Contractor Fact Sheet 承包商情况说明书(问卷表)Page 2 of 20 Notes:注意:(a) All forms must be fully completed (additional sheets may be used, if necessary).所有表格应填写完整（若需要请增加表页）。
(b) CC6 should be notified in writing of any subsequent changes in the particularssubmitted.若有任何变更应以书面形式通知中建六局并提交相关资料。
(c) Where associated firms are to be engaged in joint ventures or where Contractor are proposed to beemployed for any portion of the works, similar particulars as listed shall be provided in respect of each firm.如多家公司组成联合体，或部分工程拟雇佣分包商时，各公司应分别填写调查表。
(d) All pages are to be endorsed by the signature of the Contractor and to be accompanied by thecompany stamp.承包商需在每一页上签字并盖章。
You are required to return the completed and duly signed "Contractor Fact Sheet" within 5 working days to allow us to process your application as our approved Sub-Contractor. Thank you for your interest and support in M+W.贵公司需在5 个工作日内填写并返还签字的”承包商情况说明书”，以便我们对贵公司进行审核。
感谢对M+W 的热忱和支持。
1. Company Name:公司名称2. Address:地址3. Postal Code:邮编4. Telephone:电话5. Telefax:传真6. E-Mail:电子信箱7. Date:日期8. Sales Person in charge of M+Wrelated business account:联系人Handphone:手机Page 3 of 209. Paid Up Capital / Capital Set Aside / Supplementary Information注册资金/闲置资本/补充信息For this purpose, the Contractor shall complete the accompanying Financial Data table (on the next page).为此目的，承包商应完成随附的财务数据表(下一页)。
In addition, copies of the following shall be submitted:作为补充, 需提交下列资料的复印件:(a) Brief particulars of the company from the Registry of Companies and Businesses’ (RCB)Instant Information Services.可立即查询的公司注册简要资料。
(b) Certificate of Incorporation of Limited Company.有限责任公司的法人证明。
(c) Audited Financial Reports for the last three years. This report should include the DirectorsReport, Balance Sheet, Profit and Loss Account, Trading Account, Sources and application ofFunds and Notes to Accounts.近三年的财务审计报告，包括董事报告、资产负债表、损益表、资金往来、资金来源和申请, 应收应付帐。
(d) Copy of Insolvency report and a description of any litigation in which the company is currentlyinvolved.破产报告复印件，任何涉及公司的诉讼案件。
(e) Copy of ISO certification (if available).质量认证体系证书（ISO）复印件（如果有）。
(f) Copy of Quality Assurance / Control Program质量保证/控制程序的复印件。
(g) Copy of Safety Management System安全管理系统复印件。
Page 4 of 20Page 5 of 20Page 6 of 20Page 7 of 2013. Company Registration公司注册(a) Register of Companies/Business Names公司注册名称(b) Registration Number注册编号(d) Place of registration注册属地(c) IC Card no企业IC 卡号(e) RegisteredPerson法定代表人14. Type of company公司类型(a) Stated Owned, Foreign Owned, Joint Venture(Chinese-Foreign, Domestic), Private,Partnership, or Corporation国营、外商独资、合资（中外合资、国内合资）、私营、合伙或股份公司(b) Type of qualification / grade资质类型/ 资质等级(c) Date company was founded:公司成立日期(d) Under present managementsince:何时开始目前经营方式(内容)Page 8 of 2017 Additional Information required (for Overseas Applicants only)补充资料（仅适用于海外企业）(a) Name and address of Local Representative.本地代表机构的名称和地址.(b) Indicate whether you intend to establish a local office of your own inChina.是否有在中国建立本地办公室的意向.Yes No 是否(c) State name and address of Local Banker本地银行的名称和地址Page 9 of 20Page 10 of 20Page 11 of 20Page 12 of 20Page 13 of 2024. Safety Evaluation Checklist安全评估检查表*Please indicate NA if not applicable(如果不适用请标明NA)(a) Does your company have a Safety Policy? Please provide a copy.贵公司是否有安全管理规定? 请提供一份复印件。
(b) Does your company set Safety Management System (SMS) targets andobjectives? If yes, please describe the process and provide extracts from current targets.贵公司是否制定安全管理系统(SMS)目标，如果有，请叙述过程并提供摘要。
(c) Are personal SMS objectives and targets set? If yes, describe the processand provide examples of current targets.是否有个人安全管理系统目标?如有, 请叙述过程，并举例说明。
(d) Does your organizational structure provide clear lines of accountability forSMS matters? Please provide a copy of an organization chart whichdemonstrates this.贵公司的组织机构是否有安全管理系统事务相关的责任图，请提供一份示范责任图的组织机构图复印件。
(e) Who has overall and final responsibility for SMS in your company? Pleaseprovide name, title and management experience.谁是贵公司安全管理系统的总负责人?请提供姓名、职位和管理经历。
(f) Are the SMS responsibilities of employees down to and includingsupervisors defined? Please state where these are defined and provide an example from each organizational level down to supervisor.是否安全管理系统雇员细分到包括具体明确的管理人员，请叙述每个管理层面的具体的安全管理人员。
Yes No 是否Yes No 是否Yes No 是否Yes No 是否Yes No 是否Yes No 是否Page 14 of 20(g) Does your company employ full-time and/or part-time Safety Officer /Safety Supervisors? Kindly provide their names.贵公司是雇佣全职且/或兼职安全员/安全管理人员，请列出他们的名字。