that the information mentioned above is true to the best of my knowledge
and if any information is found incorrect or incomplete my prequalification form will be liable
for disqualification.

Name of Person completing this form:_________________________________________

______________________ ____________________
Signature & Seal Date

Note: Any change in mailing address and contact numbers will be intimated within 48 hours to Indus Motor
Company, in writing.

FOR IMC USE ONLY

Recommendation / Remarks / Observations:


_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

Recommended by Reviewed by Reviewed by Approved by Posted by


Dept:
I.A. Finance CEO IT Department
___________

HOD Signature COIA Signature CFO Signature CEO Signature IT Personnel Signature

This document is the Intellectual Property of Indus Motor Company. Any unauthorized use, including the modification and
reproduction of the content is strictly prohibited. © Copyrights Ordinance 2002, All Rights Reserved.

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