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APPLICATION FORM UNDP Sudan Intranet

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					                                    APPLICATION FORM

                                  Ref. EOI-GF-SERVICES-LTA

                      SHEET A - ADMINISTRATIVE INFORMATION

Please complete this carefully.

Full legal name:

Abbreviated legal name:

Company legal registration status:
(certificate of registration must be provided)
Company registered qualification status:
i.e. Class A, B, C etc. with the relevant line
ministry, i.e. Ministry of Public Works or the
relevant public/government organization:

Postal address:

Street name and No:

Governorate:

Telephone (including area code):

Fax No. (including area code):

Corporate E-mail address:

Internet address http://

Full name(s) of the firm’s owners:

Full name and contact details of the focal point:   Name:

                                                    Telephone:

                                                  E-mail:
This form must be accompanied by proof of enrolment on a professional or trade register as
stipulated and required by the Government legislations.
                SHEET B - ECONOMIC AND FINANCIAL CAPACITY


Corporate bank details including bank
account name:




Audited Balance Sheets or extracts from
Audited Balance Sheets for at least the
last three years:


A statement of overall turnover and
quick ratio during the
Last three financial years in US$:

                                          Turn Over   Quick Ratio
                                Year 1:
                                Year 2:
                                Year 3:
                 SHEET C - TECHNICAL AND PROFESSIONAL CAPACITY

1. General expertise of the Firm
General projects that were carried out over the past 3 years, including information on clients,
project description and geographical location inside or outside Sudan

                            Geographical                  Value       Duration and
Project Description                              Client                                     Status
                              location                     US$          Year(s)




2. Relevant expertise of the Firm
Relevant projects that were carried out over the past 3 years, including information on clients,
project description and geographical location inside or outside Sudan

                            Geographical                  Value       Duration and
Project Description                              Client                                     Status
                              location                     US$          Year(s)




3. Personnel:
CVs of the firm’s key staff maximum six CVs (each in one page) as follows*:
(a)   General Manager.
(b)   Chief Technical Advisor (Head of Technical Division or Chief of Engineers)
(c)   Senior Civil Engineer
(c)   Senior Electrical Engineer
(d)   Senior Mechanical Engineer
(e)   Senior Elector-Mechanical Engineer

Declaration: I, the undersigned, declare that the information given above:
- is correct and true, and
- where the applicant is representing a company or consortium, has been provided in the full
knowledge of the appropriate authorities

                                          Authorized Signature
Signature:

Name:

Title:

Date:

* Note: CVs shall be covering the following:
  1. Personal Information
  2. Qualifications
  3. Experience in the required field of business.

				
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posted:10/31/2012
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