Vendor Prequalification Requirements

Submitted Not Submitted Not Applicable Section / Page Comments

1 Company Presentation/ Profile x 2 to 21
2 Articles of Association ( if a company ) x

3 Valid Commercial Registration Certificate x 41

4 Valid Chamber of Commerce Registration Certificate x 42

5 Valid Zakat Certificate x 43 to 44

6 Valid VAT Certificate x 45

7 Valid GOSI Certificate (General Organization for Social Insurance ) x 46

8 x 47
Valid Saudization Certificate
9 Valid copy of Council of Saudi Engineers x
10 Health, Safety,Security and Environmental Plans x
11 Risk Management Plan x
12 ISO 9001 certification x 48
13 Company Liability Insurance x
14 Professional Indemnity Insurance x

15 Product Liability Insurance x 49 to 50

16 Does the Company have any previous criminal conviction x

17 Previous Amaala Approval x 22 to 40

17
Previous NWC Approval (National Water Company) x
Previous material Approvals (from other governmental
18 x 51 to 80
organisations such as Aramco, Neom, Sabic, MOT, MOH…etc)
19 Regulatory Approval (such as food and Drugs authority,…etc) x
20 provide electronic copies of last 3 years Audited company accounts x
21 Previous Similar Experience x 81 to 83
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5/23/23, 8:17 AM Aconex

CTS DAR DC Final (WF-036289) 13-4800000206/010-IN-Construction … 05/21/2023

DAR AL-HANDASAH (SHAIR AND PARTNERS) - SAUDI ARABIA WORKFLOW TRANSMITTAL DAH-WTRAN-006852

13 Sindalah Island

Riyadh, KSA

Riyadh

Saudi Arabia

MAIL TYPE MAIL NUMBER REFERENCE NUMBER

Workflow Transmittal DAH-WTRAN-006852 DAH-WTRAN-006852

Final (WF-036289) 13-4800000206/010-IN-Construction - IFR (MAT - ELE, SEC,

ICT, AVC)

From Mr CTS DAR DC - Dar Al-Handasah (Shair and Partners) - Saudi Arabia

To (4) Neom Pmc Region 13 - AECOM (+3 more...)

Cc (10) Mr Mohamed Aboadma - AECOM (+9 more...)

Sent Sunday, May 21, 2023 2:05:52 PM AST (GMT +03:00)

Status N/A

DOCUMENT ATTACHMENTS (2)

(0 selected)

Revision
File Document No Revision Title Status
Date

13-211002- 4800000206/010 – Material Submittal for B - Incorporate

4800000206-NAP-ELE- 03 5/17/23 CABLE MANAGEMENT SYSTEM – KSC - Comments -

CRS-000111 Building 23 (Cluster 1) Proceed

13-211002- 4800000206/010 – Material Submittal for B - Incorporate

4800000206-NAP-ELE- 03 5/17/23 CABLE MANAGEMENT SYSTEM – KSC - Comments -

MAT-000038 Building 23 (Cluster 1) Proceed

MESSAGE

Workflow Review History

The attached documents have completed the "13-4800000206/010-IN-Construction - IFR (MAT - ELE, SEC, ICT, AVC)" workflow with the

following results :

This transmittal was automatically generated.

Doc No Step Participant Review Outcome Comments

https://ksa1.aconex.com/hub/index.html# 1/2
5/23/23, 8:17 AM Aconex

13-211002-4800000206- B - Incorporate Comments Refer to comments on

AECOM/PMC Review C DAR DC
NAP-ELE-MAT-000038 - Proceed attached CRS

13-211002-4800000206- B - Incorporate Comments Refer to comments on

AECOM/PMC Review C DAR DC
NAP-ELE-CRS-000111 - Proceed attached CRS

https://ksa1.aconex.com/hub/index.html# 2/2
5/23/23, 8:20 AM Aconex

Maqbool Ahmad Final (WF-036312) 13-4800000206/010-IN-PQD RQM ( … 05/21/2023

NEOM - ENGINEERING & TECHNICAL SERVICES DEPT WORKFLOW TRANSMITTAL NEN-WTRAN-024339

13 Sindalah Island NEOM - Engineering & Technical Services Dept

Riyadh, KSA ITCC Complex, Al Raidah Digital City

Riyadh Level 2, Building IN01

Saudi Arabia Riyadh

An Nakheel 12382 Saudi Arabia

MAIL TYPE MAIL NUMBER REFERENCE NUMBER

Workflow Transmittal NEN-WTRAN-024339 NEN-WTRAN-024339

Final (WF-036312) 13-4800000206/010-IN-PQD RQM (MAT / EQP)- IFR

From Mr Maqbool Ahmad - NEOM - Engineering & Technical Services Dept

To (2) Neom Pmc Region 13 - AECOM (+1 more...)

Cc (10) Mr Mohamed Aboadma - AECOM (+9 more...)

Sent Sunday, May 21, 2023 10:28:45 AM AST (GMT +03:00)

Status N/A

DOCUMENT ATTACHMENTS (2)

(0 selected)

Revision
File Document No Revision Title Status
Date

4800000206/010 – Pre-Qualification Document of

13-211002- B - Incorporate
KHEREIJI SHOWROOMS COMPANY LTD.
4800000206-NAP- 01 5/18/23 Comments -
(KSC) – Cable Tray And Wiring Devices Back
ELE-CRS-000175 Proceed
Box Manufacturer

4800000206/010 – Pre-Qualification Document of

13-211002- B - Incorporate
KHEREIJI SHOWROOMS COMPANY LTD.
4800000206-NAP- 01 5/18/23 Comments -
(KSC) – Cable Tray And Wiring Devices Back
ELE-PQD-000061 Proceed
Box Manufacturer

MESSAGE

Workflow Review History

The attached documents have completed the "13-4800000206/010-IN-PQD RQM (MAT / EQP)- IFR" workflow with the following results :

This transmittal was automatically generated.

Doc No Step Participant Review Outcome Comments

https://ksa1.aconex.com/hub/index.html# 1/2
5/23/23, 8:20 AM Aconex

13-211002-4800000206- B - Incorporate Comments Comments on attached

ACM/PMC- Review M Ahmad
NAP-ELE-PQD-000061 - Proceed CRS

B - Incorporate Comments Comments on attached

ETSD_Review M Ahmad
- Proceed CRS

13-211002-4800000206- B - Incorporate Comments Comments on attached

ACM/PMC- Review M Ahmad
NAP-ELE-CRS-000175 - Proceed CRS

B - Incorporate Comments Comments on attached

ETSD_Review M Ahmad
- Proceed CRS

https://ksa1.aconex.com/hub/index.html# 2/2
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2453277775037777776-5 1'/ 19 'ÿ0B& 0ÿ7B 7ÿ5ÿ)  ÿ'  ÿ'02
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2453277775037777776-5 1'/ 19 'ÿ0B& 0ÿ7B 7ÿ5ÿ)  ÿ'  Yÿ2

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5/3/23, 9:08 AM Aconex

Gad Markous Final (WF-032506) 13-4200000086/002-IN-Construction… YESTERDAY

AECOM WORKFLOW TRANSMITTAL ACM-WTRAN-077748

13 Sindalah Island
Riyadh, KSA
Riyadh
Saudi Arabia

MAIL TYPE MAIL NUMBER REFERENCE NUMBER

Workflow Transmittal ACM-WTRAN-077748 ACM-WTRAN-077748

Final (WF-032506) 13-4200000086/002-IN-Construction -

IFR-/C3/C4/C6/MAT/MEP/MEC/PLD/FPR/FLS

From Gad Markous - AECOM

To (2) Neom Pmc Region 13 - AECOM

Gad Markous - AECOM

Cc (15) Mr Imran Shahid - AECOM

Vitalij Vilesko - AECOM

Mr Waleed Bushara - AECOM

Mr Mohammed Ibrahim - AECOM

Mr Jason Agriam - AECOM

Mr Omar Al Khateeb - AECOM

Mr Randy Oracion - AECOM

Mr Alvin Delfin - AECOM

Mr Hazim Shakir - AECOM

Mohammed Minhajuddin Ahmed - AECOM

Mr 4800000588 BEI DCC - BEC Arabia Ltd

NEOM Quality & Excellence Document Control - NEOM - Engineering & Technical Services Dept

NEOM Regional DC - NEOM - Projects

Mr Mohammed Alzahrani - NEOM - Projects

Sarah Basyouni - NEOM - Projects

Sent Tuesday, May 2, 2023 2:14:24 PM AST (GMT +03:00)

Status N/A

DOCUMENT ATTACHMENTS (1)

(0 selected)

https://ksa1.aconex.com/hub/index.html?mainTarget=%2FViewCorrespondence%3FCorrespondence_ID%3D1360313594%26CORRESPONDENCE_… 1/2
5/3/23, 9:08 AM Aconex

Revision
File Document No Revision Title Status
Date

4200000086/002- Material Submittal for Cable Tray

13-213001- E - Review
with Accessories,Cable Ladder with Accessories &
4200000086-BEI- 02 4/13/23 Not Required -
Cable Trunking with Accessories Khereiji show room
ELE-CRS-000016 Proceed
For Cluster 3

MESSAGE

Workflow Review History

The attached documents have completed the "13-4200000086/002-IN-Construction - IFR-/C3/C4/C6/MAT/MEP/MEC/PLD/FPR/FLS" workflow

with the following results :

This transmittal was automatically generated.

Doc No Step Participant Review Outcome Comments

13-213001-4200000086- E - Review Not Required - See attached CRS, for

AECOM/PMC Review G Markous
BEI-ELE-CRS-000016 Proceed your input

https://ksa1.aconex.com/hub/index.html?mainTarget=%2FViewCorrespondence%3FCorrespondence_ID%3D1360313594%26CORRESPONDENCE_… 2/2
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811911 !"#$3%&'(!!$4%(!!)*+$4+94,-2-32,,$3.(/0012 /3+13(1)4 313

Sensitive #

NEOM COMMENTS RESOLUTION SHEET

Contract No. & Title: 4800000522/000-OXAGON D&B for Interim Warehouses at T0

REVIEWED DOCUMENT DATA
Transmittal / Workflow 03-120000-4800000522-AMT-ELE-MAT-000005 CRS Identification No: 03-120000-4800000522-AMT-ELE-CRS-000011 Revision No: 01

Transmittal / Document Title 4800000522/000 MATERIAL SUBMITTAL FOR CABLE TRUNKING Status Code:

Document Type MAT - Material Submittal CRS Prepared by:

PMC Reviewer CRS Reviewed by:

Discipline(s) involved ELE-Electrical
PMC Reviewer CRS Approved by: D.Hanly Date 2023/02/12

Location Date
Sign
ETSD No Objection :
Transmittal received date by NEOM / EPM Date

Disclaimer : Permission to proceed shall not constitute acceptance or approval of design details, calculations, analyses, test methods or materials developed or selected by the Contractor and shall not relieve the Contractor from full compliance with Contractual obligations and NEOM
requirements

Status Codes: All codes must be as per NEOM Documents NEOM-NPR-PLN-101 (Design Management Plan) & NEOM-NEN-PRC-030 (Project Document Numbering and Revision Procedure)
A = Work may proceed , B = Incorporate Comments - Proceed , C = Revise & Resubmit - Do not Proceed , D= Rejected, E = Review not required - Proceed

Document / Drawing No. / Comments made Responded

No. NEOM`s Reviewer/EPM Comments Initial Status Originator Response Revised Status
Section/ Page by By
03-120000-
4800000522- The Contractor is required to submit evidence for compliance with NEOM sustainability requirements
1 IM B
AMT-ELE-MAT- regarding Materials Procurement, and Material Re-used/Recycled content.
000005_01

8924-be22-7fd1-50a7 Page 1 of 3 NEOM CRS Template: 10-000000-0000100854-BEC-DCC-TMP-000001, Rev. 02, SPINE Version
2/12/23, 8:07 PM Aconex

David Hanly Final (WF-043587) 4800000522/000 MATERIAL SUBMI… 4:49 PM

SAUDI ARABIAN PARSONS LIMITED WORKFLOW TRANSMITTAL PAR-WTRAN-115720

03 OXAGON
NEOM Industrial City
NEOM
Saudi Arabia

MAIL TYPE MAIL NUMBER REFERENCE NUMBER

Workflow Transmittal PAR-WTRAN-115720 PAR-WTRAN-115720

Final (WF-043587) 4800000522/000 MATERIAL SUBMITTAL FOR CABLE

TRUNKING

From Mr David Hanly - SAUDI ARABIAN PARSONS LIMITED

To (6) Mr NIC.DC Parsons - SAUDI ARABIAN PARSONS LIMITED (+5 more...)

Cc (11) Mr 4800000522 AMTG - Abdul Mohsen A.H. Al Tamimi Partners Company (+10 more...)

Sent Sunday, 12 February 2023 4:49:39 PM AST (GMT +03:00)

Status N/A

DOCUMENT ATTACHMENTS (2)

(0 selected)

Revision
File Document No Revision Title Status
Date

4800000522/000 MATERIAL B - Incorporate

03-120000-4800000522-
01 05/02/2023 SUBMITTAL FOR CABLE Comments -
AMT-ELE-CRS-000011
TRUNKING Proceed

4800000522/000 MATERIAL B - Incorporate

03-120000-4800000522-
01 05/02/2023 SUBMITTAL FOR CABLE Comments -
AMT-ELE-MAT-000005
TRUNKING Proceed

MESSAGE

Workflow Review History

The attached documents have completed the "4800000522/000 MATERIAL SUBMITTAL FOR CABLE TRUNKING" workflow with the
following results :

This transmittal was automatically generated.

Doc No Step Participant Review Outcome Comments

03-120000-4800000522- B - Incorporate
PMC Sustainability I Martin
AMT-ELE-MAT-000005 Comments - Proceed

https://ksa1.aconex.com/hub/index.html 1/2
2/12/23, 8:07 PM Aconex

B - Incorporate
PMC SPM Final dispatch D Hanly See comments on CRS
Comments - Proceed

03-120000-4800000522- B - Incorporate
PMC Sustainability I Martin
AMT-ELE-CRS-000011 Comments - Proceed

B - Incorporate
PMC SPM Final dispatch D Hanly See comments on CRS
Comments - Proceed

https://ksa1.aconex.com/hub/index.html 2/2
5/26/2021 Aconex

Sanjeev Guness Final (WF-001720) R02I16B01 - Material Submittal for … 10:13 AM

THE RED SEA DEVELOPMENT COMPANY WORKFLOW TRANSMITTAL TRS02I16-WTRAN-004877

MAIL TYPE MAIL NUMBER REFERENCE NUMBER

Workflow Transmittal TRS02I16-WTRAN-004877 TRS02I16-WTRAN-004877

Final (WF-001720) R02I16B01 - Material Submittal for KSC Cable Management

System (By: KSC Khereiji Showrooms CO. LTD.) - rev.01

From Mr Sanjeev Guness - The Red Sea Development Company

To (12) Mr Ringo Deloeste - AECOM

Mr Enrico Purugganan - AECOM

Mr Tamer Issa - AECOM

Mr Moossan Shad - AECOM

Mr Roberto Bayawa - NAPJV

Mr Ammar Ghaith - The Red Sea Development Company

Bassem Rizk - The Red Sea Development Company

Mr Sanjeev Guness - The Red Sea Development Company

Ana Araujo - The Red Sea Development Company

Houssam Cheaib - The Red Sea Development Company

Mr Marcus Luff - The Red Sea Development Company

Mohamed Macci - The Red Sea Development Company

Cc (11) Dr Aysar Odeh - AECOM

Mr Rowell Lizardo - NAPJV

Mr Charbel Sebaaly - NAPJV

Mr Aseel Basakran - NAPJV

Mr Ahmed Basfar - NAPJV

Ms Valerie Castro - The Red Sea Development Company

Mr Khaled Gad - The Red Sea Development Company

Mr Ossama Wahdan - The Red Sea Development Company

Mr Amit Yadav - The Red Sea Development Company

Mr Ali Obaid - The Red Sea Development Company

Mr James Marsden - The Red Sea Development Company

Sent Wednesday, May 26, 2021 10:13:32 AM AST (GMT +03:00)

Status N/A
https://ksa1.aconex.com/Logon?Action=View&ENTITY=MAIL&ID=1349782764&USERID=1342240441 1/4
5/26/2021 Aconex

DOCUMENT ATTACHMENTS (1)

(0 selected)

File Document No Revision Title Status

R02-I16B01-NAP-MAT- KSC Cable Management System (By: KSC Khereiji Accepted with
01
EL-0046 Showrooms CO. LTD.) Comments

ATTRIBUTES

Attribute 1 Airside

MESSAGE

Workflow Review History

The attached documents have completed the "R02I16B01 - Material Submittal for KSC Cable Management System (By: KSC Khereiji
Showrooms CO. LTD.) - rev.01" workflow with the following results :

This transmittal was automatically generated.

Doc No Step Participant Review Outcome Comments

R02-I16B01-NAP-MAT- AECOM Document

R Deloeste Accepted
EL-0046 Controller

AECOM Supervision T Issa Accepted with Comments Material submittal is

accepted with the below
comments: - Provide
loading calculation for the
used cable trays and cable
ladders. - All fixation
hardware: bolts, nuts,
washers, couplers, bends,
tees, risers, elbows, plates,
supports and fittings shall
be compatible with the
used cable tray / ladder
and to be delivered from
the same
manufacturer/supplier. -
The cable tray / ladder
shall be sized to suit the
proposed cabling
requirements with min of
30% spare capacity for
tray and 25 % for ladder. -
Sizes and compartments
shall be as per indicated in
the shop drawings and

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 1110241544
٣٠٠٢٤٥٠٢٩٤
١١١٠٢٤١٥٤٤
‫ ﻫـ‬١٤٤٤/١٢/٠١

‫ﺷﻬﺎدة‬
Certificate
The Zakat,Tax and Customs ‫ﺗﺸﻬﺪ ﻫﻴﺌﺔ اﻟﺰﻛﺎة واﻟﻀﺮﻳﺒﺔ‬

Authority certifies that the Taxpayer / ‫واﻟﺠﻤﺎرك أن اﻟﻤﻜﻠﻒ‬

‫ﺷﺮﻛﺔ ﻣﻌﺎرض اﻟﺨﺮﻳﺠﻲ‬

Entity Unified No./ID No. ٧٠٠١٢٥٧٧٨٦ ‫ رﻗﻢ ﻫﻮﻳﺔ‬/ ‫اﻟﺮﻗﻢ اﻟﻤﻮﺣﺪ ﻟﻠﻤﻨﺸﺄة‬

Commercial Registration/License/
٤٠٣٠٠١٦٣٠٣ ‫ ﻋﻘﺪ رﻗﻢ‬/ ‫ رﺧﺼﺔ‬/ ‫ﺳﺠﻞ ﺗﺠﺎري‬
Contract No

Has submitted his tax return for the period ending on 31/12/2022 AD, and he ، ‫ ﻫـ‬١٤٤٤/٠٦/٠٧ ‫ﻗﺪم إﻗﺮاره ﻋﻦ اﻟﻔﺘﺮة اﻟﻤﻨﺘﻬﻴﺔ ﻓﻲ‬
was granted the certificate to complete all his transactions including the ‫وﻗﺪ ﻣﻨﺢ ﻫﺬه اﻟﺸﻬﺎدة ﻹﻧﻬﺎء ﺟﻤﻴﻊ ﻣﻌﺎﻣﻼﺗﻪ ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺻﺮف‬
payment of the final amount due on the contract. .‫ﻣﺴﺘﺤﻘﺎﺗﻪ اﻟﻨﻬﺎﺋﻴﺔ ﻋﻦ اﻟﻌﻘﻮد‬
The Certificate is valid until 21/10/1445 AH corresponding to 30/04/2024 ‫ ﻫـ اﻟﻤﻮاﻓﻖ‬١٤٤٥/١٠/٢١ ‫ﻳﺴﺮي ﻣﻔﻌﻮل ﻫﺬه اﻟﺸﻬﺎدة ﺣﺘﻰ ﺗﺎرﻳﺦ‬
AD ‫ م‬٢٠٢٤/٠٤/٣٠

( The Twenty first of Shawwal one thousand four hundred forty-five Hijri ) ( ‫) اﻟﺤﺎدي و اﻟﻌﺸﺮون ﻣﻦ ﺷﻮال أﻟﻒ و أرﺑﻌﻤﺎﺋﺔ و ﺧﻤﺴﺔ و أرﺑﻌﻮن ﻫﺠﺮي‬

www.zatca.gov.sa :‫ﻻﻳﻌﺘﺪ ﺑﻬﺬه اﻟﺸﻬﺎدة إﻻ ﺑﻌﺪ اﻟﺘﺤﻘﻖ ﻣﻦ ﻣﻮﻗﻊ اﻟﻬﻴﺌﺔ اﻻﻟﻜﺘﺮوﻧﻲ‬

This certificate is not valid until verified by the Authority's Website: www.zatca.gov.sa
‫‪1110241544‬‬
‫‪٣٠٠٢٤٥٠٢٩٤‬‬
‫‪١١١٠٢٤١٥٤٤‬‬
‫‪ ١٤٤٤/١٢/٠١‬ﻫـ‬

‫ﻗﺎﺋﻤﺔ ﻓﺮوع اﻟﻤﻜﻠﻒ‬

‫‪List of Taxpayer Branches‬‬

‫اﻟﻤﺪﻳﻨﺔ‬ ‫إﺳﻢ اﻟﻔﺮع‬ ‫رﻗﻢ ﺳﺠﻞ ﺗﺠﺎري ‪/‬رﺧﺼﺔ ‪/‬ﻋﻘﺪ‬

‫‪City‬‬ ‫‪Branch Name‬‬ ‫‪CR/License/Contact Number‬‬

‫اﻟﺮﻳﺎض‬
‫ﻓﺮع ﺷﺮﻛﺔ ﻣﻌﺎرض اﻟﺨﺮﻳﺠﻲ‬ ‫‪١٠١٠٠٧٠٣٠٨‬‬
‫‪Riyadh‬‬

‫اﻟﺮﻳﺎض‬
‫ﻓﺮع ﺷﺮﻛﺔ ﻣﻌﺎرض اﻟﺨﺮﻳﺠﻲ‬ ‫‪٤٦٥٠٠٣٩٣٩٦‬‬
‫‪Riyadh‬‬

‫اﻟﺮﻳﺎض‬
‫ﻓﺮع ﺷﺮﻛﺔ ﻣﻌﺎرض اﻟﺨﺮﻳﺠﻲ‬ ‫‪١٠١٠٢٩٢٣٥٠‬‬
‫‪Riyadh‬‬

‫اﻟﺪﻣﺎم‬
‫ﻓﺮع ﺷﺮﻛﺔ ﻣﻌﺎرض اﻟﺨﺮﻳﺠﻲ اﻟﻤﺤﺪودة‬ ‫‪٢٠٥٠٠٦٥٠٣٨‬‬
‫‪Dammam‬‬

‫اﻟﺪﻣﺎم‬
‫ﺷﺮﻛﺔ ﻣﻌﺎرض اﻟﺨﺮﻳﺠﻲ‬ ‫‪٢٠٥١٠٦٤٦٧٩‬‬
‫‪Dammam‬‬
 ‫‪١٤٤٤/١١/١٥‬‬ ‫ﺍﻟﺘﺎﺭﻳﺦ‬
‫‪٠٤/٠٦/٢٠٢٣‬‬ ‫ﺍﻟﻤﻮﺍﻓﻖ‬
‫ﺭﻣﺰ ﺍﻟﺸﻬﺎﺩﺓ ‪٥٤٩٧٦٩٢١‬‬

‫ﺷﻬﺎﺩﺓ‬

‫ﺣﺪﻳﺚ ﻟﻤﺴﺘﻠﺰﻣﺎﺕ ﺍﻟﻜﻬﺮﺑﺎﺀ‪/‬ﺷﺮﻛﺔﺍﻟﻤﺼﻨﻊ‬ ‫ﺇﺳﻢ ﺍﻟﻤﻨﺸﺄﺓ ‪:‬‬

‫ﺹ‪.‬ﺏ ‪ ٤٢٢ :‬ﺍﻟﺪﻣﺎﻡ ‪٣١٤١١‬‬
‫ﺍﻟﺴﻌﻮﺩﻳﺔ‬
‫‪٢٠٠٠٥٤٢٨٨‬‬ ‫ﺭﻗﻢ ﺍﻹﺷﺘﺮﺍﻙ ‪:‬‬
‫ﻣﺼﺪﺭﻩ ‪:‬‬ ‫ﺭﻗﻢ ﺍﻟﺴﺠﻞ ﺍﻟﺘﺠﺎﺭﻱ‪٢٠٥٠٠٣١٨٦٠ :‬‬

‫ﻛﺘﺎﺑﺔ‬ ‫ﺭﻗﻤﺎ‬
‫ﺳﺘﺔ ﻭ ﻋﺸﺮﻭﻥ ﻣﺸﺘﺮﻛﺎ‬ ‫‪٢٦‬‬ ‫ﻋﺪﺩ ﺍﻟﻤﺸﺘﺮﻛﻴﻦ ﺍﻟﺴﻌﻮﺩﻳﻴﻦ‬
‫ﻭﺍﺣﺪ ﻭ ﺛﻤﺎﻧﻮﻥ ﻣﺸﺘﺮﻛﺎ‬ ‫‪٨١‬‬ ‫ﻋﺪﺩ ﺍﻟﻤﺸﺘﺮﻛﻴﻦ ﻏﻴﺮ ﺍﻟﺴﻌﻮﺩﻳﻴﻦ‬
‫ﻣـﺎﺋﺔ ﻭ ﺳﺒﻌﺔ ﻣﺸﺘﺮﻛﺎ‬ ‫‪١٠٧‬‬ ‫ﺍﻟﻤﺠﻤﻮﻉ‬

‫ﺗﺸﻬﺪ ﺍﻟﻤﺆﺳﺴﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﻴﻨﺎﺕ ﺍﻹﺟﺘﻤﺎﻋﻴﺔ ﺑﺄﻥ ﺍﻟﻤﻨﺸﺄﺓ ﺍﻟﻤﺬﻛﻮﺭﺓ ﺃﻋﻼﻩ ﻗﺪ ﺃﻭﻓﺖ ﺑﺈﻟﺘﺰﺍﻣﺎﺗﻬﺎ ﺗﺠﺎﻩ ﺍﻟﻤﺆﺳﺴﺔ‬
‫ﻭﻓﻖ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻟﻤﻘﺪﻣﺔ ﻣﻨﻬﺎ ﺣﺘﻰ ﺗﺎﺭﻳﺦ ﺇﺻﺪﺍﺭ ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ‪ ،‬ﻭﺍﻟﺘﻲ ﺗﻢ ﻣﻨﺤﻬﺎ ﻟﺘﻘﺪﻳﻤﻬﺎ ﻷﻳﺔ ﺟﻬﺔ ﺗﻄﻠﺒﻬﺎ ‪ ،‬ﻭﻫﻲ‬
‫ﺻﺎﻟﺤﺔ ﻟﺠﻤﻴﻊ ﺍﻷﻏﺮﺍﺽ ﺍﻟﺘﻲ ﻧﺺ ﻋﻠﻴﻬﺎ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺍﻹﺟﺘﻤﺎﻋﻴﺔ ﻓﻲ ﺍﻟﻤﺎﺩﺓ )‪ (١٩/٦‬ﻣﻨﻪ‪.‬‬
‫ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﺳﺎﺭﻳﺔ ﺍﻟﻤﻔﻌﻮﻝ ﺣﺘﻰ ‪ ١٤٤٤/١٢/١٥‬ﻫـ‪.‬‬
‫ﻋﻦ ﻃﺮﻳﻖ ﺍﺳﺘﺨﺪﺍﻡ‬ ‫ﺃﻭ‬ ‫ﻳﻠﺰﻡ ﺍﻟﺘﺤﻘﻖ ﻣﻦ ﺻﺤﺔ ﻭﺻﻼﺣﻴﺔ ﺍﻟﺸﻬﺎﺩﺓ ﻋﺒﺮ ﺯﻳﺎﺭﺓ ﺍﻟﺮﺍﺑﻂ‬
‫ﺍﻟﺮﻣﺰ ﺍﻟﻤﻌﺮﻑ ﺍﻟﺘﺎﻟﻲ ‪:‬‬ ‫ﺃﺩﻧﺎﻩ ﻓﻲ ﺍﻟﻤﻮﻗﻊ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ ﻟﻠﻤﺆﺳﺴﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﻴﻨﺎﺕ ﺍﻹﺟﺘﻤﺎﻋﻴﺔ‬

‫‪www.gosi.gov.sa/vc‬‬

‫) ﺍﻟﺸﻬﺎﺩﺓ ﻣﻌﺘﻤﺪﺓ ﻣﻦ ﺻﺎﺣﺐ ﺍﻟﺼﻼﺣﻴﺔ ﻭﻻ ﺗﺤﺘﺎﺝ ﺇﻟﻰ ﺗﻮﻗﻴﻊ ﺃﻭ ﺧﺘﻢ (‬

‫ﺗﻌﺪ ﻫﺬﻩ ﺍﻟﺸﻬﺎﺩﺓ ﻣﻦ ﺍﻟﻮﺛﺎﺋﻖ ﺍﻻﻟﻜﺘﺮﻭﻧﻴﺔ ﺍﻟﺤﻜﻮﻣﻴﺔ ﺍﻟﺮﺳﻤﻴﺔ ‪ ،‬ﻭﻳﺤﻈﺮ ﻗﻄﻌﻴﺎ ﺗﻘﻠﻴﺪﻫﺎ ﺃﻭ ﺇﺩﺧﺎﻝ ﺃﻱ ﺗﻌﺪﻳﻼﺕ ﻋﻠﻴﻬﺎ ﺳﻮﺍﺀ ﺑﺎﻹﺿﺎﻓﺔ ﺃﻭ ﺍﻟﺤﺬﻑ‬
‫ﺃﻭ ﺍﻟﺘﻐﻴﻴﺮ ﻓﻲ ﺑﻴﺎﻧﺎﺗﻬﺎ ﺃﻭ ﻏﻴﺮ ﺫﻟﻚ ﻣﻦ ﺍﻧﻮﺍﻉ ﺍﻟﺘﻌﺪﻳﻞ ‪ ،‬ﻭﺗﻌﺪ ﺍﻟﺸﻬﺎﺩﺓ ﻻﻏﻴﺔ ﺇﺫﺍ ﺷﺎﺑﻬﺎ ﺷﻲﺀ ﻣﻦ ﺫﻟﻚ ‪ ،‬ﻛﻤﺎ ﺗﻌﺮﺽ ﺻﺎﺣﺒﻬﺎ ﻟﻠﻤﻼﺣﻘﺔ ﺍﻟﻨﻈﺎﻣﻴﺔ‬
‫ﺃﻣﺎﻡ ﺍﻟﺠﻬﺎﺕ ﺍﻟﻤﺨﺘﺼﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﻣﺎﻳﻔﺮﺿﻪ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻣﻦ ﻋﻘﻮﺑﺎﺕ ‪ ،‬ﻭﻻﻳﺠﻮﺯ ﺗﺪﺍﻭﻝ ﺍﻟﺸﻬﺎﺩﺓ ﺇﻻ ﻓﻲ ﺍﻷﻏﺮﺍﺽ ﺍﻟﺘﻲ‬
‫ﺃﺻﺪﺭﺕ ﻷﺟﻠﻬﺎ ﻭﻓﻘﺎ ﻷﺣﻜﺎﻡ ﻧﻈﺎﻡ ﺍﻟﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ‪ ،‬ﻭﺍﻟﻤﺆﺳﺴﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺘﺄﻣﻴﻨﺎﺕ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ ﻏﻴﺮ ﻣﺴﺆﻭﻟﻪ ﻋﻦ ﺃﻱ ﺁﺛﺎﺭ ﺃﺧﺮﻯ ﻣﺘﺮﺗﺒﺔ‬
‫ﻗﺒﻞ ﺍﻟﻐﻴﺮ ﻋﻦ ﺍﻟﺸﻬﺎﺩﺓ ﻭﻏﻴﺮ ﻣﺴﺆﻭﻟﺔ ﻋﻦ ﺃﻱ ﻋﻤﻠﻴﺔ ﺗﺰﻭﻳﺮ ﺃﻭ ﺗﻌﺪﻳﻞ ﺗﺘﻢ ﻋﻠﻰ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻟﻮﺍﺭﺩﺓ ﻓﻴﻬﺎ ‪.‬‬
AMALAA TRIPLEBAY PROJECT
Al Ayuni investment co
25/07/2023
Warranty and insurance
Document Submittal Form
Document 14-189000-4800000338-ABI-ELE-
Contractor AL BADDAD INTERNATIONAL
submittal no. PQD-000003

Contract no. 4800000338 Date July 18, 2022

To PMC AECOM

Document no. Type Description Rev no. Action required

 Approval Comments
14-189000- 4800000338/000 Information Other
4800000338-ABI- Prequalification Prequalification for Khereiji
01
ELE-PQD- Document Showrooms Company (KSC)
000003 Electrical Materials Supplier

Approval Comments
Information Other
Approval Comments
Information Other
Contractor authorized signatory
REY JOHN ELAPE
Name Date July 18, 2022

Signature

PMC’s comments

Exception as noted revise

No exception taken Revise and resubmit
Status code and resubmit for record
Rejected Review not required Issued for Construction
Engineer’s
Date
name

Signature

Received by Contractor
Name Date

Signature

14-189000-4800000338-ABI-ELE-PQD-000003 Revision 01 Page 1 of 146

 Document Submittal

4800000338/000 Prequalification for Khereiji Showrooms Company

(KSC) Electrical Materials Supplier
<14-189000-4800000338-ABI-ELE-PQD-000003= R e v <01=, <July, 2 0 2 2=

14-189000-4800000338-ABI-ELE-PQD-000003 Revision 01 Page 2 of 146

 Document history

Revision code Description of changes Purpose of issue Date

01 First issue. For Approval July 18,2022

Document approval

Prepared by Reviewed by Approved by

Name Wael Abdul Rey John Rey John Elape
Elape
Job Title QC Inspector QAQC Manager QAQC Manager

14-189000-4800000338-ABI-ELE-PQD-000003 Revision 01 Page 3 of 146

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 KINGDOM OF SAUDI ARABIA PROJECTS LIST

SL NO PROJECTS CONTRACTOR
1 FAISALIYA TOWER –RIYADH SAUDI BIN LADEN
2 KINGDOM CENTREͲRIYADH IMPREGILO
3 MAJMAH SUBSTATION SCHNEIDER ELECTRIC
4 KEMYA POWER PLANT, JUBAIL SCHNEIDER ELECTRIC
5 VARIOUS SUBSTATION MEEDCO
6 VARIOUS SUBSTATION ABB
7 TRANSMISION LINE PROJECT NATIONAL CONT CO
8 SUBSTATION 9009/9006 SST
9 SCECOͲ132KVͲS/S8071 COGELEX
10 VARIOUS SUBSTATION AL TOUKHI
11 VARIOUS SUBSTATION SSEM
12 POWER PLANT PP9 SAUDI BINLADEN
13 KINGDOM ACADEMY, RIYADH SAUDI SPECIALIST
14 HUNTER PROJECT, RIYADH NESMA EMCORE
15 AL TAMEER PROJECT, RIYADH SAUDI TRADE &SERVICES
16 SAUDI HOLLAND BANK SWAYEH COMPANY
17 HAYYAT REGENCY, RIYADH SWAYEH COMPANY
 SL PROJECTS CONTRACTOR
NO
18 APICORP, ALKHABAR SAUDI BIN LADEN
19 SAUDI CARTON ALRAJHI
20 NATIONAL GUARD HOSPITAL AL FOZAN
21 AL HOKAIR PALACE, RIYADH AL FOZAN
22 BUGSHAN BUILDING SWAYEH COMPANY
23 ROYAL SAUDI HEAD QUARTERS NAMALAH EST
24 NCCI HEAD QUARTERS SAUDI SPECIALIST
25 SABIC R&D LAB ABWA CONT
26 NAYARA CELEBRATION HALL SAUDI TECHNICAL CO
27 EGYPTIAN EMBASSY HOSHANCO
28 RIYADH COURT COMPLEX SAUDI OGER
29 EQUESTRAIN CLUB AL FAYHA
30 NATIONAL COM BANK AL BOYZ
31 SULTAN CITY FOR HUMENITARION SERVICE YUKSEL INSATT
32 SAUDI GERMAN HOSPITAL SGH
33 AL BABTAIN HARTAGE TAROUKH CONT CO
34 OLAYA COMM. CENTRE JABRIA CONT. CO
35 ZULFI AND SAGHRA HOSPITAL JAWDAT
36 AL MIZANTOWER TEST ELECTRO
37 DALLAH HOSPITAL JAWDAT
38 AL HOKAIR LAND SWAYEH COMPANY
SL PROJECT CONTRACTOR
NO
39 RIYADH TECHNICAL COLLEGE RTCC
40 KINGDOM MEDICAL CENTRE STS
41 ABDUL AZIZ PALACE AL FREIHI CONT CO
42 AL JAZITRAH PRINTING PRESS SAUDI BINLADEN
43 SAUDI BRITISH BANK SAUDI BRITISH BANK
44 AL MARAI HEAD OFFICE AL LATIFIA CONT CO
45 MINISTRY OF TELECOMMUNICATION MINISTRY OF TELECOM
46 AL WAZIR CENTRE ABB
47 HABOONA NAJRAN HOSPITAL RAJAB AND TAYYEB CONT
48 GHASIM IMARA PALACE MANSOORIYAH CONT CO
49 MADAF TELECOMMUNICATION SYSTEM REGULAR CUSTOMER
50 SCHOOL PROJECT TEBRAK CONTCO
51 SHEIKH OMAR QASIM AL ESSAYI V3 ALESAYI CONSULT COMPANY
52 JABAL AL KABAH PHASE 1 MAKKAH AL MEC
MUKARRAMAH PACKAGE TIP 3
53 JAMJOOM PHARMACEUTICALͲ JAMJOOM (CONSULTANT)
EXTENSION
54 ARAC HOTEL,MAKKAH INTERNATIONAL BUILDING SYSTEMS
55 JEDDAH GATE IBS CO. FOR CONTRACTING