MODEL 5 Pre-Qualification Questionnaire

8/3/2019 MODEL 5 Pre-Qualification Questionnaire

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Housing PFI Procurement Pack ModelDocumentation

MODEL 5

The Pre Qualification Questionnaire

Model [ ] Pre-Qualification Questionnaire Page 1 of 44


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Please read the note below before using this ModelDocumentation

Disclaimer

Please note that this document is currently in draft and open forconsultation until 11 September 2009 and may be subject to changefollowing such consultation.

This Model Documentation has been produced by the 4ps, HCA and CLG inconsultation with Pinsent Masons (legal advisors) and Gleeds (technical advisors)(together, the Advisors) to provide assistance to Local Authorities in the

procurement of Housing projects through the Private Finance Initiative. TheModel Documentation has been published in good faith by the 4ps, HCA and CLGwith the help of its Advisors, and neither the 4ps, HCA, CLG nor its Advisors shallincur any liability for any action or omission arising out of any reliance beingplaced on the Model Documentation by any Local Authority or organisation orother person. Any Local Authority or organisation or other person in receipt ofthis Model Documentation should take their own legal, financial and otherrelevant professional advice when considering what action (if any) to take inrespect of any initiative, proposal, or other involvement with any public privatepartnership, or before placing any reliance on anything contained therein.

Copyright

Public Private Partnerships Programme 2009



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Name or Logo of Local Authority

Name of PFI Project

Pre-Qualification Questionnaire


Notes

Technical capacity and ability are not defined in the Procurement Regulations.Questions have arisen as to whether technical capacity would cover the ability tocomply with legal requirements, for example, health and safety legislation, equalopportunities or environmental management.

Whilst some Local Authorities have included specific questions on these aspects aspart of a PQQ, Local Authorities must take care when including such provisions andlegal advice should be sought on whether it is acceptable to include provisionsrelating to health, safety, equal opportunities and environmental protection in thePQQ.

Model questions on quality assurance, health and safety, equal opportunities andenvironmental management are included in this model PQQ should Local Authorities

determine that questions on such aspects are acceptable.

Some Local Authorities use the Department for Business Enterprise & RegulatoryReforms pre-qualification database Constructionline. Relevant Organisations mayhave already supplied some of the information and documents requested in this Pre-Qualification Questionnaire to Constructionline.

This Pre-Qualification Questionnaire identifies the information and documents thatfirms registered on Constructionline need not provide. Local Authorities registeredwith Constructionline will need to amend the Questionnaire accordingly.

If the Local Authority has set minimum standards of financial and economic standingand/or technical capacity and ability, these minimum standards should be disclosed

either in the relevant section of the OJEU contract notice, or in the PQQ (with a cross-reference to the PQQ in the OJEU notice). In addition, if the Local Authority intends toscore PQQ responses with a view to shortlisting a maximum number to take forwardinto dialogue, an explanation of this approach should be provided to bidders with acopy of the scoring methodology.


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Introduction and Instructions

OJEU Contract Notice [insert details]

This Pre-Qualification Questionnaire (PQQ) has been issued by the LocalAuthority in connection with a competitive procurement conducted inaccordance with the competitive dialogue procedure under the Public ContractsRegulations 2006.

This PQQ should be read in conjunction with the accompanying DescriptiveDocument, which provides Bidders with appropriate information about the LocalAuthority and the housing PFI project.

This PQQ sets out the information which is required by the Local Authority toenable it to assess the suitability of organisations that have responded to theOJEU contract notice in terms of their eligibility, economic and financial standingand technical and professional ability. The selection criteria will be a combinationof both financial and non-financial factors and will be in accordance withRegulations 23 to 26 of the Public Contracts Regulations 2006.

[The Local Authority intends to arrive at a short list of between [x] and [y]potential Bidders to proceed to the next stage of the procurement.]

The resources, range and depth of skills needed to provide the services to the

Local Authority under this PFI project are such that it is thought likely thatorganisations may wish to collaborate to form a consortium, with a leadorganisation or Special Purpose Vehicle ultimately contracting with the LocalAuthority. This does not preclude a single organisation offering all the resourcesand services. The Local Authority does not require any consortium to form alegal entity at this stage, although it will be required to do so prior to awardingany Contract. For the purposes of evaluating responses to this PQQ, the LocalAuthority needs information about each of the members of any proposedconsortium (consortium member) and their respective role(s) within theproposed consortium, and each proposed sub-contractor to any consortiummember which will be contributing significantly to the services the LocalAuthority requires (significant sub-contractor).

The term Relevant Organisation in this Questionnaire refers to all consortiummembers and significant sub-contractors.

Collectively, each entity that wishes to bid (whether it is a single organisation ora consortium) is referred to as a Bidder. The Bidder is responsible for ensuringthat this PQQ is fully completed and the required information is provided.

Instructions for Completion

[Sample drafting]



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In some cases, a Relevant Organisation may not be able to give all of theinformation requested. In these circumstances, please identify clearly where aRelevant Organisation is providing information on behalf of another.

It is essential that all questions in this PQQ are answered and that all informationrequested is submitted and in the correct format in the same order as thequestions are presented. If this is not done, the Bidders application may bedisqualified.

It is not acceptable to cross-refer to previous pre-qualification questionnaire(s) orother submissions made to the Local Authority. Bidders are advised neither tomake any assumptions about their past or current supplier relationships with theLocal Authority nor to assume that such prior business relationships will be takeninto account in the evaluation procedure.

If a question is not applicable, please state this in the relevant box, and explainwhy it is not applicable. If additional information is to be attached to theapplication as a means of providing the answer, please make this clear withinthe relevant box.

If the space provided for an answer is inadequate, please use additional sheetsof paper making it clear to which sections and questions they apply. Also, pleaseput the bidder and, if relevant, the Relevant Organisations name on eachadditional sheet. Finally, please provide a summary list of all attachmentsaccompanying the completed PQQ.

The Local Authority expressly reserves the right to require a Bidder to provideadditional information supplementing or clarifying any of the informationprovided in response to the requests set out in this PQQ.

The information supplied will be checked for completeness and compliance withthe instructions before responses are evaluated, scored and ranked.

Bidders must be explicit and comprehensive in their responses to this PQQ.Failure to provide the required information, make a satisfactory response to anyquestion, or supply documentation referred to in responses, within the specifiedtimescale, may mean that a potential Bidder is not invited to participate further.In the event that none of the responses are deemed satisfactory, the Authority

reserves the right to terminate the procurement and where appropriate re-advertise the procurement.

Interested Bidders wishing to be considered for the housing PFI project mustcomplete and return [insert number] copies of their PQQ, together with allaccompanying information, by [insert closing date and time] in writing, by post,to:

[Insert name and address of person to whom responses should be made]

An electronic version [insert details] of the completed PQQ should also besubmitted in accordance with the above instructions.



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Where a Bidder submits the pre-qualification information both in writing, by post,and in an electronic version (CD Rom), then in the event of any discrepancy thehard copy will take precedence.

Please note that completed PQQs received after the closing date and time willnot be accepted

The PQQ should be submitted using the pre-addressed labels included with theDescriptive Document.

[Insert any other submission requirements/details required by the LocalAuthority in accordance with their Standing Orders, for example no markings onenvelopes].

The Local Authority reserves the right to request Bidders to attend interviews

with the Project Team before the list of pre-qualified candidates is selected.Provisional dates for any necessary interviews are [insert relevant dates]. If itproves necessary to arrange interviews, Bidders will be informed as soon aspossible after receipt of the PQQ submissions.

Enquiries

All requests for clarification or further information in respect of this PQQ shouldbe sent in writing or by e-mail to the Project Director at the following address:

[Insert contact details and address for the Project Director]

The Project Director must receive any such enquiries relating to the PQQ no laterthan close of business on [insert date].

No approach of any kind in connection with this PQQ should be made to anyother person within, or associated with, the Local Authority.

A written response will be sent to enquirers and, except where the enquiry is of acommercially sensitive or confidential nature, the enquiry and response will besupplied in a suitably anonymous form to all Bidders.

Subject to the confidentiality provisions outlined in the Descriptive Document, it

will be a requirement that the parties and their advisors shall keep all exchangesconfidential. Bidders may also be asked to enter into undertakings ofconfidentiality should it become appropriate to release confidential informationto them.

The PQQ has been split into 6 sections.

Section A of the Questionnaire requests details of the Bidder, how it isorganised and, where appropriate, what the relationship is between the RelevantOrganisations. Confirmation is sought regarding eligibility to tender under thePublic Contracts Regulations 2006.



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Section B asks for information that will be used in determining whether theRelevant Organisations meet the Local Authoritys minimum standards ofeconomic and financial standing.

Section C, supplemented by Section D and Section E, asks for informationthat will be used in determining whether the Relevant Organisations meet theLocal Authoritys minimum standards of ability and technical capacity (i.e. aBidders skills, efficiency, expertise and reliability a Bidders track record). Inresponding to Section C, the Relevant Organisations must detail their respectiveexperience in PFI/PPP projects and technical experience which is relevant to theirrespective designated roles within the Bidders proposals for the LocalAuthoritys Project.

Section D asks for details of the experience of each Relevant Organisation ofworking on similar projects.

Section E asks for details of the experience and capacity of key individualsproposed by the Bidder, and methods of working.

Section F is included to inform the Local Authority on the experience of theBidder in raising project finance and/or corporate finance.

The PQQ Evaluation Methodology is attached at Appendix A.

[Please refer to the note on the front cover in respect of minimum standards andscoring methodologies]

[Insert details of Sections G to J as appropriate, referring to the note on the frontcover]

Please complete the PQQ in English.

Where any of the pre-qualification information provided by a Bidder relates toany other entity or a company in the same group this must be clearly identifiedand all pre-qualification information requested in the remainder of this PQQ (i.e.Sections [ ] to [ ]) should be provided by the relevant entity/company in thesame group. For example if a newly established Bidder relies on the experienceof a company in the same group in relation to Section C of this PQQ, this must be

clearly stated and full PQQ details should be provided for that company.

Bidders are advised not to provide any information additional to that specificallyrequested in this PQQ.

If relevant information and/or accounts are not available in respect of anyRelevant Organisation, the information and/or accounts relating to a holdingcompany may be supplied. However, in this case the holding company mustsupply a letter addressed to the Local Authority confirming that:

the Relevant Organisation is its subsidiary; and

the holding company supports the Relevant Organisation in itsparticipation in the project.



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Please note that if any of the information supplied in response to the PQQchanges in the ensuing evaluation period, or thereafter (subject to the Bidderhaving been invited by the Local Authority to participate in a competitive

dialogue), the Bidder is required to provide the Local Authority promptly with fulldetails in writing of the relevant change(s). The Local Authority reserves the rightto revisit its PQQ evaluation in the light of any such change or if the LocalAuthority becomes otherwise aware of a change to the information supplied and,where appropriate, to disqualify Bidders.

[The questions in the PQQ are of a retrospective nature in general]



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A. General Information

Questions A1 to A7, to the extent applicable, are to be completed by

the Bidders lead consortium member, or if the Bidder is a soleorganisation, that organisation

A1 Full legal name of the organisation that will act as lead Bidder for thisproject, and names of each of the Relevant Organisations:

Lead Organisation:

Relevant Organisations:

1.

2.

3.

4.

5.

6.

A2 Name and contact details of principal contact for this project:

Name:

Position:

Address:

Telephone:

Fax no:

E-mail:



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A3 Current legal status of Lead Organisation (e.g. partnership, private limited

company, etc):

Sole Trader

Partnership

Limited LiabilityPartnership

Limited Company(Private or Public)

Other

A4 Date and place of formation of the Lead Organisation, registration under theCompanies Act 2006 (or equivalent), copies of certificate of incorporation and

any changes of name, registered office and principal place of business:

Date of formation

Place of formation

Date of registration

Registration number

Certificates

enclosed YES / NO

Registered Office

Principal Place of

Business



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A5 Specify the services that each Relevant Organisation will deliver:

Relevant Organisation

1.

Services to be delivered

2.

3.

4.

5.

6.

A6 Provide an organisation chart and details of the relationship between theRelevant Organisations and, where relevant, whether this may change during theprocurement and design, build, refurbishment and operational phases of the

contract.



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A7 Provide details of the likely share holding of each Relevant Organisation inthe service delivery vehicle for this project (where relevant).

Relevant Organisation Percentage shareholding

Questions A8 to A13 are to be completed by each Relevant Organisationon separate sheets, if applicable

A8 Name of Organisation [If registered with Constructionline, please alsoprovide details of the Constructionline registration number]:

A9 Provide details of registered office and registered number and date ofregistration of company. If not a company, provide status of organisation,including details of the trading address [Constructionline organisations need not

provide this information].

Registered Office:

Registered Number:

Date of registration:

A10 If the Relevant Organisation is a limited company, please indicate whetherit is a subsidiary of another company. If so, provide details of the name,registered office, registered number and date of registration of the holding orparent company [Constructionline organisations need not provide this

information].



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A11 Will the obligations of any Relevant Organisation be guaranteed by theparent or holding company? Alternatively, if a guarantee is to be provided byanother party please specify who that party is and what its relationship is or willbe to the Relevant Organisation. Where a guarantee is to be provided by theparent or holding company or by another party please provide a letter from theproposed guarantor confirming the proposed guarantors agreement to provide aguarantee in respect of the obligations of the Relevant Organisation, togetherwith the scope and form of the guarantee.

A12 Provide confirmation that there are no grounds applicable to the RelevantOrganisation pursuant to which a Bidder may be rejected in accordance with

Regulation 23 of the Public Contracts Regulations 2006, namely [legal advisorsto insert details]:

The Local Authority may seek evidence at a later date, in confirmation of youranswer.

A13 If known, please provide details of funders, technical, financial, legal andinsurance advisers (for the Bidder and the funders as appropriate) who will beinvolved (referred to in this PQQ as the Funders and Advisers)

[Either insert name(s) or state Not currently identified]



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B. Economic and Financial Information for each RelevantOrganisation

Questions B1 to B4 are to be completed by each Relevant Organisationon separate sheets, if applicable

B1 Name of the Relevant Organisation:

B2 Provide copies of the full report and audited accounts for each of the

previous three financial years. Where the last financial years report andaccounts are unsigned, draft accounts for that year should be provided[Constructionline organisations need not provide this information].

3 years accounts attached Yes / No

B3 Provide details of the Relevant Organisations overall turnover and theturnover for [insert type of service] or similar projects for the previous three

financial years.

Overall Turnover

[Insert type of service] orsimilar projects

Year: Year: Year:

B4 Provide a statement, as at the last reporting date, of any contingent liability

or loss (where not otherwise reported) that would require disclosure inaccordance with International Accounting Standard 10.

Statement

[Either insert required details or state none.]



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B5 - Please give details of any changes in accounting policy since the lastpublished accounts or any planned changes in accounting policy, for exampleacquisitions, mergers, share issues, major investment, major loans etc.

B6 Please give details of any event between the date on which the latest set ofaccounts was authorised for issue and the date of the submission of thisQuestionnaire that, had the accounts not been authorised for issue until thesubmission date, would have required an adjustment or disclosure in accordancewith the provisions of International Accounting Standard 10.

B7 Please provide copies of any company announcement made to theauthorities of the stock exchange, market or bourse on which the stocks orshares of the company are publicly traded, since the publication of the latest setof accounts.

B8 Provide similar financial/economic information (i.e. in accordance withquestions B1 to B4 above) in relation to any holding/parent company of theRelevant Organisation who is proposing to provide a guarantee for theobligations of the relevant organisation, or where a third party organisation mayact as a guarantor, in respect of that guarantor.

(a) Name:



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(b) Provide copies of the audited accounts for each of the previous three financialyears. Where the most recent accounts remain to be signed, draft accountsfor that year should be provided [Constructionline organisations need not

provide this information].

Accounts AttachedYes / No

(c) Turnover information:

Overall Turnover

[Insert type of service] orsimilar projects (it isacknowledged that thismay be a nil response forthe guarantor, if forexample, the guarantor is

a bank)

Year: Year: Year:

(d) Contingent liabilities or loss:

B9. Please give details of outstanding claims, litigation or judgments against, orother court orders affecting, the Bidder and/or the Relevant Organisations and/orany holding/parent company or third party organisation who proposes to act as aguarantor which could affect its financial stability or continued existence.

B9.1 Provide such details where the claim:

- exceeds [100,000]; and/or

-is greater than [10%] of the whole life value of the contract to which theclaim applies.



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[Either insert required details or state None]

B10 Provide evidence of the insurances held (including employers liability,public liability, professional liability/indemnity and any other relevant insurance)for the Relevant Organisation. The evidence should include the name of theinsurers, policy numbers, expiry dates, limits of indemnity (per occurrence andany annual aggregate cap) and any policy excesses [Constructionlineorganisations need not provide this information].

Name of Insurer:

Policy Number:

Expiry Date:

Limits of indemnity(per occurrence andin aggregate):

Excess (if any):

EmployersLiability

Insurance

PublicLiabilityInsuran

ce

Professional Liability

orIndemnityInsurance

[Anyother

relevantinsuranc

e]

B11. Please give details of any claims above [100,000]1 that the Bidder and/or

any Relevant Organisation has made within the last three years in respect of thepolicies referred to in Question B10. above:

[Either insert required details or state None]

1Local Authority Action: review figure, bearing in mind the amount of information that may beprovided.



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C. Technical Capacity and Ability of Relevant Organisations

Questions C1 to C6 are to be completed by each Relevant Organisation,

on separate sheets, if applicable

C1 On no more than [insert number] sides of A4 paper provide a description ofthe Relevant Organisations experience obtained in the past three years in:

Project Management

Design and build / construction / refurbishment of similar housing schemes

Long-term maintenance and operation of similar housing schemes or otherpublic or private sector housing accommodation

Working with public sector bodies, particularly local authorities

PFI/PPP projects for local authorities generally, and for social housing schemes

or other similar schemes [Insert other sector specific matters where relevant].

Each Relevant Organisation should specify in their response what experiencethey have. The description should include the date when the RelevantOrganisation's involvement started. Also state whether each scheme is atbidding stage, at Preferred Bidder, has reached financial close, is underconstruction/refurbishment, is operational, or has been cancelled, or if none ofthese are applicable, what stage it has reached.

C2 Provide details of any Contracts to which the Relevant Organisation is asignatory over [insert value in million] where there has been a failure tocomplete the contract on time or at all, or where there have been claims fordamages, or where damages have been deducted or recovered, in either caseonly where the amounts exceed [insert ]. Details should also be provided ofany contracts terminated or employment determined; an explanatory statementshould be provided in relation to each. This statement should only take accountof incidents in the past three years.

Failures to complete theContract

Claims for Damages

Damages deducted orrecovered

Contracts terminated

Employment determined

Year: Year: Year:



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C3 Provide details for the Relevant Organisation of the following:

PermanentFull Time

PermanentPart Time

Casual

Managerial /Supervisory

OperationalTotal staff employed

Number of staff currentlyinvolved directly inhousing or similar projects

C4 Provide details of staff turnover as a percentage of the total workforce forthe past three years.

Staff turnover as apercentage of workforcefor the past three years

Year: Year: Year:

C5 Provide details of the Relevant Organisations average annual number ofemployees and the number of managerial staff over the previous three years(figures should be shown as full time equivalents).

Average AnnualEmployees

Number of Managerial

Staff

Year: Year: Year:

C6 Provide details for the Relevant Organisation of any awards or externalquality accreditation schemes subscribed to or achieved.



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D. Details of the Bidders Methods of Working

Questions D1 to D4 are to be completed by the Bidders lead

consortium member, or if the Bidder is a sole organisation, thatorganisation, and relate to experience over the past three years

Key Personnel

D1 Please provide:

- Details together with CVs of the key persons who will be involved indialogue with the Local Authority and in the bid preparation andprocurement of this project;

- If known at this stage, details together with CVs of all the key persons who

are likely to be involved in the management structure and/or running ofthe project for the Bidder and state if these are different from those whowill be involved in negotiations with the Local Authority. If the key personswho are likely to be involved in the management structure and/or runningof the project are not known at this stage, how and when will they beappointed?

Experience of Working Together

D2 On no more than [insert number] sides of A4 paper using [insert font size]point font, provide details as to whether the Relevant Organisations have workedor are working together on other similar PFI or PPP projects. Disclose the clientname, capital cost, date when the Relevant Organisations involvement startedand whether the scheme is at bidding stage, at Preferred Bidder, has reachedfinancial close, is under construction, refurbishment, is operational, has been

cancelled, or if none of these are applicable, the stage the scheme has reached.

Creation of New Working Relationships



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D3 If new relationships are being created for this project, on no more than[insert number] sides of A4 paper using [insert font size] point font, providedetails as to how the Relevant Organisations are drawing on their experience of

similar projects over the last three years to form the new relationships necessaryfor the delivery of the project.

Experience of Achieving Financial Close

D4 During the last three years where the Bidder has been appointed aspreferred bidder on a public private partnership for works and/or services, PFIproject or equivalent type project ,works and/or services provided underframework arrangements or equivalent:-

- provide details of whether financial close was achieved in accordance withthe timetable agreed at the time of appointment, or if there was any delaythe reasons for the delay; and

- if the overall cost of the relevant project increased during the period fromthe appointment of preferred bidder up to financial close, the reasons forany such increase.



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E COMMERCIAL MATTERS

Questions E1 to E6 are to be completed by the Bidder on behalf of itself

and, if applicable, each Relevant Organisation, on separate sheets. Thissection should not be completed in respect of the Funders andAdvisers.

E1. Have you ever suffered deductions for liquidated and/or ascertaineddamages and /or any other form of contractual deductions for poor or lateperformance in respect of any contract within the last two years?

Yes / No

Please provide details by replying to question E6 where the aggregate valueof the deductions in any year:

- exceeds [50,000]; and/or- is greater than [10%] of the whole life value of the contract.

E2. Have you ever had a contract terminated or its employment determined forits own default under the terms of the contract in the last three years?

Yes / No

E3. Have you ever failed to receive a contract renewal on the basis ofunsatisfactory performance in the last three years?

Yes / No

E4. Is there any material pending or threatened litigation or other legalproceedings connected with similar projects against you that may affect deliveryof this project?

Yes / No

E5. Do you have any potential conflicts of interest that may arise if selected todeliver this project? If yes, please provide details.

Yes / No



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E6. If you have answered yes to any of questions E1 to E5 above, please give abrief explanatory statement:



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F. Ability and Approach to Raising Project and/or CorporateFinance

Question F1 is to be completed by the Bidder and, where the Bidder is aconsortium, by each Relevant Organisation within that consortium

F1 - Provide details of both your and your financial advisers previous experienceof raising finance:

- in schemes involving housing accommodation; and/or- in projects involving the public sector.

In each case this should include:

- your experience of raising finance for PFI/PPP Projects (or equivalent typeproject) with the public sector [involving multiple phases of services

and/or works];- the form of the finance (amount, dates and project) and where a Relevant

Organisation is providing the information, the role played by that RelevantOrganisation in that project (e.g. Bidder, consortium member etc)

- how you ensured the continuing value for money of the funding packagethroughout the duration of the PFI/PPP Project.

Where you do not have experience of raising finance in the circumstancesidentified above, but have experience of raising finance for projects involving theprivate sector then please provide details of this experience.

Question F2 is to be completed by the Bidder lead consortium memberor, if the Bidder is a sole organisation, that organisation

F2 - Based on your past experience, provide a preliminary indication as to howyou would go about securing finance for this project. You are requested toindicate the following:

- what the contribution of each equity partner/shareholder is likely to be inany special purpose vehicle established to deliver the project and thewillingness of each to put capital into the project;

- the likely sources of funds (e.g. bank debt, institutional finance or equity).



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Question F3 is to be completed by the Bidders lead consortiummember or, if the Bidder is a sole organisation, that organisation

F4 - Please list for each PFI/PPP Project (or equivalent type project) the period oftime your investment has been retained following the expiry of any agreed lock-in period?



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G. Quality Assurance [see note on front cover]

Questions G1 to G4 are to be completed by each Relevant Organisation,

on separate sheets, if applicable [Constructionline organisations neednot provide responses to questions [G1, G2 and G3]].

Quality Assurance Questions

G1 Does the Relevant Organisationhold a recognised quality assuranceaccreditation, for example BS/EN/ISO9000, Investors in People (UK only) orother recognised or equivalent qualityassurance standard?

Yes / No

G2 If you do hold a recognisedquality assurance accreditation,please provide details of theaccreditation body, the level ofaccreditation, when the accreditationwas awarded, and to which businessfunctions the accreditation applies.

G3 If not, does the RelevantOrganisation have a quality assurancesystem*?

Yes / No

G4 If you do not have a qualityaccreditation system, please givereasons.

* System means processes and procedures to ensure that the subject isproperly managed. This includes making sure that legal requirements are met



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H. Health and Safety [see note on front cover]

Questions H1 to H31 are to be completed by each Relevant

Organisation, on separate sheets, if applicable

Health and Safety Questions

H1 Does the Relevant Organisationhave a health and safety at workpolicy**

Yes / No

H2 Does the Relevant Organisationhave a health and safety at work

system*

Yes / No

H3 If no to either H1 or H2, pleasegive reasons.

H4 Are copies of the writtenstatement (as required by section 2(3)

of the Health and Safety at Work Act1974 and Regulation 4 of theManagement of Health and Safety atWork Regulations 1999, or EU memberstate equivalent) enclosed of theRelevant Organisations:

general policy on health and safetyat work?

allocation of organisationalresponsibilities at work?

adopted preventative andprotective measures, such assafety codes of practice and safetyinstructions, relevant to the type ofproject proposed, and its adoptedarrangements for the effectiveplanning, control, monitoring andreview of these preventative andprotective measures?

Yes / No

Yes / No

Yes / No



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H5 Does the Relevant Organisation

have processes and procedures toensure that these Regulations arefollowed?

Yes / No

H6 State the name and status of theperson responsible for theimplementation of the RelevantOrganisations health and safetypolicy.

H7 Give brief details of safety auditsand inspections carried out in similaractivities to this project, includingdetails of frequency, whether recordsare kept and who is responsible forremedial action.

H8 Does the Relevant Organisationtrain staff in health and safetyaccording to their particular job?

Yes / No

H9 Does the Relevant Organisationkeep health and safety trainingrecords for staff?

Yes / No

H10 Does the Relevant Organisationhave a clear process for consultingstaff on health and safety matters?

Yes / No

H11 Is this consultation process setout in the Relevant Organisationshealth and safety procedures?

Yes / No

H12 Does the Relevant Organisationhave health and safetyrepresentatives?

Yes / No



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have clear arrangements for staff toreport health and safety risks andissues to management?

Yes / No

H14 Does the Relevant Organisationhave a risk assessment processapplicable to each type of process orarea of work?

Yes / No


record the findings? Yes / No

H16 Are they regularly reviewed? Yes / No

H17 Does the Relevant Organisationproduce method statements of how towork safely, based on riskassessments?

Yes / No

H18 Does the Relevant Organisationhave procedures to make sure its staffunderstand these method statements?

Yes / No

H19 Does the Relevant Organisationhave access to competent health andsafety advice (either within theorganisation or external)?

Yes / No

H20 Does the Relevant Organisationbelong to any safety organisations?

Yes / No

H21 Does the Relevant Organisationreport incidents and accidents whenrequired under the applicable EUrequirements?

Yes / No



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keep records and statistics ofaccidents and incidents? Yes / No

H23 Does the Relevant Organisationmake sure it learns from incidents andaccidents, and changes workingpractices as necessary?

Yes / No

H24 Does the Relevant Organisationhave a nominated manager to whom

any employee health problems can bereported?

Yes / No

H25 Does the Relevant Organisationprovide any necessary personnelprotective equipment to staff free ofcharge?

Yes / No

H26 State (and provide details if

necessary) whether any ProhibitionNotices or Improvement Notices (or EUequivalent) have been served on theRelevant Organisation or any of itsdirectors / managers in the last threeyears with respect to health andsafety or fire safety issues in relationto PPP/PFI projects, [insert type ofservice] projects or similar projects.



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H27 State the number of fatal

accidents and major injury accidents(requiring immediate notification tothe relevant Health and Safetyenforcing authority) which haveoccurred to (a) the RelevantOrganisations employees over thepast three years arising from theconduct of activities similar to thosecovered by PPP/PFI projects, [inserttype of service] projects or similarprojects; (b) people other than itsemployees (for example, members of

the public) over the past three yearsarising from the conduct of suchactivities.

H28 Does the Relevant Organisationmake sure that its managers andsupervisors understand the dutiesunder the CDM Regulations (or EUequivalent)?

Yes / No

H29 - Give brief details of how theRelevant Organisation will dischargethe duties of and/or appoint the rolesof client, principal contractor anddesigners pursuant to the CDMRegulations 2007, together with abrief description of how such mattershave been dealt with by the RelevantOrganisation on similar projects.

H30 - In relation to the CDMRegulations 2007, provide details of

how the Relevant Organisation's ownpolicy, organisation and arrangementsmeet the Core Criteria set out in theApproved Code of Practice for theappointment of client, principalcontractor and designers.

H31 - Will the Relevant Organisationagree to taking a novation of thecontract between the CDM Coordinatorand the Local Authority?



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* System means processes and procedures to ensure that the subject isproperly managed. This includes making sure that legal requirements are met.

** A Health and Safety Policy usually consists of three distinct sections namely:

General Policy Statement a short statement outlining the Companyscommitment to health and safety, signed a dated by the senior companyofficial (for example, the Managing Director)

Organisation how the Company is organised for health and safety; linesof communication; and any specific duties/responsibilities assigned withinthe organisation

Arrangements the systems and procedures in place for ensuringemployees health and safety at work



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I. Equal Opportunities [see note on front cover]

Questions I1 to I12 are to be completed by each Relevant Organisation,

on separate sheets, if applicable [Constructionline organisations needto provide a response to [I[ ]] only].

Equal Opportunities Questions

I1 Is it the policy of the RelevantOrganisation as an employer tocomply with the statutory obligationsunder the Equal Pay Act 1970, RaceRelations Act 1976, the SexDiscrimination Act 1975, the Disability

Discrimination Act 1995, theEmployment Equality (Religion orBelief) Regulations 2003, theEmployment Equality (SexualOrientation) Regulations 2003 and theEmployment Equality (Age)Regulations 2006 (together being theEqualities Legislation), whichapply in the United Kingdom, orequivalent legislation that applies inthe countries in which the Relevant

Organisation employs staff?

Yes / No

I2 Is it the policy of the RelevantOrganisation as an employer topromote equality as set down in theEqualities Legislation or equivalent?

Yes / No

I3 If the answer to questions I1and/or I2 is No, please provide otherevidence to show how the RelevantOrganisation promotes equality in

employment.

I4 In the last three years has anyfinding of unlawful racialdiscrimination in the employment fieldbeen made against the RelevantOrganisation by any court,employment tribunal or employmentappeal tribunal or in comparableproceedings in any other jurisdiction?

Yes / No



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I5 In the last three years has the

Relevant Organisation been thesubject of formal investigation by theCommission for Racial Equality (CRE)or the Disability Rights Commission(DRC) or the Equality and HumanRights Commission (EHRC) (orcomparable body) on grounds ofalleged unlawful discrimination in theemployment field?

Yes / No

I6 If the answer to question I5 is yes

or in relation to I6, the CRE, DRC,EHRC or comparable body made afinding adverse to the RelevantOrganisation, what were the breachesand what steps did the RelevantOrganisation take in consequence ofthat finding?

I7 Is the Relevant Organisationspolicy on race relations and equality

promotion set out: In instructions to those concerned

with recruitment, selection,remuneration, training andpromotion?

In documents available toemployees, recognised tradeunions or other representativegroups of employees?

In recruitment advertisements orother literature?

If asked, could the Relevant

Organisation supply examples ofthe instructions, documents,recruitment advertisements orother literature?

Yes / No

Yes / No

Yes / No

Yes / No

I8 Are the staff of the RelevantOrganisation who have managerialresponsibilities required to receivetraining on equal opportunities?

Yes / No



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I9 Does the Relevant Organisation

observe as far as possible the CREsCode of Practice for Employment, theDisability Rights CommissionsStatutory Code of Practice onEmployment and Occupation and theCode of Practice on the DisabilityEquality Duty, or a comparablestatutory code, or guidance issuedunder equivalent legislation in anotherMember State, which gives practicalguidance to employers and others onthe elimination of racial discrimination

and the promotion of equality ofopportunity in employment, includingmonitoring of workforce matters andsteps that can be taken to encouragepeople from ethnic minorities to applyfor jobs or take up trainingopportunities?

Yes / No

I10 In the last three years, has anyfinding of unlawful sex or disabilitydiscrimination in the employment fieldbeen made against the RelevantOrganisation by the employmenttribunal, employment appeal tribunalor any court, or in comparableproceedings in any other jurisdiction?

Yes / No

I11 If the answer to question I10 isyes, what steps have been taken as aresult of that finding?

I12 If the Relevant Organisation isnot currently subject to UK legislation,please supply details of the Relevantorganisations experience (asappropriate) in complying withequivalent legislation that is designedto eliminate discrimination (including,but not limited to, age, racial, sexual,sexual orientation, religion or beliefand disability discrimination) and topromote equality of opportunity.



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J. Environmental Issues [see note on front cover]

Questions J1 to J4 are to be completed by each Relevant Organisation,

on separate sheets, if applicable

Environmental Issues Questions

J1 Does the Relevant Organisationhave a documented environmentalmanagement system*?

Yes / No

J2 If so, does the environmentalmanagement system meet the

standards in BS7750, ISO14001, EMASor equivalent?

Yes / No

J3 Does the Relevant Organisationhave an environmental policy and/orgreen policy for services the same asor similar to the services likely to beprovided in the proposed project?

Yes / No

J4 If so, please provide details.

* System means processes and procedures to ensure that the subject isproperly managed. This includes making sure that legal requirements are met



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K. References

Please provide details of three recent contracts relevant to the current

requirement.

Reference 1

Name:

Contact Name andTelephone Number:

Date Contract Awarded:

Brief Description ofContract:

Value of Contract

Reference 2Name:

Contact Name andTelephone Number:



Value of Contract

Reference 3



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Name:

Contact Name and

Telephone Number:



Value of Contract



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L. Certification

This section is to be completed by all members of the bidding

consortium.

I certify that the information provided within this questionnaire is accurate (adirector, or other authorised senior member of the organisation should providethis certification).

Name:

Position:

For and on behalf of:

Date:



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Appendix A

PQQ Evaluation Methodology

[Note: Local Authority to insert]

Documents

MODEL 5 Pre-Qualification Questionnaire