Ref. EOI-GF-SERVICES-LTA

APPLICATION FORM

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:

Title:

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