INVITATION TO PREQUALIFICATION DOCUMENT

FOR

AMMONIA UREA II PROJECT

PT PETROKIMIA GRESIK
FEBRUARY 2013

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

ANNOUNCEMENT OF AMMONIA UREA II

PRE - QUALIFICATION
PT Petrokimia Gresik ("PG) intends to invite companies for the pre-qualification for
Engineering, Procurement, Construction and Commissioning (EPCC) for AmmoniaUrea II Plant Project at PGs Industrial Complex, Gresik-East Java, Indonesia.
The Ammonia-Urea II Plant Project is anticipated to be executed by a Main Contractor
in the form of consortium between a local Engineering, Procurement and Construction
(EPC) company and a foreign EPC company.
The Main Contractor shall own, or granted license from the owners of eligible proven
process technologies for ammonia and/or urea manufacturing, evidence by the original
permit and supporting letter especially for this project from the relevant required
process licensor(s). The process licensors list are as follows:
No.

Plant Process

1.

Ammonia

2.

Urea

Process Licensor
HaldorTopsoe
Kellogg Brown & Root (KBR)
Uhde
Snamprogetti
Stamicarbon
Toyo Engineering Corporation (TEC)

Note : Process Licensors are arranged in alphabetic order.

Such consortium will be selected based upon their experiences and capabilities and
will be judged on the following requirements:
1. Consortium Requirements
a. Having capability and experiences in EPC project scope in both proven
Ammonia and Urea process technology with the minimum capacity of 1,500
MTPD and 1,725 MTPD, respectively;
b. Being EPC company who owns proven process technology in ammonia and
urea manufacturing, and/or EPC company who are granted with License from
the owners of both proven ammonia and urea process technologies with
minimum capacity of 2,000 MTPD ammonia and 1,725 MTPD Urea, evidenced
by the original permit and supporting letter especially for this project from the
relevant required process licensor(s);
c. The consortium shall consist of one local EPC company and one foreign EPC
company only, where is each company is prohibited to set up more than one
consortium for this project;
d. A detailed consortium statement, which clearly stipulates the preliminary scope
and responsibilities of the respective parties shall be submitted (A Notarized
consortium agreement to be submitted later during the submission of technical
proposal and the respective parties shall fill the statement of compliance to

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

submit consortium agreement as per attached). The consortium shall not be
changed under any circumtances;
e. The Indonesian local content shall be clearly identified to be not less than 35%
(thirty five percent);
f. Having financially sound status for the last 3 years, supported with Audited
Financial Reports (Long form Financial Report) since 2009, including third
quarter (Q3) of 2012 Financial Report (un-audited);
g. Declaration statements that there are no cases of dispute or litigation in any
court under any jurisdiction or having a petition of bankruptcy or legal charge
filed by or against the company, shall be signed by the authorized person that
represent and act on behalf of the company, for local company that statement
should made on the paper with "meterai Rp. 6000.
2. Local EPC Company Requirements
a. Registered as Grade 7 qualification from Gabungan Perusahaan Nasional
Rancang Bangun Indonesia / the Association of Indonesian National
Engineering Companies (GAPENRI); or
b. Holds a License of Construction Services or ljin Usaha Jasa Konstruksi (IUJK)
of large scale classification;
c. Having financially sound status for the last 3 years, supported with Audited
Financial Reports (Long form Financial Report) since 2009, including third
quarter (Q3) of 2012 Financial Report (un-audited);
d. Accredited with ISO 9001-2008;
e. Accredited with OSHAS 18001-2007;
f. Having experiences at least as Construction Company with a minimum scope of
contract value worth minimum USD 50 million in:
- Ammonia/urea projects in the last 15 years; or
- Oil & Gas or Refineries or Petrochemicals projects in the last 10 years.
g. In the event they are assigned as consortium leader, the following minimum
requirement shall be complied with:
- Having experiences as consortium leader/member in Ammonia/Urea project
in the last 15 years with a minimum project value worth equivalent to USD
200 million, or
- Having experiences as consortium leader/member in Petrochemical,
Refinery, and Natural Gas based process industry project in the last 10 years
with a minimum project value worth equivalent to USD 200 million.
3. Foreign EPC Company Requirements
a. Having license of Representative for foreign Construction Company Services
(Ijin Perwakilan Perusahaan Jasa Konstruksi Asing/IPJKA). They may submit
any evidence(s) showing that the license is still under processed by authorized
Government body and they shall fill statement of compliance to have IPJKA as
per attached;
b. Being EPC company who owns proven process technology in ammonia and/or
urea manufacturing, and/or EPC company who are granted with License from
the owners of both proven ammonia and urea process technologies with
minimum capacity of 2,000 MTPD ammonia and 1,725 MTPD Urea, evidenced
by the original permit and supporting letter especially for this project from the
relevant required process licensor(s);
II

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

c. Having experiences in EPC project scope in both proven Ammonia and Urea
process technology of having minimum capacity of 1,500 MTPD ammonia and
1,725 MTPD Urea;
d. Having financially sound status for the last 3 years, supported with Audited
Financial Reports (Long form Financial Report) since 2009, including third
quarter (Q3) of 2012 Financial Report (un-audited) or audited 2012 Financial
Report if any.
4. For detail terms & conditions and PQ document can be accessed and downloaded
at website http://www.petrokimia-gresik.com and all information stated in the
pre-qualification documents shall be submitted not later than March 6th, 2013 at
16.00 oclock local time.
5. We offer your company the opportunity to be short-listed for the above project, and
to submit Expression of Interest (EoI) not later than February 20th, 2013 via the email address:
[email protected] and [email protected]
Any and all cost incurred by the company in this pre-qualification exercise including
presentations, if required, shall be solely at the company expense and will NOT be
reimbursed by PG under any circumstances. Furthermore, PG shall not be responsible
for the loss and/or any delay in the delivering of the company pre-qualification
proposals.
PG reserves the right to reject any or all prospective companies or to select its choice
without assigning any reason. If the company is short listed, the company will be
invited to participate in the final bidding process for the above work.
Any query of the pre-qualification result will not be entertained.
For and on behalf of PT Petrokimia Gresik,
Ammonia-Urea II Project Tender Committee

III

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

SECTION 1.
GENERAL INSTRUCTIONS
1.1

GENERAL
The Notice of Pre-qualification and the prequalification documents shall not be
construed as binding in any form of contract, which may be subsequently
awarded.
PG intends to award the contract to the technically acceptable and financially
competitive Main Contractor (the Company).

1.2

QUESTIONNAIRES
In order to assure ourselves that bids for the work are solicited only from
technically acceptable and financially competitive companies. The Company
must answer the Pre-qualification Questionnaires as per Section 4 with
complete, clear and accurate statements in accordance with the format and
sequence of the Pre-qualification Questionnaires Evaluation. The Company is
requested to respond to all questions/instructions. Incomplete responses may
result that the submission will be disqualified.
The Company is responsible to ensure completeness of the questionnaires
submission.

1.3

RELATED LITERATURE
The Company may enclose with the reply any descriptive literature(s) or
supplementary information, which may have a direct bearing on the prequalification exercise.

1.4

CLIENT REFERENCE
PG intends to use client references given in the Company submission in order
to gain information regarding the company performance in previous and
current contracts.

1.5

SUBMISSION
The language of the PQ proposal shall be written in English.
PQ proposal shall be made into one (1) original, two (2) copies and one (1)
soft file copy. The soft file copy shall be delivered in flash disk and shall be
submitted together with other documents before the time and date as
specified to the owner with the following address:
"PRE-QUALIFICATION PROPOSAL FOR ENGINEERING, PROCUREMENT,
CONSTRUCTION AND COMMISSIONING OF AMMONIA-UREA II PLANT
PROJECT"

PT Petrokimia Gresik

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

PT Petrokimia Gresik
Jln. Jenderal Akhmad Yani
Gresik 61119, East Java, INDONESIA
Attn.
Phone
Facsimile
E-mail

:
:
:
:

Ammonia-Urea II Project Tender Committee

(+62-31) 398-2100, 398-2200 ext 2436
(+62-31) 398-1722, 398-2272
[email protected]
[email protected]

The deadline for PQ proposal submission is : 16.00 oclock (Local time) on

March 6th, 2013.
1.6

INVITATION FOR BID (IFB)

PG reserves the right not to shortlist any or all-prospective companies and to
shortlist companies of its choice without assigning any reasons. If the
company is short-listed, it will be invited to participate in final bidding process
and receive an Invitation for Bid document for the project tentatively in March
2013.
The EPCC Technical and Administration Proposal shall be submitted within
two (2) months after issuance of the IFB document & Project Specification.
Company passing technical and administration evaluation will be invited to
submit commercial proposal.

1.7

ENQUIRIES BEFORE SUBMISSION

Any enquiries for information and details regarding the Pre-qualification
Document shall be directed to:
PT Petrokimia Gresik
Jln. Jenderal Akhmad Yani
Gresik 61119, INDONESIA
Attn.
Phone
Facsimile
E-mail

:
:
:
:

Ammonia-Urea II Project Tender Committee

(+62-31) 398-2100, 398-2200 ext 2436
(+62-31) 398-1722, 398-2272
[email protected]
[email protected]

Enquiries shall be submitted before February 27th, 2013.

1.8

EXPENSES FOR PRE-QUALIFICATION PROPOSAL

Any and all costs and expenses incurred by the Company in an effort to be
short listed including presentations, if it required, it shall be borne by the
Company and not be reimbursed by PG.
PG shall not be responsible for the loss and/or delay in the delivery of the
Company pre-qualification proposals.

PT Petrokimia Gresik

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

SECTION 2.
PROJECT DESCRIPTION

2.1

PROJECT OVERVIEW
PT Petrokimia Gresik, a company duly organized under the laws of the
Republic of Indonesia (hereinafter referred to as PG) at its industrial complex
in Gresik, East Java, Indonesia, is planning to tender Engineering,
Procurement, Construction and Commissioning (EPCC) for Ammonia-Urea II
Plant Project with a capacity of 2,000 Ammonia metric tons per day; 1,725
Urea metric tons per day; Utilities and Offsite Facilities included but not limited
to steam (2x150 ton per hour) and power generation (25 MW net coal based
power plant), cooling water system, waste water treatment, Nitrogen gas
generator unit, product storage & conveyor system, buildings and any other
off-sites required for normal operation of the plants. (Hereinafter referred to as
Project).
The necessary services and civil works to build and operate the plant are also
to be included.
Process Licensors will be used in this Project are as follows:
No. Plant Process
Process Licensor
Haldor Topsoe
1.
Ammonia
Kellogg, Brown & Root (KBR)
Uhde
Snamprogetti
2.
Urea
Stamicarbon
Toyo Engineering Corporation (TEC)
Note : Process Licensors are arranged in alphabetic order.

Bidder shall either work together with Process Licensor for preparing the
tender proposal and executing the project. Bidder shall select appropriate
Process Licensors to give the best of tender proposal and project execution.
2.2

PROJECT LOCATION
The proposed project area is located in PGs Fertilizer complex.
Available area for this project :
Ammonia and Urea Plant is approximately: 7.2 (ha)
Steam Generation and Power Plant is approximately: 3.6 (ha)

PT Petrokimia Gresik

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

2.3

PROJECT ORGANIZATION
2.3.1

PROJECT MANAGEMENT
PG will setup the Project Management Team of the Project.

2.3.2

EPC CONTRACTOR
Main Contractor that will be awarded for this Project shall be
responsible for the Engineering Design, Procurement, Construction
and Commissioning of the Project.

2.4

EPCC PROJECT SCHEDULE

Expected Effective Date of EPCC Contract is within the 4th Quarter of year
2013.
Tentative EPCC Contract Duration is max. 33 months (since Effective Date of
Contract up to Initial Acceptance).

PT Petrokimia Gresik

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

SECTION 3.
SCOPE OF WORK AND SUPPLY
3.1

GENERAL
Scope of the Project shall include complete supply for Engineering,
Procurement, Construction and Commissioning for Ammonia-Urea II Plant
Project consisting of the followings:
Ammonia plant with a capacity of 2,000 metric tons per day;
Urea plant with a capacity of 1,725 metric tons per day;
Utilities and Offsite Facilities included but not limited to steam (2x150 ton
per hour) and power generation (25 MW net coal based power plant),
cooling water system, waste water treatment, Nitrogen gas generator unit,
product storage & conveyor system, buildings and any other off-sites
required for normal operation of the plants.

3.2

HEALTH, SAFETY AND ENVIRONMENT

PG commit to the protection of health, the environment, and the safety of
personnel working on this Project as well as others may be affected by Project
activities.
It is required that The Company fulfills this commitment and in so doing
provides for the protection of people, property and the environment. The
Company shall, in advance, endeavor to eliminate any foreseeable hazard,
which could result in accidental loss, including personnel injury, fire security
loss and property damage.
The Company shall follow the procedure and requirements defined in the IFB
and Project specification to be issued.
The Company shall develop and provide all documents necessary for the
successful completion of the work.

3.3

QUALITY MANAGEMENT SYSTEM

The Company shall provide and implement an effective quality Management
System that conforms which ISO 9001. Detailed requirements for the Quality
Management System will be included in IFB and Project specification to be
issued.
The Company shall follow the procedures and requirements defined in the IFB
and Project specification.
The Company shall develop and provide all documents necessary for the
successful completion of the work.

PT Petrokimia Gresik

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

3.4

DETAILED ENGINEERING
The Company shall carry out the detailed engineering such as to provide a
safe plant which can achieve the performance in accordance with the Project
Specification.
In the event of an item being omitted from the Project Specification it does not
relieve Main Contractor of his responsibilities under the Contract to provide all
facilities necessary to ensure plant operability, maintainability or safety.
The Company shall take all such necessary measures for tie-ins into the
existing Off-sites and Utilities.
The Company should provide 3-D electronic plant model for the whole Project.
The model shall be a detailed model fully to scale, reflecting engineering
details, containing all items and facilities as described in IFB to be issued.

3.5

PROCUREMENT
The Company shall provide all procurement services necessary to control,
purchase, expedite, inspect (including provision of Third Party Inspection),
transport, ship and deliver to work site, all materials, supplies, spare parts and
any other items required for the work through the final location on the work
site, all in accordance with the requirements of the Contract.

3.6

CONSTRUCTION AND PRE-COMMISSIONING

The Company shall execute all construction and Pre-commissioning activities
until Ready for Start-Up (RFSU) of the Project is achieved, in accordance with
high standards of Quality Assurance, Quality Control and Safety. Additionally,
Contractor shall provide all necessary construction equipment, the
mobilization and control of the required labor force and the efficient and safe
construction management of the work site efforts.

3.7

COMMISSIONING AND PROJECT PERFORMANCE TESTS

Once of the Project is achieved and on mechanical acceptance by PG,
Company shall proceed with the activities relating to the Commissioning, and
Performance Test.
The Company shall be responsible for the Commissioning, including
Performance Test up to Initial Acceptance.
The Company shall provide the labor, tools/equipment and services during
Start-up, Commissioning and Performance Test.
PG will provide skilled operators to operate the plants during Commissioning
and Performance Test under assistance and supervision by the Company.

3.8

TIE-INS AND COMMON FACILITIES

The Company is required to carry out tie-ins of raw material and utilities
supply with existing plants and common systems.

PT Petrokimia Gresik

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

3.9

HAND-OVER
The Company shall complete and commission each system on a phased
basis. Upon successful Performance Test, Company shall hand-over the
Project for normal operation.

3.10

BENEFIT TO INDONESIA
Bidder shall describe in detail how Bidder intends to comply with the above
requirements for Indonesian local content and the methods of achieving these
minimum requirements. The Indonesian local content shall be clearly identified
to be not less than 35% (thirty five percent).

3.11

PROVISION FOR PG / PROJECT MANAGEMENT TEAM

The Company shall be required to provide at its cost separate office
accommodation and fully serviced office facilities, for use of PG/Management
Project resident team, in The Companys detailed engineering home offices,
and in The Company's office at Project Site.

PT Petrokimia Gresik

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

SECTION 4.
PREQUALIFICATION QUESTIONNAIRES
4.1

PROJECT SPECIFIC
a)

The Pre-Qualification is sought under a Consortium.

List the Leader and the Consortium Members and define their roles.
Also, provide the proposed Project Organization Structure explaining the
relationship and roles.
Name of Leader & Consortium
Member

b)

Does your Company has experience as EPC contractor of Ammonia and

Urea Plant project with the minimum capacity of 1,500 mtpd Ammonia
and 1,725 mtpd Urea as per format below:
Client

c)

Roles

Location

Project

Year of
Completion

Contract Value
USD

Does your Company, or a member of Consortium (for Local Company

only) has experience as EPC contractor in :
- Ammonia/urea project for the last fifteen (15) years, or
- Oil & gas or Refineries or Petrochemicals project in the last ten (10)
years
with a minimum project value worth equivalent to USD 50 million as per
format below:
Client

d)

Location

Project

Year of
Completion

Contract
Value USD

Consortium
Members

Does your Company (for Foreign Company only) has own proven
process technology in ammonia and/or urea manufacturing or who are
granted with license from owners of both ammonia and urea process
technology with capacity:
- Ammonia (min. 2,000 MTPD) and Urea (min. 1,725 MTPD) ,

PT Petrokimia Gresik

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

Client

e)

Location

Capacity

Year of
Completion

Process
Licensors

Consortium
Members

Provide Letter of Reference from a reputable Bank to demonstrate

financial ability of your Company and Consortium.
Letter of Reference included _______ (YES / NO)

f)

Please confirm that the Participant is willing to furnish the following:

YES

NO

Parental Guarantee upon award (if applicable)

Performance Bond upon award (5% of Lump Sum Fixed
Price)
Bid Bond during Tendering amounted to USD 7,500,000

g)

Bonding Data

Company

________________________

Agent & Phone No

________________________

Total bonding capacity

________________________

Each member of the Consortium is required to fill-up the Pre-Qualification Questionnaire separately
under a common submission. However, each member should limit the information with respect to their
role (as mentioned under Section 4.1.a) within the Consortium.

All information provided will be held in confidence. Your accurate response to the foregoing will be a
material factor in our consideration of your company for the Project.

PT Petrokimia Gresik

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

4.2

GENERAL
a)

Company Name : ----------------------------------------------------Registered Business Address (Street): .

(City):
Telephone No:

Country:
Fax No.:

Postcode:
E-Mail

Correspondence Address (Street): ..

(City):
Country:
Postcode:
Telephone No:
Fax No.:
E-Mail :

Contact Person : -------------------------------b)

List of the shareholders of your company below, or if space provided

here is insufficient, attach a separate listing.
Name

c)

% Of Equity

Please provide the following information with regard to your company:

Nature of Company: ......
(Stated Owned Limited, Private Limited, public, Corporation or others)

Date of registration and Country of incorporation:

File registration number:
(Registrar of Companies)
Date of commencement of business operation: ...
Is your company a resident in Indonesia? YES ________ NO _________
If YES, please attach a copy of IRD or Tax Consultant confirmation letter
and provide the Indonesia Income Tax File reference number of your
company.
d)

Does your company work under an overseas parent company? If YES,

please name parent company: YES ______ NO _______

e)

List of the principal individuals / Directors of your company below, or if

space provided here is insufficient, attach a separate listing.
Individuals Name

f)

Present Position

Years w/Company

What is your Companys Core Business?

How many years has this company been in this Business?

PT Petrokimia Gresik

10

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

g)

Provide details and copy of registration and complete the following

Company Information.
EQUITY (*)
%I

%F

MANAGEMENT
%I

%F

EMPLOYEE
%I

%F

Note:
I: Indonesian
F: Foreign

h)

Are you willing to execute this Project on a Lump sum basis?

YES ________ NO ________
What is the minimum value of work accepted by you: .USD
What is the maximum value of work accepted by you: USD

i)

Are you willing to fulfil local content requirement not less than 35% (thirty
five percent) ?
YES ________ NO ________
If no, please give the reason.

PT Petrokimia Gresik

11

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

4.3

LEGAL AND FINANCIAL

a)

Bank and Credit Institute Reference :

Bank Name & Contact Details

b)

Individuals Name and Phone No.

Capital Structure:
No
a)
b)
c)

Description

Amount (USD) and/or (IDR)

Authorized Capital
Paid-up Capital
Working Capital

c)

Financial Statement: (Attach copy of latest audited financial statements

for past three (3) years consisting of a balance sheet and profit and loss
statement with all qualifications.

d)

Are you now or have you been involved as a party to a pending or

concluded litigation concerning your performance of work within the last
ten (10) years?
YES ________ NO ________
If yes, please specify the nature of all such litigation (i.e. breach of
contract, negligence, filing of lien claims, etc).

e)

Insurance Coverage:
Type

Amount

Insurer

a). Workers Compensation

b). All Risk Physical Damage
c). Insurance for use of Vehicle/ Equipment
d). Professional Indemnity
e). Comprehensive General Liability
f). Others (Please specify)

f)

PT Petrokimia Gresik

Affiliations with other companies (parent or sister or subsidiaries or

associate organizations) and attach organization chart. Also, explain the
activities of these organizations.

..

12

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

4.4

PERFORMANCE
a)

Client

Please provide a listing of Ammonia and/or urea of World Scale within

the last fifteen (15) years or Oil & Gas or refineries or petrochemicals
based process industry of World Scale within the last ten (10) years
which has been executed by your Company. Please use the format
below. (if space provided here is insufficient, attach a separate listing).
Location
and
Project

Year

Plant
Product

Plant
Capacity

Contract Work
and Type (Unit
Rate / Lump Sum)

Total
Manhours
Spent

b)

Have you ever failed to complete any work awarded to you?

YES ________ NO ________
(If yes, attach description of when, where, why and for whom).

c)

Annual Turnover (USD or IDR) for the past five (5) years:
2012 .
2011 .
2010 .
2009 .
2008 .

d)

Largest Contract (USD or IDR) past five (5) years:

2012 .
2011 .
2010 .
2009 .
2008 .

e)

Smallest Contract (USD or IDR) past five (5) years:

2012 .
2011 .
2010 .
2009 .
2008 .

PT Petrokimia Gresik

13

Total Cost
USD

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

f)

Please provide a listing of the Current Contracts in progress per format

below:
(if space provided here is insufficient, attach a separate listing)
Client

g)

Contract Type
(Eng. Or
Proc&Const or
Const or EPCC)

Commence
Date

Expected
Duration

ContractValue
USD or IDR

Previous project experience with PG during last ten (10) years (if any):
(if space provided here is insufficient , attach a separate listing).
Project /
Location

h)

Location and
Project

Job Size (USD or

IDR)

Contract
Type

Total Manhours Spent

Largest number of personnel employed on any one job in last five (5)
years.
Average

Peak

Total

Office Base Man-hours

Site Base Man-hours

i)

Largest number of personnel employed on any one job in last year:

Average

Peak

Total

Office Base Man-hours

Site Base Man-hours

j)

Current Total Manpower (indicate in Man-hours)

Average

Peak

Total

Office Base Man-hours

Site Base Man-hours

k)

PT Petrokimia Gresik

Please also provide any printed technical and operational information

detailing the general capabilities, services offered and other information
such as capabilities document, company profile etc.

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PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

4.5

PERSONNEL
a)

Employees:
Office Base
Permanent
%LOCAL

Contract

%FOREIGN

%LOCAL

%FOREIGN

Permanent
%LOCAL
%FOREIGN

%LOCAL

Contract
%FOREIGN

Site Base

b)

Other than the principal individuals / directors listed in 4.2.g above, state
the number of permanent employees on your payroll, by classification:
(If space provided is insufficient, attach a separate listing).
Total No. of
Employees

Classification

No Available
for this Project

Office Base (Specify all

positions in the break-up)

Site Base (Specify all

positions in the break-up)

c)

Please provide an organization chart of your company.

PT Petrokimia Gresik

15

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

d)

Do you have a comprehensive training program for your employees?

If YES please provide an outline of the program.

e)

Number of engineering personnel in your company with the following

total years of experience in ammonia and/or urea or oil & gas or
refineries or petrochemicals plant engineering design.
0-5 years

5-10 years

Over 10 years

a). Process Engineers

b). Mechanical & Inspections
Engineers
c). Civil Engineers
d). Instrument & Electrical Eng.
c). Engineers (others)

f)

Number of Procurement personnel in your company with the following

total years of experience in ammonia and/or urea or oil & gas or
refineries or petrochemicals plant construction.
5-10 years

Over 10 years

a). Procurement Executive / Manager

b). Buyer
c). Expeditor

g)

Number of Construction personnel in your company with the following

total years of experience in ammonia and/or urea or oil & gas or
refineries or petrochemicals plant construction.
5-10 years
a). Site Manager
b). Site Engineer
c). Site Supervisors
d). Commissioning Manager
e). Commissioning Engineer

PT Petrokimia Gresik

16

Over 10 years

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

4.6

TECHNICAL
a)

b)

PT Petrokimia Gresik

Engineering Design (provide additional sheets to complete response):

1.

Does your Company have Engineering Design Capabilities? If YES,

please provide details of engineering design projects performed by
you.

..

2.

At which location (provide address) is your Engineering and Drafting

performed? Where do you intend to do the Engineering for this
project?

..

3.

Please list licensed Engineering and Drafting Software available

within your company for the usage of this project.
(If space provided here is insufficient, attach a separate listing).

..

4.

At which location (provide address) is your Planning and Scheduling

done? Where do you intend to do the Planning and Scheduling for
this project?

..

5.

What type of Planning and Scheduling programs do you utilize?

What do you propose to use for this project?

..

6.

Do you prepare weekly / monthly progress reports for Engineering,

Procurement and Construction Phases of the project? If Yes, furnish
sample format.

..

Procurement (provide additional sheets to complete response):

1.

Do you have a procurement department? If yes, please provide

Organization Chart?

..

2.

Do you carry out pre-qualification for your suppliers, vendors,

manufacturers etc? If yes, please provide a sample of Vendor
Assessment Form.

..

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PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

3.

Are you familiar with Customs Duties and Tax Exemptions

procedures for Importing Goods to Indonesia? If yes, demonstrate
your experience by listing down the Projects where the above
activities were involved.

..

4.

What Procurement Software you use to perform Procurement

activities i.e. from Issue of Enquiry till Goods received at Site.
Please state.

..
Do you have procurement procedures in-place?
YES _____ NO ______, If YES, Please enclose List of Procedures.

5.

c)

Briefly state, how do you carry out Inspection at Vendor Shop? What
method would you propose for this Project based on your previous
experience?

..

Construction (provide additional sheets to complete response):

1.

Typed of Construction Works you usually perform or have others

perform for you as Sub-contractors? Please tick where applicable.
Type of Work

In-house

Subcontract

Civil Foundations
Piling Works
Structural Steel Prefabrication and Installation
Mechanical Equipment Installation
Material Handling Equip. /Package Installation
Heavy Lift
Pipe Prefabrication and Installation
Electrical & Instrument Installation
Electrical Works
Instrumentation Works
Painting and insulation
Others (please specify)

PT Petrokimia Gresik

2.

Furnish typical construction organization chart for a similar project.

..

3.

Do you provide your site workers with PPE (personal protective

equipment)?
YES ________ NO ________

4.

Construction Equipment:
Furnish list of construction equipment owned by your company
Furnish list of Sub-Contractors from whom you rent construction
equipment and list type of equipment.

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PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

4.7

5.

Do you keep a set of drawings, marked up to show weekly progress,

in your field office?
YES ________ NO ________
If no State briefly, how would you monitor weekly progress at site?

..

6.

Site Facilities
Office: ___________ Square Feet (provide details)
Site Office-Provide description of Site Office facilities available.

QUALITY
a)

What is your philosophy on Quality?

b)

Do you have a formal written Quality Program?

YES ________ NO ________
If Yes, please submit your Quality Program.
Is your Quality Program in accordance with ISO 9001?
YES ________ NO ________
If accredited, please submit copy of ISO 9001 certificate.

c)

Who is responsible for your Quality Program?

Name:

d)

Phone

Do you normally assign a full time Quality person to your jobsite?

YES ________ NO ________

e)

Do you have a Quality Control Manual?

YES ________ NO ________
If Yes, submit the content list.

f)

Do you have a formal QA/QC Organization/Department

YES ________ NO ________
If Yes, please submit chart.

g)

PT Petrokimia Gresik

Furnish your Quality Policy.

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No.

PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

4.8

HSE
Health, Safety and Environment is an integral part of production efficiency and
cost effectiveness in the construction of this project. In order to properly
evaluate each contractors qualifications to perform the work in a safe manner,
all contractors must supply the following information to qualify for
consideration.
The information provided is used in the selection process to identify those
contractors who have an effective loss prevention program and who can
adequately control accident costs.
Apart from answering to the questions below, please attach relevant documentary evidence
to demonstrate your commitment to HSE.

a)

Please provide the Safety Statistic of your company as per format below:
Safety Statistic

2008

2009

2010

2011

2012

a). No of cases of Lost Time Injury (LTI)

b). Restricted workday cases
c). Medical attention only cases
d). Recordable doctors cases
e). No of Fatalities
f). Lost Days - LTI

b)

Employee hours worked in the last five years (include only site
construction hours).
2012 .. hours
2011 .. hours
2010 .. hours
2009 .. hours
2008 .. hours

c)

Who is (are) responsible for safety on your project worksites? (tick one
only)
Safety Supervisor _____________
Personnel
_____________
Superintendent _____________
Foreman
_____________
Others
_____________

d)

Do you have a written safety / loss prevention program? YES __ NO ___

If No, do you provide a copy of the applicable requirements as per Local
Regulatory?
Who receives copies:
Superintendents? ________, Foremen?______, Others?______

e)

What steps do you take to ensure compliance with these rules as per
Item 4 above?
In ensure the safety program is through monitoring and evaluation
..

PT Petrokimia Gresik

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PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

f)

Do you have Safety orientation program for new hires? YES ___ NO ___
If yes, do you provide and Employee Safety Rules booklet?
YES ________ NO ________
If yes, attach a copy to this reply.

g)

Do you have any organized, written safety recognition or other

motivational programs for safety? YES ____ NO ____

h)

Smoking, Illegal Drugs, Alcohol and Firearms Policy.

Do you currently have a policy in effect? YES __ (attach copy) NO ____

i)

Are accident reports and report summaries sent to the following? How
often?
NO

YES

Monthly

Quarterly

Annually

Field Superintendent
Head of Construction
Head of Company

j)

Do you hold management safety meetings? YES____ NO_____

How often (tick one only):
Weekly ____ Bi-weekly ____ Monthly____ Less often, as needed _____
Conducted by ..

k)

Do you hold site safety meetings for field supervisor? YES ___ NO____
How often (tick one only):
Weekly ____Bi-weekly ____ Monthly.____ Less often, as needed
______
Conducted by .

l)

m)

Do you conduct safety inspections? YES_____ NO ____

If
YES,
who
conducts
this
inspection

and how often?

Do you provide your site workers with PPE (personal protective

equipment)?
Safety Helmet

YES __

NO__ Safety Works Boots

YES__ NO___

Work Gloves

YES __

NO__ Overalls

YES__ NO___

Safety Harness

YES __

NO__ Face Shields

YES__ NO___

Safety Goggles/Glasses YES __

n)

NO__

Do you have a safety-training program for promoted foremen?

YES ________ NO ________
Is it in form of written procedure? YES__ NO __

PT Petrokimia Gresik

(title)?

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PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

o)

Do you have Fall Prevention Program with a goal to achieve 100% fall
protection for all personnel when working above ground level?
YES ________ NO ________

I, the undersigned hereby declare to the best of my knowledge and believe that all
particulars furnished under this application are true and accurate. I also authorize PG
to undertake further investigation if so desired.
I, also agree that any incorrect information given in this document may disqualify us
from this Pre-Qualification exercise.

Signature

: .

Name

: .

Title

: .

Date

: .

PT Petrokimia Gresik

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PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

STATEMENT OF
PRE-QUALIFICATION COMPLIANCE

To: PT Petrokimia Gresik

Jln. Jenderal Akhmad Yani
Gresik-61119
INDONESIA
Attn:

Sub: AMMONIA-UREA II PLANT PROJECT

Statement of Pre-qualification Compliance

Having examined the Invitation to Pre-qualification Document, this is to warrant that

this document hereby fully complies with all the provisions of the Invitation to Prequalification Document.

Signature

Name

Designation

..

Company

PT Petrokimia Gresik

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PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

STATEMENT OF COMPLIANCE TO HAVE IPJKA

This Statement Of Compliance to Have IPJKA (STATEMENT) made in this .... day of .....,
2013 is by the company as bidder of Ammonia-Urea II Project (Project):
..........................., Inc.,hereinafter called "the COMPANY".
WHEREAS, the COMPANY is a foreign EPC company who agrees to perform as a Project
contractor, in a consortium form, with the preliminary scope and responsibilities are stated in a
Consortium Statement (CONSORTIUM STATEMENT) or CONSORTIUM AGREEMENT
number:
WITNESSETH, that as a foreign EPC company performing work in Indonesia, the COMPANY
hereby agrees to submit license of Representative for Foreign Construction Company
Services/IPJKA (Ijin Perwakilan Jasa Konstruksi Asing) as required by the law. If such license
is being processed by the authorized Government body, the proof or evidence shall be
submitted, and the license of Representative for Foreign Construction Company
Services/IPJKA shall be submitted as soon as applicable but not later than the submission
date of Commercial Proposal.
This STATEMENT is made to furnish the requirement of PT Petrokimia Gresik in PreQualification and is made truthfully.
IN WITNESS WHEREOF, the COMPANY, by its representative duly authorized, have
executed this STATEMENT in 2 originals as of the day and year first above written.

APPROVED AS TO FORM:
DATE

..............(Foreign Company) :

BY: Mr.........................,
------------------------------------------PRESIDENT DIRECTOR/ CEO

PT Petrokimia Gresik

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PREQUALIFICATION FOR AMMONIA-UREA II PROJECT

STATEMENT OF COMPLIANCE TO SUBMIT

CONSORTIUM AGREEMENT
This Statement Of Compliance to Submit Consortium Agreement (STATEMENT) made in
this .... day of ....., 2013 is by and between the companies as bidder of Ammonia-Urea II
Project (Project):
..........................., Inc., hereinafter called ".................," and
..........................., Inc., hereinafter called ".................."
.. and .. hereinafter called the CONSORTIUM.
WHEREAS, the CONSORTIUM agrees to perform together as a Project contractors, in a
consortium form, with the preliminary scope and responsibilities are stated in a Consortium
Statement (CONSORTIUM STATEMENT) number: (to be attached
herewith). The CONSORTIUM hereby agrees to submit a detailed and notarized
CONSORTIUM AGREEMENT in the technical proposal stage.
WITNESSETH, that both CONSORTIUM STATEMENT and CONSORTIUM AGREEMENT
hereinafter mentioned, to be made and performed by the CONSORTIUM. The CONSORTIUM
when has been awarded as the winner of the Project hereby agrees to furnish all qualified
personnel, facilities, materials and services for the engineering, procurement, construction and
commissioning of the Project, to perform the Project as PT Petrokimia Gresik intention and
requirements, that will be stipulated in an EPC Contract.
This STATEMENT is made to furnish the requirement of PT Petrokimia Gresik in PreQualification and is made truthfully.
IN WITNESS WHEREOF, the CONSORTIUM, by their representatives duly authorized, have
executed this STATEMENT in 3 originals as of the day and year first above written.
APPROVED AS TO FORM:
DATE
PT (Local Company) :

BY: Mr.......................
PRESIDENT DIRECTOR/ CEO
............. (Foreign Company) :

BY: Mr.........................,
------------------------------------------PRESIDENT DIRECTOR/ CEO

PT Petrokimia Gresik

25