<p> APPLICATION FORM </p><p>Ref. EOI-GF-SERVICES-LTA</p><p>SHEET A - ADMINISTRATIVE INFORMATION</p><p>Please complete this carefully.</p><p>Full legal name:</p><p>Abbreviated legal name:</p><p>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:</p><p>Postal address:</p><p>Street name and No:</p><p>Governorate:</p><p>Telephone (including area code):</p><p>Fax No. (including area code):</p><p>Corporate E-mail address:</p><p>Internet address http://</p><p>Full name(s) of the firm’s owners:</p><p>Full name and contact details of the focal point: Name:</p><p>Telephone:</p><p>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</p><p>Corporate bank details including bank account name:</p><p>Audited Balance Sheets or extracts from Audited Balance Sheets for at least the last three years:</p><p>A statement of overall turnover and quick ratio during the Last three financial years in US$:</p><p>Turn Over Quick Ratio Year 1: Year 2: Year 3: SHEET C - TECHNICAL AND PROFESSIONAL CAPACITY</p><p>1. General expertise of the Firm General projects that were carried out over the past 3 years, including information on clients, project description and geographical location inside or outside Sudan </p><p>Geographical Value Duration and Project Description Client Status location US$ Year(s) </p><p>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 </p><p>Geographical Value Duration and Project Description Client Status location US$ Year(s) </p><p>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 </p><p>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</p><p>Authorized Signature Signature:</p><p>Name:</p><p>Title:</p><p>Date:</p><p>* Note: CVs shall be covering the following: 1. Personal Information 2. Qualifications 3. Experience in the required field of business. </p>