National Prequalification Scheme application form (PDF) - RTA

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GUIDE NOTE: Documentary evidence may be provided. However, the Applicant must ensure that its use for the purposes of an Application for prequalification is permitted by the owner of the subject documents. Evidence to support the Applicant’s overall suitability for prequalification can include reports, references or referees. It is necessary that the Application includes advice that the referees or the originators of any reports and references have given permission for the Participating Authority to contact them for comment on the Applicant’s overall performance. Edition 1 Revision 4 – December 2012
6. SUBMITTING THE APPLICATION Applications should include a covering letter on company letterhead including the following paragraph: In submitting this Application for prequalification, we certify that the information in this Application is true and correct and fully complies with the requirements in the Guidelines and Application Form. We also acknowledge and agree to and hereby incorporate the ‘Terms and Conditions’ referred to in Section 2 of the Guidelines and provide the undertakings detailed in Section 2.8 of the Guidelines. The letter must be signed by the Applicant’s authorised representative as follows: Signed: …………………………………………………….. Name: ……………………………………………………… Company Secretary / Director Date: …………….………………………………………… Applications should consist of all documentation outlined in these procedures, together with any other supporting technical or financial information. Two copies of the Application and supporting information must be provided. The technical information should be separate from the financial information. Applicants are encouraged to submit the Application on disc, in a read-only format. Applications cannot be submitted via facsimile. Applications should be forwarded to: Post to: Manager Contracts Strategy Infrastructure Contracts Branch Roads and Maritime Services Locked Bag 928 NORTH SYDNEY NSW 2059 or Deliver to: Manager Contracts Strategy Infrastructure Contracts Branch Roads and Maritime Services Level 17 101 Miller Street NORTH SYDNEY NSW 2060 Edition 1 Revision 4 – December 2012
Page 1 and 2: `` Application Form National Prequa
Page 3 and 4: 1.1. General Information Applicants
Page 5 and 6: (p) Contact for general enquiries (
Page 7 and 8: 2. Company Profile GENERAL INSTRUCT
Page 9 and 10: Resume attached (please tick to con
Page 11 and 12: GUIDE NOTE: The extent of use of co
Page 13 and 14: 3. Financial Capacity GENERAL INSTR
Page 15 and 16: Cash flow (a) Provide details of hi
Page 17 and 18: 4. COMPANY EXPERIENCE GENERAL INSTR
Page 19 and 20: 4.4. Contract Completion Has the Ap
Page 21 and 22: GUIDE NOTE: Evidence could include,
Page 23 and 24: (c) Provide copies of the reports o
Page 25 and 26: (b) Provide documentary evidence of
Page 27 and 28: Prequalification categories R2/B2 a
Page 29 and 30: (b) Provide evidence of utilisation
Page 31 and 32: (g) Has the Applicant ever received
Page 33 and 34: 5.2. Key Operational Personnel Prov
Page 35 and 36: NAME ROLE DETAILS Resume attached (
Page 37: GUIDE NOTE: Evidence could include,

National Prequalification Scheme application form (PDF) - RTA

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