SPDInitialSelectionDocumentPLANTJanuary2017
SPDInitialSelectionDocumentPLANTJanuary2017
DOCUMENT
JANUARY, 2017
i
This document may be used and reproduced for non-commercial purposes only. Any commercial
use, including without limitation reselling, charging to access, redistribute, or for derivative
works such as unofficial translations based on this document is not allowed.
ii
Revisions
January 2017
Foreword
This Standard Procurement Document (SPD) has been prepared by the World Bank for Initial
Selection of Applicants for the Request for Proposals (RFP) for procurement of Plant (Design,
Supply, and Installation).
The Initial Selection Document (ISD) shall be used by the Borrower with minimum changes as
may be necessary, and acceptable to the Bank, when an Initial Selection process takes place prior
to issuing request for proposals.
iv
Preface
This SPD reflects the World Bank’s Procurement Regulations for IPF Borrowers (“Procurement
Regulations”), July, 2016. This SPD is applicable to the procurement of Plant (Design, Supply,
and Installation) funded by IBRD or IDA-financed projects whose Legal Agreement makes
reference to the Procurement Regulations.
To obtain further information on procurement under World Bank financed projects or for
question regarding the use of this SPD, contact:
This Section includes provisions that are specific to each contract and supplement
Section I, Instructions to Applicants.
This Section includes the Application Submission Letter and other forms required to
be submitted with the Application.
This Section provides the Applicants with the reference to the Bank’s policy in
regard to Fraud and Corruption applicable to the Initial Selection process.
2. The [insert name of implementing agency] intends to initially select Applicants for [insert
contract number and/or name, a brief description of the type(s) of Plant Design, Supply and
Installation to be provided, including key performance/functional requirements, location,
key qualification requirements and other information necessary to enable Applicants to
decide whether or not to respond to this invitation for Initial Selection.] It is expected that
the Request for Proposals will be made in [insert month and year].
3. Initial Selection will be conducted through the procedures as specified in the World Bank’s
Procurement Regulations for IPF Borrowers [insert date of applicable Procurement
Regulations edition as per legal agreement] (“Procurement Regulations”), and is open to all
eligible Applicants as defined in the Procurement Regulations.
4. Interested eligible Applicants may obtain further information from the [insert name of
agency] at the address below [insert address at end of document] during office hours [insert
1
Substitute “contracts” where Proposals are called concurrently for multiple contracts. Add a new para. 3 and
renumber paras 3 - 8 as follows: “Initially selected Applicants may submit Proposals for one or several contracts, as
further defined in the RFP Document.”
2
Insert if applicable: “This contract will be jointly financed by [insert name of cofinancing agency]. Procurement
process will be governed by the World Bank’s Procurement Regulations.”
viii
office hours if applicable, i.e. 0900 to 1700 hours]. A complete set of Initial Selection
documents in [insert name of language] may be purchased by interested Applicants on the
submission of a written application to the address below and upon payment of a
nonrefundable fee of [insert amount in local currency] or [insert amount in specified
convertible currency, i.e. US$]. The method of payment will be [insert method of payment].
The document will be sent by [insert delivery procedure].3
5. Applications for Initial Selection should be submitted in clearly marked envelopes and
delivered to the address below by [insert time] on [insert date]. Late applications may be
rejected.
3
The delivery procedure is usually airmail for overseas delivery and surface mail or courier for local delivery. If
urgency or security dictates, courier services may be required for overseas delivery. With the agreement of the
World Bank, documents may be distributed by e-mail, downloading from authorized web site(s) or electronic
procurement system. Initial Selection Document (in Read Only form) should to be posted on the Employer’s web
page, if available, for inspection by prospective Applicants.
Invitation for
Initial Selection
Plant
(Design, Supply, and Installation)
Procurement of:
[insert identification of the Plant - Design, Supply
and Installation]
(This Initial Selection Document is for use with a Request for Proposals process)
Standard Procurement Document
Table of Contents
A.General
1. Scope of Application 1.1 In connection with the invitation for Initial Selection
indicated in Section II, Initial Selection Data Sheet
(ISDS), the Employer, as defined in the ISDS, issues
this Initial Selection Document (“Initial Selection
Document”) to prospective applicants (“Applicants”)
interested in submitting applications (“Applications”)
for Initial Selection to submit Proposals for the Plant
Design, Supply and Installation described in Section
VII, Scope of Employer’s Requirement. In case
proposals for the Plant Design, Supply and Installation
are to be invited as individual contracts (i.e., the slice
and package procedure), these are listed in the ISDS.
The Request for Proposals (RFP) number corresponding
to this Initial Selection is also provided in the ISDS.
2. Source of Funds 2.1 The Borrower or Recipient (hereinafter called
“Borrower”) indicated in the ISDS has applied for or
received financing (hereinafter called “funds”) from the
International Bank for Reconstruction and Development
or the International Development Association
(hereinafter called “the Bank”) in an amount specified
in the ISDS, towards the cost of the project named in
the ISDS. The Borrower intends to apply a portion of
the funds to eligible payments under the contract(s)
resulting from the Request for Proposals (RFP) process
for which this Initial Selection is conducted.
2.2 Payment by the Bank will be made only at the request of
the Borrower and upon approval by the Bank, and will
be subject, in all respects, to the terms and conditions of
the Loan (or other financing) Agreement. The Loan (or
other financing) Agreement prohibits a withdrawal from
the loan (or credit) account for the purpose of any
payment to persons or entities, or for any import of
goods, equipment, plant or materials, or services if such
payment or import, to the knowledge of the Bank, is
prohibited by a decision of the United Nations Security
Council taken under Chapter VII of the Charter of the
United Nations. No party other than the Borrower shall
derive any rights from the Loan (or other financing)
Agreement or have any claim to the proceeds of the loan
Section I – Instructions to Applicants (ITA) 4
(or credit).
3. Fraud and Corruption 3.1 The Bank requires compliance with the Bank’s Anti-
Corruption Guidelines and its prevailing sanctions
policies and procedures as set forth in the WBG’s
Sanctions Framework, as set forth in Section VI, Fraud
and Corruption.
3.2 In further pursuance of this policy, Applicants shall
permit and shall cause their agents (where declared or
not), subcontractors, subconsultants, service providers,
suppliers, and their personnel, to permit the Bank to
inspect all accounts, records and other documents
relating to any Prequalification process, Initial Selection
process, Bid submission (in case prequalified), Proposal
submission (in case initially selected), and contract
performance (in the case of award), and to have them
audited by auditors appointed by the Bank.
4. Eligible Applicants 4.1 Applicants shall meet the eligibility criteria as per this
Instruction and ITA 5.1.
4.2 An Applicant may be a firm that is a private entity, a state-
owned enterprise or institution subject to ITA 4.9 - or any
combination of such entities in the form of a joint venture
(“JV”) under an existing agreement or with the intent to
enter into such an agreement supported by a letter of
intent. In the case of a joint venture, all members shall
be jointly and severally liable for the execution of the
entire Contract in accordance with the Contract terms.
The JV shall nominate an authorized representative who
shall have the authority to conduct all business for and
on behalf of any and all the members of the JV during
the Initial Selection process, RFP process (in the event
the JV submits a Proposal) and during contract
execution (in the event the JV is awarded the Contract).
Unless specified in the ISDS, there is no limit on the
number of members in a JV.
4.3 A firm is not permitted to participate for initial selection
for the same contract both as an individual firm and as a
part of a joint venture or as a subcontractor. However, a
firm may participate as a subcontractor in more than one
Application but only in the capacity of a subcontractor.
Applications submitted in violation of this procedure
will be rejected.
Section I – Instructions to Applicants (ITA) 5
C. Preparation of Applications
9. Cost of Applications 9.1 The Applicant shall bear all costs associated with the
preparation and submission of its Application. The
Employer will in no case be responsible or liable for
those costs, regardless of the conduct or outcome of the
Initial Selection process.
10. Language of Application 10.1 The Application as well as all correspondence and
documents relating to the Initial Selection exchanged
by the Applicant and the Employer, shall be written in
the language specified in the ISDS. Supporting
documents and printed literature that are part of the
Application may be in another language, provided they
are accompanied by an accurate translation of the
relevant passages in the language specified in the
ISDS, in which case, for purposes of interpretation of
the Application, the translation shall govern.
11. Documents Comprising the 11.1 The Application shall comprise the following:
Application
(a) Application Submission Letter, in accordance
with ITA 12.1;
(b) Eligibility: documentary evidence establishing
the Applicant’s eligibility, in accordance with ITA
13.1;
(c) Qualifications: documentary evidence
Section I – Instructions to Applicants (ITA) 10
18. Late Applications 18.1 The Employer reserves the right to accept applications
received after the deadline for submission of
applications, unless otherwise specified in the ISDS.
19. Opening of Applications 19.1 The Employer shall open all Applications at the date,
time and place specified in the ISDS. Late
Applications shall be treated in accordance with ITA
18.1.
19.2 Applications submitted electronically (if permitted
pursuant to ITA 17.1) shall be opened in accordance
with the procedures specified in the ISDS.
19.3 The Employer shall prepare a record of the opening of
Applications to include, as a minimum, the name of the
Applicants. A copy of the record shall be distributed to
all Applicants.
22. Responsiveness of 22.1 The Employer may reject any Application which is not
Applications responsive to the requirements of the Initial Selection
Document. In case the information furnished by the
Applicant is incomplete or otherwise requires
clarification as per ITA 21.1, and the Applicant fails to
provide satisfactory clarification and/or missing
information, it may result in disqualification of the
Applicant.
23. Margin of Preference 23.1 Margin of preference for domestic Proposers shall not
apply in the RFP process resulting from this Initial
Selection.
24. Subcontractors 24.1 Unless otherwise stated in the ISDS, the Employer
does not intend to execute any specific elements of the
Plant Design, Supply and Installation by sub-
contractors selected in advance by the Employer (so-
called “Nominated Subcontractors”).
24.2 The Applicant shall not propose to subcontract the
whole of the contract. The Applicant may propose
subcontractors for certain specialized parts of the
contract. Applicants planning to use such specialized
subcontractors shall specify, in the Application
Submission Letter, the parts of the contract proposed to
be subcontracted along with details of the proposed
subcontractors including their qualification and
experience.
process;
(c) Step 3 - Long List: Applicants that
substantially meet the qualification criteria and
requirements in Table 1: Qualification Criteria
and Requirements will be long listed, and
evaluated further;
(d) Step 4 - Depending on the number of
Applicants that are long listed, one of the
following options will apply:
Option 1: All are Initially Selected: Where the
number of long listed Applicants is ≤x, all long
listed Applicants are Initially Selected. In this
scenario, there is no requirement to evaluate
these long listed Applicants against Table 2:
Rated Criteria and Requirements;
Option 2: Applicants are evaluated using
Table 2 Evaluation: Where the number of long
listed Applicants is ˃x, the Employer shall
evaluate all long listed Applicants against Table
2: Rated Criteria and Requirements. This
evaluation method involves scoring each
Application against rated criteria using the
scoring methodology described;
(e) Step 5 - Rank Applicants: The total scores,
from this step of the Initial Selection evaluation,
for each long listed Applicant are compared,
and the Applicants are ranked from the highest
to the lowest total score;
(f) Step 6 - Initial Selection up to x: In
accordance with the values selected by the
Employer for x and y, the Employer Initially
Selects the Applicants that are ranked from the
highest score, to the Application ranked as x;
(g) Step 7 - Reject y+1 Applicants: Where the
number of long listed Applicants is ˃y, the
Employer rejects all Applicants that are ranked
greater than y, i.e. ranked as y+1, y+2, y+3, etc.;
(h) Step 8 - Optional, at the Employer’s
Discretion: Ranked Applicants which are
greater than x, up to, and including y, are not
normally Initially Selected. However, the
Section I – Instructions to Applicants (ITA) 16
ITA 2.1 The Borrower is: [insert name of the Borrower and statement of relationship
with the Employer, if different from the Borrower. This insertion should
correspond to the information provided in the RFP]
Loan or Financing Agreement amount: [insert US$ equivalent]
____________________________
The name of the Project is: [insert name of Project]
ITA 4.2 Maximum number of members in the JV shall be: [insert a number or insert “not
limited”]
ITA 4.8 A list of debarred firms and individuals is available on the Bank’s external website:
http://www.worldbank.org/debarr.
ITA 7.1 & 8.2Web page: [In case used, identify the widely used website or electronic portal of
free access where Initial Selection information is published]
[If Yes, please add the address, date and time of the meeting]
C. Preparation of Applications
ITA 10.1 This Initial Selection document has been issued in the [Insert “English” or
“French” or “Spanish”] language.
Note: In addition to one of the above languages, and if agreed with the Bank, the
Borrower has the option to issue translated versions of the Initial Selection
document in another language which should either be: (a) the national
language of the Borrower; or (b) the language used nation-wide in the
Borrower’s country for commercial transactions. In such case, the following
text shall be added:]
“In addition, the Initial Selection document is translated into the [insert national or
nation-wide used] language [if there are more than one national or nation-
wide used language, add “and in the ____________” [insert the second
national or nation-wide language].
Applicants shall have the option to submit their Initial Selection Application in any
one of the languages stated above. Applicants shall not submit Applications in
more than one language.]”
All correspondence exchange shall be in ____________ language.
The Application as well as all correspondence shall be submitted in
_____________________. [Insert the language of the Initial Selection
document in case of one language]
Note: If the Initial Selection document is issued in more than one language, the
following text shall be inserted above: “in one of the above languages”]
Language for translation of supporting documents and printed literature is
_______________________. [Specify one language]
ITA 11.1 (d) The Applicant shall submit with its Application, the following additional documents:
[insert list of additional documents]
ITA 14.2 The source for determining exchange rates is [insert a publicly available source]
ITA 15.2 In addition to the original, the number of copies to be submitted with the Application
is: [insert number of copies]
D. Submission of Applications
ITA 17.1 The deadline for Application submission is:
Date: [insert date]
Time: [insert time]
[The time allowed for preparation and submission of the Initial Selection document
Section II – Initial Selection Data Sheet (ISDS) 21
ITA 19.1 The opening of the Applications shall be at [Insert date, time and address]
ITA 19.2 The following provision should be included and the required corresponding
information inserted only if Applicants have the option of submitting their
Applications electronically. Otherwise omit.]
The electronic Application opening procedures shall be: [insert a description of
the electronic Application opening procedures.]
Section II – Initial Selection Data Sheet (ISDS) 22
ITA 25.2 The relevant qualifications of the proposed Specialized Subcontractors [‘will be’/
‘will not be’] added to the qualifications of the Applicant for the purpose of
evaluation as indicated in Section III - Initial Selection Criteria and
Requirements.
ITA 31.1 The procedures for making a Procurement-related Complaint are detailed in
the “Procurement Regulations for IPF Borrowers (Annex III).” If an Applicant
wishes to make a Procurement-related Complaint, the Applicant should submit
its complaint following these procedures, in writing (by the quickest means
available, that is either by email or fax), to:
For the attention: [insert full name of person receiving complaints]
Title/position: [insert title/position]
Employer : [insert name of Employer]
Email address: [insert email address]
Fax number: [insert fax number] delete if not used
In summary, at this stage, a Procurement-related Complaint may challenge any
of the following:
Section II – Initial Selection Data Sheet (ISDS) 23
Contents
Table 1 – Qualification Criteria and Requirements......................25
1. Eligibility..................................................................................................................25
2. Historical Contract Non-Performance......................................................................26
3. Financial Situation and Performance........................................................................27
4. Experience.................................................................................................................29
Table 2 – Rated Criteria and Requirements................................30
1. Past Performance......................................................................................................31
2. Contract/Project Management Capability.................................................................32
3. Employer’s Requirements.........................................................................................33
4. Sustainable Procurement...........................................................................................34
Section III – Initial Selection Criteria and Requirements 25
1. Eligibility
3.1 Financial (i) The Applicant shall demonstrate Must meet Must meet N/A N/A Form FIN – 3.1, with
Capabilities that it has access to, or has available, requirement requirement attachments
liquid assets, unencumbered real
assets, lines of credit, and other
financial means (independent of any
contractual advance payment)
sufficient to meet the cash flow
requirements estimated as USD $
[insert amount in US$] for the subject
contract(s) net of the Applicants other
commitments. [In case the contracts
are to be procured as individual
contracts under a slice and package
(multiple contracts) state the cash
flow requirement to qualify for
individual and multiple contracts.]
3. Experience
Section III – Initial Selection Criteria and Requirements 30
All
Each One Submission
No. Subject Requirement Members
Member Member Requirements
Combined
4.1 General Experience in Plant Design, and/or Must meet N/A Must meet N/A Form EXP – 4.1
Experience Supply and/or Installation contracts in requirement requirement
the role of prime contractor, JV
member, subcontractor, or
management contractor for at least the
last [insert number] years, starting 1st
January [insert year].
4.2 Specific A minimum number of [state the Must meet Must meet N/A N/A Form EXP 4.2
Experience number] similar contracts specified requirement requiremen
below that have been satisfactorily t10
and substantially7 completed as a
prime contractor, joint venture
member 8, management contractor or
subcontractor between 1st January
[insert year] and Application
submission deadline:
7
Substantial completion shall be based on 80% or more of the contracts completed.
8
For contracts under which the Applicant participated as a joint venture member or sub-contractor, only the Applicant’s role and responsibilities shall be considered to meet this
requirement.
Section III – Initial Selection Criteria and Requirements 31
All
Each One Submission
No. Subject Requirement Members
Member Member Requirements
Combined
requirements for each slice, state the
specific experience requirement to
qualify for individual and multiple
contracts.]9
[Note to Employer: The criteria, requirements, maximum scores, weightings and scoring methodology contained in the tables below are
examples only and may be modified to suit the nature and complexity of the contract. Only applications that are substantially responsive
to the qualification criteria and requirements in Table 1 are to be assessed against Table 2, Rated Criteria and Requirements]
1. Past Performance
Scoring Documentation
Maximum Submission
Requirement Remark
score Requirement
1.1 Number of similar contracts [select a In case of JV, Form EXP 4.2
[Number of satisfactorily and substantially completed Plant Design, Supply and Installation maximum all members
contracts that exceed the number specified in Table 1, Sub-Factor 4.2(where this number is x)that score (out of combined will
are: 100) between be evaluated.
30 and 40]
1. similar to the Requirements (Reference Table 1, 4.2); and
2. completed during the past___ years. [insert number equal or more than the number of years
specified in Table 1, Sub-Factor 4.2] ]
Scoring methodology:
Number of contracts
[Number of satisfactorily and [>= x+4 [x+3 [x+2 [x+1 [x contracts]
substantially completed similar contracts] contracts] contracts] contracts]
contracts.]
[Contract/project management capability demonstrated in the following key areas: [select a In case of JV, Table 2-PM
[Note to Employer: consider putting a page limit on each of the responses] maximum the capability
score (out of of the lead
1. Description of project management system/s and how they will be applied (including status 100) between member will
of accreditation with recognized international standards applicable to the industry) 20 and 30] be evaluated
2. Environmental, Social, Health, and Safety management practice, and
3. Use of value Engineering, innovation and continuous improvement.]
Scoring methodology:
3. Employer’s Requirements
Criteria Scoring Documentation
Maximum Submission
Requirement Remark
score Requirement
4. Sustainable Procurement
Criteria Scoring Documentation
Maximum Submission
Requirement Remark
score Requirement
[Sustainable procurement (to be specified by the Employer) practices demonstrated in the following [select a In case of JV, at Table 2-SP
key areas: maximum least one
score (out of member will be
1. Sustainable procurement practice, and evaluated.
2. Track record of delivering sustainable procurement outcomes. 100) between
0 and 20]
Scoring methodology:
We, the undersigned, apply to be initially selected for the referenced Request for Proposal (RFP) and
declare that:
(a) No reservations: We have examined and have no reservations to the Initial Selection
Document, including Addendum(s) No(s). issued in accordance with ITA 8: [insert the
number and issuing date of each addendum].
(b) No conflict of interest: We have no conflict of interest in accordance with ITA 4.6;
(c) Eligibility: We (and our subcontractors) meet the eligibility requirements as stated in ITA 4, we
have not been suspended by the Employer based on execution of a Bid-Securing Declaration or
Proposal-Securing Declaration in accordance with ITA 4.10;
(d) Suspension and Debarment: We, along with any of our subcontractors, suppliers,
consultants, manufacturers, or service providers for any part of the contract, are not subject
to, and not controlled by any entity or individual that is subject to, a temporary suspension
or a debarment imposed by the World Bank Group or a debarment imposed by the World
Bank Group in accordance with the Agreement for Mutual Enforcement of Debarment
Decisions between the World Bank and other development banks. Further, we are not
ineligible under the Employer’s country laws or official regulations or pursuant to a decision
of the United Nations Security Council;
(e) State-owned enterprise or institution: [select the appropriate option and delete the other]
[We are not a state-owned enterprise or institution] / [We are a state-owned enterprise or
institution but meet the requirements of ITA 4.9];
(f) Subcontractors and Specialized Subcontractors: We, in accordance with ITA 24.2 and
25.2, plan to subcontract the following parts of the contract:
[Insert any part of the contract which the Applicant intends to subcontract along with
complete details of the Specialized Subcontractors, their qualification and experience]
(g) Commissions, gratuities, fees: We declare that the following commissions, gratuities, or
fees have been paid or are to be paid with respect to the Initial Selection process, the
corresponding RFP process or execution of the Contract:
[insert full name for [insert street/ [indicate reason] [specify amount
each occurrence] number/city/country] currency, value,
exchange rate and
US$ equivalent]
________________ ________________ ________________ ________________
________________ ________________ ________________ ________________
________________ ________________ ________________ ________________
________________ ________________ ________________ ________________
[If no payments are made or promised, add the following statement: “No commissions or gratuities
have been or are to be paid by us to agents or any third party relating to this Application]
(h) Not bound to accept: We understand that you may cancel the Initial Selection process at any
time and that you are neither bound to accept any Application that you may receive nor to
invite the initially selected Applicants to Submit Proposal for the contract subject of this
Initial selection process, without incurring any liability to the Applicants, in accordance with
ITA 26.1.
(i) True and correct: All information, statements and description contained in the Application are
in all respect true, correct and complete to the best of our knowledge and belief.
Applicant’s Name [insert full name of Applicant or the name of the JV]
[For a joint venture, either all members shall sign or only the authorized representative, in
which case the power of attorney to sign on behalf of all members shall be attached]
Section IV – Application Forms 39
Applicant's name
[insert full name]
In case of Joint Venture (JV), name of each member:
[insert full name of each member in JV]
Applicant's actual or intended country of registration:
[indicate country of Constitution]
Applicant's actual or intended year of incorporation:
[indicate year of Constitution]
Applicant's legal address [in country of registration]:
[insert street/ number/ town or city/ country]
Applicant's authorized representative information
Name: [insert full name]
Address: [insert street/ number/ town or city/ country]
Telephone/Fax numbers: [insert telephone/fax numbers, including country and city codes]
E-mail address: [indicate e-mail address]
1. Attached are copies of original documents of
Articles of Incorporation (or equivalent documents of constitution or association), and/or
documents of registration of the legal entity named above, in accordance with ITA 4.5.
In case of JV, letter of intent to form JV or JV agreement, in accordance with ITA 4.2.
In case of state-owned enterprise or institution, in accordance with ITA 4.9 documents
establishing:
Legal and financial autonomy
Operation under commercial law
Establishing that the Applicant is not under supervision of the Employer
2. Included are the organizational chart, a list of Board of Directors, and the beneficial
ownership.
Section IV – Application Forms 40
Applicant name:
[insert full name]
Applicant's JV Member’s name:
[insert full name of Applicant's JV Member]
Applicant's JV Member’s country of registration:
[indicate country of registration]
Applicant JV Member’s year of constitution:
[indicate year of constitution]
Applicant JV Member’s legal address in country of constitution:
[insert street/ number/ town or city/ country]
Applicant JV Member’s authorized representative information
Name: [insert full name]
Address: [insert street/ number/ town or city/ country]
Telephone/Fax numbers: [insert telephone/fax numbers, including country and city codes]
E-mail address: [indicate e-mail address]
1. Attached are copies of original documents of
Articles of Incorporation (or equivalent documents of constitution or association), and/or registration
documents of the legal entity named above, in accordance with ITA 4.5.
In case of a state-owned enterprise or institution, documents establishing legal and financial
autonomy, operation in accordance with commercial law, and they are not under the supervision of
the Employer, in accordance with ITA 4.9.
2. Included are the organizational chart, a list of Board of Directors, and the beneficial ownership.
Section IV – Application Forms 41
Form CON – 2
Historical Contract Non-Performance, and Pending
Litigation and Litigation History
[The following table shall be filled in for the Applicant and for each member of a Joint Venture]
Non-Performed Contracts in accordance with Section III, Table 1 Qualification Criteria, and
Requirements
Contract non-performance did not occur since 1st January [insert year] specified in Section III,–
Table 1 Qualification Criteria, and Requirements, Sub-Factor 2.1.
Contract(s) not performed since 1st January [insert year] specified in Section III,– Table 1
Qualification Criteria, and Requirements, Sub-Factor 2.1.
Year Non- Contract Identification Total Contract
performed Amount (current
portion of value, currency,
contract exchange rate
and US$
equivalent)
[insert [insert amount Contract Identification: [indicate complete contract [insert amount]
year] and percentage] name/ number, and any other identification]
Name of Employer: [insert full name]
Address of Employer: [insert street/city/country]
Reason(s) for nonperformance: [indicate main
reason(s)]
Pending Litigation, in accordance with Section III, Table 1 Qualification Criteria, and Requirements
No pending litigation in accordance with Section III, Table 1 Qualification Criteria, and
Requirements, Sub-Factor 2.3.
Pending litigation in accordance with Section III, Table 1 Qualification Criteria, and
Requirements, Sub-Factor 2.3 as indicated below.
Section IV – Application Forms 42
Judiciary]
Litigation History in accordance with Section III, Table 1 Qualification Criteria, and Requirements
No Litigation History in accordance with Section III, Table 1 Qualification Criteria, and
Requirements, Sub-Factor 2.4.
Litigation History in accordance with Section III, Table 1 Qualification Criteria, and
Requirements, Sub-Factor 2.4 as indicated below.
Year of Outcome as Contract Identification Total Contract
award percentage of Net Amount
Worth (currency), USD
Equivalent
(exchange rate)
[insert [insert Contract Identification: [indicate [insert amount]
year] percentage] complete contract name, number, and
any other identification]
Name of Employer: [insert full name]
Address of Employer: [insert
street/city/country]
Matter in dispute: [indicate main issues
in dispute]
Party who initiated the dispute: [indicate
“Employer” or “Contractor”]
Reason(s) for Litigation and award
decision [indicate main reason(s)]
Section IV – Application Forms 43
1. Financial data
Type of Financial information Historic information for previous _[insert number] years,
in [insert in words]
(currency) (amount in currency, currency, exchange rate*, USD
equivalent)
Year 1 Year 2 Year 3 Year4 Year 5
2. Sources of Finance
[ The following table shall be filled in for the Applicant and all parties combined in case of a Joint
Venture]
Specify sources of finance to meet the cash flow requirements on contracts currently in
progress and for future contract commitments.
3. Financial documents
The Applicant and its parties shall provide copies of financial statements for [number] years pursuant
Section III, Table 1 –Qualification Criteria, and Requirements Sub-factor 3.1. The financial statements
shall:
(a) reflect the financial situation of the Applicant or in case of JV member , and not an
affiliated entity (such as parent company or group member).
Attached are copies of financial statements11 for the [number] years required above; and
complying with the requirements
11
If the most recent set of financial statements is for a period earlier than 12 months from the date of Application, the reason
for this should be justified.
Section IV – Application Forms 45
Average Annual
Turnover **
[The following table shall be filled in for the Applicant and in the case of a JV Applicant, each
Member]
[As per Section III, Table 1 Qualification Criteria, and Requirements, Sub-Factor 4.1. list
contracts chronologically, according to their commencement (starting) dates.]
[The following table shall be filled in for contracts performed by the Applicant, each member
of a Joint Venture, and Specialized Sub-contractors]
Information
Similar Contract No.
[insert number] of [insert number
of similar contracts required]
Contract Identification [insert contract name and number, if applicable]
Award date [insert day, month, year, i.e., 15 June, 2015]
Completion date [insert day, month, year, i.e., 03 October, 2017]
Role in Contract Prime Member in Management
Sub-contractor
[check the appropriate box] Contractor JV Contractor
Table 2-PM
Contract / Project Management Capability
The applicant shall demonstrate Contract / Project Management Capability in accordance with
Table 2
Section IV – Application Forms 50
Table 2-ER
Understanding of the Employer’s Requirement
The applicant shall demonstrate an Understanding of the Employer’s Requirement in
accordance with Table 2
Section IV – Application Forms 51
Table 2-SP
Sustainable Procurement
The applicant shall demonstrate capability in Sustainable Procurement in accordance with
Table 2
Section V – Eligible Countries 52
In reference to ITA 5.1, for the information of the Applicants, at the present time firms and
individuals, supply of goods, or contracting of works or services, from the following countries are
excluded from this Initial Selection process:
Under ITA 5.1 (a) [insert a list of the countries following approval by the Bank to apply the
restriction or state “none”]
Under ITA 5.1 (b) [list the countries or state “none”]
Section VI – Fraud and Corruption 53
1. Purpose
1.1 The Bank’s Anti-Corruption Guidelines and this annex apply with respect to procurement
under Bank Investment Project Financing operations.
2. Requirements
2.1 The Bank requires that Borrowers (including beneficiaries of Bank financing); bidders
(applicants/proposers), consultants, contractors and suppliers; any sub-contractors, sub-
consultants, service providers or suppliers; any agents (whether declared or not); and any of
their personnel, observe the highest standard of ethics during the procurement process,
selection and contract execution of Bank-financed contracts, and refrain from Fraud and
Corruption.
b. Rejects a proposal for award if the Bank determines that the firm or individual
recommended for award, any of its personnel, or its agents, or its sub-consultants, sub-
contractors, service providers, suppliers and/ or their employees, has, directly or
indirectly, engaged in corrupt, fraudulent, collusive, coercive, or obstructive practices in
competing for the contract in question;
c. In addition to the legal remedies set out in the relevant Legal Agreement, may take other
appropriate actions, including declaring misprocurement, if the Bank determines at any
time that representatives of the Borrower or of a recipient of any part of the proceeds of
the loan engaged in corrupt, fraudulent, collusive, coercive, or obstructive practices
during the procurement process, selection and/or execution of the contract in question,
without the Borrower having taken timely and appropriate action satisfactory to the Bank
to address such practices when they occur, including by failing to inform the Bank in a
timely manner at the time they knew of the practices;
d. Pursuant to the Bank’s Anti-Corruption Guidelines, and in accordance with the Bank’s
prevailing sanctions policies and procedures, may sanction a firm or individual, either
indefinitely or for a stated period of time, including by publicly declaring such a firm or
individual ineligible (i) to be awarded or otherwise benefit from a Bank-financed
contract, financially or in any other manner; 12 (ii) to be a nominated13 sub-contractor,
consultant, manufacturer or supplier, or service provider of an otherwise eligible firm
being awarded a Bank-financed contract; and (iii) to receive the proceeds of any loan
made by the Bank or otherwise to participate further in the preparation or implementation
of any Bank-financed project;
e. Requires that a clause be included in request for bid/request for proposals documents and
in contracts financed by a Bank loan, requiring (i) bidders (applicants/proposers),
consultants, contractors, and suppliers, and their sub-contractors, sub-consultants, service
providers, suppliers, agents personnel, permit the Bank to inspect14 all accounts, records
and other documents relating to the procurement process, selection and/or contract
execution, and to have them audited by auditors appointed by the Bank.
12
For the avoidance of doubt, a sanctioned party’s ineligibility to be awarded a contract shall include, without limitation, (i)
applying for pre-qualification, expressing interest in a consultancy, and bidding, either directly or as a nominated sub-
contractor, nominated consultant, nominated manufacturer or supplier, or nominated service provider, in respect of such
contract, and (ii) entering into an addendum or amendment introducing a material modification to any existing contract.
13
A nominated sub-contractor, nominated consultant, nominated manufacturer or supplier, or nominated service provider
(different names are used depending on the particular bidding document) is one which has been: (i) included by the bidder in
its pre-qualification Application or bid because it brings specific and critical experience and know-how that allow the bidder
to meet the qualification requirements for the particular bid; or (ii) appointed by the Borrower.
14
Inspections in this context usually are investigative (i.e., forensic) in nature. They involve fact-finding activities undertaken
by the Bank or persons appointed by the Bank to address specific matters related to investigations/audits, such as evaluating
the veracity of an allegation of possible Fraud and Corruption, through the appropriate mechanisms. Such activity includes
but is not limited to: accessing and examining a firm's or individual's financial records and information, and making copies
thereof as relevant; accessing and examining any other documents, data and information (whether in hard copy or electronic
format) deemed relevant for the investigation/audit, and making copies thereof as relevant; interviewing staff and other
relevant individuals; performing physical inspections and site visits; and obtaining third party verification of information.
Section VI – Fraud and Corruption 55
2. Implementation Period