Building & Architectural Works RFP

CL MASTERBATCH PROJECT
REQUEST FOR PROPOSAL

BUILDING & ARCHITECTURAL WORKS
Client : PT Cabot Asia Pacific South

Contract No./PO No. : CW2177413
Package Name : FEED and EP Services
Document No. : CL-MB(3)-TPE-CV-RFP-5004
Client
Revision Date Description Originator Checker Approver
Approval
00 04-05-2020 Issued For Information GAP MST CAW N/R

REQUEST FOR PROPOSAL (RFP)
TABLE OF CONTENT
TABLE OF CONTENT.......................................................................................................2
1. INTRODUCTION ........................................................................................................3
1.1 Project Background 3
1.2 Project Data 3
2. SCOPE .......................................................................................................................3
2.1 Scope of Supply 4
2.2 Scope of Work 4
3. VALIDITY PROPOSAL ...............................................................................................7

4. REFERENCE DOCUMENTS ATTACHED TO THIS REQUISITION ..........................7
5. DEVIATION(S) FROM PURCHASER’S REQUIREMENT ..........................................7
6. DOCUMENT TO BE SUBMITTED BY VENDOR IN THE PROPOSAL ......................8
7. ADDRESS AND CLOSSING DATE .......................................................................... 10
APPENDIX 1 – SPLIT OF WORK
APPENDIX 2 – SCOPE OF SUPPLY
APPENDIX 3 – APPLICABLE DOCUMENT
APPENDIX 4 – SCHEDULE OF PRICE
APPENDIX 5 – SCHEDULE OF WORK
APPENDIX 6 – COMMERCIAL PROPOSAL
APPENDIX 7 – HSE REQUIREMENTS FOR SUBCONTRACTOR
APPENDIX 8 – QAQC REQUIREMENTS FOR ENG OPERATION INSTALLATION

SERVICES SUB
APPENDIX 9 - SPECIFICATION AND SCHEDULE
APPENDIX 10 - DRAWING
Page 2 of 10
1. INTRODUCTION
1.1 Project Background
Cabot Corporation is a leading global specialty chemicals and performance materials
company headquartered in Boston, Massachusetts, USA. Has manufacturing assets
around the globe with primary products are rubber carbon black and specialty grade
carbon blacks, masterbatches, conductive compounds, inkjet colorants, fumed metal
oxides, aerogels, and activated carbon (Norit).
PT. Cabot Asia Pacific South (hereinafter referred to as the "Cabot") is new entity
which will build new masterbatch manufacturing plant. The new asset will be located
besides existing carbon black unit.
This specific project objective is to build new masterbatch plant with 20,000 MT/year
capacity in order to meet business demand of masterbatch in Asia Pacific South
region.
The main equipment is Twin Screw Extruder technology with capabilities of 1500-3000
kg/hr. Expected product melting temperatures inside extruder will range from 120°C -
330°C having a maximum Temp of 300°C. The extruder design is defined in scope 1.
Raw material handling and product handling capacity is following extruder capacity
under scope 2. Packaging system (scope 3) capacity is able to handle 2 line or twice
as big as extruder capacity.
Some utility will be tied-in from existing Carbon Black plant such as process water, fire
protection water, electricity, waste water and other. The rest is individually built in the
masterbatch plant. Building to contain raw material storage, office area, utility room,
process building, warehouse product storage building and other required
infrastructure.
1.2 Project Data
Name of Owner : PT CABOT ASIA PACIFIC SOUTH

Project Name : CL MASTERBATCH PROJECT
Location : Jl. Amerika I kav A-5, KIEC, Cilegon, Banten, Indonesia
2. SCOPE
The main scopes of this work package are to perform interior & exterior work, electrical
& instrumentation in the building, HVAC system, and above ground plumbing sanitary
system for the following facilities:
 CCR (Central Control Room) and Office Building
 WSHE and Shipping Room
 Guard House
The scope excludes foundation work, slab floor, and underground plumbing.
Page 3 of 10
Vendor shall quote the Building & Architectural Works according to Scope of Work
stipulated in Section 2.2, Split of Work and Scope of Supply stated in Appendix 1 and
2 respectively.
2.1 Scope of Suppl y

Vendor’s Scope of Supply shall include material, manpower, and equipment that are
required to perform the Scope of Work outlined in Section 2.2. (Scope of Work),
Appendix 1 (Split of Work), and Appendix 2 (Scope of Supply) unless otherwise
specified in “Special Notes”, with references provided in Appendix 3 (Applicable
Document). Vendor shall prepare the proposal in full compliance with the stipulations,
conditions, and requirements stated in this Requisition.
2.2 Scope of Work

The general Scope of Work is stipulated in Section 2 above, with the following details:
1. This scope excludes Piling Works, Foundation for Building, Structure, Fencing,
Paving, Drainage, and Pre-Engineered Building. Table below shows the scope
matrix and battery limit.
RFP Number RFP Items Scope

CL-MB(3)-TPE-CV-RFP-5001 Package for Pre Engineered PEB for Main Building including Steel Structure for
Building CCR and Office Building, Canopy, Veranda, Roof,
(By Other) Louver, Wall Metal Sheet, Steel Door, Exterior, etc.
CL-MB(3)-TPE-CV-RFP-5002 Package for Piling Work PC Square Pile Works, including PDA test and Static
(By Other) Load Test.
CL-MB(3)-TPE-CV-RFP-5003 Package for General Civil and Early Site Preparation, Landscaping, Foundation (Incl. PHT,
Work Slab Floor, Fencing, underground plumbing for
(By Other) Buildings), etc.
CL-MB(3)-TPE-CV-RFP-5004 Package for Building & Finishing Interior-Exterior & Architectural for
Architectural Buildings, Electrical, Instrument, HVAC and
Aboveground Plumbing Sanitary System for CCR and
Office Building; WSHE and Shipping Room and Guard
House.
For Electrical and instrument:
Installation all material and equipment included
associated Electrical and Instrument system inside
buildings such as lighting, HVAC, Telephone, CCTV
system, etc. until connection and termination to
distribution panel.
CL-MB(3)-TPE-CV-RFP-5005 Package for Steel, Mechanical and 1. Steel Structure Equipment & Shelter, (waste solid
Piping structure)
(By Other) 2. Piping works, and
3. Mechanical Works
CL-MB(3)-TPE-CV-RFP-5006 Package for Electrical & instrument 1. Installation Electrical and Instrument system
(By Other) outside building
2. Installation all electrical equipment and
connection cable from CCR building and other
building to distribution panel.
Bidders shall quote the appointed Work Package under CL-MB(3)-TPE-CV-RFP-5004.
Page 4 of 10
2. The scope of work are identified by the following types of works according to the
following Functional Work Breakdown Structure:
FWBS CODE CLMB WBS Work Description

31-6*2 218220001-200-200B-20120 Structural Frame Work
31-6*3 218220001-200-200B-20120 Substructure (wall, floor, etc.)
31-6*4 218220001-200-200B-20120 Exterior & Interior Finishing
31-6*5 218220001-200-200B-20140 HVAC
31-6*6 218220001-200-200B-20150 Utility & Sanitary
31-6*7 218220001-200-200B-20160 Electrical Work
31-6*8 218220001-200-200B-20170 Instrumentation
3. Further details of work categories are broken down as per relevant FWBS code
and detail definitions of scope of work items, and "Details of Work items and typical
sequence". It shall be noted that the work items and work sequences only show
major items and typical sequences. All other associated activities supported the
completion of each work category, shall be including the work but not limited to the
item that are stipulated in item no 4.
4. The following shall be deemed to be within this scope of work:

a) Protection/supports that against other construction works or services.
b) Supplying, erection and maintenance of necessary scaffolding including
removal thereof
c) Adjusting, installation, setting and placing of necessary materials according to
the drawings and specifications
d) Supplying and Installation of template, frames, supports, or other temporary
items to fix embedded items in position, and removal thereof after completion
of the work
e) Adjusting, installation, setting and placing of necessary materials according to
the drawings and specifications
f) Installation of supports or other temporary items to fix embedded items in
position, and removal thereof after completion of the work
g) Necessary fabrication and fixing materials such as door and windows etc.,
including preparation and application of coating/painting for the exposed
surfaces.
h) Preparation and submission of REBAR BENDING SCHEDULE which shows
dimension (including the lapping length)/weight/bending radius/etc. of
individual rebar assembly for approval of COMPANY.
i) Supplying and Installation of various sizes and shapes of anchor bolts and
mechanical/chemical bolts including boxing out and their protection
j) Protection/curing of newly placed concrete structures
k) Restoring of the existing roads, paving and suchlike which were excavated or
damaged due to the new installation and construction
l) Isolation from existing facilities to prevent penetration of drainage into the
construction areas
m) Necessary fabrication and fixing materials such as door and windows, etc.,
Page 5 of 10
including preparation and repair after installation if there are any damaged.
n) Install insulation as per thermal conductivity as per drawing and specification
(if required).
o) Providing and installing waterproof material for roofing unless specified for
other Work Package scope. Further detail about waterproofing roof will be
explained in the drawing and specification,
p) The concrete floor shall be leveled as per requirement from mechanical,
electrical and instrument equipment
q) Supplying and Installation Finishing Floor. Material of the floor shall refer to
building specification.
r) Opening for equipment, ducting, conduit, cabling and other shall have
structural frames and shall be air-tight and water tight. For shelter, opening
shall be finished after cutting for an opening. Finishing result of an opening of
shelter shall meet COMPANY’s satisfaction.
s) Supplying and Installation Structure, Roof covering, Ceiling, and Roof Frame
including Siding, Fascia, and painting, except the item specified to be included
from the Work Package.
t) Supplying and Installation Interior and Exterior walls. Material of the wall shall
refer to building specification.
u) Finishing could be painting, panel or else. All material shall follow
specifications and drawings, and as approved by COMPANY.
v) Supplying and Installation Architectural Accessories shall refer specifications
and drawings, and as approved by COMPANY.
w) Supplying and installation HVAC, Instrument, and Process Safety Items.
x) Supplying and installation Utility piping/plumbing installation and its supports,
including sanitary system and accessories unless specified for other Work
Package scope. It shall exclude underground plumbing system to septic tank.
y) Electrical works including installation of power generation facilities,
communication system, fire alarm system, lightning, etc. unless specified for
other Work Package scope.
For Building - CCR and Office Scope : Will be excluded from Supply and Installation of
Structure Steel Structure, Exterior Wall Corrugated Metal Zincalume, Louver, Roll-up
Doors with complete sets of Hardware, Connection Bolts, Downspout, Gutter, Canopy,
Roof Vent, Flashings, Trims, Closures, Expansion Joints, Roof Panel etc..
5. The SUBCONTRACTOR shall include the following scope for the excavation work
related to the construction of sewer and drainage systems:
a) All required excavation including test excavation either manual or using
machine.
b) All required backfilling either manual or using machine.
c) Dewatering and provide sufficient side wall protection/shoring for the ditches
or holes.
Page 6 of 10
3. V ALIDITY PROPOS AL
- 2 months from issued date of Proposal.
4. REFERENCE DOCUMENTS ATTACHED TO THIS REQ UISITION

Appendix 1 – Split Of Work
Appendix 2 – Scope Of Supply
Appendix 3 – Applicable Document
Appendix 4 – Schedule Of Price
Appendix 5 – Schedule of Work
Appendix 6 – Commercial Proposal
Appendix 7 – HSE Requirements For SUBCONTRACTOR
Appendix 8 – QAQC Requirements For Eng Operation Installation Services Sub
Appendix 9 - Specification And Schedule
Appendix 10 - Drawing
5. DEVI ATION(S) FROM PU RCHASER’S REQUIREMEN T

Vendor’s quotation may be subjected to rejection unless it includes a list which shows
specially any deviation from the specifications attached hereto, or statement “ NO
DEVIATION “.
Vendor shall notify the alternatives and reasons for any deviation made.
Page 7 of 10
6. DOCUMENT TO BE SUBMI TTED BY VENDOR IN TH E PROPOS AL
No. Description
1 Cover Letter
2 Proposed SUBCONTRACTOR’s Project Organization
At minimum This Document shall clearly describe the following item:
1. Proposed Project Organization

2. Proposed SUBCONTRACTOR’s Key Personnel complete with Curriculum Vitae
3. Rules and responsibility of each key personnel
4. Coordination procedure of each section of the work including Construction
Management, Quality Control Management, and Safety, Health, Environment &
Security Management.
5. Key Personnel SKA ( Sertifikat Keterangan Ahli) & SKT ( Sertifikat keterangan
Trampil)
SKA Tenaga inti (Sertifikat Keterangan Ahli) & SKT (Sertifikat keterangan Trampil)
3 Proposed Detailed Construction Schedule
1. Duration of the detailed work breakdown structure

2. Key Milestone Completion date according to COMPANY’s Requirement
4 Execution Plan/Work Methodology
At minimum, This Document shall clearly describe the following item:
1. Organization chart showing communication flow and person incharge for execution
2. Key Concept of Execution Plan
3. Scope of work and Split of Work
4. Execution of The Work, including sequential job step from preparation to
completion.
5. Sample of SUBCONTRACTOR’s daily, weekly, & monthly execution report
6. Sample of Method Statement and Specific Construction Procedure (if any)
7. SUBCONTRACTOR Equipment List & Data:
a. Valid Construction equipment certificate by authorized organization
b. Equipment safety operation procedure from equipment manufacturer
c. Valid Operator certificate by authorized organization
d. Valid Tools Calibration Certificate by authorized organization
8. SUBCONTRACTOR’s Direct manpower & Equipment Loading
Page 8 of 10
No. Description
9. SUBCONTRACTOR’s Typical Temporary Facility Layout

10. SUBCONTRACTOR’s utilities, water & power source
5 Operation Plan
At minimum, This Document shall clearly describe the following item:
1. SUBCONTRACTOR Direct Manpower Recruitment Plan including security &

supporting personnel.
2. SUBCONTRACTOR Transportation Plan
3. SUBCONTRACTOR Security Plan
4. Local Bussines Opportunity
SUBCONTRACTOR shall provide commitment and plan on maximizing the use of

local business that includes details of the list or types of jobs that will be given to
local business.
Project QA/QC Plan

6
1. SUBCONTRACTOR Quality Management Organization chart

2. Roles and responsibility in quality management
3. Quality Plan, Quality Objectives and Quality Workflow
4. Design Change Control
5. Material Purchasing, handling, receiving and storing
6. Document Controlling & Quality Record
7. Inspection and Test Plan
8. Non-Conformance Controlling
9. SUBCONTRACTOR Existing Quality Management system, verified by valid
certificate by authorized organization such as ISO ( if any)
10. Sampel of Existing SUBCONTRACTOR’s Inspection Report
Project SHE Plan

7
1. SUBCONTRACTOR’s SHE Management Organization chart

2. Rules and responsibility in SHE management
3. SUBCONTRACTOR’s Existing SHE Management system, verified by valid
certificate by authorized organization (if any)
4. Emergency Response Plan
5. Personnel Protection Equipment to be used by SUBCONTRACTOR’s manpower
including type and brand used
Page 9 of 10
No. Description
6. Safety Performance, Monitoring & Reporting Program including procedure for the
following inspection :
a. Manpower Medical Check Up before mobilization
b. Training and Safety Induction for local recruited employee
c. Pre-mobilization safety inspection for construction equipment
d. Permit to Work System
e. Job safety analysis prior commencement of the work
Technical administration
8
See Instruction to bidders for detail requirement
Technical Bid Evaluation Form

9
See section 10 ; Technical Bid Evaluation form to be filled by SUBCONTRACTOR
Commercial Form
10
See Commercial Part of this Requisition
7. ADDRESS AND CLOSSING DATE

BIDDERS shall submit the PROPOSAL to TPEC within 2 (one) week after receiving this RFP
DOCUMENTS and shall be addressed to:
PT. TRIPATRA Engineers and Constructors

Attn : FERDIANSYAH (f.ferdiansyah@tripatra.com)
Indy Bintaro Office Park

Jl. Boulevard Bintaro Jaya Blok B7/A6 Sektor VII CBD Bintaro Jaya
Tangerang Selatan 15224, Indonesia
Telp : 021-29770700 Fax : 021-29770701
Page 10 of 10
APPENDIX - 1
SPLIT OF WORK
TRIPATRA ENGINEERS & CONSTRUCTORS
Project : CL MASTERBACTH PROJECT
Client : PT CABOT ASIA PACIFIC SOUTH
Job No. : 2920
SPLIT OF WORK
No. DESCRIPTION COMPANY SUBCONT REMARKS

I GENERAL
Construction Management Servise (CMS) on behalf COMPANY to
A SITE MANAGEMENT, CONTROL AND SUPERVISION X X coordinate with entire project, SUBCONTRACTOR to manage
SUBCONTRACTOR's scope
B PERMITS
Permits from local government, local community and Related Department
1 X
such as DLLAJR and Police Department
2 Insurance X
3 Other Local Permits X
4 Taxes such as pajak galian C, retribusi daerah, & other retribution. X
5 IMB X
C MANPOWER MOB/DEMOB
1 SUBCONTRACTOR's Manpower X
2 Construction Management Servise (CMS) - Manpower X
D SAFETY EQUIPMENT
1 Personal Protective Equipment (PPE) X X
2 Fire Extinguisher X
3 Safety Sign and Barricade X
4 Others Safety Equipment Related to Support Construction X
II TEMPORARY FACILITIES
A GENERAL
COMPANY provide space only, SUBCONTRACTOR shall build &
1 Area/Space for temporary facility X
maintenance Temporary Facilities
2 Housing for SUBCONTRACTOR's Staff & Labor X
3 SUBCONTRACTOR's Office & Other Buildings X SUBCONTRACTOR to prepare and maintain
4 Warehouse and Storage X SUBCONTRACTOR to prepare and maintain
B UTILITIES
1 Water X
2 Electricity X
3 Others Utility X
4 Power Backup X
5 Fuel X
6 Temporary Fencing & Road X
7 Temporary Sewer / Drainage X
8 Demolishing of Temporary Facilities X
C GENERAL EXPENSES & SUPPLY

1 Home and office for SUBCONTRACTOR's operation X
2 Daily consumables for SUBCONTRACTOR X
COMPANY & SUBCONTRACTOR will be responsible for their own staff &
3 Security, Safety, health, environment control and medical services X X
material
4 Daily Transportation for SUBCONTRACTOR's labor to/from site X
5 SUBCONTRACTOR's office equipment and office supply X
III PROJECT CONTROL

A Execution Plan Approval X
B Working Schedule Approval X
C Construction Equipment Approval X
D Tool and Machinery Approval X
E Skilled worker Approval X
F Construction Procedures Approval X
G Reports
1 Daily Work Report Approval X
2 Weekly Work Report Approval X
3 Monthly Work Report Approval X
4 Daily Manpower Report Approval X
4 Daily Equipment Report Approval X
5 Material Status Report (Weekly and Monthly) Approval X
H Testing material & Field Inspection Approval X
I Other requested by COMPANY Approval X
J Completion of QA/QC documents Approval X
Details of Sub-vendor, from whom material will be procured, including supply
K Approval X
experience list and company profile of the Sub-vendor.
SPLIT OF WORK
No. DESCRIPTION COMPANY SUBCONT REMARKS

GENERAL
IV EXECUTION
A ENGINEERING
A.1 BUILDING WORKS
SUBCONTRACTORS shall follow and refer to Applicable Documents listed

1 Schedule, Specifications and Basic Design Drawings X
in Appendix 3
2 Detail Design Drawing X
in Appendix 3
3 Engineering Calculation & Report X
in Appendix 3
4 Construction Drawing Approval X
SUBCONTRACTOR to provide shop drawing such as bar bending schedule,

5 Shop Drawing/Cutting Plan Approval X
Window Schedule, etc.
6 As Built Drawing Approval X Subcontractor shall provide mark-up drawings.
Subcontractor shall provide testing equipment including inspector. All test

7 Inspection Approval X
equipment shall be properly calibrated with evidence of calibration certificate
issued by recognized authority
B CONSTRUCTION
B.1 BUILDING WORKS
1 Structural works (beam,Column Concrete) X

2 Sub-structure works X
3 Structural Walls construction X
4 Door & window installation X
5 Roofing system construction X
6 Masonry works X
7 Ceiling installation works X
8 Floor coverings works X
9 Ventilation & air condtioning system installation X
10 Grouting works, incl. preparation X
11 Painting & touch up painting X
12 Plumbing & sanitary works X
13 Electrial & instrumentation works X
14 Fire Fighting System / sprinkler installation X
15 Communication System installation X
APPENDIX - 2
SCOPE OF SUPPLY
SCOPE OF SUPPLY
31-6 BUILDING & ARCHITECTURAL WORKS
GENERAL SCOPE OF WORK

The main scopes of this work package are to perform interior & exterior work, electrical & instrumentation,
HVAC system, and above ground plumbing sanitary system for the following facilities:
 CCR and Office Building
 WSHE and Shipping Room
 Guard House
The scope excludes foundation work, slab floor, and underground plumbing.
APPLICABLE WORK CATEGORIES :
FWBS CODE CLMB WBS Work Description

31-6*2 218220001-200-200B-20120 Structural Frame Work
31-6*3 218220001-200-200B-20120 Substructure (wall, etc.) Work
31-6*4 218220001-200-200B-20120 Exterior & Interior Finishing
31-6*5 218220001-200-200B-20140 HVAC
31-6*6 218220001-200-200B-20150 Utility & Sanitary
31-6*7 218220001-200-200B-20160 Electrical Work
31-6*8 218220001-200-200B-20170 Instrumentation
--------------------------------------------------------------------------------------------------------------------------------------------
MATERIALS SUPPLY FORMATION
COMPANY SUBCONTRACTOR
================================================================================
1. Concrete/Soil Works
(1) Concrete - x
(2) Borrow soil - x
(3) Rebar - x
(4) Bricks - x
(5) Concrete Block Wall - x
(6) Timber - x
2. Suspended Ceiling
(1) Acoustic tile - x
(2) False ceiling frame - x
3. Floor
(1) Ceramic tiles - x
(2) Cement Mortar - x
(3) Floor Hardener - x
(4) Epoxy Floor Painting - x
(5) Anti-Static Mat - x
(6) Resilient Vinyl - x
4. Wall
(1) Gypsum Board - x
(2) Ceramic tiles - x
(3) Calcium Silicate Board - x
(4) PVC Wall Lining - x
APPENDIX - 2 Page 2 of 4
5. Door & Window

(1) Steel Doors x x
Note: COMPANY provides Rolling Doors in Main Building.
SUBCONTRACTOR provide in the CCR room/offices and other building
that in scope of CL-MB(3)-TPE-CV-RFP-5004.
(2) Panic Handles - x
(3) Stainless Steel Door - x
(4) Aluminum (Metal) Doors and Windows - x
(5) Wooden and or PVC Doors and Windows - x
--------------------------------------------------------------------------------------------------------------------------------------------
MATERIALS SUPPLY FORMATION
(5) Wood Door - x
(6) Door, Windows and glass - x
(7) UPVC - x
(8) Louvers x x
Note: COMPANY provides Louver in Main Building. SUBCONTRACTOR
provide in the CCR room/offices and other building that in scope of CL-
MB(3)-TPE-CV-RFP-5004.
(9) Glazing - x
(10) Melamine Paint - x
(11) Fabrique - x
(12) Anodized - x
(13) Melamine Paint - x
(14) Oil Paint - x
(15) Anodized - x
7. Roofing & Siding

(1) Built-up roofing - x
(2) Water proof membrane - x
(3) Translucent Glass Fiber Reinforced Plastic Roofing - x
(4) Insulation - x
(5) Metal Roofing x x
Note: COMPANY provides Metal Roofing in Main Building.
(6) Roof drains - x

(7) Concrete Slab Roofing - x
(8) Canopy x x
Note: COMPANY provides Canopy in Main Building and corridor to
existing Building. SUBCONTRACTOR provide in the CCR room/offices
and other building that in scope of CL-MB(3)-TPE-CV-RFP-5004.
(5) Fascia - x
(6) Eaves gutters - x
(7) Down spouts x x
Note: COMPANY provides Downspout in Main Building.
8. Plumbing & HVAC

(1) Circulation pump x -
(2) Sanitary fixtures - x
(3) Sanitary piping system - x
(4) Drain piping system - x
(5) Septic tank x -
(6) HVAC system - x
9. Electricity & Instrument

(1) Lighting Panel Building and Shelter - x
(2) Lighting And Small Distribution Board Building and Shelter - x
(3) Electricity Work System - x
(4) Communication System - x
(5) Fire Alarm System - x
(6) Lightning Rod - x
10. Other
(1) Painting - x
(2) Joint sealant - x
(3) Room name plates - x
Unless otherwise specified in above supply formation for materials and in relevant
specifications/drawings, all the necessary materials for this category of work shall be supplied by the
Contractor.
--------------------------------------------------------------------------------------------------------------------------------------------
MANPOWER SUPPLY FORMATION
================================================================================
1. Indirect ( Manager, Engineer, other Staff) x x

2. Direct (Foreman, Bricklayer, Blacksmith, etc.) - x
Unless otherwise specified in above supply formation for manpower, all the necessary manpower for
this category of work shall be supplied by the Contractor
--------------------------------------------------------------------------------------------------------------------------------------------
EQUIPMENT SUPPLY FORMATION
COMPANY CONTRACTOR
================================================================================
1. Heavy Equipment (Excavator, Crane, etc.) - x
Unless otherwise specified in above supply formation for equipment, all the necessary manpower for
this category of work shall be supplied by the Contractor.
APPENDIX - 3
APPLICABLE DOCUMENT
APPLICABLE DOCUMENT
No. DOCUMENT NO. TITLE REV REMARKS
ATTACHMENT 1 – SPECIFICATION AND SCHEDULE

SCHEDULE
1 CL-MB(3)-200-EL-DWG-0006 Power and Control Cable Schedule B
2 CL-MB(3)-200-IN-DWG-0001 Instrument Cable Schedule B
3 CL-MB(3)-200-PS-LST-0001 Hazardous Area Schedule B
SPECIFICATION
1 Cab000-Ci-Spc-001 Rev.0 Painting
Specification
2 CL-MB(3)-000-CV-BOD-0001 Design Basis for Civil and Structure B
3 CL-MB(3)-000-CV-SPC-0001 Design Specification for Civil, Structure B
and Architecture
4 CL-MB(3)-200-CV-SPC-0002 Specification for Plumbing B
5 CL-MB(3)-200-EL-DWG-0006 Power and Control Cable Schedule B
6 CL-MB(3)-200-EL-SPC-0001 Electrical General Specification B
7 CL-MB(3)-200-IN-LST-0003 Fire Alarm Equipment List A
8 CL-MB(3)-200-IN-LST-0004 Telecommunication Equipment List B
9 CL-MB(3)-200-IN-SPC-0001 General Specification for Instrumentation B
10 CL-MB(3)-000-MR-SPC-0001 Specification for HVAC B
11 CL-MB(3)-200-MR-DAS-0004 Data Sheet for HVAC_AWC 00
12 CL-MB(3)-200-PS-DAS-0001 MDS for FPS Hydrant 00
13 CL-MB(3)-200-PS-DAS-0002 MDS for FPS Sprinkler Spray 00
14 CL-MB(3)-200-PS-SPC-0001 Specification for Fire Protection System B
ATTACHMENT 2 – DRAWINGS
1 CL-MB(3)-200-CV-DWG-0006 Main Building Plan View and Detail A
2 CL-MB(3)-200-CV-DWG-0006 Main Building Plan View and Detail A
3 CL-MB(3)-200-CV-DWG-0016 Plumbing Layout 00
4 CL-MB(3)-252-CV-DWG-0008 Drawing for Control room & Office Floor B

Plan & Detail
5 CL-MB(4)-000-CV-DWG-0309 Standard drawing for architecture C
6 CL-MB(4)-000-CV-DWG-0313 Standard drawing for flooring C
7 CL-MB(3) -200-EL-DWG-0007 Typical Schematic Diagram A
8 CL-MB(3)-000-EL-DWG-0012 Lighting Layout A
9 CL-MB(3)-200-EL-DWG-0001 Single Line Diagrams A
10 CL-MB(3)-200-EL-DWG-0008 Electrical Equipment Layout A

Grounding Wiring Lightning Protection
11 CL-MB(3)-200-EL-DWG-0009 A
Layout
12 CL-MB(3)-200-EL-DWG-0011 Power Control Wiring Layout A
13 CL-MB-3-200-IN-DWG-0005 Telecommunication Block Diagram A
14 CL-MB-3-200-IN-DWG-0006 General layout Telecommunication A
15 CL-MB(3)-200-IN-DWG-0003 Instrument Layout Control Room B

Arrangement
16 CL-MB(3)-200-IN-DWG-0004 Fire Alarm Block Diagram A
17 CL-MB(3)-000-MR-DWG-0001 AC Equipment Layout B
18 CL-MB(3)-200-PS-DWG-0001 Firefighting Equipment Layout A
19 CL-MB(3)-200-PS-DWG-0003 Fire Detection Layout B
20 CL-MB(3)-260-CV-DWG-0010 Drawing For Guard House Floor Plan 01
21 CL-MB(3)-260-CV-DWG-0014 Drawing For Guard House, Structure 01
CL-MB(3)-000-PI-DWG-0001 Plot Plan 01
Note: The items above are attached in Appendix of this tender document.
APPENDIX - 4
SCHEDULE OF PRICE
APPENDIX - 5
SCHEDULE OF WORKS
CLIENT: CONSULTANT:
PROJECT MASTER SCHEDULE
PT CABOT ASIA PACIFIC SOUTH CL MASTERBACTH PROJECT PT. Tripatra Engineers & Constructors
RUNNING MONTH M1 M2 M3 M4 M5 M6 M7 M8 M9 M10 M11 M12 M13 M14 M15 M16

RUNNING WEEK 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
C CONSTRUCTION
1. CIVIL WORKS
Temp. Facility
Piling Works
General Civil Works
PEB Works
Building & Architectural Works
SMP Works
E&I Works
Commissioning Works
LEGEND:
CONSTRUCTION ACTIVITY START
CONSTRUCTION ACTIVITY FINISH

APPENDIX - 6
COMMERCIAL PROPOSAL
GENERAL CIVIL WORKS
COMMERCIAL PROPOSAL
PROPOSAL KOMERSIAL
1. INTRODUCTION 1. PENGANTAR
The Bidder is required to submit the Peserta Lelang harus mengajukan Proposal
Commercial Proposal, in accordance with the Komersial sesuai dengan Petunjuk kepada
Instructions to Bidders. Peserta Lelang.
The Commercial Proposal – Pricing Proposal Komersial – Informasi Harga harus

Information shall contain all the pricing berisi semua informasi harga yang
information required under Part E, and shall dibutuhkan berdasarkan Bab E, dan harus
comprise the originals of the following: berisi dokumen asli dari:
 Schedule of Prices and Rates  Schedule of Prices dan Rates
 Additional commercial information  Informasi komersial tambahan
The Bidders shall submit their Prices and Peserta Lelang harus mengajukan Harga dan
Rates based on the remark to Schedule of Tarifnya berdasarkan Keterangan Schedule
price included in this Pricing Information. of Prices yang terdapat pada Informasi Harga
ini.
2. REMARKS TO SCHEDULE OF PRICE 2. KETERANGAN SCHEDULE OF

PRICES
1. The rates and prices shall be fully 1. Tarif dan harga harus termasuk semua
inclusive of all fees, charges, duties, upah, biaya-biaya, bea cukai, pajak dan
taxes and expenses and all other costs semua pengeluaran serta semua biaya
incurred to administer the execution of the lainnya yang terjadi untuk pelaksanaan
Work including costs for the Pekerjaan termasuk biaya biaya
administration administrasi yang timbul.
2. The Commercial Proposal comprises of 2. Proposal Komersial ini meliputi

the construction Works as indicated in Pekerjaan konstruksi sebagaimana
COMPANY’s Technical Requirements – tertera pada Persyaratan Teknis
Scope of Work and the commercial COMPANY – Lingkup Pekerjaan dan
proposal shall include but not limited to Proposal komersial harus sudah
the following provision of all labour, termasuk namun tidak terbatas pada
materials, consumables, excavation, penyediaan tenaga kerja, material,
fabrication, lifting, erection, scaffolding, material habis pakai, penggalian,
construction equipment, temporary works fabrikasi, pengangkatan, pemasangan,
and everything whether of a temporary or perancah, peralatan konstruksi,
permanent nature required in and for pekerjaan sementara dan lainnya, baik
such construction, completion and defects yang bersifat sementara atau permanen,
correction so far as the necessity for yang dibutuhkan dalam dan untuk
APPENDIX -6 Page 1 of 4
GENERAL CIVIL WORKS
providing the same is specified in, or can konstruksi, penyelesaian dan perbaikan
reasonably be inferred from the kesalahan sepanjang kebutuhan untuk
Commerical Proposal Documents. menyediakan hal yang sama yang
disebutkan dalam, atau disimpulkan
secara layak dari dokumen Proposal
Komersial.
3. Pursuant to the General Terms and 3. Sesuai dengan Syarat dan Ketentuan
Conditions and Special Terms and Umum dan Syarat dan Ketentuan
Condition of SUBCONTRACT and Khusus dari SUBKONTRAK serta
Instructions to Bidders, the Subcontractor Petunjuk kepada Peserta Lelang,
is deemed to have visited the Site prior to menurut pendapat COMPANY, dengan
the submission of Tenders. No claims for mengunjungi lokasi proyek,
extra payment will be entertained where, Subkontraktor telah dianggap
in the opinion of COMPANY, a Site visit memahami dan mengerti semua
would have adequately informed the informasi yang berhubungan dengan
Subcontractor of the complexity or nature lingkup pekerjaan tentang kompleksitas
of an item of work. dari sifat dan jenis pekerjaan. Tidak
diperbolehkan adanya tuntutan apapun
untuk pembayaran tambahan atas hal
tersebut.
4. The rates and prices entered against the 4. Tarif dan harga setiap jenis item yang
items in the Schedules of Prices are the diajukan didalam Schedules of Prices
full inclusive value of the finished work adalah sudah mencakup semua dari nilai
shown on the Drawings and/or described total dari penyelesaian pekerjaan yang
or implied in the Specifications and the tercantum pada Gambar Teknis
Schedules of Prices and must cover the dan/atau dijelaskan atau tersirat di
cost of everything necessary for the Spesifikasi dan Schedules of Prices dan
proper execution, completion in harus mencakup biaya dari semua yang
accordance with the requirement of the dibutuhkan untuk pelaksanaan yang
SUBCONTRACT and defects correction benar, penyelesaian yang sesuai
of the Works and all the Subcontractor's dengan persyaratan dari SUBKONTRAK
obligations and liabilities under the dan perbaikan kesalahan dari Pekerjaan
SUBCONTRACT. dan semua kewajiban Subkontraktor dan
pertanggungjawaban menurut
SUBKONTRAK ini.
5. The rate or price entered against each 5. Tarif atau harga setiap jenis item yang
item in these Schedules of Prices is diajukan didalam Schedules of Prices ini
binding throughout the SUBCONTRACT mengikat untuk keseluruhan
and is not subject to revision on account SUBKONTRAK dan tidak akan berubah
of any discrepancies or inaccuracies in karena adanya perbedaan atau
the estimated quantities or the increase in ketidaktelitian ketika memperkirakan
prices of materials, manpower, jumlah atau kenaikan harga material,
consumables, etc., any additional tenaga kerja, material habis pakai, dll.,
compensation to supervisory or semua kompensasi tambahan untuk
operatives, any premiums or bonus paid supervisi atau biaya operasional, premi
to secure or accelerate deliveries of atau bonus yang dibayarkan untuk
GENERAL CIVIL WORKS
materials, plant, tools or equipment, mengamankan atau mempercepat

manpower, consumable etc. or any other pengiriman material, mesin industri, alat
causes. atau perlengkapan, tenaga kerja,
konsumsi, dll atau penyebab lainnya.
6. The rates or prices entered in the 6. Tarif dan harga yang tertulis didalam
Schedules of Prices are fixed and not Schedules of Prices adalah tetap dan
subject to revision irrespective of the tidak berubah dikarenakan adanya
difference of any entity (in addition or perbedaan entitas (penambahan atau
reduction) between the final quantities of pengurangan) yang terdapat diantara
work and the estimated quantities jumlah akhir pekerjaan dan perkiraan
indicated in the Tender stage. jumlah yang disebutkan pada tahap
Lelang.
7. The rates and prices shall not be subject 7. Tarif dan Harga tidak tergantung kepada
to any increase or decrease because of: kenaikan atau penurunan dikarenakan
hal sebagai berikut :
i. any error or omission by the i. kesalahan atau kelalaian
Subcontractor in estimating the cost of Subkontraktor pada saat
the work; memperkirakan biaya pekerjaan;
ii. any additional compensation paid to ii. segala bentuk kompensasi
supervisory personnel or operative; tambahan yang dibayarkan untuk
personil supervisi atau biaya
operasional;
iii. any premiums or bonus paid to secure iii. segala bentuk premi atau bonus
or accelerate deliveries of materials, yang dibayarkan untuk
plant, tools or equipment. mengamankan atau mempercepat
pengiriman material, mesin industri,
alat atau perlengkapan.
8. The rates and prices include all fees, 8. Tarif dan harga termasuk semua upah,
duties, taxes and other charges bea cukai, pajak dan ongkos lainnya
(excluding VAT) payable in accordance (tidak termasuk PPN) berdasarkan
with applicable law, including all peraturan yang berlaku, termasuk
insurance as specified in the General semua asuransi yang disebutkan pada
Terms and Conditions and Special Syarat dan Kondisi Umum dan Syarat
Conditions of SUBCONTRACT. dan Kondisi Khusus.
9. All the rates and prices are in specified in 9. Semua bentuk tarif dan harga yang
the Schedule of Price and are firm and tertulis didalam Schedule of Price adalah
fixed for the whole duration of the contract tetap selama jangka waktu kontrak atau
period or extended period. No change perpanjangan waktu kontrak. Tidak ada
due to fluctuation in exchange rate, perubahan akibat fluktuasi nilai tukar
escalation, duties, taxes, freights, mata uang, nilai mata uang, bea cukai,
changes, etc. will be entertained. pajak, ongkos kargo, perubahan, dll.
10. The Bill of Quantity shown in the 10. Jumlah Volume Pekerjaan yang tertulis
Schedule of Price is the SubContractor didalam Schedule of Price adalah
GENERAL CIVIL WORKS
quantity estimate required to complete the perkiraan jumlah volume oleh

Work, Bidder is responsible to calculate SubKontraktor untuk menyelesaikan
the required quantity as per the Scope of Pekerjaan, Peserta Lelang bertanggung
Work and all the documentation provided jawab untuk menghitung ulang jumlah
by COMPANY in this tender document yang dibutuhkan sesuai dengan Lingkup
and revised the quantity provided by Pekerjaan dan semua dokumentasi yang
COMPANY as bidder deem necessary. disediakan oleh COMPANY pada
Any deviation between actual quantity Dokumen Lelang ini dan merevisi jumlah
required to complete the Work and yang disediakan oleh COMPANY
quantity provided by Bidder in the tender apabila dianggap perlu. Apabila terjadi
document shall be solely at bidder risk. perbedaan antara jumlah aktual yang
dibutuhkan untuk penyelesaian
Pekerjaan dan jumlah yang disediakan
oleh Peserta Lelang pada Dokumen
Lelang akan sepenuhnya menjadi resiko
tanggung jawab peserta lelang
11. COMPANY gives two options Schedule 11. COMPANY memberikan 2 pilihan
Of Price to SUBCONTRACTOR and Schedule Of Price kepada
CONTRACTOR has full right to choose SUBKONTRAKTOR dan KONTRAKTOR
between two options. mempunyai hak penuh untuk memilih
antara kedua pilihan tersebut.
3. SCHEDULE OF PRICE 3. SCHEDULE OF PRICE
4. ADDITIONAL COMMERCIAL 4. INFORMASI KOMERSIAL TAMBAHAN

INFORMATION (IF ANY) (JIKA ADA)
APPENDIX 7
HSE REQUIREMENTS
FOR SUB CONTRACTORS
GENERAL CIVIL WORKS
TABLE OF CONTENT
HSE REQUIREMENTS ............................................................................................................ 1

FOR SUB CONTRACTORS .................................................................................................... 1
1. PURPOSE ........................................................................................................................... 4
1.1. Project Background ....................................................................................................... 4
1.2. Scope and Purpose ........................................................................................................ 4
2. REFERENCE DOCUMENTS ............................................................................................ 4
2.1. COMPANY Reference and Standards .......................................................................... 5
2.2. International Codes, Standards and Guideline .............................................................. 5
3. DEFINITION ...................................................................................................................... 5
4. HEALTH, SAFETY, AND ENVIRONMENTAL MANAGEMENT EXPECTATION ... 6
5. HEALTH, SAFETY, AND ENVIRONMENTAL REQUIREMENTS ............................. 6
5.1. Health, Safety, and Environmental Management Roles ............................................... 6
5.2. General Requirements ................................................................................................... 6
5.3. Health Certificate .......................................................................................................... 7
5.4. Training Requirements .................................................................................................. 8
6. HSE DOCUMENT TO BE PROVIDED DURING BID STAGE ..................................... 8
6.1. HSE Governance ........................................................................................................... 8
6.2. HSE Plan Requirements ................................................................................................ 9
6.3. HSE Performances ........................................................................................................ 9
7. HSE DOCUMENT TO BE PROVIDED UPON AWARD................................................ 9
8. SPECIFIC HSE REQUIREMENTS DURING EXECUTION PHASE ........................... 10
8.1. Project HSE Plan ......................................................................................................... 10
8.2. Leadership ................................................................................................................... 10
8.3. Emergency Preparedness............................................................................................. 10
8.4. HSE Personnel Mobilization ....................................................................................... 10
8.5. Commencement of the Work ...................................................................................... 11
8.6. Execution of the Work ................................................................................................ 12
8.7. SUBCONTRACTOR HSE Representative ................................................................. 12
8.8. Transportation ............................................................................................................. 12
8.9. Permit to Work ............................................................................................................ 13
8.10. Equipment and Tools .................................................................................................. 13
8.10.1. Package Requirements ................................................................................................ 13
8.10.2. Electrical Equipment ................................................................................................... 13
8.10.3. Lifting Devices ............................................................................................................ 13
8.10.4. Lifting Appliances ....................................................................................................... 14
8.10.5. Forklift Truck (if applicable)....................................................................................... 14
8.10.6. Special Equipment....................................................................................................... 14
Appendix -7 Page 2 of 19
GENERAL CIVIL WORKS
8.10.7. Pressurized Gas Cylinder ............................................................................................ 14

8.11. Surveillance and Inspection ........................................................................................ 15
8.12. Chemical Safety .......................................................................................................... 15
8.13. Material Packaging and Storage .................................................................................. 16
8.14. Near miss, Incident & Accident Investigation and Reporting .................................... 16
8.15. Environmental Protection ............................................................................................ 16
8.16. HSE Study ................................................................................................................... 17
8.17. Reporting and Meeting ................................................................................................ 17
8.18. HSE Audit ................................................................................................................... 17
8.19. HSE Close Out Audit .................................................................................................. 17
GENERAL CIVIL WORKS
PROJECT HSE REQUIREMENTS FOR SUBCONTRACTOR
1. PURPOSE
1.1. Project Background

PT Cabot Asia Pasific South (hereinafter referred to as the “COMPANY”) is new entity
which will build New Masterbatch Manufacturing Plant. The new asset will be located
at beside of existing carbon black unit (PT Cabot Indonesia) at Jalan Amerika I kav A-
5, KIEC,Cilegon, Banten, Indonesia. This specific project objective is to build New
Masterbatch Plant with 20,000 MT/year capacity in order to meet business demand of
masterbatch in Asia Pasific South region (part of Santa Fe project). Mechanical
completion is expected to be completed in May 2021.
1.2. Scope and Purpose

Purpose of this document is to define the minimum Health, Safety, and Environment
(HSE) requirements to be followed and applied by SUBCONTRACTORS during the
execution of the Project.
Remains as obligation for SUBCONTRACTORS to ensure that adequate safety levels
are maintained and environmental impacts are monitored throughout the project
execution.
This document collects the main HSE requirements for SUBCONTRACTORS, detailed
addressed in various COMPANY specifications and shall not release
SUBCONTRACTORS from the obligation of fully compliance with the HSE
requirements established in the Contract.
SUBCONTRACTORS who perform their subcontracted work at COMPANY’s SITE
BOUNDARIES are contractually obliged to comply with the requirements described in
this document and shall apply COMPANY’s HSE Management System.
SUBCONTRACTORS who perform their subcontracted work at their premises
(outside SITE BOUNDARIES) may apply their own HSE Management System,
ensuring it’s aligned to these requirements described in this document.
This document is to be considered a living document and it shall be updated by
COMPANY any time additional or modified requirements regarding Health, Safety,
and Environment control may arise during the project execution.
2. REFERENCE DOCUMENTS
SUBCONTRACTORS shall comply with all applicable national (i.e. where the
execution of the SUBCONTRACTOR’s scope of work is performed) laws and
regulations throughout the performance of the Contract.
Furthermore they shall comply with all the applicable HSE regulations and
requirements contained in the following, but not limited, reference documents.
GENERAL CIVIL WORKS
In case of conflict between the requirement contained in this document with the
reference rules, codes, and standards; the following order of priority shall apply:
1. Applicable Indonesian Laws and Regulations;
2. Contractual HSE Documents;
3. COMPANY Reference and Standards;
4. International Codes and standards;
5. Best Practice, Industry Guidelines, and Standards.
The reference codes and standards for each activity are listed in the relevant
specifications.
Unless otherwise specified, reference is made to the latest edition of the relevant rules
and standards.
2.1. COMPANY Reference and Standards

This plan covers HSE management that applicable for project where the operation
consists of engineering, procurement and construction.
2.2. International Codes, Standards and Guideline

- OHSAS 18001:2007 “Occupational Health and Safety Management System”
- ISO 14001:2015 “Environmental Management System–Requirement with Guidance
for Use”
3. DEFINITION
COMPANY PT Cabot Asia Pacific South
CONSULTANT PT Tripatra Engineers and Constructors
Project CL MASTERBACTH PROJECT
Site Boundaries Perimeter of the working area (not necessarily geographic)
where CONTRACTOR has the responsibility to set HSE
Standard and directly supervise & enforce their application.
SUBCONTRACTOR General term to define companies providing services to
COMPANY on the basis of a contract, where COMPANY has
the responsibility to set the HSE standards or to ensure that
SUBCONTRACTOR’s HSE Management System is in line
with COMPANY’s HSE Management System
GENERAL CIVIL WORKS
4. HEALTH, SAFETY, AND ENVIRONMENTAL MANAGEMENT

EXPECTATION
COMPANY Management is committed to achieving the goal of Zero Incidents on this
Project. We recognize that by achieving this goal, our employees will receive the
benefit of a safe and healthful workplace during work execution.
This standard can only be achieved through the determination and dedication of all
involved COMPANY and SUBCONTRACTOR employees.
It is a core value at all operation activities. COMPANY and SUBCONTRACTOR shall
apply these values throughout all phases of the work.
5. HEALTH, SAFETY, AND ENVIRONMENTAL REQUIREMENTS

The main rules, which govern the COMPANY – SUBCONTRACTOR relationship on
the subject of HSE related aspects are established in the following chapters.
5.1. Health, Safety, and Environmental Management Roles

SUBCONTRACTOR shall work with COMPANY in its capacity and will support
COMPANY’s desire to positively promote HSE Management.
The requirement for SUBCONTRACTOR to comply with these Guidelines does not
alter SUBCONTRACTOR’s status as an independent SUBCONTRACTOR, does not
change the rights or obligations SUBCONTRACTOR has as an independent contractor,
and does not amend or restrict SUBCONTRACTOR’s liabilities and indemnities
provided in this Contract. All costs associated with compliance are included in the
compensation provided for under this Contract, and SUBCONTRACTOR has no right
to claim any additional payment not specifically provided for in this Contract because of
the requirement for compliance with these Guidelines
SUBCONTRACTOR shall communicate these Guidelines as part of
SUBCONTRACTOR’s HSE Plan, prepared as appropriate, to its employees prior to
entering project area. SUBCONTRACTOR shall maintain written documentation of its
actions undertaken to fulfill these responsibilities and maintain a copy of such on site.
SUBCONTRACTOR shall provide COMPANY with the name of its
SUBCONTRACTOR Representative who are responsible for HSE protection and
implementation of SUBCONTRACTOR’s Plan in the project.
COMPANY or its representatives may inspect the performance of the srvices in the
project at any time to determine compliance with these requirements and prescribe
measures to SUBCONTRACTOR to achieve compliance. SUBCONTRACTOR shall
implement steps to achieve compliance with these requirements.
5.2. General Requirements

The general HSE requirements that SUBCONTRACTOR must comply with are the
following, but not limited to:
GENERAL CIVIL WORKS
 SUBCONTRACTOR shall have in place (or adopt COMPANY Policy) and apply
its own HSE Policy that demonstrates its commitment to HSE within all its business
activities and subcontracted scope of work. This Policy statement has to be dated
and signed by the top management.
 SUBCONTRACTOR shall have in place and apply its own HSE Management
System for subcontracted activities, which should describe the elements, principles,
and objectives used in implementing its own HSE policy. SUBCONTRACTOR
HSE Management System should include audits of HSE related aspects and shall be
aligned with COMPANY HSE Management System.
 SUBCONTRACTOR is contractually obliged to observe and comply with all
currents applicable legislative requirements and additional specific HSE
Requirements (if any) for this scope of work and all other requirements provided by
COMPANY.
 SUBCONTRACTOR shall, at its own costs, provide sufficient number of trained
qualified personnel who will responsible to provide guidance and advice regarding
HSE matters.
 SUBCONTRACTOR shall have a ‘Drug and Alcohol Policy’ for the work and
communicate the requirements of the policy to all personnel during the HSE
induction. In addition, SUBCONTRACTOR shall conduct random drug and alcohol
test on its employees throughout the duration of the contract.
 SUBCONTRACTORS shall develop the HSE Risk Assessment related to the
activities to be performed during the execution of the subcontracted scope and
submitted it to COMPANY for approval.
 SUBCONTRACTOR shall maintain the communication with COMPANY
Representatives in dealing with all HSE issues.
 SUBCONTRACTOR shall participate in the activities performed by COMPANY
related to HSE issues, such as: Kick-Off Meeting, HSE Regular Meeting, etc.
5.3. Health Certificate

 SUBCONTRACTOR must provide for all its personnel utilized during the Services,
a Health Certificate as proof of their fitness for their respective tasks in relation to
the Services. The said Certificate must be presented to COMPANY’s assigned
representative and also given to its HSE Team (Health Coordinator) on site (if any)
prior to their actual involvement in the Services.
 The Certificate shall include those examinations in compliance with national laws
governed by the Country where the Services are to take place.
 The minimum medical examination/check-up are the following:
1. Pre-employment check up
- Blood and urine
- Health certificate from local doctor/hospital
2. Annual check-up
- At minimum held annually as referring to Kepmenaker Per.2/Men/1980
regarding Employee Health Check
GENERAL CIVIL WORKS
 COMPANY’s representative have right to refuse SUBCONTRACTOR’s personnel

if not in possession of valid certification.
5.4. Training Requirements

 SUBCONTRACTOR working within SITE BOUNDARIES must follow and attend
COMPANY’s employee orientation program, which includes instructions given to
each new employee, regardless of prior experience. The induction shall be given to
employees prior to start work. A record of this training is to be kept and individuals
are to sign on completion, confirming they are fully conversant with the
instructions.
 SUBCONTRACTOR’s employees have to be trained to those subjects pertaining to
local realities/threats/HSE risk factors, in compliance with their professional
position, and scheduled so as to provide a sufficient number of First Aid trained
personnel continuously available on site.
 COMPANY shall conduct the required assistance, supervision, checks, and
training for the workers capability to ensure the workers are able to proceed
with the work in the safest manner and safest conditions, and as an effort to prevent
accident COMPANY has a right on SUBCONTRACTOR risk to refuse any
personnel who is proven not have adequate competency for performing his work
6. HSE DOCUMENT TO BE PROVIDED DURING BID STAGE

During Bid Phase, SUBCONTRACTOR is required to provide details of his approach
to HSE. To this aims the following evidence have to be provided together within its
offer.
6.1. HSE Governance

 SUBCONTRACTOR working within SITE BOUNDARIES must follow and attend
COMPANY’s employee orientation program, which includes instructions given to
each new employee, regardless of prior experience. The induction shall be given
within the first day of reaching the facility. A record of this training is to be kept
and individuals are to sign on completion, confirming they are fully conversant with
the instructions.
 Submit a copy of HSE Policy.
 Submit a copy of HSE Management System Manual.
 Copy Organization Chart and Project Organization Chart, specifying the number
and the appointment of HSE Personnel.
 Provide details of employee’s orientation program and HSE training program.
 Arrangement for provision and upkeep of PPE, both standard issue and that
required for specialized activities.
 Provide details of how do you ensure that plant and equipment used within your
premises, sites or other locations by your employees are correctly registered,
controlled, and maintained in a safe working condition.
GENERAL CIVIL WORKS
6.2. HSE Plan Requirements

 In accordance with activities to be performed, submit your proposal of Project HSE
Plan that is in compliance with this document and HSE local and international
legislation. The HSE Plan shall address at least the following, but not limited to
items:
- HSE Objectives
- Project HSE Organization and Responsibilities
- Communication System
- HSE Induction and Training
- Risk Management
- Accident/Incident Investigation and Reporting
- Emergency Response Procedure
- HSE Inspection and Audit
- List of HSE Procedures applicable to the scope of work
 Provide details of your Company system for planning, approving, and performing
HSE Audits.
 Provide details if the managers and supervisors at all levels, which will plan,
monitor, oversee, and carry out the work, received formal HSE training in their
responsibilities with respect to conducting work from HSE requirements standpoint.
6.3. HSE Performances

Provide a list of the last 5 (five) years HSE performance statistics within
SUBCONTRACTOR organization. The list should indicate the number of Fatality,
Worked Man-hours, Lost Time Injury (LTI), Lost Time Injury Frequency Rate
(LTIFR), TRIR (Total Recordable Injury Rate) in 1,000,000 worked Man-hours,
Restricted Work Day Cases, Medical Treatment Cases, First Aid Cases, Occupational
Health Diseases, and Near-Misses.
7. HSE DOCUMENT TO BE PROVIDED UPON AWARD

Upon Contract Award, the SUBCONTRACTOR is required to provide, within 30
(thirty) days, the following information and supporting documentation:
a. Project HSE Plan dedicated to the subcontracted activities.
b. Specific HSE Risk Assessment covering the subcontracted activities.
c. HSE Procedures, comprising all the appropriate procedures for the subcontracted
activities.
d. Emergency procedures, covering all the emergency situations that could arise from
the specific of the subcontracted activities.
e. Training program, dedicated to the subcontracted activities.
GENERAL CIVIL WORKS
8. SPECIFIC HSE REQUIREMENTS DURING EXECUTION PHASE
8.1. Project HSE Plan

SUBCONTRACTOR shall develop, implement, and maintain its HSE Plan in which
describes specific details as to how it intends to manage HSE throughout all phases of
the work.
8.2. Leadership
SUBCONTRACTOR shall encourage all its members to monitor the unsafe acts or
unsafe conditions throughout the course of the work. Where an employee identifies or
observes an unsafe act or situation, work shall be stopped, reported and/or remedied as
appropriate. It is everyone’s right and responsibility to intervene (i.e. SWA Policy)
when safety is being compromised in order to be safe, look after the safety, and well-
being of others.
This mechanism establishes the responsibility and authority of any individual to stop
work when the control of HSE risk is not clearly established or understood. In general
terms, the intervention process involves a stop, notify, correct, and resume approach for
the resolution of a perceived unsafe condition, act, error, omission, or lack of
understanding that could result in an undesirable event.
8.3. Emergency Preparedness

 SUBCONTRACTOR shall be responsible for the development and implementation
of Emergency Response Plan (ERP), ensuring that the contents of ERP are properly
communicated at all workers. In addition, the principal information shall be
displayed in strategic location of the working area and a specific communication
flowchart (between SUBCONTRACTOR and COMPANY) shall be developed and
submitted for approval to COMPANY.
 SUBCONTRACTORS shall appoint adequate trained personnel for the Emergency
and First Aid Teams (i.e. first aid, fire-fighting, confined space rescue, etc.),
according to the applicable local legislation (i.e. 1 First Aider per 25 workers), as
well as performing adequate drills.
8.4. HSE Personnel Mobilization

 As per contractual requirements, SUBCONTRACTOR shall communicate their
HSE Plan and any other significant HSE aspects of the Contract to all key personnel
assigned to the job. Progress meetings shall then be used as a formal method of
reviewing HSE implementation.
 SUBCONTRACTOR shall appoint the following qualified personnel for each
worksite:
GENERAL CIVIL WORKS
Requirements
HSE Lead 1 (one) qualified HSE Lead for each worksite
HSE Officer 1 (one) qualified HSE Officer per 50 workers
First Aider 1 (one) trained First Aider per 25 workers
8.5. Commencement of the Work

 SUBCONTRACTOR, before the actual commencement date, shall carry out and
provide to the COMPANY a site survey to assess working, safety, environmental,
and health conditions, to identify hazards and to optimize the lay-out of his
equipment and premises.
 SUBCONTRACTOR shall ensure that the Specific HSE Risk Assessment covering
subcontracted activities shall be completed and approved by COMPANY and no
outstanding actions prior to perform the activities.
 SUBCONTRACTOR shall ensure that the site emergency plans are updated and
available.
 SUBCONTRACTOR shall ensure the medical organization and health facilities
provided at the site are able to ensure an effective first aid, medical assistance, and
medical emergency response, and that occupational health requirements are
compiled for according to COMPANY HSE Standards.
 SUBCONTRACTOR shall ensure that training certificates for personnel scheduled
to work or appointed for safety critical jobs are made available to the COMPANY
upon request.
 SUBCONTRACTOR shall provide their personnel and visitors with all items of
equipment and clothing necessary for the safe and healthy conduct of the job;
training or induction sessions on their use shall be conducted and competence or
awareness assessed.
 SUBCONTRACTOR shall provide PPE for all SUBCONTRACTOR’s personnel in
accordance with best practice, SNI, or other recognized international standards.
 The following Mandatory PPE must be supplied to each worker as a minimum:
- Safety helmet
- Safety shoes
- Safety glasses
- Safety gloves
- Working clothing (coverall)
- Additional PPE must be available at each work site and issued to specific task
workers such as welders, grinders, painters etc.
- Additional PPE for preventing pandemic situation, such as face mask.
GENERAL CIVIL WORKS
8.6. Execution of the Work

 SUBCONTRACTOR shall ensure all relevant information regarding HSE aspects
of the worksite and the contracted job are properly communicated to each
employees and handed over from shift to shift and at the time of the periodical
reliefs of the COMPANY’s Representative on site (if any).
 SUBCONTRACTOR shall ensure the permit-to-work system has been established
before any hazardous work and that these works are assigned to qualified personnel
only.
 Throughout the execution of the contracted job, SUBCONTRACTOR shall provide
and maintain in good operating conditions, all safety critical equipment identified in
HSE risk assessment, all lights, guards, marks, signals, and fences.
 SUBCONTRACTOR shall be responsible for disposal of all waste (according to the
applicable environmental laws) from any source under his care, custody or control
and generated through the execution of the subcontracted scope, as well as to keep
detailed records of waste generation, transfer and disposal.
8.7. SUBCONTRACTOR HSE Representative

To ensure that all applicable COMPANY’s HSE policies and rules are
implemented:
 SUBCONTRACTOR shall ensure HSE Organization & Responsibilities for the
subcontracted scope are defined in their HSE Plan;
 SUBCONTRACTOR shall appoint a full time SUBCONTRACTOR'S HSE
Representative, this requirement will depend on the complexity of the
subcontracted scope;
 He/she shall have clear responsibilities and duties;
 He/she shall be a competent personnel and hold relevant certificates;
 He/she shall coordinate all HSE aspects at SUBCONTRACTOR's activities and
coordinate with COMPANY Representative;
 A training program shall be established for SUBCONTRACTOR’s HSE
representative, if required.
8.8. Transportation
 SUBCONTRACTOR shall ensure all relevant information regarding HSE aspects
of the worksite and the contracted job are properly communicated to each
employees and handed over from shift to shift and at the time of the periodical
reliefs of the COMPANY’s Representative on site (if any).
 SUBCONTRACTOR’s HSE Representative shall ensure all personnel who use or is
involved in transportation shall comply with all relevant regulations, policy,
procedure, and standards for transportation.
 SUBCONTRACTOR shall ensure all transportations to be used in the PROJECT
are properly assessed and adequate preventative maintenance is scheduled.
GENERAL CIVIL WORKS
8.9. Permit to Work

SUBCONTRACTOR may use its Permit to Work system, as well as its HSE
Management System, upon agreement and approval with COMPANY.
8.10. Equipment and Tools

 All equipment brought to the SITE BOUNDARIES by SUBCONTRACTOR must
be in a safe operating condition and no potential for environmental damage.
 The equipment or tools, based on the local regulation or industrial best practice,
shall be certified for fit for use.
 COMPANY retains the right to conduct inspection to any equipment without
necessarily giving prior notice.
 SUBCONTRACTOR’s equipment must be operated only by proper licensed and/or
competent Personnel.
 All SUBCONTRACTOR’s equipment shall not exceed noise level of 85 dBA at the
point source. If noise levels below 85 dBA cannot readily be achieved,
SUBCONTRACTORS shall implement controls to reduce personnel exposure to 85
dBA or less.
8.10.1. Package Requirements

SUBCONTRACTOR shall ensure all pressure vessels, tanks, and containers brought
onto any site are in good condition and have appropriate and current test certificates
and comply with the requirements of all relevant legislation, regulations, Standards or
codes of practice.
8.10.2. Electrical Equipment

SUBCONTRACTOR shall ensure all portable electric equipment used is in good
condition and complies with the requirements of all relevant legislation, regulations,
Standards or codes of practice.
8.10.3. Lifting Devices

 SUBCONTRACTOR shall ensure adequate preventative maintenance is
scheduled for all lifting devices to maintain them in a safe condition.
 SUBCONTRACTOR shall ensure all lifting devices under its direct or indirect
control are registered and certified and that all operators (i.e. riggers, banksman)
hold valid certificates of competency.
 COMPANY has right to verify and hold copy of personnel certificate.
 SUBCONTRACTOR shall ensure that all cranes are in good condition and are
given a safety inspection prior to mobilization. The reports shall be forwarded to
COMPANY Representative.
GENERAL CIVIL WORKS
 All identified corrective actions shall be completed prior to mobilization and

supporting documentation attached to the report.
 Logbooks detailing all inspections, maintenance, calibration, and repairs are to
be maintained for all lifting devices
8.10.4. Lifting Appliances

 SUBCONTRACTOR shall ensure all lifting appliances have appropriate and load
test certificates, comply with the requirements of all relevant legislation,
regulations, Standards or codes of practice.
 SUBCONTRACTOR shall ensure all lifting appliances are in good condition and
undergone an inspection program.
 All identified corrective actions shall be completed prior to mobilization and
supporting documentation attached to the report.
 SUBCONTRACTOR shall maintain logbooks detailing all inspections,
maintenance, and repairs for all lifting appliances.
8.10.5. Forklift Truck (if applicable)

 SUBCONTRACTOR shall ensure all forklifts to be used are properly assessed
and adequate preventative maintenance is scheduled.
 SUBCONTRACTOR shall maintain logbooks detailing all inspections,
maintenance, and repairs for forklifts.
8.10.6. Special Equipment

 SUBCONTRACTOR shall ensure all special equipment’s used are properly
assessed and adequate preventative maintenance is scheduled.
 SUCONTRACTOR shall ensure all special equipment must be accompanied with
detailed operating and maintenance manual together with the codes and standards
to which the equipment has been designed and built. Any applicable certificate of
the origin or test certificates must also be provided. This type of equipment
includes, but is not limited to:
- All pipework, vessels, valves and any other equipment to be used under
pressure.
- All electrical and other equipment requiring certification for use in hazardous
areas (Classified Areas).
8.10.7. Pressurized Gas Cylinder

 Pressurized gas cylinders or any dangerous substances will not be accepted upon
delivery unless all the stipulations have been met.
 Any delays caused by rejection due to non-compliance will be at
SUBCONTRACTOR's sole cost.
GENERAL CIVIL WORKS
 All pressurized gas cylinders to be used in the agreement are required to comply
with the following:
- Color coded according to content.
- Content printed clearly on each cylinder body
- Proper label shall be attached to the cylinders
- Each valve must be sealed and provided with a protective cap
- Cylinder must be transported upright in custom built cradles
- Copies of cylinder test certificate shall be provided and have at least one (1)
year before expiry (5 years).
- The expiry date of cylinders must be clearly stamped on each cylinder.
- All electrical and other equipment requiring certification for use in hazardous
areas (Classified Areas).
8.11. Surveillance and Inspection

 CONTRACTOR and COMPANY reserves the rights to control and monitor
SUBCONTRACTOR’s activities through meetings, surveillance, and inspections.
 SUBCONTRACTOR shall allow and assist CONTRACTOR Representatives in:
- Access to any document relevant to contract;
- Access to any work site where contractual activities are carried out;
- Attendance of any meeting, inspection, and formal test session relevant to the
contract and conducted under SUBCONTRACTOR’s responsibility
8.12. Chemical Safety

 All chemicals or other dangerous substances to be used for the performance of the
Service or delivered to the Site Boundaries are required to be suitably handled,
sealed, packaged, clear identification of the substance contained and prominent,
hazard warning signs, label and placard. The label shall conform to Globally
Harmonized System (GHS).
 SUBCONTRACTOR shall provide suitable and specific place for chemical
substance.
 SUBCONTRACTORS shall provide the Material Safety Data Sheet (MSDS) for
chemicals or similar products provided by SUBCONTRACTOR in performance of
the Service.
 Handling and storage of dangerous goods shall be in accordance with all relevant
legislation, regulations, Standards or codes of practice.
 All SUBCONTRACTOR’s Personnel who handle these chemicals shall be trained
on the hazards and proper handling of this chemical including personal protective
equipment required to perform the job.
 Chemical, (including fuel, engine oil, chemical cleaning, etc.) storage and handling
shall have a secondary containment adequate for any potential spillages.
 Spill control kit shall be provided close to chemical storage and handling.
GENERAL CIVIL WORKS
 SUBCONTRACTOR shall record the manifest of hazardous waste disposal in

compliance with local regulation
8.13. Material Packaging and Storage

 At mobilization SUBCONTRACTOR shall ensure that all equipment and materials
are properly packed, stacked, crated and/or palletized, or provided in certified
transit basket, or pre-slung with certified wire rope slings as necessary for safe and
secure handling of said equipment and materials. Pallets used should be adequately
strong for the load and have no damage.
 Dangerous goods packaging shall comply with applicable regulations for air and
water transportation. It should have proper label and placards.
 Drums to store chemicals or oils shall be in good condition and provided with
secondary containment and stack away from edges of the drilling unit where it can
spill directly into the sea.
 Drums should have properly labels and signs Drums that are punctured, excessively
rusty, dented and or broken rims shall not be used.
8.14. Near miss, Incident & Accident Investigation and Reporting

 SUBCONTRACTOR shall implement and adhere to the COMPANY incident and
accident investigation & reporting procedure that will be communicated upon
contract award.
 SUBCONTRACTOR shall notify COMPANY immediately (within 24 hours) of
any HSE incidents that occur in the performance of the services.
 An incident includes any actual or potential instances of Asset damage, Personnel
injury or illness, or Environmental impact (spillage, etc.).
 SUBCONTRACTORS shall implement a system to report, analyze, and remedy
HSE related events.
 COMPANY retains the right to conduct independent investigation on serious
accident, i.e. fatality, serious injury, lost time accident, community conflict,
environmental damage or spillage.
8.15. Environmental Protection

 SUBCONTRACTORS are required to identify significant environmental impacts
from its operations and implement controls to eliminate or minimize these impacts
and submit to the COMPANY.
 SUBCONTRACTOR shall develop waste management plan and submit to
COMPANY for approval.
 Waste management plan shall comply with Indonesian regulation on Hazardous
Waste PP 101/2014 and PERMENLH no 14/2013 “Hazardous Waste Symbol and
Labeling”.
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 SUBCONTRACTOR shall implement secondary containment policy on any point

of potential accidental discharge. If this is not impractical, then a method to contain
or prevent accidental discharge to the environment shall be established.
 SUBCONTRACTOR shall assume all liability for the control and removal of
pollution or contamination of the land or water arising from spills, leaks or
discharge of fuels, lubricants, motor oils, paints, coatings, solvents, ballasts, bilge,
garbage, sewage and other material in SUBCONTRACTOR's possession and/or
control.
8.16. HSE Study

SUBCONTRACTOR shall be available, upon COMPANY’s request, to attend the
relevant HSE Studies (i.e. HAZID, HAZOP, SIL, Risk Assessment, etc.) and they will
be responsible to implement any action assigned to them.
8.17. Reporting and Meeting

SUBCONTRACTOR shall provide detailed HSE statistics report (Leading and Lagging
Indicators) by filling Monthly HSE Report (please see the sample in the last page) and
submit the report to COMPANY on monthly basis not later than the 5th working day of
the following month.
8.18. HSE Audit

COMPANY reserves right to conduct HSE audits on SUBCONTRACTOR’s
equipment and working procedures at any time or HSE performance going to adverse
trend, upon previous notification given 7 (seven) days in advance. At the time of such
audits of the HSE System, SUBCONTRACTORS will provide to COMPANY any
assistance necessary to allow checking of the used organizational HSE procedures, their
efficiency and adequacy to work methods, machinery, equipment, and legal regulations.
8.19. HSE Close Out Audit

SUBCONTRACTOR, after completion of the services, shall issue all the
documents/information stated in:
 Contract Documents,
 Technical Documentation
 HSE Data
The work cannot be considered as completed until the above has been received.
The report shall include the HSE Statistics, HSE programs and activities during the
services
Monthly Report Form Sample
MONTHLY SHE PERFORMANCE REPORT
MONTHLY PROJECT SHE PERFORMANCE REPORT
Project :
Job No. :
Periode : (cut off date is the last Friday of the reported month)
A. Industrial Injury
This Month Overall Project
No Description Remarks
Jkt Site Sub-Cont Total Jkt Site Sub-Cont Total
1 Fatalities *) (Number)
2 LTI's *) (Number)
3 Days Lost (Day)
4 MTC (Number)
5 RWDC(Number)
6 First Aids (Number)
7 Near Misses (Number)
8 Work Hours (Manhours)
9 LTI R (number / 1 mio mhr)
10 TRIR (number /200 000 mhr)
B. Accident
No Description This Month Total Overall Project Remarks
Jkt Site Sub-Cont Total Jkt Site Sub-Cont Total
1 Equipment Accident
a. Number
b. Operating hour
c. Frequency
= a x 100,000
b
2 Construction Vehicle accident
a. Number
b. Km driven
c. Frequency
= a x 1,000,000
b
3 Support Vehicle accident
a. Number
b. Km driven
c. Frequency
= a x 1,000,000
b
4 Environmental accident
(number)
Note : Construction Vehicle : Heavy transportation vehicle such as, Dumptruck, trailler truck.
Support Vehicle : Employee's transportation, such as minibus (kijang, panther), bus, etc.
Equipment : Excavator, motor grader, vibro, dozer, etc.
C. List of Accident
No Date Type of Accident Project Description
D. Activities
This Overall
Project This Year
Month Project
Induction
Total Need
% Completed
Other SHE Training
Total Need
% Completed
Action Management
Total Action
% Completed
Medical examination
Total required
% Completed
Inspection and Audit
Total Finding
% Completed
Housekeeping
% average score
please provide the detail attached to this report
Prepared by, Approved by,
Project SHE Leader Project Manager

Date:…………………………… Date:……………………………
Distribution :
- SHE Corporate
- Project SHE File
Note: the report shall be submitted to corporate on the 3rd day of the following month reported at the latest
Definitions :
A. 1 Work-related fatality
A. 2 Lost Time Injury (LTI) - w here more than one (1) schedule w ork days are lost
A. 3 Total Day lost related to the LTI
A. 4 Medical Treatment Case (MTC) - w here medical/doctor treatments required
A. 5 Restricted Work Day Case (RWDC) - w here employees are assigned w orking duties other than normal to fully recover from a
w orkplace incident
A. 6 First Aid - eg. Treatment administrated by a first and or from first aid kit
A. 7 Near Miss - w here no injuries/property damage occurred but could have if circumstances w ere slightly different
A. 8 The total number or w ork-related hours.
A. 9 Lost time Injury Frequency = (2) multiplied by 1,000,000 divided by (8)
A. 10 Total Recordable Case Frequency = (2) + (4) + (5) multiplied by 200,000 devided by (8)
*) Include the detail of accident chronologist
APPENDIX 8
QA/QC REQUIREMENTS
OF
ENGINEERING, OPERATION, INSTALLATION SERVICES
FOR SUB CONTRACTOR
GENERAL CIVIL WORKS
TABLE OF CONTENTS
TABLE OF CONTENTS 2
1. PURPOSE 3
1.1 PROJECT BACKGROUND 3
1.2 SCOPE AND PURPOSE 3
2. REFERENCE DOCUMENTS 3
3. DEFINITION 4
4. RESPONSIBILITY 4
5. QUALITY ASSURANCE REQUIREMENT 4
6. QUALITY AUDIT REQUIREMENTS 5
6.1 COMPANY AUDITS 5
6.2 SUBCONTRACTOR AUDITS 6
7. SERVICE REALIZATION (FOR INSTALLATION AND OPERATION SERVICES) 6
7.1 PERSONNEL QUALIFICATION 6
7.2 TOOL & MEASURING EQUIPMENT 7
7.3 MATERIAL USED 8
7.4 PLANNING, SCHEDULING AND REPORTING 8
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1. PURPOSE
1.1 PROJECT BACKGROUND
PT Cabot Asia Pasific South (hereinafter referred to as the “Cabot”) is new entity which will
build New Masterbatch Manufacturing Plant. The new asset will be located at beside of
existing carbon black unit (PT Cabot Indonesia) at Jalan Amerika I kav A-5, KIEC,Cilegon,
Banten, Indonesia. This specific project objective is to build New Masterbatch Plant with
20,000 MT/year capacity in order to meet business demand of masterbatch in Asia Pasific
South region (part of Santa Fe project). Mechanical completion is expected to be completed
in May 2021.
1.2 SCOPE AND PURPOSE
This document defines the quality requirement for the following services:
 Engineering services cover for Engineering Study Services (Safety studies, Electrical
studies, architect use studies, dynamic simulation etc.) and HSE Study services
(HAZID, HAZOP, SIL);
 Operation services cover for Construction study services (Constructability ITM
Methodology, Load out ITM Methodology) and Commissioning (Leak test, lube oil
flushing, chemical cleaning, flange management, load test, and WIN Pcs training);
 Installation Services cover to Berthing, Load out execution, expediting and inspection,
towing tug services, providing crew boat services, catering services etc.
2. REFERENCE DOCUMENTS
2.1 Standard Reference
[1] ISO 9000 : 2005 Quality Management System – Fundamentals and
Vocabulary
[2] ISO 9001 : 2015 Quality Management System – Requirements
[3] ISO 10005 : 2005 Quality Management System – Guideline for Quality
Plan
[4] ISO 10006:2003 “QMSs Guidelines for quality management in
projects”
[5] ISO 19011:2011 “Guidelines for quality and/or environmental
management systems auditing”
2.2 Company Reference
[1] Nil
2.3 Consultant Reference

[1] WI-COR-QA-004 Project Quality Plan
[2] WI-COR-QA-009 Model of Quality Control Plan for Field
[3] WI-COR-QA-002 Control of Records
GENERAL CIVIL WORKS
3. DEFINITION
 COMPANY PT Cabot Asia Pacific South
 CONSULTANT PT TRIPATRA ENGINEERS & CONSTRUCTORS
 SUBCONTRACTOR Organization, to whom any part of the construction,
fabrication and installation has been subcontracted by
COMPANY.
 Quality Management Coordinated activities to direct and control an organization
System (QMS) with regard to quality
 Quality Control COMPANY standard documents containing minimum
Requirements (QCR) requirements for Quality Control activities at Site.
Regardless of specific contract/COMPANY obligations, the
QCR include ITP and inspection FORMs to be customized
and improved with contractual obligations when QCR is
transformed into Project QCP.
 Quality Control SUBCONTRACTOR standard documents containing
Specifications (QCS) minimum requirements for Quality Control activities at Site.
Regardless of specific contract/COMPANY obligations, the
QCR include ITP and inspection FORMs to be customized
and improved with contractual obligations when QCR is
transformed into Project QCP.
 Quality Control Plan Project document to manage inspection activities, derived
(QCP) from SUBCONTRACTOR QCR/QCS and integrated with
all specific contract/COMPANY obligations.
 Quality Assurance (QA) Part of quality management focused on providing
confidence that quality requirements will be fulfilled.
 Quality Control (QC) Process to verify that the product complies with
requirements. It is ensured by an organization not directly
involved in Product realization.
 Non Conformity Report Document recording a non-fulfilment of a requirement.
(NCR)
 Non Conformity The non-fulfilment of specified requirements.
4. RESPONSIBILITY
• COMPANY Project Team has the responsibilities to control and supervise that
SUBCONTRACTOR complies with the Quality requirements expressed in this
document and in the other contractual documentation issued for the Project.
• SUBCONTRACTOR is responsible for the implementation and management of the
work process for Quality Assurance and Quality Control relevant to his work scope on
the Project and in particular to apply the Quality Requirements expressed in this
documents and in the Contractual documentation issued for the Project.
5. QUALITY ASSURANCE REQUIREMENT

SUBCONTRACTOR shall be responsible for establishing and implementing its own
Quality Management System (QMS) conforming to the requirements of ISO 9001:2008
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Quality Standard, implemented within COMPANY Scope of Supply framework.

SUBCONTRACTOR will be responsible for implementing the adequate actions as to
provide and to maintain such Quality Management System (QMS) up to the closure of the
contract.
COMPANY reserves the right of inspecting SUBCONTRACTOR’s Quality Management
System at any time for the overall duration of the contract may assess the compliance with
specified quality requirements.
If any part of the SUBCONTRACT is sub-contracted, the Tier-Subcontractor shall also
comply with the requirements of this specification. SUBCONTRACTOR, however, shall
remain ultimately responsible for the Quality Management System (QMS) implemented in
the contract.
The SUBCONTRACTOR Quality Management System shall include all control/ inspection/
testing personnel and equipment required to assure conformance of the Supply or the Work
to the contract, as well as the governing specifications and standards. SUBCONTRACTOR
shall appoint an adequate number of competent Quality Assurance, Inspection (Quality
Control), and Verification Personnel as to ensure an adequate Quality Management in the
execution of the contract.
COMPANY reserves the right of auditing Vendor’s Quality Management System at any
time for the overall duration of the contract to assess the compliance with the specified
quality requirements. Such right is extended also to tier-vendors, as deemed necessary.
SUBCONTRACTOR shall carry out a proper contract review process to be sure that all
contractual requirements and relevant documentation have been received, analyzed,
reviewed, and/or accepted. Appropriate records of this review shall be kept and available for
review during COMPANY’s audits and inspections.
6. QUALITY AUDIT REQUIREMENTS
6.1 COMPANY AUDITS

In general, extent of COMPANY surveillance is indicated in the respective Quality Control
Plan marked-up and approved by COMPANY.
Notwithstanding the above, COMPANY personnel may perform any additional audit on
SUBCONTRACTOR and involved tier-vendors Quality Management System, Supply and
Work as deemed necessary.
The SUBCONTRACTOR shall provide unrestricted access and suitable assistance to
representatives of COMPANY at any location where the supply is being performed, in order
to carry out audits of technical execution and quality.
COMPANY shall give seven (7) days notice to SUBCONTRACTOR of its intention to
carry out a scheduled COMPANY audit, giving at least details of the audit subject,
documents and procedures, SUBCONTRACTOR personnel to be involved, COMPANY
personnel to be involved, and expected duration of the audit.
GENERAL CIVIL WORKS
6.2 SUBCONTRACTOR AUDITS

SUBCONTRACTOR shall manage, audit and assess all activities and phases of the Supply
so as to ensure performance in accordance with the quality requirements of this document
and the approved Quality Control Plan, included the activities subcontracted.
SUBCONTRACTOR shall maintain a fully operational Project Auditing System in place,
complete with Project Audit Plan (at least for internal audits system) and will implement on
a regular basis.
COMPANY will ensure by mean of inspections and Audit that SUBCONTRACTOR has
implemented his own Audit Plan, and review relevant Audit results.
SUBCONTRACTOR shall maintain a summary log of all Non Conformities and Corrective
Action Requests raised during Internal and External audits.
7. SERVICE REALIZATION (FOR INSTALLATION AND OPERATION SERVICES)

This section covers for the following services:
 Loadout Execution;
 Berthing;
 Expediting and Inspection;
 Commissioning Services (Leak test, lube oil flushing, chemical cleaning, flange
management, load test).
7.1 PERSONNEL QUALIFICATION

SUBCONTRACTOR shall provide the Organization Chart for the execution of the
Subcontract, highlighting the relevant responsibilities and authorities. Organization Chart
will clearly indicate independent and dedicated quality assurance and quality control
functions, including clear reference to their communication and reporting lines. Even though
separated, Quality Control functions will maintain communication line with production
functions and will maintain full authority and decisional freedom with reference to quality
related matters.
All personnel appointed by the SUBCONTRACTOR to perform the activities within the
contract shall be properly qualified, trained, experienced and certified (if required by
applicable standards), in all the aspects of the activities for which they are employed. They
shall have previous experience on similar Subcontracts of an equivalent extent and be
formally qualified on the relevant matters.
SUBCONTRACTOR shall ensure to COMPANY the right to review the relevant Personnel
Qualifications, in accordance with COMPANY contractual and standard requirements as
specified. COMPANY will review such qualifications to ensure that compliance with
relevant requirements is met. In case a qualification will not comply, COMPANY has the
right to ask SUBCONTRACTOR personnel replacement. It will be SUBCONTRACTOR
responsibility to replace personnel that has not been accepted by COMPANY.
The SUBCONTRACTOR shall appoint sufficient Quality Assurance/Quality Control
personnel as to ensure that the Quality Management System, Quality Assurance, and Quality
Control/Inspections are carried out and maintained throughout the duration of the Purchase
GENERAL CIVIL WORKS
Order or the Subcontract, including those relevant to material or service furnished by its
Tier-Subcontractors.
The Quality Assurance and Quality Control Personnel shall be based at the location where
the Work is carried out, they shall not be involved into the execution process of the Work
and they shall have no other duties or responsibilities, unless prior approval in writing is
granted by COMPANY.
Where elements of Quality Control are part of the responsibilities of workers involved into
the execution process, the SUBCONTRACTOR shall identify independent verification
requirements and provide adequate coverage.
The SUBCONTRACTOR is required to document, or to carry out specifically requested
qualifications of personnel performing special processes, according to applicable related
standard/rules. SUBCONTRACTOR shall furthermore verify/ensure the proper qualification
of tier-subcontractors personnel in charge of special processes and guarantee availability of
relevant documentation/certificates in case of COMPANY’s inspection.
7.2 TOOL & MEASURING EQUIPMENTS

It is responsibility of the SUBCONTRACTOR to define the methodology for the correct
management of the measuring instruments, their calibration and relative calibration
certificates.
Subcontractor shall be responsible for drafting a list of the instruments necessary to the
development of the operating activities. This list will be inserted in the Quality Control Plan.
Instrument Calibration Status Log shall contain information regarding, when applicable:
 instrument type;
 manufacturer;
 serial number;
 type of calibration;
 instrument uncertainty/resolution/measuring range ad declared by the calibration
certificate;
 reason for calibration: certificate expired, damages or out of calibration, calibration not
adequate to the purpose, first calibration, second calibration and etc.;
 last calibration date;
 calibration certificate expiry date;
 eventual remarks.
Responsible personnel shall manage the Instrument Calibration Status Log in order to take
adequate actions to maintain under control the Instruments Status.
The measuring instruments shall be identified by a serial number. On each instrument, there
shall be personnel responsible for placing an identifying label reporting, when applicable:
 Serial number;
 Reference number of the calibration certificate;
 Calibration date;
 Expiry date of the calibration.
GENERAL CIVIL WORKS
7.3 MATERIAL USED

A Procurement Plan containing all materials shall be prepared by SUBCONTRACTOR,
showing adequate control and monitoring of the purchasing activities. Such plan shall
contain, as a minimum, the list of all the items purchased, the purchase orders reference
numbers, the names of the tier-vendors and the planned and actual delivery dates.
SUBCONTRACTOR shall give evidence to have under control its procurement activities
also in terms of monitoring of progress status of the purchased items, to give confidence that
planned delivery dates will be respected.
SUBCONTRACTOR shall be responsible to qualify and control its Tier-Subcontractor and
to provide COMPANY with relevant documentation/information. SUBCONTRACTOR
shall guarantee and give evidence of its own quality control activities on purchased items.
COMPANY may decide to perform its own inspections and/or surveillance of the material
purchased by the SUBCONTRACTOR.
Tier-Subcontractor control activities shall be carried out pursuant the same provisions
described for the SUBCONTRACTOR control activities; the related Quality Control Plans,
once reviewed and marked-up by the respective SUBCONTRACTOR shall be submitted to
COMPANY for approval and mark-up of intervention points.
7.4 PLANNING, Scheduling and Reporting

SUBCONTRACTOR shall issue a specific Project Master Plan (or Execution Schedule) that
clearly indicates the list of the activities and the relevant planned start and completion dates
and mile stones (e.g. project breakdown structure). Each item of the activities list shall be
clearly linked to the relevant Quality Control Plans, to allow a complete traceability of the
production and inspection status. Such plan shall also include the activities assigned to tier-
subcontractors or refer to their relevant plans.
SUBCONTRACTOR shall submit to COMPANY a Project Progress Report showing, for
each activity, the actual status of the project and relevant criticalities, including photos of the
produced items. Such reporting shall be issued on a monthly basis or according to other
agreed frequencies in the contract or during the kick off meeting.
Quality Document Requirement
The following lists of documents shall constitute a minimum set of quality document to be
submitted with the bid.
BID Document to be provided with the Bid
In case of certified Quality Management System -ISO 9001 certificates
In case of non-certified Quality Management System -Top Management
statement with the commitment to adhere to ISO 9001 and actual
specification requirements within SUBCONTRACTOR scope of work.
Typical Project Quality Plan
Typical Quality Control Plan
GENERAL CIVIL WORKS
The following lists of documents shall constitute a minimum set of quality document to be
submitted upon the Contract award.
CONTRACT AWARD Document to be provided within agreed date
Project dedicated Quality Plan
Detailed Quality Control Plan(s) including applicable standard forms and
quality records
Applicable QC and traceability procedures
Project Organization Chart
For simple service (towing tug, crew boat, welder test, etc.) SUBCONTRACTOR shall
provide copy of ISO 9001 certificate during bid only.
APPENDIX - 9
SPECIFICATION
APPENDIX - 10
DRAWINGS

Building & Architectural Works RFP

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Building & Architectural Works RFP

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CL MASTERBATCH PROJECT

REQUEST FOR PROPOSAL

Client : PT Cabot Asia Pacific South

00 04-05-2020 Issued For Information GAP MST CAW N/R

1.2 Project Data 3

2.2 Scope of Work 4

3. VALIDITY PROPOSAL ...............................................................................................7

APPENDIX 1 – SPLIT OF WORK

APPENDIX 2 – SCOPE OF SUPPLY

APPENDIX 3 – APPLICABLE DOCUMENT

APPENDIX 4 – SCHEDULE OF PRICE

APPENDIX 5 – SCHEDULE OF WORK

APPENDIX 6 – COMMERCIAL PROPOSAL

APPENDIX 7 – HSE REQUIREMENTS FOR SUBCONTRACTOR

APPENDIX 8 – QAQC REQUIREMENTS FOR ENG OPERATION INSTALLATION

APPENDIX 9 - SPECIFICATION AND SCHEDULE

1.2 Project Data

Name of Owner : PT CABOT ASIA PACIFIC SOUTH

2.1 Scope of Suppl y

2.2 Scope of Work

RFP Number RFP Items Scope

Bidders shall quote the appointed Work Package under CL-MB(3)-TPE-CV-RFP-5004.

FWBS CODE CLMB WBS Work Description

4. The following shall be deemed to be within this scope of work:

4. REFERENCE DOCUMENTS ATTACHED TO THIS REQ UISITION

Appendix 2 – Scope Of Supply

Appendix 3 – Applicable Document

Appendix 4 – Schedule Of Price

Appendix 5 – Schedule of Work

Appendix 6 – Commercial Proposal

Appendix 7 – HSE Requirements For SUBCONTRACTOR

Appendix 8 – QAQC Requirements For Eng Operation Installation Services Sub

Appendix 9 - Specification And Schedule

5. DEVI ATION(S) FROM PU RCHASER’S REQUIREMEN T

6. DOCUMENT TO BE SUBMI TTED BY VENDOR IN TH E PROPOS AL

2 Proposed SUBCONTRACTOR’s Project Organization

At minimum This Document shall clearly describe the following item:

1. Proposed Project Organization

3 Proposed Detailed Construction Schedule

At minimum This Document shall clearly describe the following item:

1. Duration of the detailed work breakdown structure

4 Execution Plan/Work Methodology

At minimum, This Document shall clearly describe the following item:

9. SUBCONTRACTOR’s Typical Temporary Facility Layout

At minimum, This Document shall clearly describe the following item:

1. SUBCONTRACTOR Direct Manpower Recruitment Plan including security &

SUBCONTRACTOR shall provide commitment and plan on maximizing the use of

Project QA/QC Plan

1. SUBCONTRACTOR Quality Management Organization chart

Project SHE Plan

1. SUBCONTRACTOR’s SHE Management Organization chart

Technical Bid Evaluation Form

7. ADDRESS AND CLOSSING DATE

PT. TRIPATRA Engineers and Constructors

Indy Bintaro Office Park

BUILDING & ARCHITECTURAL WORKS

No. DESCRIPTION COMPANY SUBCONT REMARKS

4 Taxes such as pajak galian C, retribusi daerah, & other retribution. X

C GENERAL EXPENSES & SUPPLY

III PROJECT CONTROL

BUILDING & ARCHITECTURAL WORKS

No. DESCRIPTION COMPANY SUBCONT REMARKS

A.1 BUILDING WORKS