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Request For Proposals

1. Proposer Information

Firm’s Information

Firm’s legal name

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In case of joint venture (JV), legal name of each partner


Firm’s country of constitution


Firm’s year of constitution


Firm’s legal address in country of constitution


Firm’s authorized representative(name, address, telephone numbers, fax numbers, e-mail address)Attached are copies of the following original documents.

1. Articles of incorporation or constitution of the legal entity named above.

2. Authorization to represent the firm or JV named in above,

RFP# P-05/2014 UWI ST. AUGUSTINE SOUTH CAMPUS PENAL/DEBE 51


Joint Venture( JV)/Associates Information Sheet

Each member of a JV or each Associate must fill in this form

JV/ Associate Information

Firm’s legal name


JV Partner’s legal name


JV Partner’s country of constitution


JV Partner’s year of constitution


JV Partner’s legal address in country of constitution


JV Partner’s authorized representative information(name, address, telephone numbers, fax numbers, e-mail address)


Attached are copies of the following original documents. 1. Articles of incorporation or constitution of the legal entity named above. 2. Authorization to represent the firm named above.



2. Pending Litigation

The Proposer and each member of a JV, or Associate, must fill in this form

Pending Litigation

No pending litigation.

Pending litigation as follows:

Year Matter in Dispute

Value of Pending Claim in

TT$ Equivalent

Value of Pending

Claim as a Percentage

of Net Worth


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3. Financial Situation

Proposer and each Associate or member of a JV must fill in this form

Financial Data for Previous 3 Years [TT$ ]Year 1: Click here to enter text.

Year 2: Click here to enter text.

Year 3: Click here to enter text.

Information from Balance Sheet

Total Assets Click here to enter text.



Total Liabilities Click here to enter text.



Net Worth Click here to enter text.



Current Assets Click here to enter text.



Current Liabilities Click here to enter text.



Information from Income Statement

Total Revenues Click here to enter text.



Profits Before Taxes Click here to enter text.



Profits After Taxes Click here to enter text.



The Applicant will be required to substantiate the above information by submitting copies of financial statements (balance sheets including all related notes, and income statements) for the last three years, as indicated above, complying with the following conditions.

All such documents reflect the financial situation of the Firm or partner to a JV, and not sister or parent companies.

Historic financial statements must be audited by a certified accountant. Historic financial statements must be complete, including all notes to the financial statements. Historic financial statements must correspond to accounting periods already completed and audited (no

statements for partial periods shall be requested or accepted).



4. Average Annual Turnover

The Proposer and each member of a JV, or Associates, must fill in this form

Annual Turnover Data for the Last 3 Years

YearAmountCurrency

Exchange Rate

TT$Equivalent


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Average Annual Turnover Click here to enter text.

The information supplied should be the Annual Turnover of the Firm or each member of a JV in terms of the amounts billed to clients for each year for contracts in progress or completed, converted to TT Dollars where applicable, at the rate of exchange of US$1= TT$ 6.30.



5. Financial Resources

Specify proposed sources of financing, such as liquid assets, unencumbered real assets, lines of credit, and other financial means, net of current commitments, available to meet the total cash flow demands of the subject project if awarded the contract.

Alternatively, a Banker’s reference may be submitted.

Financial ResourcesNo. Source of financing Amount (TT$ equivalent)1 Click here to enter text. Click here to enter text.2 Click here to enter text. Click here to enter text.3 Click here to enter text. Click here to enter text.




6. Current Contract Commitments

Proposers and each partner to a JV, or Associate, should provide information on their current commitments on all contracts that have been awarded, or for which a letter of intent or acceptance has been received, or for contracts approaching completion, but for which an unqualified, full completion certificate has yet to be issued.

Current Contract Commitments

No. Name of Contract

Employer’sContact Address, Tel,

Fax

Value of Outstanding

Work[Current TT$ Equivalent]

Estimated Completion

Date

Average Monthly Invoicing Over Last

Six Months[TT$/month)]

1 Click here to enter text.
































8. General Experience

The Proposer and each Associate or member of a JV must fill in this form

General ExperienceStartingMonthYear

EndingMonthYear

Years

Contract Identification and TitleName and Address of Employer

Brief Description of the Goods and related services Executed by the Firm

Role of Firm























9. Specific Experience

Fill up one (1) form per contract.

Contract of Similar Size and Nature

Contract No: Click here to enter text.

Contract Identification Click here to enter text.

Award Date Click here to enter text.

Completion Date Click here to enter text.

Role in Contract Supplier Management Supplier

Sub-Supplier

Total Contract Amount

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If partner in a JV or sub Supplier, specify participation of total contract amount

Percent of Total: Click here to enter text.

Amount: Click here to enter text.

Employer’s NameAddressTelephone/Fax NumberE-mail


Description of the similarity with this project




Form EXP - 2(b): Specific Experience in Key Activities as listed in Item 4e on Page 1 above

Contract with Similar Key Activities

Contract No: Click here to enter text.

Contract Identification Click here to enter text.

Award Date Click here to enter text.

Completion Date Click here to enter text.

Role in Contract Main Supplier Management Supplier

Architect

Total Contract Amount

Click here to enter text. TT$

If partner in a JV or sub Supplier, specify participation of total contract amount

Percent of Total: Click here to enter text.

Amount: Click here to enter text.

Employer’s NameAddressTelephone Number Fax NumberE-mail


Description of the key activities.




10. Personnel

Key Personnel Available

1. Title of position* Click here to enter text.

Name Click here to enter text.







11. Resume of Key Personnel

Position: Click here to enter text.

Personnel information

Name


Date of birth


Professional qualifications


Present employment

Name of employer


Address of employer


Telephone


Contact (manager / personnel officer)




Fax


E-mail


Job title


Years with present employer


Summarize professional experience in reverse chronological order. Indicate particular technical and managerial experience relevant to the project.

From To Company / Project / Position / Relevant technical and management experience



























7.0 Price Proposal Forms

1. Price Schedule For Goods To Be Offered From Within Trinidad and Tobago

Name of Proposer: Click here to enter text. RFP Number Click here to enter text. Page Click here to enter text. of Click here to enter text.

1 2 3 4 5 6 7 8Item Descriptio

nCountry of

OriginQuantity

and Unit of Measureme

nt

Unit Price EXW

Total EXW Price per

item

Sales and Other Taxes

Per Item

Total Price per Item excluding

Value Added Taxes

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.TOTAL Click

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Notes:Column 1: Items must be consistent with the List of Goods and Related Services (LGRS) in

Employers Requirements, Section 3Column 6: Currency in TT$

Column 8: Total Payable in Trinidad and Tobago if Contract is awarded

Name: Click here to enter text.

In the capacity of Click here to enter text.

Signed : Click here to enter text.

Duly authorized to sign the Bid for and on behalf of : Click here to enter text.

Date: Click here to enter text.

2. Price Schedule For Goods To Be Offered From Outside Trinidad and Tobago

Name of Proposer: Click here to enter text. RFP Number: Click here to enter text. Page Click here to enter text. Of Click here to enter text.

1 2 3 4 5 6Item Description Country

of Origin

Quantityand Unit of

Measurement

Unit PriceCIF POS

Total PriceCIF per Item

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TOTAL Click here to enter text.

Notes:

Column 1: Items must be consistent with the List of Goods and Related Services (LGRS) in Employers Requirements, Section 3

Column 5, 6: TT$ Currency


In the capacity of: Click here to enter text.

Signed: Click here to enter text.

Duly authorized to sign the Proposal for and on behalf of: Click here to enter text.




3. Price Schedule For Related Services To Be Offered From Within and Outside Trinidad and

Tobago

Name of Proposer: Click here to enter text. RFP Number: Click here to enter text. Page Click here to enter text. of Click here to enter text.

1 2 3 4 5 6Unit Price Total Price

Item Description

Country of

Origin

Quantity and Unit of measurem

ent

(a) (b) (a) (b)Foreig

n Curren

cy

Local Curren

cy

Foreign Currency Local Curren

cy

4x5(a) 4x5(b)Click here to enter text.







TOTAL Click here to enter text. Click here to enter text.








4. Schedule of Rates For Related Services To Be Offered From Within and Outside Trinidad and

Tobago

Name of Proposer Click here to enter text. RFP Number Click here to enter text. Page Click here to enter text. Of Click here to enter text.

1 2 3 4 5 6Unit Price Total Price

Item Description

Country of

Origin

Unit of measurem

ent

(a) (b) (a) (b)Foreign Currenc

y

Local Curren

cy

Foreign Currency Local Curren

cy4x5(a) 4x5(b)








TOTAL Click here to enter text. Click here to enter text.

Note: List rates for all services including insurances and warehousing. These rates will be applied to additional agreed services not included in the bid price, if required.







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