Standard Prequalification Document

Prequalification of Service
Providers for 2011

MALAWI PROPERTY INVESTMENT COMPANY

P.O.BOX 30459,
CAPITAL CITY,
LILONGWE 3.
OCTOBER,2010

APPLICATION FORM 1: COMPANY DETAILS AND GENERAL INFORMATION

Name of Company:
------------------------------------------------------------------------------------------------------------Certificate of Registration/Incorporation No. ------------------------------------------------------ (Attach copy)
NCIC Registration No. --------------------------------------------------------------------------------- (Attach copy)
NCIC Registration Category ------------------------------------------------------------------------------------Tax Compliance Certificate -------------------------------------------------------------------------- (Attach copy)
2. Physical Address (Street and Building):
3. P.O. Box and Mailing Address:
------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------Plot No. ------------------------------------------------------- City: --------------------------Country: ------------------4. Tel: ---------------------------------------------------------------------------5. Fax:: --------------------------------------------------------------------------6. Email--------------------------------------------------------------------------7. WWW Address: ---------------------------------------------------------------------------------------8. Type of Business (Mark one only) :
Sole Proprietor:

Corporate/Limited:

Partnership:

Other (specify):----------------------

Give details in the table below of proprietor, Partners or Directors whichever is applicable from above (8):
Name in Full

Age

Nationality

1
2
3
4
9. Service Category:
General Maintenance:
(specify):

Electrical:

Water proofing :

Mechanical :

Other

10. Year Established: ----------------------- 11. Number of Full-time Employees: --------------------------I, the undersigned, warrant that the information provided in this form is correct, and in the event of changes details will be provided as
soon as possible:
Name:---------------------------------------------- Functional Title:---------------------------------------------------------Signature:---------------------------------------------------Date:-------------------------------------------------------------

APPLICATION FORM 2: FINANCIAL INFORMATION

1. Annual Turnover for the last 2 Years:
Year 2009: MK---------------------------------------- Year 2010: MK ---------------------------------------------2. Bank Name: --------------------------------------------------------------------------------------------------Address and Branch: ------------------------------------------------------------------------------------------------------Bank Account Number:-------------------------------------- Account Name: -----------------------------------------3. Provide a copy of the companys Bank Statements or Annual or Audited Financial Report for the last Two
years.
and
Clearly demonstrate that your companys financial position is healthy enough to enable you transact business
with MPICO Limited, may include a letter from the bank indicating willingness to give you financial support.
4. Public Liability Insurance Cover:
Company:-------------------------------------- Policy No: -------------------------------- Expiry Date : ------------------

APPLICATION FORM 3: KEY PERSONNEL

NAME

POSITION

QUALIFICATION

EXPERIENCE IN
SIMILAR WORK (Yrs)

I, the undersigned, warrant that the information provided in this form is correct, and in the event of changes
details will be provided as soon as possible:
Name:---------------------------------------------- Signature & Date:--------------------------------------------------------

APPLICATION FORM 4: DETAILS OF CONTRACTS OF SIMILAR NATURE

1. Please provide a listing of any five major client reference sources for similar works rendered by your
firm; include address and value of contract
NATURE OF WORK

CLIENTS NAME

CONTACT
PERSON AND
NUMBER

VALUE OF WORK

2. State number of years in supply of similar services or in business operation;

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------3. Please list any current legal disputes in which your company may be involved.
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------I, the undersigned, warrant that the information provided in this form is correct, and in the event of changes
details will be provided as soon as possible:
Name:---------------------------------------------- Signature & Date:--------------------------------------------------------

APPLICATION FORM 5: MAJOR ITEMS OF CONTRACTORS EQUIPMENT

1. Please provide a listing of any four major equipment at your disposal for this type of work :
Item of equipment
Equipment
informatio
n

Name of manufacturer

Model and power rating

Capacity

Year of manufacture

Current
status

Current location
Details of current commitments

Source

Indicate source of the equipment

Owned
Rented
manufactured

Leased

Specially

Item of equipment
Equipment
informatio
n

Name of manufacturer

Model and power rating

Capacity

Year of manufacture

Current
status

Current location
Details of current commitments

Source

Indicate source of the equipment

Owned
Rented
manufactured

Leased

Specially

Item of equipment
Equipment
informatio
n

Name of manufacturer

Model and power rating

Capacity

Year of manufacture

Current
status

Current location
Details of current commitments

Source

Indicate source of the equipment

Owned
Rented
manufactured

Leased

Specially

Item of equipment
Equipment
informatio
n

Name of manufacturer

Model and power rating

Capacity

Year of manufacture

Current
status

Current location
Details of current commitments

Source

Indicate source of the equipment

Owned
Rented
manufactured

Leased

Specially

For equipment owned attach a copy of proof of ownership.

I, the undersigned, warrant that the information provided in this form is correct, and in the event of changes
details will be provided as soon as possible:
Name:---------------------------------------------- Signature & Date:--------------------------------------------------------