Standard Consulting Firm Registration Form*

* This form is prepared by the Arab Fund for Economic and Social Development along the lines of the equivalent form recommended by the International Federation of Consulting Engineers (FIDIC)

Agency: Consulting Firm Registration Form Date (Month, Day, Year)

1. Firm Name (firm to be registered)

Year Estab.

State or Country Indiv.

Type of Organization Partshp. Corp. Other

1a. Affiliated Firms

2. Home Office(s) Business Address(es), Telephone No., Cable Address, Telex No. Offices or Partners to be contacted

3. Former Firm Name(s), if any, and year established

4. Firm Ownership

5. Present Branch Office(s) and year established, Address, Telephone No., Cable Address, Telex No., Person in Charge

(continue on additional page if necessary)

Date

Name of Firm

Page 1 of 8

6. Number of personnel in your present organization(s) listed in 1 and 1a

Architects Civil and Structural Engineers Electrical Engineers Mechanical Engineers Construction Management Economists Operations & Management Specialists Others (Specify) Others (Specify)

Surveyors

Estimators

Inspectors

Technicians & Draftsmen

Administration & Clerical

Specification Writers

Others ( Specify)

Others (Specify)

Total

7. Annual Volume of gross fees (last 5 years) in US $ (per 1 and 1a) Prime Consulting Firm 19 19 19 19 19 $ $ $ $ $ Associate and Joint Venture Total

Financial rating or bank reference

Total 8. Largest Projects handled by firm as prime consultant in major fields only Show name of project, type of service, client reference and engineers level of effort Level of effort to be classified as follows: Class 1- Fee less than US$ 100,000 or 20 man months Class 2- Fee from US$ 100,000 to US$ 500,000 or from 20 man months to 100 man months Class 3- Fee from US$ 500,000 to US$ 1,000,000 or from 100 man months to 200 man months Class 4- Fee over US$ 1,000,000 or over 200 man months

(continue on additional page in necessary)

Date

Name of Firm

Page 2 of 8

9. Partners, directors, officers, and key personnel of firm Name and Title Degree(s) Years with Firm Year of Birth

(add curriculum vitae showing experience, professional affiliation and language capability)

(continue on additional page if necessary)

Date Name of Firm Page 3 of 8

10. Fields of specialization of permanent full-time staff (Check Appropriate Items)

Agricultural and natural resources

A-1 Farm Mechanization A-2 Field and Horticultural Crops A-3 Fisheries A-4 Forestry and Forest Products A-5 Irrigation and Flood Control A-6 Land and Water Feasibility Studies A-7 Land Reclamation and Soil Conservation A-8 Livestock A-9 Marketing and Credit A-10 River Regulation and Control A-11 Storage Facilities Others (Specify) A-12 A-13 A-14

Public utilities and related fields (continued)

C-9 Housing C-10 Industrial Utilities C-11 Marina Terminal Facilities C-12 Mining C-13 Nuclear Energy C-14 Parking Facilities C-15 Power Stations C-16 Power Transmission and Distribution C-17 Solid Waste Management C-18 Buildings C-19 Telecommunications C-20 Wastewater Collection, Treatment and Disposal C-21 Water Supply and Distribution Others (Specify) C-22 C-23 C-24 C-25 C-26 C-27

Industry (continued)
D-21 Steel and Iron Worlds D-22 Textiles D-23 Timber Processing Others (Specify) D-24 D-25

Architectural and related fields

E-1 Conservation E-2 Educational Facilities E-3 Factories and Buildings E-4 Parks E-5 Social and Low Cost Housing E-6 Urban Development and City Planning E-7 Zoos Others (Specify) E-8 E-9

Transport
B-1 Airports and Air Transport B-2 Bridges B-3 Bus Transport Facilities B-4 Highways and Road Transport B-5 Pipelines B-6 Public Transport B-7 Rapid Transit B-8 Railroads B-9 River and Sea Transport B-10 River-, Seaports and Harbors B-11 Subways B-12 Tunnels Others (Specify) B-13 B-14 B-15

Economic planning and related fields

F-1 Accounting and Auditing F-2 Economic Impact Statements F-3 Economic Policy F-4 Energy Conservation F-5 Finance F-6 Foreign Trade F-7 Marketing F-8 Organization and Management of Public and/or Private Enterprises F-9 Regional Development Planning Others (Specify) F-10

Industry D
D-1 Agricultural Products and Food Processing D-2 Bricks and Tiles D-3 Cement Works D-4 Ceramics D-5 Chemical Plants (including Petrochemicals, Fertilizers, Plastics) D-6 Coal D-7 Fish Processing D-8 Foundries D-9 Glass Plants D-10 Hides and Leather Processing D-11 Industrial Estates D-12 Machinery Plants D-13 Materials Handling D-14 Metallurgical D-15 Mineralogy D-16 Non-ferrous Processing Plants D-17 Oil D-18 Pharmaceutical Plants D-19 Pulp and Paper D-20 Rubber

Public utilities and related fields

C-1 Air Pollution Control C-2 Cartography C-3 Dams C-4 Drainage C-5 Electrical Installations C-6 Gas Installations and Transmissions C-7 Heating, Ventilating, AirConditioning C-8 Hospitals

Tourism
G-1 Hotel Development G-2 Resort Development Others (Specify) G-3 G-4

Date

Name of Firm

Page 4 of 8

11. Types of services A. Advisory Services B. Aerial Photography C. Architectural D. Computer Services E. Construction Management F. Design of Machinery and Equipment G. Economic Studies H. Engineering Design, Estimating, Preparation of Contrast Documents, Bid Evaluation I. Environmental Studies J. Farm Extension Services K. Geological Surveys L. Geophysical Surveys M. Hydro-Geology N. Hydrological Surveys O. Industrial Process Engineering P. Machine Processing of Engineering Data Q. Management Studies R. Market Surveys S. Mineral Surveys, Photo Interpretations T. Mineral Exploration U. Oceanography V. Operation and Maintenance

W. Planning Studies X. Project Management Y. Purchasing, Inspection and Testing of Materials and Equipment Z. Resources Surveys Z-1 Rate Studies and Appraisals Z-2 Sector Studies Z-3 Soils Engineering, Foundation Engineering and Design Z-4 Supervision of Construction or Equipment Installation Contracts Z-5 Testing and Inspection Z-6 Topographical and Soil Surveys Z-7 Technical Feasibility Studies and Preliminary Engineering Z-8 Traffic Studies Z-9 Value Analysis Others (Specify) Z-10 Z-11 Z-12 Z-13 Z-14 Z-15

Date

Name of Firm

Page 5 of 8

12. Countries in which work performed within past 10 years (Check Appropriate Countries) Afghanistan Equatorial Guinea Lesotho Albania Ethiopia Liberia Algeria Fiji Libya Argentina Finland Liechtenstein Australia France Luxembourg Austria Gabon Madagascar Bahamas Gambia (The) Malawi Bahrain Germany (Dem. Rep. Of) Malaysia Bangladesh Germany (Fed. Rep. Of) Maldives Barbados Ghana Mali Belgium Greece Malta Benin (Dahomey) Grenada Mauritania Bhutan Guatemala Mauritius Bolivia Guinea Mexico Botswana Guinea-Bissau Monaco Brazil Guyana Mongolia Bulgaria Haiti Morocco Burma Holy See Nepal Burundi Honduras Netherlands Byelorussian USSR Hungary New Zealand Cameroon Iceland Nicaragua Canada India Niger Central African Rep. Indonesia Nigeria Chad Iran Norway Chile Iraq Oman China Ireland Pakistan Colombia Israel Panama Congo Italy Paraguay Costa Rica Ivory Coast Peru Cuba Jamaica Philippines Cyprus Japan Poland Czechoslovakia Jordan Portugal Denmark Kenya Qatar Dominican Rep. Korea (Rep of) Romania Ecuador Kuwait Rwanda Egypt Khymer Republic San Marino (Cambodia) El Salvador Laos Saudi Arabia Lebanon Senegal

Sierra Leone Singapore Somalia South Africa Spain Sri Lanka Sudan Swaziland Sweden Switzerland Syria Tanzania Thailand Togo Trinidad and Tobago Tunisia Turkey Uganda Ukraine USSR United Arab Emirates United Kingdom United States Upper Volta Uruguay Venezuela Vietnam Western Samoa Yemen Yugoslavia Zaire Zambia Others (Specify)

Date

Name of Firm

Page 6 of 8

13. Narrative Description of Firm

(continue on additional page if necessary) As of this date The foregoing is a true statement of facts

Name of firm submitting questionnaire

Typed name and title of person signing

Signature

Date

Name of Firm

Page 7 of 8

14. Typical projects for which consultant services have been furnished during past five years (Reference sheets may be submitted for as many projects as desired. Sheets should include at least one project in each field of specialization checked in Item 10 and each type of service checked in Item 11) Name of overall project: Location of overall project: Engineers level of effort: (For classifications see Section 8) Owners name and address: Year firms services completed (indicate if estimated or actual): Associated firms: Description of project

(firm may submit as many pages as necessary) Description of services firm provided:

List all fields of experience (by symbols from Item 10) for associated aspects of overall project

List all types of services (by symbols from Item 11) for associated aspects of overall project

Date

Name of Firm

Page 8 of 8