Guarantee Construction Certificate - DOC

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Guarantee Construction Certificate - DOC Powered By Docstoc
					                               Notes
This application relates to a performance guarantee/construction guarantee facility.

Kindly complete the form and forward it to our office together with the following
documentation.

      Signed financial statements.
      The last 6 months bank statements or management accounts.
      Certificate of incorporation.
      Copy of ID of main shareholders.
      The letter of appointment if a contract has been awarded.
      A list of all contractors that has quoted on this project together with their tender
       price if a contract has been awarded.
      If there are any judgements against the shareholders or the company kindly
       provide us with full details thereof. If the judgements have been settled provide
       proof of settlement. Where the judgements are still outstanding provide proof
       of arrangement of settlement.
                                                        734 Helena Street               PO Box 970
                                                        Discovery                       Florida Hills
                                                        1709                            1716
                                                        Telephone (011) 763 1556        Cellular 082 803 0234
                                                        Fax (011) 760 1362              Email gerhard@gmfs.co.za
                                                        FSB No 13628                    Web site www.gmfs.co.za




     COMPANY QUESTIONNAIRE FOR CONSTRUCTION BONDS (FACILITY)



1.          COMPANY / BUSINESS DETAILS
Registered Name :
Postal Address :

Physical Address :



Telephone :                          Fax :                                 Email :
Cell No.:                                                Date Business Commenced :
Registration No. :                                       VAT No. :
Nature of Business :



2.          REQUIRED UNDERWRITING INFORMATION ATTACHED
 (Please indicate with a tick where applicable, items marked with * are compulsory documentation and must form
                                              part of this submission)

                                                                     Company         Associated    Affiliated
                                                                     and Group       Companies    Companies

* AUDITED FINANCIAL STATEMENTS


DRAFT FINANCIAL STATEMENTS


MANAGEMENT ACCOUNTS


ASSET AND LIABILITY STATEMENTS
(SHAREHOLDERS / DIRECTORS / MEMBERS)

GROUP OPERATING STRUCTURE


* CERTIFICATES OF INCORPORATION


* 6 MONTHS BANK STATEMENTS


* LETTER OF APPOINTMENT


OTHER
     3.     SHAREHOLDERS / MEMBERS / PARTNERS / SOLE TRADER


               Full Names                 % Shares Held        ID Number Co.             Married ANC /
                                                                Reg. Number                  COP




     4.     SUBSIDIARY / ASSOCIATED / AFFILIATED COMPANIES

               Name                    Reg. No.          % Shares            Nature of       Guarantees
                                                           Held              Business        Required?




     5.     BANKING DETAILS


1. Name of Bank                                    7. Overdraft Facility R
2. Branch                                          8. Overdraft Used R
3. Acc. No.                                        9. How is overdraft secured?
4. Period with bank                               10. Bank Guarantee Facility R
5. Cash Balance R                                 11. Guarantees Outstanding R
6. Investments R                                  12. Other Banks


6.          PERSONNEL
Total permanent employees :                  as at                                          20____
                                      Key Personnel
Name                                          Position                            Period with Co




Has any of the key personnel been a director / shareholder of a company which was liquidated or
compromised with creditors?                If so, please provide details of page 4 (10.2)
7.          GUARANTEE HISTORY

1.     Has any previous guarantees been
       issued and by whom?
2.     Have any guarantees issued on your behalf
       ever been called up? If so, supply details.


3.     Have you applied to anyone else for this facility or guarantee? If yes, with whom?



4.     Have any applications ever been turned down? If yes, by whom and why?




     8.       EXISTING GUARANTEES


Name of Bank/Ins Co.                              Facility              Guarantees           Rate
                                                                        Outstanding          Charged




How secured?


     9.       NEW REQUIREMENTS


Required facility :      R

To replace existing facility :    Yes            No
Addition to existing facility :   Yes            No


                                        Security / Collateral Offered
                                                      Y/N                                      Y/N
1. Personal Sureties – Shareholders                          6. Cession of Life Policies
2. Personal Sureties – Directors                             7. Cession / Pledge of Cash /
3. Cession of Loan Accounts                                    Fixed Deposits
4. Cession of Book Debts                                     8. Covering Bonds
5. Notarial Bond over Plant / Equipment                        Over Fixed Property(ies)

Other (Specify)
Remarks / Other
information
     10.       GUARANTEE PARTICULARS
                CONTRACT DETAILS

 1. Guarantee in favour of

      Address

      Contact Person                                                                Tel :

 2. Consulting Architect /
    Engineer / Quantity
    Surveyor
      Contact Person                                                                Tel :

 3. Contract Number

 4. Description and Location
      of Contract (exact
      wording as it is to appear
      on guarantee)


 5. Contract Value                 R                      a)       % of value to be Sub-Contracted
                                   R
 6. Guarantee Value                                       b) Will Sub-Contractors give guarantee Y/N

 7. Contract Dates :               Start                               Complete
    Construction
      Maintenance                  Start                               Complete


Is Maintenance to be covered by this Guarantee? - Please ‘tick’               Yes                 No
appropriate box

 8. Type of Guarantee              Performance         Retention              Other (Specify)
    (Please Tick)
 9. Guarantee Wording              JBCC, NEC, etc.                            Other (Specify)
10. State date that Guarantee                    11.   Conditions of
    is required                                        Contract
12. Lowest Tenderers for this                 Name Of Companies                                 Price
    Contract (or attach
    tender list)
1.                                                                                     R

2.                                                                                     R

3.                                                                                     R

4.                                                                                     R

5.                                                                                     R

13. Expected Profit %              Gross                  %            Nett                     %
    11.         LEGAL ACTION
1. Please note details of any legal action, summons, judgments, liquidation / sequestration orders or
   offer of compromise against any shareholder or director of the company, or against the company,
   its holdings, subsidiaries or associated companies.




2. Please note details of any legal action, summons, judgments, liquidation / sequestration orders or
   offer of compromise against any key personnel that were a shareholder or director of a company




    12.          DECLARATION

I/We hereby declare that the details and information furnished in this application, to the best of
knowledge, fairly represent the true state of affairs of the company/business and I/we authorise the
verification of any aspect of this application. I/We have not concealed any material fact relevant to this
application and this questionnaire will form the basis upon which any guarantee, surety or bond may be
issued.
I/We hereby declare that if an Insurance Company agrees to issue guarantees on my/our behalf, I/we
hereby bind my/ourselves as follows :
1. To reimburse the Insurance Company for all amounts which it is called upon to pay in respect of its
     guarantees.
2. I/We nominate, constitute and appoint the Insurance Company irrevocably to be my/our lawful agent
     to obtain payment of and give valid receipts for any money due to me/us by way of retention or
     otherwise, whether such money became due before, at the time of or after my/our failure, default or
     breach of Contract.
3. To reimburse the Insurance Company for any legal or other costs and charges which may
     reasonably be incurred by them in consequence of the foregoing clauses or resulting from this
     application?
4. To pay the Insurance Company such consideration as it may require in the form of premium for the
     guarantees hereby applied for and for any extension thereof beyond the completion date stated
     herein.
5. To reimburse the Insurance Company for any costs including valuation costs incurred in regard to
     guarantees provided or to be provided.

Date:__________________________ Signature: ___________________________________________

                                                                  (Please initial all pages )
Name : ______________________________________________________________
                        (Being duly authorised to sign this document)

Designation : _________________________________________________________
13.          CONTRACTS IN PROGRESS
                                    Contract No 1   Contract No 2   Contract No 3   Contract No 4

      Employer / Principal
1.

      Contract Description
2.

3.    Principal Agent/Engineer

      Contact Name

      Telephone Number
4.    Contract Value
5.    Retentions Deducted
6.    Value of Completed Works
7.    Certified to Date
8.    Contract Period

      Start Date

      Completion Date
9.    Details of Delays
      Variations/Extensions
10    Value of Guarantee Lodged

      Name of Bank / Insurer

      When due for Return
11    Estimated Final Profit/Loss
14.           MOST RECENT CONTRACTS COMPLETED
                                      Contract No 1   Contract No 2   Contract No 3   Contract No 4

1.    Date Completed

2.    Employer / Principal


3.    Contract Description


4.    Contract Location
5.    Final Contract Value
6.    Completion Certificate
      issued? Yes or No
7.    Final Certificate Issued?
      Yes or No
8.    Amount of Retention Money
      Outstanding
      When Due
9.    Amount of Claims
      Outstanding
10    Amount of Penalties Imposed
11    Amount or Percentage of
      Final Profit/Loss on Contract
12    Guarantee Provided (Value)

      Name of Bank/Insurer

      When due for return
13    Principal Agent / Engineer

      Contact Name

      Telephone Number

				
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Description: Guarantee Construction Certificate document sample