Part A [To be completed by the Executing Agency]

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For reference purposes only and should not be used in preparing submission documents. Please download the latest version of the forms from ADB website at the following link: http://www.adb.org/site/business-opportunities/operational-procurement/consulting/documents PAI No. 2.05 Appendix 8a, Page 1 Executing Agency Consulting Recruitment Submission 1: Shortlisting of Consulting Firms and Request for Proposals (QCBS/QBS/FBS/LCS) Part A [To be completed by the Executing Agency] Loan/Grant (Country) (No.): Title Package/Component: This is the: [indicate whether 1 st, 2 nd, 3 rd, etc.] request for review Name of Executing Agency (EA): Report Submitted by: Name: Signature: Designation: Date Submitted: Date of EA Consultant Selection Committee-Shortlisting (CSC-SL) Meeting: Checklist of Attached Documents (For 1 st Review): In case of succeeding reviews, please attach only the information or documents requested in the latest review. Attachment 1: Latest Uploaded Procurement Plan Yes No [Procurement plan must be within a year and for each loan, not MFF. Attach approval memo for individual changes in the procurement plan] Attachment 2: Budget for consulting services including details of Yes No provisional sums and contingency Attachment 3: Longlist of Consulting Firms Yes No Attachment 4: Narrative Evaluation Criteria (NEC) Yes No [EA to prepare the NEC. Provide weights for each criterion in the summary evaluation sheet and detailed information on how to apply these weights and, if necessary, to distribute them to sub-criteria in NEC.] Attachment 5: Draft Request for Proposals (RFP) with Terms of Yes No Reference (TOR), Data Sheet, Summary and Personnel Evaluation Sheets 1 and Draft Contract Attachment 6: Copy of Previous Communications with OSFMD Procurement Yes No Specialist related to items covered by this Submission Document (if any) Attachment 7: Minutes of EA CSC-SL Meeting Yes No Attachment 8: Updated Consultant Recruitment Activities Monitoring (CRAM) Yes No Sheet [Project Unit to update CRAM sheet in Consulting Services Reference (Lotus Notes) before submitting this Submission 1 review to LCU. Indicate in the CRAM the reasons for any delay, and remedial action taken.] 1 The appropriate templates can be downloaded from the ADB website in the following link: http://www.adb.org/site/businessopportunities/operational-procurement/consulting/documents. Include the Attachment: Grounds for Disqualification of an Expert.

Appendix 8a, Page 2 Names of EA CSC Members*: [List the names of members according to ministry/department/agency and designation in a table format. Please provide additional rows in the table below, if required.] Name Ministry/Department/Agency Designation * Is there any consultant in the EA s CSC Meeting? Yes No If Yes, please state whether potential or actual conflict of interest exists. 1 1. EOIs via CMS-CSRN (30 days) Yes No Date of Posting: Deadline of EOI Submission: [For reduced period of advertisement (less than 30 days) or waiver of advertisement, please attach the formal approval] 2. Number of EOIs Received: 3. Advance Action? Yes No 4. Retroactive Financing? Yes No (If yes, please attach the document approving retroactive financing) 5. Loan Approval Date: 6. Loan Effective Date: 7. Loan Closing Date: 8. Estimated Contract Duration (in months): 9. Budget for this consulting services: US$ Estimated Maximum 10. Shortlisting: 2 International Shortlist National Shortlist * * (Please attach document approving the national shortlisting) 11. Method of Selection: FBS LCS QBS QCBS 12. (For QCBS) Quality Cost Ratio: 80:20 70:30 90:10 Document/s to support quality-cost ratio of 70:30 or 90:10: 1 2 The EA should confirm that the consultant in the EA s CSC Meeting does not have any ongoing business associations (whether direct or indirect) with any of the firms in the shortlist. The same requirements for ordinary selection still apply to national shortlisting except geographic spread as waived in the Guidelines on the Use of Consultants by ADB and Its Borrowers, para. 2.9.

Appendix 8a, Page 3 13. Shortlisting criteria*: [Apply the following criteria for the shortlisting of consulting firms for loan/grant projects]: (i) Eligibility (ii) Management competence (iii) Technical competence (iv) Geographic spread (for international assignments) * Additional criteria should have ADB s prior approval. a) b) c) 14. Proposed Shortlist: 1. 2. 3. 4. 5. 6. Firm Name (Full Name not Acronym)/ Country of Incorporation 1 Nature of Association (Indicate if the firm is Lead, JV Partner, or Subconsultant) Nature of Organization [Indicate if Private Consulting Firm, State- Owned (SOE) or NGO] a) Six (6) firms with wide geographic spread (no more than 2 firms from Yes No any 1 member country, and at least 1 firm from developing member country). If No, justification/s for proposed shortlist: b) Checking of Conflict of Interest [in accordance with the Guidelines on the Use of Consultants by ADB and Its Borrower (CG)]: i) Conflict between consulting activities [CG 1.11(a)] Yes No ii) Conflict among consulting assignments [CG 1.11(b)] Yes No 1 Corporations or companies must be incorporated in an ADB Member Country. Partnerships or non-corporations must be duly registered or legally established in an ADB Member Country. These include universities, institutions, public sector organizations, and NGOs.

Appendix 8a, Page 4 iii) Relationship with borrower s staff [CG 1.11(c)] Yes No If Yes, state relationship & whether potential or actual conflict of interest exists. c) Did any of the shortlisted firms participate in upstream assignment such Yes No as PPTA or other assignment regardless of financing source from which the firm may derive an unfair competitive advantage to this assignment? [RFP Section 2 (ITC), para. 4, Data Sheet 4.1, and CG 1.12] If yes, state the name of the firm and complete RFP Data Sheet 4.1. 15. Proposed Modifications on Contract Forms: [Revision/s for additional provision/s or deletion of certain provision/s in the General Conditions of the Contract (GCC) is not permissible. Instead, the Project Unit should advise the EA to incorporate revision/s through the Special Conditions of Contract (SCC) and changes should be reviewed by the Office of the General Counsel (OGC) prior to Submission 1.] State proposed revision/s and attach OGC s review in this Submission 1 document. 16. Type of Contract to be used: Time-Based Lump-Sum

Appendix 8a, Page 5 Part B [ADB Comments on EA s Submission] 1. Comments on Part A: 2. Shortlisting Criteria: 3. Shortlist: 4. Narrative Evaluation Criteria (NEC): 5. Request for Proposals (RFP): a) Section 1: Letter of Invitation (LOI): i b) Section 2: Data Sheet: i c) Summary and Personnel Evaluation Sheets (SES and PES): i

Appendix 8a, Page 6 d) Section 7: Terms of Reference (TOR): i e) Special Conditions of Contract (SCC): i 6. Other Issues: 7. Advance Reminders for Submission 2 Review: Please refer to the Guide in Reviewing Submission 2 for detailed instructions. a) In reference to SRFP Section 1, LOI, para. 7(a), the Project Unit should request the EA to secure a confirmation of withdrawal in writing from a shortlisted firm if the EA did not receive its proposal on the submission. b) Copy of confirmation of withdrawal from the Consultant should be attached in Submission 2. Unless the status of shortlisted Consultants which were not evaluated is clarified with evidence, ADB will not be able to process Submission 2. c) EA should confirm approval if there is a change (dropping/removal or addition) in the original association with reference to Section 1, LOI, paras. 4 and 7(b). d) EA must ensure that the firm that submits the proposal is the same legal entity that submitted the EOI. If the proposal received has a different legal entity from the shortlisted one, the proposal should be rejected. This also applies when a parent company, a group of firm, a subsidiary, or a local affiliate of the shortlisted firm submits the proposal. e) The EA should ensure that evaluation is conducted taking into account the issues on disqualification (see Grounds for Disqualification of an Expert attachment to SES/PES). f) If there is an expert proposed by multiple firms for the same position, the EA should evaluate the expert in accordance with the CV. This may result in uniform rating for the said expert if the same CV is used or otherwise different ratings if the CVs submitted by the firms for the expert were different. g) If there is more than 1 expert proposed by the firm for 1 position, the lowest rating among the experts evaluated should be applied and reflected in the PES/SES.

Appendix 8a, Page 7 8. Anticorruption Sanction/Terrorism Lists and Performance Evaluation Report (PER) Checking: a) Any of the shortlisted firms (including their Joint Venture Yes No Partner/s or Sub-consultant/s) in ADB Anticorruption Sanction Lists and Terrorism Lists? If Yes, state the name of the consulting firm/s: b) PER of the firms in the shortlist (including their Joint Venture Yes No Partner/s or Sub-consultant/s) checked? (Attached as Appendix 1) [Note: Results of PER Checking (Appendix 1) should be retained with the Project Unit] c) External ADB auditor included in the shortlist? Yes No If Yes, please obtain clearance from OAI before proceeding. 9. Checking of Conflict of Interest [in accordance with the Guidelines on the Use of Consultants by ADB and Its Borrowers (CG)]: a) Conflict between consulting activities [CG 1.11(a)] Yes No b) Conflict among consulting assignments [CG 1.11(b)] Yes No c) Conflict with concerned OSFMD/Project Unit Specialists [CG 1.11(c)] Yes No If Yes, state relationship & whether potential or actual conflict of interest exists: Reminders for the Project Unit 1. Subject to Section F of PAI 2.05, upon receipt of the EA s Submission 1, the Project Unit ensures that the EA submitted complete documents required (Checklist of Attached Documents) in the submission form before immediately forwarding an electronic copy of the submission to OSFMD- LCU (see PAI 2.05, paragraph 14). 2. The Project Unit should assist the EA to obtain and use the latest version of the Standard RFP without modification or omission of the standard provisions. 3. The Project Unit should ensure that the submission is consistent with the latest/updated procurement plan. 4. The Project Unit will send an updated CRAM sheet to the EA for its monitoring of the recruitment activities. 5. The Project Unit will send to OSFMD a request for posting the shortlist in the ADB website with the following information: the names of the shortlisted firms; the name of the EA and its contact details listed in LFIS/GFIS ALS704 under the EA Loan Address section; and the RFP date. 6. The Project Unit will convey the above decisions and recommendations to the EA.

Appendix 8a, Page 8 Prepared by: Signature above Printed Name OSFMD (If applicable) Date Signature above Printed Name Project Unit Note: When OSFMD review is required, the Project Unit Officer signs the review document after the OSFMD Officer signs it. Approved: Yes No Date Approved by: Signature above Printed Name Director, Project Unit / Country Director, Resident Mission (Please sign as applicable) Date Disclaimer: The review and approval of this submission document is conducted independently and must not serve as a precedent for future reviews. Distribution: Country Director / Director (Project Unit) / (Project Unit Specialist) OSFMD-LCU