Eligibility and Qualification Criteria Compliance Requirements Document/ Form No. Subject Requirement Single Entity Joint Venture (existing or intended) Submission Requirement All Members Combined Each Member One Member 1. Eligibility 1.1 Nationality Nationality in accordance with ITA 4.5 Must meet requirement Must meet requirement Must meet requirement N/A Forms ELI – 1.1 and 1.2, with attachments 1.2 Conflict of Interest No conflicts of interest in accordance with ITA 4.6 Must meet requirement Must meet requirement Must meet requirement N/A Application Submission Letter 1.3 Bank Eligibility Not having been declared ineligible by the Bank, as described in ITA 4.7 and 5.1 Must meet requirement Must meet requirement Must meet requirement N/A Application Submission Letter 1.4 Entity of the Borrower Country Applicant required to meet conditions of ITA 4.8 Must meet requirement Must meet requirement Must meet requirement N / A Forms ELI -1.1 and 1.2, with attachments 1.5 United Nations resolution or Borrower’s country law Not having been excluded as a result of prohibition in the Borrower’s country laws or official regulations against commercial relations with the Applicant’s country, or by an act of compliance with UN Security Council resolution, both in accordance with ITA 5.1 and 5.2 and Section V. Must meet requirement Must meet requirement Must meet requirement N/A Forms ELI – 1.1 and 1.2, with attachments Eligibility and Qualification Criteria Compliance Requirements Document/ Form No. Subject Requirement Single Entity Joint Venture (existing or intended Submission Requirement All Members Combined Each Member One Member
including part of the requirements that may be met by Specialized Subcontractors, if permitted in accordance with ITA 25.2] 4.2 (b) For the above and any other contracts [substantially completed and under implementation] as prime contractor, joint venture member, or sub-contractor between 1st January [insert year] and Application submission deadline, a minimum construction experience in the following key activities successfully completed: [list key activities indicating volume, number or rate of production as applicable. Under 4.2(a), specified requirements define similarity of contracts, whereas the key activities or production rates to be specified under 4.2 (b) define the required capability of the Applicant to execute the Works. There shall not be any inconsistency or repetition of requirement between 4.2(a) and 4.2(b).For the rate of production, specify that the rate of production shall be on the basis of either the average during the entire specified period OR the rate of annual production in any 12 month period in the specified period, ] Must meet requirements [Specify activities that may be met through a specialized if permitted in accordance with ITA 25.2] Must meet requirements [Specify activities that may be met through a Specialized Subcontractor, if permitted in accordance with ITA 25.2 ] N/A Must meet the following requirements for key activities listed below [if applicable, out of the key activities in the first column of this 4.2 b), list key activities (volume, number or rate of production as applicable) and the minimum requirements that have to be met by one member, otherwise this cell should state: “N/A”.] Form EXP – 4.2 (b)
Form FIN – 3.1 Financial Situation and Performance [The following table shall be filled in for the Applicant and for each member of a Joint Venture] Applicant’s Name: [insert full name] Date: [insert day, month, year] Joint Venture Member Name: [insert full name] RFB No. and title: [insert RFB number and title] Page [insert page number] of [insert total number] pages 1. Financial data Type of Financial information in (currency) Historic information for previous _[insert number] years, [insert in words] (amount in currency, currency, exchange rate*, USD equivalent) Year 1 Year 2 Year 3 Year 5 Statement of Financial Position (Information from Balance Sheet) Assets (TA) Total Liabilities (TL) Total Equity/Net Worth (NW) Current Assets (CA) Current Liabilities (CL) Working Capital (WC) Information from Income Statement Total Revenue (TR) Profits Before Taxes (PBT) Cash Flow Information Cash Flow from Operating Activities * ITA 14 for the exchange rate
activities 6. Characteristics [insert other characteristics as described in Section VII, Scope of Works] Form EXP - 4.2(b) Construction Experience in Key Activities Applicant's Name: [insert full name] Date: [insert day, month, year] Applicant's JV Member’s Name: [insert full name] Sub-contractor's Name (as per ITA 24.2 and 24.3): [insert full name] RFB No. and title: [insert RFB number and title] Page [insert page number] of [insert total number] pages All Sub-contractors for key activities must complete the information in this form as per ITA 24.2 and 24.3 and Section III, Qualification Criteria and Requirements, 4.2. 1. Key Activity No. One: [insert brief description of the Activity, emphasizing its specificity] Quantity of Activity under the contract: _____________________________________ Information Contract Identification [insert contract name and number, if applicable] Award date [insert day, month, year, e.g., 15 June, 2015] Completion date [insert day, month, year, e.g., 03 October, 2017] Role in Contract [check the appropriate box] Prime Member in JV Management Contractor Total Contract Amount [insert total contract amount in contract currency(ies)] US$ [insert exchange rate and total contract amount in US$ equivalent] Quantity (Volume, number or rate of production, as applicable) performed under the contract per year or part of the year [Insert extent of participation indicating actual quantity of key activity successfully completed in the role performed] Total quantity in the contract (i) Percentage participation (ii) Actual Quantity Performed (i) x (ii) Year 1 Year 2 Year 3