DocuSign Envelope ID: BB09FC93-B5BA-4D7F-BF9D-0524F4B1EF7F

Tender Reference:
Date:

Prequalification Questionnaire
(all documents are mandatory and all requested information must be provided)

DEMOLITION works
Data return requirements:

O Company Data
O Approved Power of Attorney of the Senior Representative
O Shareholder structure
O Company structure / Organization chart (parents, subsidiaries, joint ventures, shared etc…)
O General Presentation of Company
O Copy of Registration certificate
O Copy of valid Environmental Permits
O Copy of valid Certificates of Romanian Railway Authority (for railways dismantling works)
O Copy of Management System Certificate (e.g. ISO 9001)
O Copy of the Environmental System Certification (e.g. ISO 14001)
O Financial information: turnover, profit & loss, rating
O VAT certificate
O Excerpt of your Company’s Financial Statements for the last three (3) years
O Letter of Confort from primary bank
O List of Products / Services offered Activities that can be assured by the Applicant
O Relevant Experience: five (5) references in the last three (3) years
O Personnel data
O List of key personnel related to tender and corresponding CVs
O HSSE questionnaire
O Subcontractors and Suppliers information
O Code of Conduct signed
DocuSign Envelope ID: BB09FC93-B5BA-4D7F-BF9D-0524F4B1EF7F

Tender Reference:
Date:

1 Company data

1.1 Full Company name:

1.2 Business operating address - street, city, state/province, country, postal code:

1.3 Contact person (name, telephone number, e-mail):

1.4 Please attach an approved power of attorney of the senior representative, stating that she/he is authorized
to act and sign on behalf of the company:

1.5 Telephone and fax number (including area code):

1.6 Please attach Company structure / organization chart (ownership structure, subsidiaries, joint ventures
and shared companies…)

1.7 Parent Company name and address (if required use attachments to this Questionnaire for shareholder
information):

1.8 If the application for participation in this tendering process is submitted on behalf of a consortium or
alliance, list all member companies of the consortium or alliance, and specify for each the full and official company
name, commercial registration details, full postal address (if required use attachments to this Questionnaire).:

1.9 Do you have previous oil and gas experience? If yes, state the number of years.

YES NO

_____ years

1.10 Contracts with OMV will be in Romanina / English language, subject to Romanin law. Confirm willingness
to enter into a commitment subject to these terms.

YES NO
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Tender Reference:
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1.11 Attach a general presentation of your Company

1.12 Attach a copy of the Registration Certificate

1.13 Attach copy of the valid Environmental Permits

1.14 Attach copy of valid Certificates of Romanian Railway Authority (for railways dismantling works)

1.15 Attach a copy of Management System Certificate (e.g. ISO 9001)

1.16 Attach a copy of the Environmental System Certification (e.g. ISO 14001)

2 Financial Status and Information

2.1 Please confirm that details of your company’s Financial Statements can be made available to OMV upon
request.

YES NO
or
[Attach excerpt of your Company’s Financial Statements for the last three (3) years.]

2.2 State credit rating if available from one of the international credit agencies [Coface, D&B, etc].

Agency Name:
Date of rating:
Rating:

2.3 Please confirm willingness to provide Letter of Confort from your primary bank:

YES NO

2.4 State annual turnover for the last three (3) full operating years, in RON.

2015
2016
2017

2.4.1. State net profit/loss for the last three (3) full operating years, in RON

2015
2016
2017

2.5 Proposed payment would be in RON. Confirm willingness to accept payment in RON

YES NO

2.6 Acceptance of Romanian Law

YES NO
DocuSign Envelope ID: BB09FC93-B5BA-4D7F-BF9D-0524F4B1EF7F

Tender Reference:
Date:

3 Works/ Activities that can be assured by the Applicant

3.1 The Applicant must clearly indicate which specific works/activities (demolition and/or mechanical
activities) they are willing, capable, and judge themselves experienced and competent to provide to OMV Group
(if required use attachments to this Questionnaire):

4 Relevant Experience

4.1 Provide details of the most recent five (5) similar contracts on last three (3) years (2016-2018) where you
provided similar works, anywhere in the world, as requested below:
"similar contract" = means individual orders / contracts of similar works in amount of minimum 150,000 Euro per
order / contract and/or min 3 months duration for demolition or 50.000 Eur per order/contract for mechanical
works.

Client Company:
Project description:
Country Location:
Contract Duration (start-finish):
Value (EURO / RON ):

Client Company:
Project description:
Country Location:
Contract Duration (start-finish):
Value (EURO / RON ):

Client Company:
Project description:
Country Location:
Contract Duration (start-finish):
Value (EURO / RON ):

Client Company:
Project description:
Country Location:
Contract Duration (start-finish):
Value (EURO / RON ):

Client Company:
Project description:
Country Location:
Contract Duration (start-finish):
Value (EURO / RON ):
DocuSign Envelope ID: BB09FC93-B5BA-4D7F-BF9D-0524F4B1EF7F

Tender Reference:
Date:

5 Personnel Competency, Training, Qualifications and Certification ; Equipment available

5.1 Attach a copy of your organizational chart, CVs and certification documents according to the job position
of the key personnel related to this tender: manager contract, Sef de santier, responsabil SSM, supervizor de
siguranta, RSVTI, Maistri/Tehnicieni/Sef echipa, Responsabil gestiunea deseurilor, Mecanici/lacatusi, Legatori de
sarcina, sudori oxiacetilenic, electricieni, operatori utilaje, operatori utilaje de ridicat, soferi.

Note:
The winning bidder will receive at the same time up to 4 demolition works.

5.2 a. Average number of employees over the last three (3) years. Please split as per below table separate
workers / white collars (if required use attachments to this Questionnaire):

Resources / Personnel 2016 2017 2018

1. Personal de conducere
2. Personal tehnic
2.1 Project Manager/Manager Contract
2.2 Sef santier
2.3 Responsabil SSM
2.4 Supervizor siguranta
2.5 RSVTI (daca e cazul)
2.6 Maistri/Tehnicieni/Sef echipa
2.7 Responsabil gestiunea deseurilor
3. Personal de executie
3.1. Personal calificat
3.1.1 Mecanici/lacatusi
3.1.2 Legatori de sarcina
3.1.3 Sudori oxiacetilenic
3.1.4 Electricieni
3.1.5 Operatori utilaje
3.1.6 Operatori utilaje de ridicat
3.1.7 Soferi
3.2. Personal Necalificat

5.2 b. Average number of equipment over the last three (3) years:

Equipment 2016 2017 2018

1. Excavator dotat cu foarfeca de
metal, picon si pulverizator
betoane / Excavator with metal
shear, pickhammer, concrete
shear:
2.1 Pe senile, sau / On tracks, or
2.2 Cu pneuri / On wheels
2. Excavator dotat doar cu cupa
de excavare / Excavator with
bucket only:
DocuSign Envelope ID: BB09FC93-B5BA-4D7F-BF9D-0524F4B1EF7F

Tender Reference:
Date:

2.1 Pe senile, sau / On tracks, or

2.2 Cu pneuri / On wheels
3. Incarcator frontal (Wola) cupa
±2.5m3 / Wheel loaders bucket
of ±2.5m3
4. Graifer pt incarcat deseuri fier
vechi / Grapples for loading
scrap
5. Buldoexcavator / Backhoe
Loaders
6. Buldozer senile / Bulldozer on
tracks
7. Cilindru vibrocompactor / Single
drum vibrating roller:
7.1 12.5-16 t
7.2 5-8 t
8. Placa vibratoare / Manual
operated vibrating plate
9. Basculante / Trucks:
9.1 – 20 t
9.2 – 40 t
9.3 – 60 t
10. Tractor + trailer / Tractor +
trailer
11. Nacela(telelift) pt ridicare
personal la inaltime, brat min
10m
Man-lift telescopic handler for lifting
personnel, arm min. 10m
12. Concasor mobil pentru betoane
rezultate din demolari
Mobile Concrete crusher for
resulted demolition debree

5.3 Is there a formal, organized, company personnel training program for all employees, with each position
having a job description, competency definition, specific training or qualification requirements, training course
specifications, training plans or schedules or matrix, training records, and qualification and certification records?

YES NO

5.4 Is training normally informal, in-house, “on-the-job” training; or, are trainers used who are qualified and
approved to issue national or internationally recognized certificates for specialized training?

[insert minimum specific requirements in terms of personnel certification, qualification and training]
DocuSign Envelope ID: BB09FC93-B5BA-4D7F-BF9D-0524F4B1EF7F

Tender Reference:
Date:

6 HSSE

6.1 Please use the standard HSSE Questionnaire Attached

7 Subcontractors

7.1 What is the share of in-house activities and subcontractors in percentage?

In-house (%):
Subcontracted (%):

7.2 Name and address of subcontractors you intend to use for this contract (if required use attachments to
this Questionnaire):

Name of Subcontractor:
Address:
Work to be subcontracted:
Reason for subcontracting:

Name of Subcontractor:
Address:
Work to be subcontracted:
Reason for subcontracting:

Name of Subcontractor:
Address:
Work to be subcontracted:
Reason for subcontracting:

Name of Subcontractor:
Address:
Work to be subcontracted:
Reason for subcontracting:

Name of Subcontractor:
Address:
Work to be subcontracted:
Reason for subcontracting:

8 Code of Conduct

OMV Company is committed to a Code of Conduct that is listed as Annex to this Prequalification Questionnaire.
Does your Company agree to this policy?

YES NO*
*Reason for not agreeing OMV Petrom Code of Conduct: …………….
DocuSign Envelope ID: BB09FC93-B5BA-4D7F-BF9D-0524F4B1EF7F

Tender Reference:
Date:

The bidder will consider showing that the following requirements are met:
a) The bidder has to provide responsible personnel (key personnel): one Contract Manager; one Site
Manager/Project Manager for each demolition project as well as safety responsibles and a designated person to
ensure the fullfilment of the obligations under Law 211 / 2011 on each location where the services are carried out.
The site manager and the safety responsible will be permanently present on-site throughout the entire work. For
good understading, if the bidder is going to have several works in progress at the same time, he will have one
Site Manager and safety responsible for each individual work.
b) The bidder has to provide a list of the equipment allocated to the project. It has to specify: ownership
(property/leased /sub-contracted), year of manufacture, type, brand, identification data, number of hours of
operation. The supporting documents (registration certificate, identity card or any other relevant document etc.)
will be provided. The equipment with more than 12 years a manufacturing age of will not be accepted..
The winning bidder will receive at the same time up to 3 demolition works.
c) As a matter of principle, Bidders will consider that the maximum level of subcontracting of demolition
works is 50% for staff (excluding HSS responsible) and used machinery (except for trucks).
Associations or groups of companies are accepted (group of companies meaning that all the companies
mentioned by the bidder have a common majority shareholder). In the case of associations or groups of
companies, the Bidder will have to mention the names of the companies with which the association is intended
and the way of distributing the deliverables and the responsibilities related to this contract. For example, who is
the association leader or group and what are the percentages of participation for the rest of the association or
group companies. For good understanding, all companies in such an association or group will be fully described
in the Bidder's Letter of Conduct and will comply with the requirements of the Tendering Documentation.
DocuSign Envelope ID: BB09FC93-B5BA-4D7F-BF9D-0524F4B1EF7F

Tender Reference:
Date:

Annex 1

CODE OF CONDUCT

Company is committed to a Code of Conduct that is based on the UN Global Compact

(http://www.unglobalcompact.org).

Contractor hereby commits itself to Company’s Code of Conduct principles as follows:

A. During performance of its contractual obligations in manufacturing its goods and/or rendering of its
services (both in-house as well as by its subcontractors), Contractor must, all in line with international
standards such as the UN Global Compact,

a) refuse to offer, pay or accept bribes;

b) pay remunerations (including commissions and payment to third parties) exclusively for legitimate
services;
c) permit gifts, hospitality entertainment or similar benefits only if done transparently, occasionally,
customarily and without obligation;
d) ensure in relation to its employees:
 full equality and non-discrimination,
 limitation of working hours,
 fair procedures regarding dismissal, sanctions and grievances,
 adequate living wages and
 right to association and collective bargaining;
e) avoid and not to accept child labor or forced labor;
f) fully respect human rights in its sphere of influence, especially:
 right to life, physical integrity, liberty and security of person,
 right to privacy and family life,
 right to freedom of opinion and expression,
 right to freedom of assembly and association,
 right to own property and an adequate standard of living and
 right of minorities and indigenous peoples;
g) disclose any conflicts of interest of Contractor or its employees to Company;
h) abide by all laws and regulations concerning the protection of the environment; and
i) ensure that its advertisements, commercials, publications and sponsoring do not offend or violate
religious or cultural sentiments of the people living in the surrounding community and wider society
where Company or Contractor operate.

B. In case of non-fulfilment of the above-mentioned obligations, Company shall be entitled (i) to invite
Contractor in order to discuss any such actual or suspected non-fulfillment within a reasonable period
of time (in no case later than one (1) month after receipt of the invitation), or (ii) if such discussions
failed to achieve adequate measures and dates for improvement on part of Contractor, Company shall,
under its sole discretion, also be entitled to blacklist Contractor for any further performance in its group.

C. Company (by own personnel or by mandating qualified third parties bound to confidentiality) shall be
entitled, upon reasonable advance notice, to verify Contractor’s compliance with these obligations. This
shall include reasonable access to all relevant information as well as to all persons, locations and
DocuSign Envelope ID: BB09FC93-B5BA-4D7F-BF9D-0524F4B1EF7F

Tender Reference:
Date:

documentation concerned. If Contractor refuses or prevents such verifications without providing justified
reasons, Company shall be entitled to act in accordance with Section B. hereof.

Approved by Contractor / Contractor / Bidder

Signature: ……………………………………