Medini Iskandar Malaysia Sdn Bhd

MEDINI ISKANDAR MALAYSIA SDN BHD

PREQUALIFICATION OF CONSULTANTS

NAME OFCOMPANY / :
REGISTRATION PARTICULARS
Category of Services (tick [x] whichever applicable)
Project Development
PC01. Planning
PC02. Architectural
PC03. Civil & Structural Engineering
PC04. Mechanical & Electrical Engineering
PC05. Quantity Surveying
PC06. Traffic & Transportation Engineering
PC07. Interior Design
PC08. Façade
PC09. OSHA
PC10. Landscaping
PC11. Environmental Engineering
PC12. Land Surveying
PC13. Project Management
PC14. Claims Specialist
PC15. GBI Specialist
PC16. Wind Engineering Specialist
PC17. Kitchen Equipment Specialist
PC18. Audio Visual and Sound Specialist
PC19. Lighting Specialist
PC20. MSC Specialist
PC21. Wayfinding Specialist
Integrated Facilities Management
PC22. Building Management
PC23. Estate Management
PC24. Security Management
PC25. IT Management
Smart City Services
PC26. Smart City
PC27. Integrated Operation Centre / Legal and Secretarial
NP01. Legal
NP02. Secretarial
Human Resources
NP03. Executive Search
NP04. Training & Development
NP05. Insurance Broker
Finance
NP06. Audit
NP07. Taxation
NP08. Transfer Pricing
Sales & Marketing
NP09. Branding
NP10. Market Research
NP11. Media Monitoring
NP12. Event Management
Risk Management
NP13. Risk Management
NP14. Business Continuity Management
NP15. Quality Assurance & Quality Control
NP16. Forensics
NP17. Business Process Improvement
NP18. IT Advisory
1.0 / COMPANY PARTICULARS
1.1 / Name of Company / :
1.2 / Correspondence Address / :
1.3 / Telephone No. / :
1.4 / Fax No. / :
1.5 / Contact Person / :
1.6 / E-mail Address / :
1.7 / Website Address / :
1.8 / Registration of Business/Company
(tick [x] whichever applicable) / : / a.Sole Proprietorship
b.Partnership
c.Private Limited Company
d.Public Limited Company
e.Foreign Company
f.Others (please specify)
1.9 / Company/Business Registration No. / :
1.10 / Date of Incorporation / :
1.11 / GST Registration No. / :
1.0 / COMPANY PARTICULARS
1.12 / Board of Directors
Name / I.C. No/
Passport No. / Race/
Nationality / Designation
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
1.13 / Registration with Authorities/Governing Bodies
Authorities/Governing Bodies / Registration No. / Expiry Date
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
2.0 / FINANCIAL PARTICULARS
2.1 / Capital Structure / : / a.Authorised Capital / RM
b.Paid-Up Capital / RM
2.2 / Equity Participation / : / a.Bumiputera / %
b.Non-Bumiputera / %
c.Foreign Nationality / %
2.3 / List of Major Shareholders
Name / I.C. No/
Passport No. / Race/
Nationality / Equity % / Designation
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
3.0 / ORGANISATION STRUCTURE
3.1 / List of Principal/Associates/Directors
Name / Qualification / Designation / Years of Experiences
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
3.2 / List of Professionals/Key Personnel
Name / Qualification / Designation / Years of Experiences
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
3.0 / ORGANISATION STRUCTURE
3.3 / List of Semi Professionals/Supporting Personnel
Name / Qualification / Designation / Years of Experiences
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
3.3 / Total Headcount
Principal/
Associates/
Directors / Professionals/
Key Personnel / Semi Professionals/
Supporting Personnel / Total
Bumiputera
Non-Bumiputera
Foreign
Total

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4.0 / PROJECT PARTICULARSAll required particulars must be entered here. Reference to the Company Profile is not allowed
4.1 / List of Projects Commenced in 2015
Project Title / Name of Client / Contract Sum / Start / End / % Current Progress
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
5.0 / PROJECT PARTICULARSAll required particulars must be entered here. Reference to the Company Profile is not allowed
5.2 / List of Projects Commenced in 2016
Project Title / Name of Client / Contract Sum / Start / End / % Current Progress
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
5.0 / PROJECT PARTICULARSAll required particulars must be entered here. Reference to the Company Profile is not allowed
5.3 / List of Projects Commenced in 2017
Project Title / Name of Client / Contract Sum / Start / End / % Current Progress
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
5.0 / PROJECT PARTICULARSAll required particulars must be entered here. Reference to the Company Profile is not allowed
5.4 / List of Projects Commenced in 2018
Project Title / Name of Client / Contract Sum / Start / End / % Current Progress
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.
5.0 / PROJECT PARTICULARSAll required particulars must be entered here. Reference to the Company Profile is not allowed
5.5 / List of Prestigious/Award Winning Projects
Project Title / Name of Client / Contract Sum / Year Completed / Award Particulars
All required particulars must be entered here. Reference to the Company Profile is not allowed. This table and page will automatically expand.

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6.0OFFICIAL DECLARATION
I/We declare that all information and documents in this form are true and represent the latest information of my/our company. I/We hereby allow Medini Iskandar Malaysia Sdn Bhd, its subsidiaries, associate companies and jointly controlled entities (“MIM Group”) to refer/check any information in this form or documents appended herewith or as supplied by us to the MIM Group with any third parties, as necessary. I/We also declare that all personal data or sensitive personal data may be passed on to relevant third parties by the MIM Group on a need to know basis throughout the course of prequalification as deemed fit by the management of the MIM Group.
Signature / : / …………………………………………..
Name / :
Designation / :
Date / :
COMPULSORY DOCUMENTS TO BE SUBMITTED(tick [] where applicable)
1.Form A/B/D/8/9/24/49 (registration certificates where applicable) / 
2.Certificate of Registration Authorities/Governing Bodies / 
3.Company Profiles / 
4.Latest Audited Company Accounts / 
5.Supporting letters from reputable property developers/clients / 
6.Scans of the above supporting document (in pdf format) / 
7.Signed copy of this Prequalification Form (in pdf format) / 

PLEASE SUBMITTHE SIGNED PREQUALIFICATION FORM TOGETHER WITH THE ABOVE SUPPORTING DOCUMENTS (ALL IN PDF FORMAT) BY EMAIL TO:

ALL PARTICULARS IN THE PREQUALIFICATION FORMMUST BE FULLY COMPLETED AND FILLED IN.INCOMPLETE PREQUALIFICATION FORM SHALL BE REJECTED.DECISION TO ACCEPT OR REJECT THE APPLICATION SHALL BE AT THE SOLE DISCREATION OF MEDINI ISKANDAR MALAYSIA SDN BHD AND SHALL BE FINAL.

ANY ENQUIRY ON THIS PREQUALIFICATION SHALL BE EMAILED TO

SEPTEMBER 2018

ASARV11

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