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Ms. D. D. AGUDA Head Procurement Management Department National Grid Corporation of the Philippines Ground Floor, NGCP Main Building Quezon Avenue corner BIR Road Diliman, Quezon City 1104 PHILIPPINES Gentlemen: In response to your letter of invitation, the undersigned respectfully submits our application for the following NGCP procurement requirements: a) ______________________ b) ______________________ c) ______________________ We enclose herewith the duly filled-up Accreditation Forms, statements, and documents for your evaluation and we attest that these documents are true and correct. Also attached for your reference is my authority to sign this application and for NGCP to verify all our submitted documents. In the event of changes in our legal, financial conditions, etc., we shall submit the corresponding documentation to update our application. Should you need any clarification on our application, please feel free to contact us. Very truly yours,
Signature: Name: Designation/Position: Telephone: Date:
C - Application Letter and Accreditation Form
Accreditation Form Registered Name of Firm Date Established Address Country Note: All communications shall be sent to the above address.Application Letter and Accreditation Form Page 2 . Postcode Telephone number/s E-mail Address/es Facsimile number/s Web Site/s Share in Ownership (%) Majority Owner Minority Owner 1 Minority Owner 2 Minority Owner 3 Minority Owner 4 Nationality Percentage Ownership (%) Members of the Board/Top Officials Nationality Position C .
Organization Expiry Date 2. E-mail Tel no.CONTACTS Name 1. E-mail Company Details 1. 2a Subsidiary Company Names Address & Country Number of Employees 2b 2c Note: Please provide a copy of the corporate structure or indicate “N/A” if not applicable. 2. if any.Application Letter and Accreditation Form Page 3 . E-mail Tel no. Organization Expiry Date Note: Please give details of any trade memberships/affiliations that your company holds. Finance Mobile no. Parent Company Name Address & Country Number of Employees 2. Administration Position Contact Details Tel no. 3. TRADE ORGANIZATIONS (membership/s) 1. Mobile no. Technical Mobile no. Organization Expiry Date 3. C .
Copy of Philippine Contractors Accreditation Board (PCAB) License of Filipino contractors and other appropriate licenses. Letter authorizing NGCP to verify all submitted documents REPRESENTATIVE OFFICE IN THE PHILIPPINES (if any.Please provide the following documentary requirements: 1. whichever is applicable. partnership or cooperation. Valid joint venture agreement (if applicant is a joint venture) or other similar agreements 6. 2.Application Letter and Accreditation Form Page 4 . 5. Telephone number/s E-mail Address/es Facsimile number/s Web Site/s LIAISON COMPANY (if any) Name of the Firm/Company Address Telephone number/s E-mail Address/es Facsimile number/s Web Site/s C . 3. 4. whichever may be appropriate. or the equivalent in the country of a foreign applicant. including amendments thereto. for foreign company) Name of the Firm/Company Address Note: The facilitating contact address for communications. if any. Copy of valid and current mayor’s permit/municipal license issued by the Philippine Government or its equivalent in the country of a foreign applicant. Copy of Department of Trade and Industry (DTI) business name registration or SEC registration certificate issued by the Philippine Government. whenever applicable. Copy of articles of incorporation.
2. No.FINANCIAL INFORMATION Applicant Year 1 a. Copies of the audited financial statements of the applicant and the parent company for the last three (3) years. Current Assets d.Application Letter and Accreditation Form Page 5 . If no parent company.: INSURANCE INFORMATION Employers Liability Insurance All Risk Marine Cargo Insurance (Ocean and Inland) Contractor’s All Risk Insurance Third Party Liability Insurance Workmen’s Compensation Insurance INSURANCE COMPANY TAXPAYER CLASSIFICATION VAT-registered contractor/supplier Non-VAT contractor/supplier Tax Exempt Please indicate and submit proof C . Current Liabilities Note: Please provide the following documentary requirements: 1. Copy of Taxpayer’s Identification Number (TIN) issued by the Bureau of Internal Revenue.: Name of the Bank: Address & Tel. Inventories e. Philippines for Filipino applicants. Total Liabilities Net Equity c. Parent Company (if applicable) Year 3 Year 1 Year 2 Year 3 Year 2 BANK INFORMATION Name of the Bank: Address & Tel. Total Assets b. if applicable. please state “N/A”. No.
SUBSTATION 3. Copies of Certificates of Completion/Acceptance issued by the client 3. etc. indicate the scope of work. the voltage level. 2. other substation equipment. Owner & Address Date Awarded Date Completed Percentage Completed Contract Amount COMPLETED & ON-GOING CONTRACTS SIMILAR IN NATURE SUPPLIER’S PRODUCT LINE FOR THE LAST 10 YEARS (FOR MRO) Title of Contract Owner & Address Date Awarded Date Completed Percentage Completed TO THE Contract Amount 1. Copies of Contracts/Purchase Orders 2. 3. TRANSMISSION LINES 2. Use additional sheets if necessary. 3. please give details) C . the number of steel towers and steel poles. the number of power circuit breakers.Application Letter and Accreditation Form Page 6 . For Transmission Lines. etc. associated equipment (disconnect switches.COMPLETED & ON-GOING CONTRACTS SIMILAR IN NATURE FOR THE LAST 10 YEARS (FOR PROJECTS/MAJOR EQUIPMENT) Title of Contract 1. For Substation. 2. OTHERS Please provide the following documentary requirements: 1. indicate the scope of work. the circuit-km.. please give details) Has your company suffered a deduction for liquidated and ascertained damages in respect of any contract in the last 3 years? Yes / No (If yes. In case of major equipment. copies of three (3) Certificates of Satisfactory Operation for at least three (3) years issued by the client/s Has your company had any contracts terminated in the last 3 years? Yes / No (If yes. power transformers. OTHERS Notes: 1. instrument transformers and surge arresters). the voltage level.
please give details) Do you have any claim/s or litigation against your organization including those that are outstanding. 7. For Substation Projects 1. which relate to contracts performed? Yes / No (If yes.Application Letter and Accreditation Form Page 7 . or has been included in the Consolidated Blacklisting Report issued by the Government Procurement & Policy Board (GPPB)? Yes / No (If yes. 2. 6. 5. Equipment for other Projects Capacity Owned Leased Fabricated Note: Please indicate the quantity of equipment in the respective boxes and provide registration or proof of ownership/contract to lease C . 3. office or corporation (including LGUs). Puller and Tensioner 2. 6. Truck Trailer 3.Has your company been blacklisted by any government agency. 4. please give details) EQUIPMENT RESOURCES Construction Equipment For Transmission Line Projects 1. Flat Truck 4. Dump Truck 5.
please give details) Note: Please provide the resumé of your technical staff including copies of professional licenses SUB-CONTRACTOR APPRAISAL (if applicable) Do you use Sub-Contractors? Please give details of how you assess the technical competence of the companies/individuals with whom you place contracts. please give details) Do you provide training programs for your employees? Yes / No (If yes. Names of Personnel available for Engineering Project (if applicable) Designation Project Manager Electrical Engineer Civil Engineer QA/QC Engineer Safety Engineer Others Name Years of Experience Education/License Names of safety/environment personnel Safety personnel Environment personnel Are your officers related to any employee of NGCP within the third degree of consanguinity or affinity? Yes / No (If yes.Application Letter and Accreditation Form Page 8 . How do you communicate client’s requirements and instructions? Does your insurance include sub-contractors liabilities? Please encircle Yes No Separate Sheet Yes No C .MANPOWER RESOURCES Permanent Full-time Temporary/Agency/ Casual/Contractual Part-time Full-time Part-time Management Supervisors Sales personnel Production/Technical/Engineering personnel QA/QC personnel Administrative/Support personnel Others Note: Please state the number of staff currently directly employed by your company.
Warranty Policy/After sales service policies and procedures Yes / No (If yes. Are there any court actions and/or industrial tribunal hearings outstanding against your organization? 2. Has your organization been involved in any court action in relation to trade with third parties or with employees and/or involved in industrial tribunals over the last 3 years? Yes / No (If yes. please give details) Yes / No (If yes. please give details) Yes / No (If yes. OHSAS/OSHA certificate TRADING AND EMPLOYMENT COURT ACTIONS 1.Application Letter and Accreditation Form Page 9 . DENR permits/certifications 5. ISO 9000/9002 QMS or equivalent Quality Management 2. ISO 14000 or equivalent/environment programs 4. Insurance Policy against losses or damages C .QUALITY MANAGEMENT (Please submit the following) 1. ISO 18000 or equivalent/health and safety programs 3. please give details) OTHER REQUIREMENTS 1. please give details) 2.
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