4-Laning of Dhaka-Chittagong - Roads and Highways Department

2nd Dhaka-Chittagong National Highway (Expressway)
Request for Qualification Document
FORM XI(a) : DETAILS OF PROPOSED EQUIPMENT
Name of Applicant
The Applicant should provide adequate information to demonstrate clearly that it has
the capability to meet the requirements for each and all items of Equipment proposed
in Form XI. A separate Form XIA shall be prepared for each key item of equipment
proposed by the Applicant.
Item of equipment: ____________________________________________________
1. Manufacturer: ___________________ 2. Model and power rating: __________
3. Capacity : ______________________ 4. Year of manufacture: ____________
5. Current Condition and Location: _______________________________________
1. Details of Current Commitments: _______________________________________
__________________________________________________________________
6. In case the Applicant is a joint venture, indicate the name of the partner who will
provide this particular equipment :
__________________________________________________________________
7. Indicate whether equipment is owned or to be hired, leased, manufactured
especially, or through other means:
_________________________________________________________________
8. Owner : ___________________________________________________________
[Omit the following information for equipment owned by the Applicant, including
partners of a joint venture]
9. Owners address: _____________________________________________________
Tel: ____________________________ Fax: ______________________________
Contract Person (Name and Title) : _____________________________________
10. Details of hire/lease/manufacture agreements specific to the project
_________________________________________________________________
_________________________________________________________________
Roads and Highways Department 51