Waha Oil Company

General Questionnaire Form

PLEASE FILL IN THE FORM

Company name …………………………………………………………………………………………………..…………….
Date …………………………………………………………………………………………………..…………….

This General Questionnaire is intended to collect further information with regards to legal, technical,
financial and organizational data on the Applicants of EPC Project for the oil and gas industry for Waha
Oil Company.
Instructions for the data/ information entry:
No. Instruction
1. Detailed information on partners, affiliates, etc. shall be specified with appropriate
attachments.
2. Sections not applicable should be annotated “N/A”
3. Duplicate if necessary and attach any additional information, data sheets, catalogues,
brochures, etc. as appropriate.
4. “Company” Means your Company, “Unit” means any departmental / divisional section of
your Company.

The Authorized Persons who responsible in providing the information to this General Questionnaire is:
Name …………………….………………………………..……. Unit/ Department …………………………….……..
Position …………………….……………………………………………..………………………………………………………………..
Tel. No. …………………….……………………………………. Fax No. ………………….………………..
Email …………………….……………………………………………..………………………………………………………………..

WAHA OIL COMPANY

Burj Bulayla Tower, 32nd Floor Page 1 of 10
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169
 Waha Oil Company
General Questionnaire Form

1. COMPANY GENERAL & LEGAL INFORMATION

Company Name: ………………………………………………………………………. Reg. Office address:

……………………………………………………………………… …………………………………………………….
Telephone:

Facsimile: ……………………………………………………………………… Website :

………………………………………………………………………
……………………………………………………
Company Origin Email:
…..
……………………………………………………
Legal Reps. Name ……………………………………………………………………… Reg. Office address:
…..
Telephone: ……………………………………………………………………… …………………………………………………….
……………………………………………………………………… Email:
Facsimile:
……………………………………………………
……………………………………………………………………… Reg. Office address:
…..
Parent Company / Prev.
Name …………………………………………………….
Telephone: ………………………………………………………………………

Facsimile: ……………………………………………………………………… Website :

………………………………………………………………………
……………………………………………………
Company Origin Email:
…..
……………………………………………………
Enquiries to be Sent to …..
………………………
Company Registration No: ……………………………….. Date of Registration ………..

Company type: Partnership Public Limited Private Limited Other

………………………
Country of Reg.: ……………………………….. ……………………………….. ……………………………….. ………..

Present Ownership since: ………………………………..

Names of Owner(s): ………………………………..

Contact for insurance ………………………………..

information
1.1 Registration and Authorization
Fully Libyan Company (If Yes, please attach detail document). YES NO
Foreign Company Officially Registered in Libya (If Yes, please attach detail YES NO
document).
During the last five years has your organization been in bankruptcy or statutory
YES NO
reorganization
During the last five years has your organization been Abandoned work on any
YES NO
contract prior to its completion?
During the last five years has your organization been a defendant in any court action
YES NO
alleging breach of contract?
Does your company have any previous experience with Waha Oil Company? (If Yes,
YES NO
please attach detail document).
Does your company have any previous experience in Libya? (If Yes, please attach
detail document). YES NO

WAHA OIL COMPANY

Burj Bulayla Tower, 32nd Floor
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169
Page 2 of 10
 Waha Oil Company
General Questionnaire Form

If any individual/entity owns legally or beneficiary more than thirty percent (30%)
portion of your organization, please provide detail name and address of such YES NO
individual/entity.
Does your company have any previous experience with Litigation proceeding? (If
Yes, please attach detail document). YES NO

2. COMPANY PRIMARY BUSINESS ACTIVITIES:

Main Business Activity: …………………………………………………………………………………..…………………………………

Work normally …………………………………………………………………………………..…………………………………
Subcontracted:
Provide List of manufacturers for whom you are a licensed supplier/Vendor (please attach copy of license)

1. ……………………………………..….. 2. ……………………………………..….. 3. ……………………………………..…..

4. ……………………………………..….. 5. ……………………………………..….. 6. ……………………………………..…..

Please provide list of current Facilities, Equipment and tools availability and its status to support the project.
No. Description of Facilities/Equipment/Tools Location/Condition Status
1 ……………………………..……………………………… …………………………… …………………………
2 ……………………………..……………………………… …………………………… …………………………
3 Etc.

3. MANPOWER RESOURCES

3.1 Organization structure

1) Please fill out the following table with current data.

No. Key Position Available Full Name
1. Chairman /CEO YES NO ……………………………………….
2. General Manager YES NO ……………………………………….
3. Finance Manager YES NO ……………………………………….
4. Accounting Manager YES NO ……………………………………….
5. Sales Manager YES NO ……………………………………….
6. Technical Manager YES NO ……………………………………….
7. Operation Manager YES NO ……………………………………….
8. Procurement Manager YES NO ……………………………………….
9. Quality Manager YES NO ……………………………………….
10. Safety Manager YES NO ……………………………………….
11. Other YES NO ……………………………………….
2) Please attach the current organization chart of the company (if the company is part of group please provide
organization chart indicating the relevant position).
WAHA OIL COMPANY
Burj Bulayla Tower, 32nd Floor
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169
Page 3 of 10
 Waha Oil Company
General Questionnaire Form

3.2 Permanent Staff & Craft

Please indicate the core staff and craft that you consider as permanent manpower and include the average
years of continuous employment with your company (please add to table as required) Also please indicate
which works / disciplines that you would normally subcontract .In addition to the table below, please supply
a manpower histogram to reflect permanent manpower resources covering the previous 2 years.
Number of Personnel Combined
Staff Total years of
Junior Senior Principal Available experience

Project Management ……. ……. ……. ……. …….

Engineering ……. ……. ……. ……. …….
PDDM (Document Control) ……. ……. ……. ……. …….
Quality ……. ……. ……. ……. …….
HSE ……. ……. ……. ……. …….
Project Controls ……. ……. ……. ……. …….
Procurement ……. ……. ……. ……. …….
Construction Management & ……. ……. ……. ……. …….
Supervisor
Training ……. ……. ……. ……. …….
Finance ……. ……. ……. ……. …….
Contracting ……. ……. ……. ……. …….
IT ……. ……. ……. ……. …….
Craft ……. ……. ……. ……. …….
Civil ……. ……. ……. ……. …….
Mechanical ……. ……. ……. ……. …….
Electrical ……. ……. ……. ……. …….
Instrumentation ……. ……. ……. ……. …….
Others ……. ……. ……. ……. …….

3.3 Please answer the following (‘Yes’ / ‘No’)

Has any of your personnel ever been employed by Waha Oil Co
1 Company? If Yes, please attach the details. YES NO

Have any of your key personnel been involved in any firm, which has
2 been bankrupt, liquidated or gone into receivership? If Yes, please YES NO
attach the details.

4. FINANCIAL CAPACITY

Last year ($) Second year ($) Third year ($)

Turnover Value
…………………… …………………… ……………………
Has your company met the terms of its banking facilities and loan
arrangements during the past year? If “No” please explain why. YES NO

WAHA OIL COMPANY

Burj Bulayla Tower, 32nd Floor Page 4 of 10
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169
 Waha Oil Company
General Questionnaire Form

Has your company met all its obligations to pay creditors and
staff during the past year? If “No” please explain why. YES NO

What is the name and address of your bankers (who could provide a reference), please provide detail
below:
Bank Name----------------------------- Branch address ------------------------------------ Contact person-----------------
------
4.1 Telephone
Please No--------------------------------------------------
attach the following: Email--------------------------------------------------------

1) Copy of the organizations audited financial statement including cash flow & Funds for the last three
years.
2) Written authorization to contact the bank indicated for verification of references.
3) Declaration that no arbitration and /or litigation with client or supplier (s) exist.
4) A statement of your cash flow forecast for the current year and a bank letter outlining the current
cash and credit position.

5. INSURANCES

Please provide details of your current insurance coverage and its limits for the following:
1 Employers Liability ……………………………………… Value in USD ………………………………………
2 General Liability ……………………………………… Value in USD ………………………………………
3 Other (Please specify) ……………………………………… Value in USD ………………………………………

6. TECHNICAL EXPERIENCE & TRACK RECORD

1) Please provide list to all Oil & Gas contracts which still in the execution process or it has been
completed in the last three years, under the following headings (substitute your own schedules if
you wish and give as much detail as is relevant to undertaking for future opportunities):
2) Please ensure that under the headings of “type of work” and “value” the description and amount given
is that for the actual Contract scope undertaken by your Company. "Type of work" should indicate
whether your Company was performing FEED, EPC, PMC or other functions, and whether your Company
was the main contractor, or a sub- contractor.
3) Please ensure that under the headings of “Start Date” and “Contract Duration”, the ‘Date’ shall
be the commencement date and the ‘Project Duration’ shall be the agreed project Duration in
accordance to the particular contract including written references from the Client.
6.1 Current Contracts / Projects.
Client/location Type of work Value (USD) Start date Proj. Duration Customer contact Tel. / Fax.
……………. ……………. ……………. ……………. ……………. ……………. …………….
……………. ……………. ……………. ……………. ……………. ……………. …………….
6.2 Previous Contracts / projects in the last three years.
Proj.
Client/location Type of work Value (USD) Start date Customer contact Tel. / Fax.
Duration
……………. ……………. ……………. ……………. ……………. ……………. …………….
……………. ……………. ……………. ……………. ……………. ……………. …………….
6.3 Preferred Job Cost Range
WAHA OIL COMPANY
Burj Bulayla Tower, 32nd Floor Page 5 of 10
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169
 Waha Oil Company
General Questionnaire Form

Minimum Value ……………………………………………………………. (US$)

Banking References ………………………………………………………………………

7. WORKLOAD
Present a listing that details current Projects (backlog) with information as shown below. Please
supply Backlog curves to support the data (if available).
7.1 Current Projects:
The following data for projects currently in hand in contractor’s office (only to projects over USD 1
Billion contract price):
1) Client:
2) Project Type/Location of Project
3) Project planned & actual Start Date
4) Scheduled Completion Date
5) Installed cost/ approx. value of work performed
6) Nature of services/work performed
7) Performed as main or sub-contractor
8) Management services
9) Name of Client Representative (may be used for obtaining references)
10) Telephone / contact details of Client Representative
11) What percentage of your current workload comprises projects of less than USD 1 Billion?
7.2 Up-coming Projects
For new projects that can be expected in the near future, please supply projected staffing / craft
levels. Please complete the table below
Type of projects Number of Indirect Number of Directs Expected Man-hours
General Contracting ……………………………… ……………………………… ……………………………
Civil ……………………………… ……………………………… …
……………………………
Mechanical / Piping ……………………………… ……………………………… …
……………………………
Electrical / Instrumentation …
……………………………… ……………………………… ……………………………
…
Provide an indication, preferably in graphical form, for the next three years and expressed in staff
hours per month of:
1) Current workload
2) Expected workload
3) Total productive capacity
4) Total staff month capacity
8. ENGINEERING CAPABILITY
Please indicate any Engineering capability that your company has. This should include design, drafting
and shop detailing services if applicable. (Please add to table as required)
WAHA OIL COMPANY
Burj Bulayla Tower, 32nd Floor Page 6 of 10
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169
 Waha Oil Company
General Questionnaire Form

Engineering Type Design Drafting Shop Detailing

Civil / Structural / Architectural …………………………… …………………………… ……………………………
Piping …………………………… …………………………… ……………………………
Mechanical …………………………… …………………………… ……………………………
Electrical …………………………… …………………………… ……………………………
Instrumentation …………………………… …………………………… ……………………………
Others …………………………… …………………………… ……………………………

9. PROCUREMENT

Does your company have any experience with procurement of materials? YES NO

Does your company have an electronic materials management system? YES NO

If not then advise what systems are in place within your company to control requisitioning,
purchasing, expediting, logistics management, warehousing and material control.
Please supply USD value details of procurement that your company has undertaken in the
previous three (3) years.

Year Last year Second year Third year

Total value ………………………… ………………………… …………………………

10. QUALITY ASSURANCE

Is your company certified to ISO 9001? YES NO

If yes, please submit a copy of the Certificate from the certifying institute If not certified, does
your company have another Quality Control System?
If yes, please provide a short description of this system though the following table below or
attach the relevant documentation.

Name(s) of Company QA Representative(s) Contact details

……………………………………………………..………………… ……………………………………………………..…………………
……………………………………………………..………………… ……………………………………………………..…………………

11. PROJECT MANAGEMENT SYSTEMS & SUBCONTRACTING

Does your company use electronic Planning and Scheduling systems? If Yes,
please state name and type of software. YES NO
Does your company use electronic Cost / Time Control systems? If Yes, state
name and type of software. YES NO
Does your company use CAD or other drafting systems? If ‘Yes’, state name and
type of software. YES NO

WAHA OIL COMPANY

Burj Bulayla Tower, 32nd Floor Page 7 of 10
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169
 Waha Oil Company
General Questionnaire Form

Does your company use electronic Purchasing and Material Control systems?
If ‘Yes’, state name and type of software. YES NO

Does your company use an electronic Document Control system? If yes, state
name and type of software. YES NO

Does the above mentioned systems are to be collaborated on line system

base? YES NO

Does your company frequently subcontracting some portion of the Work to

subcontractor? If ‘Yes’, please provide the list of subcontractor you have and YES NO
describe the service they have provided to you.
Does your company prequalify any vendor/ subcontractor/supplier prior to
make an agreement? If ‘Yes’, please provide the manual. YES NO

Does your company carry out performance evaluation of any subcontracting

work to Subcontractor/vendor/supplier during and after the work completed? YES NO

12. HEALTH, SAFETY & ENVIRONMENTAL (HSE)

Does your company have Safety Policy, HSE Mission Statement and Vision in
place? If yes please attach a copy of the cover and index pages YES NO

Does your company have a HSE Program or Safety Management System? If

Yes, Please provide a copy of the primary document Table of Contents YES NO

Are there Company procedures for storing and handling hazardous

substances? If Yes, please provide details. YES NO

Does your company have a Safety Orientation Program for new hires? YES NO
Does your company have a Safety Training Program for Construction
Supervision? YES NO

Does your company hold regular workplace HSE meetings for supervisors? YES NO
Does your company hold employee ‘toolbox’ HSE meetings on site? YES NO
If yes, at what frequency? Daily Weekly Biweekly Monthly
Does your company conduct HSE pre-task assignment meeting with
employees? If yes please attach a copy of notes from a recent pre-task YES NO
assignment
Does your company conduct workplace HSE inspections? YES NO
Does your company enforce the HSE implementation to its subcontractor/
YES NO
vendors/supplier?
Does your company conduct the HSE inspection to its subcontractor/ vendors /
YES NO
supplier?
If yes, at what frequency? Daily Weekly Biweekly Monthly

WAHA OIL COMPANY

Burj Bulayla Tower, 32nd Floor Page 8 of 10
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169
 Waha Oil Company
General Questionnaire Form

12.1 Please list below the requested HSE statistics (as per OSHA definitions) for your company for the last
three years in (Libya & worldwide).

Description Last year Second year Third year

Number of OSHA Recordable Cases …………. …………. ………….
Number of Lost Workdays …………. …………. ………….
Number of Restricted Workdays …………. …………. ………….
Number of Fatalities …………. …………. ………….
Number of Man-Hours Worked …………. …………. ………….
Lost time incident rate per 200,000
…………. …………. ………….
man-hours worked
Total recordable incident rate per
…………. …………. ………….
200,000 man-hours worked
Number of Vehicle accidents …………. …………. ………….

If the record data is provided in a different format please attach the detail in proper order.

Have any notices been served upon your company with respect to Health, Safety
or Environmental incidents? YES NO

Does your company carry out random testing for alcohol and/or drug abuse? YES NO
Does your company have an equipment Safety Inspection procedure? YES NO
Does your company have a behavioral safety management system in place? If
yes please attach a flow chart (or other) detailing this YES NO
Do your employees / sub-contractors read, write and understand English such
that they can perform their job tasks safely without an interpreter? YES NO

Do you 'Safety Qualify' your sub-contractors? YES NO

13. ENVIRONMENTAL COMPLIANCE

During the last five years, has your company/firm received a violation/fine/penalty for non-
compliance involving any of the following?
Improper disposal/dumping of hazardous waste or hazardous materials on YES NO
land or in water.
Discharging oil, an oil byproduct, or other hazardous substances to land, YES NO
water, or air.
Release of oil or hazardous waste during transport of hazardous materials YES NO
and/or hazardous waste.
If the answer ‘Yes’ to any of the questions above, please provide an explanation of the circumstances
surrounding the violation in a separate paper.
What is your company’s normal ratio of site HSE supervisors to the workforce?
1:50 1:200 1:150 1:100 Other

Please supply of listing of other HSE related training programs that your company implements in a
separate paper.
WAHA OIL COMPANY
Burj Bulayla Tower, 32nd Floor Page 9 of 10
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169
 Waha Oil Company
General Questionnaire Form

14. PROFESSIONAL AND BUSINESS STANDING

Do any of the following apply during last 5 years to your company or to (If any) the Director(s)
/Partner(s)/ Proprietor(s) \:
Was in a state of bankruptcy, insolvency, compulsory winding up,
1 and receivership or subject to relevant proceedings? YES NO

Has been convicted of criminal offence related to business or

2 professional conduct? YES NO
Has committed an act of grave misconduct in the course of
3 business? YES NO

4 Has not fulfilled obligations related to payment of taxes? YES NO

Is not in possession of relevant licenses or membership of an
5 appropriate professional body where required by law? YES NO
Would your organization be prepared to offer a bid or performance
6 Bond if required? YES NO
Has your organization ever had a contract terminated under the
7 terms of the contract? YES NO

Has your organization ever been unable to renew a contract for

8 failure to perform to the terms of the original contract? YES NO

If ‘Yes’ to any of the above questions, please attach the details in a separate paper and proper order.

15. DECLARATION

I declare that the answers submitted in this General Questionnaire and any supporting documents
provided are correct. I understand that the information will be used in the evaluation process to assess
my organization’s suitability to fulfil Waha Oil Company further requirements.

Form completed by : …………………………………………………..

Name: …………………………………………………..
Position/Job Title: …………………………………………………..
Date : …………………………………………………..
Telephone No: …………………………………………………..

Signature & Stamp: Sign & Stamp

WAHA OIL COMPANY

Burj Bulayla Tower, 32nd Floor Page 10 of 10
P.O Box: 395 Tripoli – Libya Tel: +
218 21 3337161
Fax: +218 21 3337169