(Name of Contractor) Category of Good/Services/Works. Please submit this completed Questionnaire to

Transcription

1 Registration of Contractors QUESTIONNAIRE (Name of Contractor) Category of Good/Services/Works Please submit this completed Questionnaire to The Secretary - Tenders Committee Airports Authority of Trinidad and Tobago Airport Administration Centre South Terminal Golden Grove Road Piarco

2 Invitation to Register or Update Registration (As a Supplier/ Contractor/ Consultant with the Airports Authority of Trinidad & Tobago) The Airports Authority of Trinidad & Tobago (the Authority ) has revised its pre qualification procedures to include an open registration process of updating Suppliers, Contractors and Consultants interested in the supply of goods and the provision of services and works at the Authority. All previously pre-qualified firms and individuals are invited to update their registration information. New firms and individuals are also being invited to register with the Authority. Applicants may obtain the Registration Questionnaire from the Airport Administration Centres of Piarco and A.N.R. Robinson International Airports. The Registration Questionnaire can also be downloaded from the Airports Authority web site at The completed registration form must be submitted in sealed envelopes labelled: Application to Register as a Contractor (Also state Category of Work). and addressed to The Secretary Tenders Committee Airports Authority of Trinidad and Tobago Airport Administration Centre South Terminal Golden Grove Road Piarco Existing pre-qualified Firms/Individuals are advised to adhere to this invitation to ensure that their status as contractor/ consultant is maintained. Further information may be obtained from the Office of the General Manager at ext 2101 or at [email protected].

3 REGISTRATION INSTRUCTIONS i. Please read these General Instructions carefully before completing this Questionnaire. ii. Please provide a response to all questions. If any question is not applicable to the services provided by your organization, please mark N/A ( not applicable ) and give a brief explanation why it does not apply. iii. Responses are not limited to the spaces provided in the Questionnaire. Where additional space is required to record all the information necessary, the additional information shall be provided on a supplemental schedule in the format as presented in the Questionnaire. iv. Applicants shall provide the name and contact information of a designated Officer, in the event that the Authority requires clarification on any aspect of the Questionnaire. v. The List of Categories of Goods, Works and Services for which an applicant may register is attached to this Questionnaire as Appendix I vi. Please utilize the Registration Checklist attached as Appendix II to ensure that all supporting documents are submitted. vii. Applicants may select one or more of the financial ranges as stated in Clause 2.9. viii. The category for registration must be clearly printed on the cover page of the Questionnaire. ix. Applicants are allowed to register for more than one category but one application must be submitted for each category for which registration is sought. If one application is submitted for more than one category, the company will be evaluated on the category first stated on the Questionnaire. x. Where more than one application is submitted, the applicant may submit one bundle of supporting documents once it is relevant to all the submitted applications. xi. Applicants are advised that a representative from the Authority may visit their premises for the purpose of verifying the information recorded in the Questionnaire. xii. If any information contained in this Questionnaire is found to be false and/or misleading the Application will be rejected. Where such a determination is made subsequent to prequalification of the applicant, the Applicant would be deregistered. xiii. The Questionnaire must be signed by a duly authorized officer and/or agent of the Applicant organization. xiv. The information submitted with any application shall be held in strict confidentiality and shall be used solely for the use of the Authority

4 1. GENERAL BACKGROUND AND ORGANISATION OF FIRM (Complete in BLOCK LETTERS) 1.1 Name of Organisation: Registered Address: Mailing Address (if different from above): Telephone.: Fax.: Address:. 1.6 Designated Representative:.. Cell Address: Type of Organisation Public Limited Liability Partnership Consortium External Company Private Limited Liability Joint Venture Sole Proprietorship Other (specify) 1.8 Contractor Documentation Please attach a copy of the following documents (where applicable): 1.9 Corporate Structure Certificate of Incorporation/Continuance/Registration tice of Registered Office tice of Directors VAT Certificate BIR Clearance Certificate (not less than three years) NIS Compliance Certificate Company Brochure Product Catalogue Provide a current organisational chart illustrating your company s structure including all key personnel. Please provide the names and addresses of each affiliated and/or subsidiary company.....

5 Key Personnel (resumes may be submitted with this Questionnaire) Name Title Nationality Qualifications Experience (yrs) 1.11 Are you or any of the company s directors or employees related to any director/member or employee of the Airports Authority of Trinidad and Tobago? If yes, please specify the persons and the nature of the relationship Were you previously registered with Airports Authority under your current name or any other name? If yes, please specify

6 2. FINANCIAL INFORMATION 2.1 Please provide Audited Financial Statements for the past three years commencing If Audited Financial Statements are not available please indicate why If your audited financial statements cannot be provided, please attach signed filed returns for the last three financial years together with management accounts for the relevant periods. Sole traders are required to show proof of quarterly tax payments for the last three years 2.4 Bankers Name Branch Address Telephone Contact Name 2.5 Please provide a letter from your bank confirming your relationship, credit and banking history. 2.6 Bonding Is your Banker/Bonding Company prepared to provide sureties if required. If yes, please state the maximum limit (TT$) Insurance Coverage Please indicate your organisation ability to obtain the following insurances which are necessary in the event that a contract is awarded: Contractor s All Risk Liability* Public Liability* Workmen s Compensation* Professional Indemnity *(if applicable) Motor Vehicle Employer s Liability * The value of the cover is established on a per contract basis.

7 Please provide a Schedule outlining the types of Insurance cover maintained Do you have any pending Insurance Claim in respect of the above insurances? If yes, please specify Judgements/Litigation Are there any pending actions or claims against the company and/or the principal officers or directors? If yes, please specify) Are there any judgements registered against the company and/or the principal officers or directors? If yes, please specify Contract Size Please indicate which category of works or services your organisation is capable of financing: $0 $50, $50, $150, $150, $1 million $1 million $5 million $5 million $10 million $10 million

8 3. CONTRACTS AND REFERENCES Please provide a list of projects awarded/completed within the last three (3) years i. Contract #1 Client Name:. Client Representative Tel.. Contract Description Contract Value Contract Duration. ii. Contract #2 Client Name:. Client Representative. Tel.. Contract Description Contract Value Contract Duration. iii. Contract #3 Client Name:. Client Representative... Tel. Contract Description Contract Value Contract Duration. iv. Contract #4

9 4. EQUIPMENT 4.1 Do you own all your equipment If no, specify what % is rented/leased Please describe the Equipment # Description Owned/Leased Age Condition

10 5. SAFETY QUESTIONNAIRE 5.1 Do you have and adhere to a Health and Safety or Environmental Policy? (Please provide) 5.2 Do you provide protective clothing and devices for your staff 5.3 Do you keep an Accident log? If yes, please use your last year s accident log to fill the following: Number of Injuries: Number of Illnesses: Number of lost workday cases: Number of Restricted Workday cases: Number of cases with medical treatment only: Number of Fatalities: 5.4 Are Accident Reports prepared and sent to the following persons? If yes how often? Recipient Monthly Quarterly Annually Foreman/Supervisors Manager CEO/General Manager Safety Officer 5.5 Do you have a designated Safety Officer? 5.6 Are you compliant with the OSH legislation? If no, in the form of a % how compliant are you? 5.7 Do you keep a record of near miss incidents that might have caused serious injury, property or equipment damage? If yes, please indicate the number of near miss incidents Are Accident records and accident summaries kept?

11 5.9 Do you hold Project Safety Inspections and Security Review? If yes, who conducts this inspection? and how often? Weekly Bi-weekly Monthly Less often and/as needed Do you have an orientation programme for new hires? Does it include instruction on the following? Construction safety HSE Considerations Personal Protective Equipment 5.11 Do you hold Safety and Security Meetings? Safety Security How often? Safety Security Weekly Bi-weekly Monthly Less often and/as needed. Weekly Bi-weekly Monthly Less often and/as needed Do you have a substance abuse program in place? 5.13 Do you conduct HSE Training for employees? If yes, how often is training held? Bi-annually Annually Less often and/as needed.

12 The Applicant declares that the information provided in this Questionnaire and submitted as Schedules thereto are true and correct. This Questionnaire is signed by a duly authorized Officer and/or Agent of the Applicant. The signatory of this Questionnaire guarantees the veracity and accuracy of all responses given herein. APPLICANT NAME... SIGNATURE OF OFFICER/AGENT. NAME OF OFFICER/AGENT. TITLE.. DATE

13 AIRPORTS AUTHO RITY OF TRINIDAD & TOBAGO APPENDIX I AIRPORTS AUTHORITY OF TRINIDAD AND TOBAGO CATEGORIES OF GOODS, SERVICES & WORKS Category Code Goods, Services & Works 0001 Advertising/ Public Relations 0002 Administrative Support 0003 Air-conditioning Duct Cleaning 0004 Air-conditioning Maintenance 0005 Airfield Maintenance Grass cutting Road Sweeping 0006 Audit & Accounting Services 0007 Animal Handlers 0008 Automatic Doors (Installation/Maintenance) 0009 Builders Works 0010 Building Management Systems 0011 Car Park Management 0012 Car Park Security 0013 Carpentry 0014 Catering 0015 Carpet Cleaning 0016 Carpet Installation 0017 Civil Works 0018 CCTV Design, Installation & Commissioning 0019 CCTV Maintenance 0020 Commercial and Decorative Painting 0021 Communication 0022 Computer Hardware 0023 Computer Repairs 0024 Consulting Services Airport Development Architectural Services (including interior design) Civil/Infrastructure Engineering Electrical Engineering Electronic Communication Engineering

14 AIRPORTS AUTHO RITY OF TRINIDAD & TOBAGO Category Code Goods, Services & Works Information Technology Disaster Recovery Solutions Information Security Solutions Mechanical Engineering Project Management Telecommunications 0025 Conveyor Systems 0026 Conveyor Supplies and Maintenance 0027 Customs Brokerage 0028 Debt Collection Services 0029 Decorations 0030 Drainage Cleaning 0031 Electrical Fixture & Fittings (Runway & Building) 0032 Electrical Supplies & Services 0033 Electrical Systems Services 0034 Electrical Works 0035 Electronic Access Control/ Security Systems 0036 Elevators (Parts & Repairs) 0037 Employee Programm development 0038 Environmental Services 0039 Equipment Rental 0040 Escalators (Parts & Repairs) 0041 Events Management 0042 Facilitation and Hospitality 0043 Fencing Works 0044 Fire Suppression Systems Extinguishers/Hydrant/Hose Reels Fire Alarm Maintenance Fire Appliance Maintenance Fire Sprinklers 0045 Floral Arrangements 0046 Fuelling System Maintenance 0047 Generator Maintenance 0048 Glass Works (Installation/Cleaning/Repairs) 0049 Grounds Maintenance 0050 Insurance Brokerage Services

15 AIRPORTS AUTHO RITY OF TRINIDAD & TOBAGO Category Code Goods, Services & Works 0051 Investigative Services 0052 Janitorial/ Custodial Maintenance 0053 Labour - Skilled/ Unskilled 0054 Landscaping 0055 Locksmith Services 0056 Long Service Award 0057 Machine Shop Works 0058 Marketing 0059 Medical Equipment 0060 Medical Services 0061 Medical Supplies 0062 Network Infrastructure Services 0063 Network Infrastructure Equipment 0064 Office Equipment & Furniture (Purchase & Rental) 0065 Office Equipment Maintenance 0066 Office Furniture Reconditioning 0067 Office Supplies 0068 Paint & Sign Supplies 0069 Painting 0070 Partitioning 0071 Paper Hygienic Products 0072 Pest Control Services 0073 Photocopiers 0074 Photography 0075 Plumbing Supplies 0076 Plumbing Works 0077 Pool Maintenance 0078 Printing & Binding 0079 Pumps Maintenance 0080 Pressure wash & cleaning 0081 Records Management 0082 Road Paving/ Resurfacing 0083 Roof Repairs (Concrete/Sheeting/Asphalt) 0084 Runway Paving/ Resurfacing 0085 Safety & Protective Gear & Equipment 0086 Security Services

16 AIRPORTS AUTHO RITY OF TRINIDAD & TOBAGO Category Code Goods, Services & Works 0087 Security Uniform and Supplies 0088 Signage 0089 Shuttle Services 0090 Software Maintenance & implementation 0091 Sound Systems Equipment Rental 0092 Stationery Supplies 0093 Surveying 0094 Telecommunication Equipment 0095 Telecommunication Services 0096 Tent Rentals & Party Supplies 0097 Transport & Relocation 0098 Training Services 0099 Travel Agency 0100 Uniform Design 0101 Uniform Supplies 0102 Valuation/ Quantity Surveying 0103 Vehicle Leasing 0104 Video Production 0105 Waste Disposal 0106 Waster Water Systems Maintenance 0107 Welding Services 0108 Wrecking & Relocation Services

17 APPENDIX II AIRPORTS AUTHORITY OF TRINIDAD AND TOBAGO REGISTRATION CHECKLIST Please ensure that the following documents are submitted with the Questionnaire: NO. ITEM # DETAILS Contractor Documentation: Certificate of Incorporation/Continuance/Registration tice of Registered Office tice of Directors VAT Clearance BIR Clearance (not less than three years) NIS Compliance Certificate Company Brochure Product Catalogue Organisational Chart Resumes of Key Personnel 4 2.1/ 2.3 Financial Statements Banker s Letter Schedule of Insurances Health, Safety or Environmental Policy 8 All Schedules prepared by you in response to the Questionnaire 9 Is the Questionnaire signed?