PRE QUALIFICATION

REQUEST DOCUMENT

The Information provided will be used to assess your suitability for inclusion in the GEO's Approved Supplier
Database for 2023. The information provided will be treated confidentially
 Prequalification Request Document

CONTENTS

Part Description Page

A Company Information 1
B Products And Services 3
C Company Financial Performance & Position 4
D Company Track Record 5
E Company Capabilities and Resources 7
F Conflict of Interests 9
G Company Declaration 10

Notes:

1. Please answer all questions.

2. Check List - Supporting documents to include:
- Company Registration Certification ( Section A6 )
- Ministry of Planning & Economy Classification Certificate ( Section A7 )
- Insurance Policies ( Section A9 )
- Statement of Financial Position & Financial Performance ( Section C1 )
- Reference details from Clients / Contractors / Banks ( Section C4 )
- CV's of Senior Management Personnel ( Section E3.1 )
- Organization Chart ( Section E3.2 )
- Quality Certificates ( Section E6 )
 Prequalification Request Document
Register as Contractor Supplier / Manufacturer Others
A - Company Information
A1 - General
1 Company Name:
Legal Business Name (Arabic):
1.1 Legal Business Name (Arabic) must match CR
certifi cate
1.2 Other Names (if any):

1.3 Website:

1.4 Date of Establishment in KSA / International : Date of Registration in KSA: Date of Registration (Intenational):

Legal form of Business :

1.5 Nationality: (Local / International) (Private/Public/JV/Limited Liability,
etc.)

A2 - Company Address
Head Quarters Office in Dammam Other Offices

2.1 Street Address:

2.2 P.O. Box

2.3 City:

2.4 State / Province:

2.5 Postal Code:

2.6 Country:

2.7 Telephone :

2.8 Facsimile :

2.9 Email :

A3 - Contact Persons: Senior Management Only

3.1 Name

3.2 Position/Title:

3.3 Direct Tel:

3.4 Direct Fax:

3.5 Mobile:

3.6 Email:

A4 - Company Owners
4.1 Owner(s) Name

4.2 Nationality

4.3 % Ownership

Company Ownership Registration:

4.4 % of Local Ownership Others (Please specify)

Sponsorship (If Applicable)

4.5 Sponsor Name

4.6 Address:

4.7 Telephone:

4.8 Facsimile:

Page 3 of 12
 Prequalification Request

A5 - Authorized Signatories (attched POA)

5.1 Name:

5.2 Designation:

A6 - Company Registration Details ( Attach copies of relevant certificates )

Issued By: Municipality /
Registration No. Date of Registration Reg. Expiry Date
Authority of….

Provide Articles of
6.1
Association (if a company)

Commercial Registration
6.2
Certificate

Chamber of Commerce
6.3
Membership Certificate

6.4 Zakat Certificate

6.5 VAT Certificate

GOSI Certificate (General

6.6 Organisation for Social
Insurance)

6.7 Saudization Certificate

Industry related certification

6.8
documents (if any)

Commercial Registration
6.9
(International)

Saudi Contractors Association

6.10
(SCA) Membership

6.11 Others, if any

A7 - Company Classification ( Attach copy of certificate )

7.1 Company Classification

7.2 Classification Type:

7.3 Category

7.4 Expiry Date:

A8 - Company Associates

Company 1 Company 2 Company 3

Name of Associated
8.1
Companies:

8.2 Address:

8.3 Type of Association:

8.4 Other relevant Information:

Page 4 of
 Prequalification Request

A9 - Insurance Policies ( Attach copies of relevant Policies )

Sl No Insurance Policy Type Name of Insurer Insured Amount (in SAR)

9.1 General Liability Insurance

9.2 Workmen's Compensation

9.3 Professional Indemnity

9.4 Others…………………………

B - Products And Services - Range & Activities

( Specify the core business)
Sl No B1 - Primary Activities

10

11

12

13

Sl No B2 - Secondary Activities

10

11

12

13

Page 5 of
 Prequalification Request

C - Company Financial Performance & Position in KSA

(Please Attach copies of Audited Financial Statement and Local Content Certificate)

Sl No C1 - Financial Information for the last 3 years (amount in SAR)

Financial Year: As of December 31, 2022 As of December 31, 2021 As of December 31, 2020

1 Paid Up Capital

2 Fixed Assets

3 Current Assets

4 Cash + Accounts receivable

5 Total Assets

6 Total Liabilities:

7 Net Worth

Turn Over /
8

Sales Revenue

9 Gross Margin

10 Net Margin

C2 - Company Bankers
1 2 3

1 Bank Name:

2 Address:

3 Current Line of Credit (in SAR)

Bond/Bank Guarantee
4
Capacity (in SAR),
Cumulative Value
5 Overdraft Facilities:

a) Extent overdraft drawn

b) Monthly usage over last 12
months

6 Customer of Bank since

Bank Manager Name :

7
Contact No. :

C3 - Company Auditors
Auditor's Name: Address Contact No.
1

Page 6 of
 Prequalification Request

C4 - Performance Record (Attach reference details from Clients / Contractors / Banks)

Within the last 5 years
Sl No Event Response Explanations, if Response is YES

1 Have you been Denied Bond or Bank Guarantee ? Yes / No

2 Did any Contract terminate for default ? Yes / No

3 Did you Fail to complete awarded work or supply ? Yes / No

Had you been Penalised for failure to complete on time / liquidated
4 Yes / No
damages ?
5 Did you have any Claims or Court actions against you ? Yes / No

6 Had you made any Claims or Court actions against another firm ? Yes / No

D - Company Track Record

D1 - Track Record (of most prestigious projects executed)
Contract Value (SAR) Date of
Project Title, Location & Name of Consultant / Project
Sl No Name of Client Contract Scheduled
Scope Details Manager Original Final Actual Completion
Commencement Completion

Logistic Projects (add additional sheet if required)

Contract Value (SAR) Date of

Project Title, Location & Name of Consultant / Project
Sl No Name of Client Contract Scheduled
Scope Details Manager Original Final Actual Completion
Commencement Completion
Industrial Projects (add additional sheet if required)

Contract Value (SAR) Date of

Project Title, Location & Name of Consultant / Project
Sl No Name of Client Contract Scheduled
Scope Details Manager Original Final Actual Completion
Commencement Completion

Retail & Mixed-use Projects (add additional sheet if required)

1

Contract Value (SAR) Date of

Project Title, Location & Name of Consultant / Project
Sl No Name of Client Contract Scheduled
Scope Details Manager Original Final Actual Completion
Commencement Completion

Residential Tower Projects (add additional sheet if required)

1

Page 7 of
 Prequalification Request Document
Contract Value (SAR) Date of
Project Title, Location & Name of Consultant / Project
Sl No Name of Client Contract Scheduled
Scope Details Manager Original Final Commencement Completion
Actual Completion

Other Projects (add additional sheet if required)

D2 - List of current main projects (add additional sheet if required)

Date of
Project Title, Location & Name of Consultant / Project Original Contract Contract Project Status (......%
Sl No Name of Client Contract Scheduled
Scope Details Manager Value (SAR) Duration as on.........2024)
Commencement Completion

D3 - Details of Sub-Contractors (Typical works delegation)

Sl No Trade In-house Sub-Contract

10

E - Company Capabilities and Resources

E1 - Major Plant And Equipment (List of company's fixed and mobile plant and equipment)
Sl No Plant and Equipment Name Manufacturer and Make Yr of Mfr Capacity QTY Owned (Y/N) Location

10

Page 8 of
 Prequalification Request Document

E2 - Engineering & Technical Capabilities

Sl No Engineering / Design Services Specialised Services Fabrication Services

E3 - Human Resources
E3.1 - Key Personnel (Attach CVs of Senior Management Personnel )
Years of Years with
Sl No Name Position Qualifications
Experience Company

10

11

12

13

14

15

16

19

Page 9 of
 Prequalification Request Document
E3.2 - Total Human Resources ( Attach Organization Chart )
Sl No No. of Permanent Staff Remarks

1 Generla Manager

2 Project Directors

3 Project Managers

4 Resident Engineers

5 Cost Managers

6 Design Managers

7 Site Managers

8 Operation Managers

9 Contract Managers / Administrators

10 Senior Engineers

11 Engineers - Civil

12 Engineers - Mechanical

13 Engineers - Electrical

14 Engineers - Structural

15 Quantity Surveyors

16 Site Engineers / Inspectors - Civil/Mech'l/Elect'l

17 CAD Personnel

18 Health and Safety Personnel

19 Quality Assurance / Quality Control

20 Marketing and Sales Personnel

21 Procurement Personnel

22 Administrative Personnel

23 Foremans

24 Skilled Labours

25 Labours

26
Others (Specify................)

E4 - Company Fixed Assets (Space and location of facility)

Sl No

1 Offices

2 Workshops / Plants

3 Warehouses

4 Showrooms:

5 Testing Facilities:

Page 10 of
 Prequalification Request

E5 - Health, Safety and Environment (Attached Certificates)

Accredited Quality Quality Approving
Sl No Item Quality Plans Standards
(Yes/No) Manual Procedures Authority

Quality System (ISO 9001):

1
(Attached QMS Manual & Plan)

Health & Safety

2 Supplier to confirm they have a HSE Policy and
Plan in place. (Attached Copy)

3 Environment

Technical Standards / Codes of Practice followed. Other than Quality

4
Standards

E6- Quality Assurance Accreditations / Certifications ( Attach copies of relevant certificates )

Sl No Company Name Standards Certificate No. Issue Date Expiry Date Issued by

Quality Assurance & Sustainability

a) Supplier to confirm they have a QA/QC Policy and Plan
in place.
1

b) Supplier to confirm if they use and maintain a

QA/QC Management System and any QA/QC
Accreditation

2 Others if any

E7 - Corporate and Social Responsibility

Sl No Event Response Explanations, if Response is YES

1 Do you have a corporate and Social responsibility stratergy Yes / No If Yes, please provide copy of the same.

F - Conflicts of Interest
Questions Yes No Attached (Y/N)

Have you signed and submitted GEO’s Non-Disclosure Agreement?

1
If Yes, attach signed copy

Are you aware of any conflicts of interest which may exist if you were pre-qualified to participate in the potential tender related
to this PQQ?
2
If “Yes”, please provide details:
Please identify any conflicts of interest between your organisation and/or its directors, and GEO Company.

Page 11 of
 Prequalification Request

G. Company Declaration

The undersigned, as authorised Signatory on behalf of the company, hereby declares that the enclosed information and statements are true and valid to
the best of my knowledge. I undertake to inform GEO of any change to the enclosed information and to update the profile on a yearly basis.

I understand and acknowledge as well that submission of this document does not necessarily give our company any right whatsoever to be invited to
tender for any work that is being tendered by GEO.

Signature

Full Name

Position

On Behalf of

Date

Company Official Seal

Page 12 of