Distributor Inquiry Form

DISTRIBUTION INQUIRY FORM
Thank you for your interest in Cortec corrosion protection technologies and system solutions.
Distributor’s profile is a key requirement in Cortec's distributor pre-qualification process. Information

provided will assist in evaluating the capability of your organization to supply Cortec goods and services
according to Cortec business model.
All appropriate boxes must be filled. Please type N/A in case of not applicable. For legibility, we ask that
all required information to be typed.
All information will be treated in a strict confidence.
Please enclose the following documentation when submitting this form:
- Company profile
- A valid copy of Commercial Registration Certificate
- Organization chart identifying your personnel
Please complete and return the form including attachments within 7 working days to:
Nizar Marjaba
Regional Manager – MCI Division
Cortec Middle East
P.O. Box 115133 Dubai / United Arab Emirates
Tel.: +971-4-434 0669
Mobile: +971-56- 4843714
Fax: +971-4-434 068
[email protected]
www.cortec-me.com
Cortec Middle East FZC, P.O. Box 115133, Dubai, United Arab Emirates, Tel. +971 4 434 0669, Fax. +971 4 434
0668 www.cortec-me.com
General Information
Full company name (as shown on your company's commercial registration)
Dr.Concrete Building Material
Street Address
Alresala District opposite Kut al hajaj gas station Basra
City Basra Country Iraq Postal Code non
P.O. Box non Tel No. +964 7828 6109 74 Fax No. non
URL/Web www.drconcret.com General E-mail [email protected]
Commercial registration No. CD 5068
Issued at Iraq Baghdad Date of Issue 01/11/2016 Date of Expiry Non
Primary business activity Contracting & Trading Total No. of employees 300
Territories currently serving Basra
Number of branches 05 Locations Dhi qar, Al Najaf, Baghdad, Basra, Karbala
Number of warehouses 05 Locations Basra , Karbala, Dhi qar, Al Najaf, Baghdad
Number of showrooms 06 Locations Basra-02, Karbala 01, Dhi qar 01, Al Najaf 01, Baghdad 01
Sole Ownership  Family business  Partnership  Part of a larger group

Type of Ownership
 Corporation  other (please specify)
President Ali Abdulnabi lazim Vice President Murtadha Tawfeeq
Sales Director Ali Fuaad Ali Marketing Director Abdullah Mahmood Jassim
Contact Person
Contact person Name Ali Fuaad Ali Title Sales Director
E-mail [email protected] Mob. +964 783 4966 040
Additional Information
How did you know about
Through Carboline
Cortec?
Why do you want to partner with In order to introduce Cortec in Iraq market which might help in fulfill the need of
Cortec? clients herein Iraq region.
How do you envision your role

with Cortec?
In which Territories do you want

to sell Cortec products and why?
Water plant, road and bridges , oil and gas
Did you in the past or do you currently sell corrosion related/competitive products? (list brands)
No
Company Governance (Company's major shareholders or partners, percent of share, nationality)

Full name of owner or partner % share Nationality
Ali Abdulnabi lazim 100% Iraqi
Financial Information
Turnover in (USD) Year
600,000 2013
Annual
turnover for 850,000 2014
the last five 1,200,000 2015
years
1,600,000 2016
1,900,000 2017
Bank name Audi bank
Bank address Manawi Pascha district, Basra, Iraq
Country Iraq Postal code Non City Basra
Bank account
P.O. Box Non Tel No. +964 7703296534 Fax No. Non
details
E-mail [email protected]
Bank account No. 100068440001 Swift code AUDBIQBA
Contact person Ibrahim al-Mohsen Position Managing Director
4. Certification
Part A
System Availability Date of Declaration
Quality Management System
Yes  No
ISO-9001-2015 QMS) 10-01-2020 Renew
Environmental Management
System (ISO-14001-2015 EMS.) Yes  No
10-01-2020 Renew
Health and Safety Management
Yes  No
System (ISO 18001)
Health and Safety Management
Yes  No
System (ISO-45001-2018 OHSMS) 10-01-2020 Renew
Part B
Does your company have a written procedure to ensure that safety and
health issues are preplanned for each project and (e.g. job hazard analysis,
 Yes  No
checklists, etc.)? if yes, please submit a copy with completed questionnaire or
reference page number in SP
Brands & Representations

Total No. of Brands 09
List top 3 brands
Brand Name MAPEI Last Turnover (USD)
Specialty Building Construction Chemical
Brand 1
details Country of Origin Italy Web www.mapei.com
Type of partnership Agent  Distributor  Sole Distributor  JV
Date of collaboration 2015 Contact person Basheer abi Abdullah
Brand Name Pac Technology Last Turnover (USD)
Specialty Building Construction Chemical
Brand 2
details Country of Origin Emirate Web [email protected]
Date of collaboration 2012 Contact person Nabeel Rofil
Brand Name Carboline Last Turnover (USD)
Specialty Coating, Lining, fireproofing
Brand 3
details Country of Origin USA Web www.carboline.com
Date of collaboration 2018 Contact person Raad Alzawar
Previous Projects (Top 3 completed projects or contracts last year)
# Company Name Product/Service Value (USD) Reference Contact
1 Samsung Engineering co ltd Coating, Lining 200,000 Johan kim
2 Baker Hughes Waterproofing ,coating 300,000 Dr. Aqeel
3 Basra Gas company Insulation & Fireproofing 100,000 Eng. Ali Haider
Projects In Hand (Top 3 running projects or contracts)
# Company Name Product/Service Value (USD) Reference Contact
1 Steel pipe Factory Coating, Lining 170,000 Eng Hassan Qazar
2 Karbala Refinery Coating & Waterproofing 7,000,000 Eng. Tahir weaam
3 Ministry of electricity Coating & Fibergrate 720,000 Eng. Hamdi ali
Manpower Capabilities
List of key staff members in your organization
# Name Qualification Designation Year of Service
1 Tariq Abdulredha Zamil Master in Administration Admin Manager 20 year
2 Mohammad Murtadha BSC in Accounting Administrative 6 year
3 Abdullah Mahmood Jassim BSC in Marketing Marketing Manager 10 year
4 Abdul Muhaiman BSC in Environmental Logistic manager 8 Year
5 Saleem Akhtar Nebosh Int HSE Manager 8year

6 Murtadha Tawfeeq BSC In Finance Accountant 8+ year
7 Mohanad Sadhan Diploma of Mech Engineering Technician 12 year
8 Ali Mehdi Matriculation Warehouse Incharge 5 year
9 Manther Younes Essa Diploma in Elec Engineering Electrical Engineer 15 year
10 Ali Akbar Matriculation Painting Supervisor 7 year
Equipment Capabilities
please attach a list of owned equipment you use in delivering your services
Insurance Coverage
Please provide a copy of certificate of insurance
Litigation History (List any law suits or cases against your company or associate companies in the last 5 years)
# Client Name Year Matter under dispute Disputed Amount (USD)
Declaration
I acknowledge and present that the information furnished is complete and factual
Authorized Signature
Name Ali Abdulnabi Lazim

Position President
Date 10/03/2020
Company stamp

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DISTRIBUTION INQUIRY FORM

Distributor’s profile is a key requirement in Cortec's distributor pre-qualification process. Information

All information will be treated in a strict confidence.

Please enclose the following documentation when submitting this form:

City Basra Country Iraq Postal Code non

Issued at Iraq Baghdad Date of Issue 01/11/2016 Date of Expiry Non

Territories currently serving Basra

Number of branches 05 Locations Dhi qar, Al Najaf, Baghdad, Basra, Karbala

Number of warehouses 05 Locations Basra , Karbala, Dhi qar, Al Najaf, Baghdad

Sole Ownership  Family business  Partnership  Part of a larger group

President Ali Abdulnabi lazim Vice President Murtadha Tawfeeq

Contact person Name Ali Fuaad Ali Title Sales Director

E-mail [email protected] Mob. +964 783 4966 040

How do you envision your role

In which Territories do you want

Company Governance (Company's major shareholders or partners, percent of share, nationality)

Brands & Representations

5 Saleem Akhtar Nebosh Int HSE Manager 8year

Name Ali Abdulnabi Lazim

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