Form.

Ref: MGB C&E-TCP-04 Form 01

MGB CONSTRUCTION & ENGINEERING SDN BHD
Effective. Date : 18-01-2021

Rev : 9
SUB–CONTRACTOR’S REGISTRATION FORM Page 1 of 9

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Experienced contractors with proven track record and strong financial backing are invited to register as our sub-
contractor:

1. This form is to be completed, signed and stamped with company chop.

2. To be accompanied with company profile, certificate input, licenses from relevant authorities and
other relevant documents.

3. Information furnished is for reference and verification purposes for sole use of MGB Construction &
Engineering Sdn Bhd.

4. If there is insufficient space, please enclose additional sheet.

5. All information furnished will form a basis for sub-contractor evaluation by MGB Construction &
Engineering Sdn Bhd.

************************************************************************************************************************

Please tick the relevant category of work to be registered.

Piling Works
Infrastructure Work ( including earthworks)
Building Works (including Tiling & Roof works)
Landscaping Works
Specialist Works
Others. Please specify ………………………………………
 Form. Ref: MGB C&E-TCP-04 Form 01
MGB CONSTRUCTION & ENGINEERING SDN BHD
Effective. Date : 18-01-2021

Rev : 9
SUB–CONTRACTOR’S REGISTRATION FORM Page 2 of 9

A. COMPANY BACKGROUND

Company Name: _______________________________________________________________________

Name of PIC : Hand phone: ___________________________

Mailing Address :

Telephone No. : Fax No. : Email: ____________________

Year Established: _____________________________ Total Staff: _____________________________

Paid-Up Capital : Authorized Capital: _______________________

Type of Company: Sole Proprietor Private Limited Partnership Other ……….

Trade / Work Scope:

Licensing / Registration Authority (please tick whichever is applicable)

PKK SIRIM JBE

JKR BOMBA OTHERS
PAM CIDB
TNB JKKP

Note: Please attach relevant certificates.

B. FINANCIAL DATA
Information on Bank / Financial Institution
(Please provide company bank statements for the last year)

Name of Bank Branch/Address Account No. Name of Account Holder

 Form. Ref: MGB C&E-TCP-04 Form 01
MGB CONSTRUCTION & ENGINEERING SDN BHD
Effective. Date : 18-01-2021

Rev : 9
SUB–CONTRACTOR’S REGISTRATION FORM Page 3 of 9

C. EQUITY
Equity Participation

(a) Bumiputra (B) : % (b) Non-Bumiputra (NB): % (c) Foreign/Non Malaysian : %

D. BOARD OF DIRECTOR / TOP MANAGEMENT

1) Board of Directors / Top Management
Name I.C. No. / Race / Academic Designation
Passport No. Citizen Qualification

2) Please provide : a) Form 24 b) Form 49 c) Company Profile d) Organization Chart

E) QUALITY MANAGEMENT SYSTEM (Please tick )

1) Do you have a Quality, Health, Safety and Environmental Yes No

Management System?
a) If `yes’, how long has it been implemented? Months / years.
b) Please attach the valid certificate of registration.
c) Who is your certification body? _____________________________
d) Do you have an inspection and test plan for your scope of work? Yes No
e) Do you have a system to control non-conforming work? Yes No

f) Do you calibrate your inspection, measuring and testing equipment Yes No

as and when required ?

g) Does your company carry out regular plant and machinery Yes No
servicing/ maintenance ?

2) Please indicate your Quality, Health, Safety and Environmental System Standard:

ISO 9001: 2015 EMS 14001: 2015

ISO 45001: 2018

 Form. Ref: MGB C&E-TCP-04 Form 01
MGB CONSTRUCTION & ENGINEERING SDN BHD
Effective. Date : 18-01-2021

Rev : 9
SUB–CONTRACTOR’S REGISTRATION FORM Page 4 of 9

F. LIST OF PLANT, MACHINERY AND EQUIPMENT

Please provide the particulars of Plant / Machinery / Equipment Owned by your company.

Type, Model, Make, Capacity / Size Nos. for Current Book Age Remarks
Each Value
 Form. Ref: MGB C&E-TCP-04 Form 01
MGB CONSTRUCTION & ENGINEERING SDN BHD
Effective. Date : 18-01-2021

Rev : 9
SUB–CONTRACTOR’S REGISTRATION FORM Page 5 of 9

G. LIST OF MANAGEMENT / HQ STAFF AND SITE STAFF

Please submit C.V. of Personnel
Name I.C. No./ Race / Academic Designation KWSP
Passport No. Citizenship Qualification No.
 Form. Ref: MGB C&E-TCP-04 Form 01
MGB CONSTRUCTION & ENGINEERING SDN BHD
Effective. Date : 18-01-2021

Rev : 9
SUB–CONTRACTOR’S REGISTRATION FORM Page 6 of 9

H. LIST OF COMPLETED PROJECT FOR THE PAST FIVE (5) YEARS:

Job Title Client Value Year Completed

 Form. Ref: MGB C&E-TCP-04 Form 01
MGB CONSTRUCTION & ENGINEERING SDN BHD
Effective. Date : 18-01-2021

Rev : 9
SUB–CONTRACTOR’S REGISTRATION FORM Page 7 of 9

I. LIST OF CURRENT PROJECTS :

Job Title Client Value Completion Date

 Form. Ref: MGB C&E-TCP-04 Form 01
MGB CONSTRUCTION & ENGINEERING SDN BHD
Effective. Date : 18-01-2021

Rev : 9
SUB–CONTRACTOR’S REGISTRATION FORM Page 8 of 9

J. DECLARATION

I/We, the undersigned, hereby confirm that all particulars stated herein are precise, true and to the best of my
/ our knowledge.

Signature Company Stamp

Name : I.C. No. :

Designation : Date :

Note:

Completed forms and others relevant documents are to be filled and to be submitted in a sealed envelope to:-

MGB CONSTRUCTION &ENGINEERING SDN BHD

Tender & Contract Department
H6, Sunway PJ@51A
Jalan SS9A/19, Seksyen 51A,
47300 Petaling Jaya, Selangor Darul Ehsan.

Tel: 03- 7874 5888 Fax: 03 – 7874 5889

K. PERSONAL DATA PROTECTION ACT

I/We _____________________ have read the Personal Data Protection Notice provided by MGB
Construction & Engineering Sdn Bhd (A subsidiary of MGB Berhad) pursuant to Section 7 of Personal Data
Protection Act 2010, which includes purposes for which my personal data is collected/processed and classes
of third parties to whom MGB Construction & Engineering Sdn Bhd may disclose my personal data to. I hereby
give consent to MGB Construction & Engineering Sdn Bhd to process my personal data in accordance with the
Personal Data Protection Notice. I also hereby warrant that I have obtained all necessary consent from the third
party where I have provided their personal information as part of my application.

Signature Company Stamp

Name : I.C. No. :

Designation : Date :
 Form. Ref: MGB C&E-TCP-04 Form 01
MGB CONSTRUCTION & ENGINEERING SDN BHD
Effective. Date : 18-01-2021

Rev : 9
SUB–CONTRACTOR’S REGISTRATION FORM Page 9 of 9

L. EVALUATION ( FOR CONTRACT DEPARTMENT USE )

Item Criteria / Rating 1 - Poor 2-Good 3- Very Good 4- Excellent

1 Track Record

2 Pricing Criteria

3 Technical Experience

4 Manpower

5 QMS / EMS / OHSMS / QHSEMS

6 Plant / Machinery

Total Score

M. RECOMMENDATION FOR APPROVAL

Recommended for ASCL : Yes No

Comments: …………………………………………………………………………………………………………

Signature : ______________________ Date : ______________________

Designation : HOD, Contract Name : _______________________

Checked By :

Comments : …………………………………………………………………………………………………………

Signature : ______________________ Date : ______________________

Designation : QHSEMR Name : _______________________

Approved By :
Comments: …………………………………………………………………………………………………………

Signature : ______________________ Date : ______________________

Designation : Deputy CEO Name : _______________________