SURVEY QUESTIONAIRE AND SCREENING CRITERIA For Water Treatment Chemical includes Coagulant, Anti-scalant, and De-chlorinatorfor Deminaralised Water Unit

Part 1. Survey questionnaire

QUESTION 1: Does your company have the business licenses and/or permits authorized letter (in case of Bidder is not Manufacturer) in providing Water Treatment chemical to protect Reverse Osmosis (RO) membrane includes Coagulant, Anti-scalant, and De-chlorinator for Deminaralised Water Unit?

1. Yes
2. No

If Yes, please provide the notarized copy of these documents

QUESTION 2: Does your company/Manufacturer have experience in providing Water Treatment chemical to protect Reverse Osmosis (RO) membrane for Demineralized Water Unit including chemical delivery, technical service including operating performance monitoring, chemical optimization, troubleshooting…?

If yes, please provide us the evidence.

QUESTION 3: Please provide information of your products as Table 1:

1. Product information
2. Technical Data Sheet (TDS)
3. Safety Data Sheet (MSDS)
4. Provide one sample of COA (Certificate of Analysis)

QUESTION 4: Is your Company/Manufacturer ISO 9001 Series certified and ISO 14001 certificate?

1. Yes
2. No

If yes, please provide copy of ISO certification

QUESTION 5: Does your company have an HSE (Health, Safety, Environment) policy document?

1. Yes
2. No

If yes, please provide evidence

QUESTION 6: Does your company has technical support during normal operation including performance monitoring, chemical optimization, troubleshooting… and a policy of after sale services to customers (warranty condition and workflow how to response for any request from customer)?

1. Yes
2. No

If yes, please provide us the evidence.

QUESTION 7:  Does your company can delivery Chemical to NSRP (lead time) within 02 months from purchase order date?

1. Yes
2. No (Please clarify how many days)

TABLE 1

Part 2. Screening criteria

Potential candidate is passed and selected to form the long list if their answers are:

• (Yes) with sufficient evidence for all questions No.1, No.2, No.4, No.5 and No. 6.
• Provide with sufficient information for 3 chemicals for question No.3
• And question No.7 for gather information.