Document Name:

Supplier Prequalification
Questionnaire
Date:

74-01-V2

Ref. No.

Al-Gihaz Co. provides power transmission, power plants, cabling, telecom and contracting services for its clients. If you
would like to be considered for inclusion on our prequalification subcontractor and material supplier list, please fill out
the entire form and return it to the P.O.Box# 7451 Riyadh 11462. Thank for you for your interest.
1. Company Details:
Name of vendor
Registered address
Phone
Fax
Email
Website
Established, date
Company Registration No.
Number of employees
Turnover last year
Bank Details
Product/service range Please describe the
goods or services that your company
provides.

2. Owners:
Name
Essa Ahmed Rashid al
dossary

Khalifa Ahmed Rashid

Al dossary

Khalid Ahmed Rashid

Al dossary

Mohammed Ahmed
Rashid Al dossary

Page 1 of 3

INDUSTRIAL PROJECT MANAGEMENT SOLUTION

AL-SHATEA PLAZA; PRINCE MUHAMMED BIN
FAHAD ROAD; P.BOX NO 5555; DAMMAM 31432;
KINGDOM OF SAUDI ARABIA
+966-3-8316716
+966-3-8316677
prasb@ipms.com.sa
www.ipms.com.sa
23-04-2011
2050075764
50
10 million
RIYADH BANK- Al Mazrouiah Branch
A/C NO 3510361679940
Testing and commissioning of Transformer, switch
gear, protection panels etc.. And supply, installation
and commissioning and testing services as regards
fiber optics .(Please refer the attached company
profile)

Address
AL-SHATEA PLAZA;
PRINCE MUHAMMED
BIN FAHAD ROAD;
P.BOX NO 5555;
DAMMAM 31432;
KINGDOM OF SAUDI
ARABIA
AL-SHATEA PLAZA;
PRINCE MUHAMMED
BIN FAHAD ROAD;
P.BOX NO 5555;
DAMMAM 31432;
KINGDOM OF SAUDI
ARABIA
AL-SHATEA PLAZA;
PRINCE MUHAMMED
BIN FAHAD ROAD;
P.BOX NO 5555;
DAMMAM 31432;
KINGDOM OF SAUDI
ARABIA
AL-SHATEA PLAZA;
PRINCE MUHAMMED
BIN FAHAD ROAD;
P.BOX NO 5555;
DAMMAM 31432;
KINGDOM OF SAUDI
ARABIA

% Ownership
10%

Nationality
SAUDI

21%

SAUDI

21%

SAUDI

50%

SAUDI

Document Name:

Supplier Prequalification
Questionnaire
Date:

74-01-V2

Ref. No.
3. Contact details:
Primary Contact
Management
Quality
Sales
Purchasing
Manufacturing
Engineering
Technical
Finance
Service

Name
Prasad Bandekar
Devendran.P
Mohammed Iliyas
Loay Al suwaidan

Nabil Nasr

Title
Operation Director
Project manager
Lead BD
Purchase Manager

CFO

4. Please identify three business references:

Company
Contact Name
Nesma Contracting
Mr. Thomas Raj

Phone
+966-3-8316713
+966-3-8316715
+966-3-8316714
+966-3-8316711

+966-3-8316711

Phone

Email
prasb@ipms.com.sa
deivp@ipms.com.sa
mikhan@ipms.com.sa
lawis@ipms.com.sa

nabil@ipms.com.sa

Email

5. Quality Management System:

Yes

No

Comments

5.1
Do you have an accredited Quality Management System
like: ISO 9001:2008 or equivalent?
5.2
Do you have an accredited Health & Safety system like
OHSAS 18001:2007 or equivalent?
5.3
Do you have an accredited Environmental system like ISO
14001: 2004 or equivalent?
If you have an accredited system or approvals please attach a copy of your current approval
certificates.
6. Quality Questionnaire:
Yes
Do you design any of your own products?
Do you have a documented process to
conduct quality audits of your suppliers?
Do you have a documented process for
employee training?
Do any of your products contain
hazardous substances?
Do you have ethical practices, rules or
policies?

Page 2 of 3

No

Comments

Document Name:

Supplier Prequalification
Questionnaire
Date:

74-01-V2

Ref. No.

7. Documents to be provided by supplier:

Annual reports and financial statements for the last three years
Company organization chart, including names and position titles

Supplier to fill out:

I certify that the foregoing is true and correct.
Name of person completing this form
Mohammed Iliyas Khan
Position
Lead Business Development
Signature
Date
03-03-2015

For Al Gihaz use only:

Yes
Supplier Approved
Name of person completing this form

Approvers signature
Confirmed by
Date

Page 3 of 3

No