BID EVALUATION FORM

Quotation # Ref: SAP Order #

Job Description

Contractor 1 Contractor 2 Contractor 3

Technical
S No Description of Activities
Deviation

10
34,800.00
Total

(Specialized experienced based skills required for this job)

Contract Awarded To:

Amount In Words:
Contractor from approved List Yes No
If Yes ICI Supervisor for Contactor:
Special Instructions (If Any)
Job Completion Date:

Risk Grid Level Scope of Work Attached (Yes / No)

Inspection and test Requirement Yes No
Special PPE's and HSE Requirement Yes No
General Requirement /Information Yes No
 Frequency
F1 F2 F3 F4 F5 F6
<1 in x years
100 10 1 <1
People Health Environment Assets Reputation Security Severity 10000 1000 rarely occasionaly sometimes happens regularly

International
media International S5
F ext, Fatal Off site attention attention
>1 F on site Exposure damage > 2 M€ 6 7 8 9 10 11

National
Off site release media S4
F on site, Severe with long term attention Fatal assault
>1 SI Exposure clean-up < 2 M€ 5 6 7 8 9 10

Off site
release/on site Local S3
Occupational release with stakeholders Sabotage
Severe Injury Illness long clean-up < 500 k€ 4 5 6 7 8 9

On site
release/site External S2
Reportable clean-up/permit complaint Burglary
Injury Exposure violation < 100 k€ 3 4 5 6 7 8

S1
Minor No Trespass
First Aid Exposure Spill < 20 k€ 2 3 4 5 6 7

Unacceptable, Immediate action Action required at first Action required Acceptable For risks with a rating of
required opportunity ALARP (no further risk reduction ≤6, tolerable if ALARP, i.e. in the yellow or
(check if the frequency/probability of (by introducing more (using systems, is required) green area apply risk reduction is justified
the scenario fits with the severity, control systems:hardware, procedures, training, considering variability of knowledge,
consider using a more qualitative software) audits, or hardware) experience, availability of equipment and
assessment) financial resources