M A L A Y S I A

Lembaga Pembangunan Industri Pembinaan Malaysia

CONSTRUCTION INDUSTRY DEVELOPMENT BOARD MALAYSIA

Pendaftaran Kontraktor Tempatan

Registration of Local Contractor
R5
Permohonan Kenaikan Gred/Tambah Kategori/
Tambah Pengkhususan
Application for Upgrading/Additional Category/Additional
Specialization
Borang CIDB R1/95(Pin.2/01) / Form CIDB R1/95 (Rev.2/01)
No. Siri / Serial No: ...........................................................................

Nama Firma / Syarikat: .........................................................................................

Name of Firm / Company:

No. Pendaftaran CIDB:

CIDB Registration No.:

Tarikh Luput Pendaftaran CIDB:

CIDB Registration Expiry Date:

Lembaga Pembangunan
Industri Pembinaan Malaysia UNTUK KEGUNAAN PEJABAT
FOR OFFICE USE
CONSTRUCTION INDUSTRY DEVELOPMENT BOARD MALAYSIA
Ibu Pejabat CIDB, Tingkat 7, Grand Seasons Avenue, No. 72, Jalan Pahang, 53000 Kuala Lumpur.
P.O. Box. 12278, 50772 Kuala Lumpur. Tel: 03-2617 0200 • Fax: 03-2617 0220
h t t p : / / w w w. c i d b . g o v. m y

Head Office / Ibu Pejabat CIDB

Tingkat 7, Grand Seasons Avenue, No.72, Jalan Pahang, 53000 Kuala Lumpur. P.O. Box.12278, 50772 Kuala Lumpur.
Tarikh Terima: .......................................... Jumlah Fee Proses : .............................
CIDB Regional Offices / Pejabat Wilayah CIDB:

CIDB Wilayah Utara (Kedah) CIDB Wilayah Selatan (Johor) CIDB Wilayah Timur (Terengganu) CIDB Sabah CIDB Sarawak

No. Permohonan: ..................................... No. Resit: .............................................

Lot 1-4, Tingkat 11, Lot 2067,Batu 3, Tingkat 7, Lot EG. 11, Tingkat Bawah, Tingkat 1, Blok A, Kompleks CIDB,
City Plaza, Jalan Tampoi, Menara Yayasan Islam Terengganu, Block E, Bangunan KUW ASA, Jalan Sultan Tengah,
Jalan Tunku Ibrahim, 81200 Johor Bahru, Jalan Sultan Omar, 88100 Kota Kinabalu, 93050 Kuching,
05000 Alor Setar, Johor. 20300 Kuala Terengganu, Sabah. Sarawak.
Kedah. Terengganu.

Tel : 04-733 1243

Fax : 04-733 1175
Tel : 07-234 4808
Fax : 07-234 4807
Tel : 09-624 5311
Fax : 09-623 8973
Tel : 088-235 060
Fax : 088-242 481
Tel : 082-445 833 / 446 833
Fax : 082-447 833 Gred Dipohon:: ............................................. No. Fail: .................................................
CIDB State Of Fices / Pejabat Negeri CIDB:

Pejabat Kecil CIDB

Negeri Pulau Pinang
Pejabat Kecil CIDB
Negeri Perak
Pejabat Kecil CIDB
Negeri Kelantan
No.U7.2, Tingkat 7,
Pejabat Kecil CIDB
Negeri Pahang
Wisma Kontraktor Melayu Pahang,
Pejabat Kecil CIDB
Tawau
TB 306, Tingkat 2, Blok 35,
Pejabat Kecil CIDB
Miri
Kompleks Perdagangan Saberkas,
Nama Pegawai: .............................................................................................................
Lot 9.01, Tingkat 9, Bangunan KWSP, Lot 5.02, Tingkat 5,
No. 3009 Of f Lebuh Tenggiri 2, Bangunan KWSP, Menara Perbadanan, Tingkat Bawah, B246 & 248, Kompleks Perdagangan Fajar, Jalan Miri-Lutong,
Bandar Seberang Jaya, 13700 Jalan Greentown, Jalan Tengku Petra, Semerak, Jalan Dato’ Lim Hoe Lek, Jalan Hj. Karim, Beg Berkunci No. 7, 98000 Miri,
Seberang Jaya, 30450 Ipoh, 15000 Kota Bharu, 25200 Kuantan, 91009 Tawau, Sarawak.
Pulau Pinang. Perak Kelantan. Pahang. Sabah.

Tel : 04-390 2448 Tel : 05-2423 488 Tel : 09-743 5311 Tel : 09-517 8953 / 8734 Tel : 089-777 841 / 777 842 Tel : 085-665 431
Fax : 04-390 7448 Fax : 05-2555 488 Fax : 09-744 4311 Fax : 09-517 8751 Fax : 089-777 842 Fax : 085-665 432
Fee Proses /Processing Fee : RM30.00 Harga Borang /Price of Form : RM5.00
A. Maklumat Pemohon BORANG UPP 1 / 2
Particulars of Applicant Bahagian Pembangunan
Personel Binaan
(Construction Manpower
Development Division)
No. Pendaftaran Perniagaan/Syarikat ...................................................................................................... Tingkat 7, Grand Seasons Avenue,
Registration No. Of Business/Company No. 72, Jalan Pahang, 53000 Kuala Lumpur,
P.O. Box. 12278, 50772 Kuala Lumpur.
Alamat berdaftar/registered address Alamat surat-menyurat
(Seperti dalam borang D/borang 44/Annual Returns) Correspondence address Tel : 603-4044 8808
(As stated in form D/form 44/Form 49) Fax : 603-4045 2808
...........................................................................
.......................................................................................... ...........................................................................
.......................................................................................... ........................................................................... MAKLUMAT PERSONEL BINAAN (CONSTRUCTION PERSONNEL INFORMATION)
...........................................................................
.......................................................................................... Kontraktor dikehendaki menyatakan maklumat semua kakitangan personel binaan di Syarikat di
........................................................................... bawah kategori Pengurus Tapak Binaan, Penyelia Tapak Binaan, Pekerja Mahir Binaan, Pekerja
.......................................................................................... ........................................................................... Separuh Mahir Binaan dan Pekerja Am Binaan dengan mengisi jadual di bawah. (Sila buat salinan, jika
.......................................................................................... perlu).
Poskod/Poscode: ................................................................
Tel: ....................................... Fax : ....................................
Contractors are required to declare the information regarding all construction personnel in the company
Poskod/Postcode: ............................................................
E-mail: ............................................................................... under the category of Construction Site Manager, Contruction Site Supervisor, Skilled Construction
Tel : ....................................Fax : .................................... Worker, Semi-skilled Construction Worker and General Construction Worker by filling up the following
Webpage: ..........................................................................
E-mail : ................................. table. (Please make copies, if required).
No. Pendaftaran
B. Gred, Kategori dan Pengkhususan Semasa Kategori / Tugas
Contoh: Pekerja Mahir Binaan/ Personel Binaan
CIDB (jika ada)
Current RegisterationGrade, Category and Specialization Bil. Nama No. K/P. (Baru & Lama) Alamat surat-menyurat Penerap Bata, Tukang Konkrit
CIDB Construction
No. Name atau No. Pasport Correspondence address Category /Task
I/C No. (New & Old) e.g.: Skilled Const. Worker/ Personnel Reg.
or Passport No. Bricklayer, Concretor No. (If any)

Gred Kategori Kod Pengkhususan

Grade Category Specialization Code
1.

CE

ME 2.

C. Kenaikan Gred dan/atau Tambah Kategori dan/atau Tambah Pengkhususan Dipohon

(Sila rujuk buku panduan sebelum mengisi bahagian ini)
Upgrading and/or Additional Category and/or Additional Specialization Applied For 3.
(Please refer the guide book before completing this section)

Gred Kategori Kod Pengkhususan

Grade Category Specialization Code
4.
B
CE
ME

D. Persijilan MS ISO 9002: (Tanda

 salah satu yang berkaitan) 5.
MS ISO 9002 Certification: (Mark  whichever applicable)

a) Ada b) Tiada c) Lain-lain: .........................................................................................................

Yes No Others

(Sila Kemukakan satu salinan sijil)

(Please submit a copy of certificate)

2 7
H. Pengakuan E. Maklumat Sumber Kewangan (TIDAK PERLU UNTUK TAMBAH KATEGORI/PENGKHUSUSAN)
Declaration Particulars of Financial Resources (NOT REQUIRED FOR ADDITIONAL CATEGORY/SPECIALIZATION)

Saya/ Kami mengaku dan mengesahkan bahawa maklumat yang diberi dan segala salinan Lengkapkan butir-butir di bahagian
dokumen yang disertakan bersama borang permohonan ini adalah benar. Saya/ Kami sedar dan Complete details in section
memahami bahawa jika maklumat dan dokumen yang dikemukakan adalah palsu maka
permohonan saya/ kami akan ditolak dan sebarang kelulusan yang telah diberikan akan (i) - Bagi firma pemilik tunggal atau perkongsian ATAU
dibatalkan. For sole proprietorship or partnership firm OR

Saya/Kami dengan ini memberikan kebenaran kepada pihak LPIPM untuk mendapatkan apa-apa (ii) - Bagi syarikat sendirian berhad/syarikat berhad/koperasi dan lain-lain
maklumat lanjut dari bank/ institusi kewangan pada bila-bila masa. For private limited company/public company/cooperative and others

I / We declare and confirm that the information given and photostated copies of documents (i) FIRMA PEMILIKAN TUNGGAL ATAU PERKONGSIAN
submitted together with this application are authentic. I am/ We are aware and understand that SOLE PROPRIETORSHIP OR PARTNERSHIP FIRM
any information and documents submitted found to be false shall cause my/ our application to be
rejected and any approval granted shall be revoked. Modal terkumpul/Net capital worth RM

I / We hereby authorize CIDB to request any further information required from myl our 1. Baki penyata akaun bank untuk tiga bulan yang terkini
bank(s)/ financial institution(s) at any time. Balance of the latest three months bank account statements

a) RM ...................................... }
b) RM ......................................} Jumlah (Total ) ÷ 3 =
Tandatangan: ............................................................... c) RM ......................................}
(Signature) 2. Amaun kemudahan overdraf
Amount of overdraft facilities
Nama : .......................................................................... 3. Simpanan tetap (termasuk simpanan tetap pemilik tunggal atau setiap
(Name) rakan kongsi) yang tidak dicagar pada mana-mana bank atau institusi
kewangan
Jawatan: ........................................................................ Fixed deposit(s) (including deposit(s) of sole proprietor or each partner)
(Designation) which is/are not charged to any bank or financial institution
4. Baki di akaun simpanan (termasuk akaun simpanan pemilik tunggal atau
No. K/P./No. Pasport: ....................................................... setiap rakan kongsi)
(I/C No./Passport No) Balance in savings account (including savings account of sole proprietor
or each partner)
Tarikh : ........................................................................... 5. Lain-lain (Saham ASB/ASN dll.) Others (ASB/ASN Shares etc.)
(Date)
Jumlah/Total

Cop Syarikat / Firma (ii) SYARIKAT SENDIRIAN BERHAD/SYARIKAT BERHAD/KOPERASI DAN LAIN-LAIN
Firm / Company Chop PRIVATE LIMITED COMPANY/PUBLIC COMPANY/COOPERATIVE AND OTHERS

Modal Saham/Share capital RM

1. Jumlah modal berbayar/saham anggota dimiliki oleh badan/individu tempatan

Total paid-up capital/shares of members owned by local bodies/individual(s)

2. Jumlah modal berbayar dimiliki oleh badan/individu asing

Total paid-up capital owned by foreign bodies/individual(s)

Jumlah/Total

Nilai Syarikat/Networth RM

1. Jumlah Aset tolak Jumlah Liabiliti berdasarkan lembaran imbangan terkini

Total Assets less Total Liabilities based on latest balance sheet

6 3
 F. Maklumat Pemilik/Rakan Kongsi/Pengarah/Ahli Lembaga dan Personel Teknikal yang Digaji Sepenuh Masa
Particulars of the Owner/Partner(s) Director(s)/Board members(s) and full Time Technical Personnel

No. K/P. Baru* Kelayakan Akademik- Tahun pengalaman

atau No. pasport jika No. Pendaftaran
Ijazah@/Diploma/Sijil Personel Binaan dalam bidang
Bil. Nama No. K/P. Lama Warganegara asing Kekompetenan pembinaan #
Jawatan Warganegara CIDB (jika ada)
No. Name Old I/C No. New I/C No.* Citizenship Academic Qualification- Years of experience
Designation CIDB Construction
or Passport no. if Degree@/Diploma/ in construction
foreigner Personnel Reg. No.
Competency Certificate (If any) Industry #

4
*
Sila kemukakan salinan kad pengenalan/Please submit copy of identity card.

@ Sila kemukakan salinan sijil berkaitan. Jurutera Arkitek dan Jurukur Bahan hendaklah mengemukakan salinan pendaftaran dengan Lembaga masing-masing.
Please submit a copy the relevant certificate. Engineers, Architects and Quantity Surveyors should present a copy registration with their respective Boards.

# Sila kemukakan senarai pengalaman yang menyenaraikan jenis dan saiz projek yang dikawalselia atau diuruskan bersama dengan surat sokongan dari majikan seperti
surat tawaran jawatan atau seumpamanya.
Please submit resume Iisting type and size or projects supervised of managed, together with supporting documents from employer(s) such as employment letters and
likewise

G. Senarai Projek Yang Telah Siap Dan Sedang Dilaksanakan

List of Completed and Current Projects

Bil. KU* Tarikh Mula Tarikh Siap Peratus Siap

Huraian Kerja Nama Klien/Kontraktor Utama Nilai Projek
No. Atau/or Date of Date of Percentage
Description of Works Name of Client/Main Contractor Value of Project
SK* Commencement Completion Completed

5
*

Nyatakan KU (Kontrak Utama) atau SK (Subkontrak)

State KU (Main Contract) or SK (Subcontract)
 F. Maklumat Pemilik/Rakan Kongsi/Pengarah/Ahli Lembaga dan Personel Teknikal yang Digaji Sepenuh Masa
Particulars of the Owner/Partner(s) Director(s)/Board members(s) and full Time Technical Personnel

No. K/P. Baru* Kelayakan Akademik- Tahun pengalaman

atau No. pasport jika No. Pendaftaran
Ijazah@/Diploma/Sijil Personel Binaan dalam bidang
Bil. Nama No. K/P. Lama Warganegara asing Kekompetenan pembinaan #
Jawatan Warganegara CIDB (jika ada)
No. Name Old I/C No. New I/C No.* Citizenship Academic Qualification- Years of experience
Designation CIDB Construction
or Passport no. if Degree@/Diploma/ in construction
foreigner Personnel Reg. No.
Competency Certificate (If any) Industry #

4
*
Sila kemukakan salinan kad pengenalan/Please submit copy of identity card.

@ Sila kemukakan salinan sijil berkaitan. Jurutera Arkitek dan Jurukur Bahan hendaklah mengemukakan salinan pendaftaran dengan Lembaga masing-masing.
Please submit a copy the relevant certificate. Engineers, Architects and Quantity Surveyors should present a copy registration with their respective Boards.

# Sila kemukakan senarai pengalaman yang menyenaraikan jenis dan saiz projek yang dikawalselia atau diuruskan bersama dengan surat sokongan dari majikan seperti
surat tawaran jawatan atau seumpamanya.
Please submit resume Iisting type and size or projects supervised of managed, together with supporting documents from employer(s) such as employment letters and
likewise

G. Senarai Projek Yang Telah Siap Dan Sedang Dilaksanakan

List of Completed and Current Projects

Bil. KU* Tarikh Mula Tarikh Siap Peratus Siap

Huraian Kerja Nama Klien/Kontraktor Utama Nilai Projek
No. Atau/or Date of Date of Percentage
Description of Works Name of Client/Main Contractor Value of Project
SK* Commencement Completion Completed

5
*

Nyatakan KU (Kontrak Utama) atau SK (Subkontrak)

State KU (Main Contract) or SK (Subcontract)
Pengakuan
Declaration

Saya/kami dengan sesungguhnya mengakui dan mengesahkan bahawa

maklumat yang diberikan di dalam borang permohonan ini dan segala salinan
dokumen yang disertakan bersamanya adalah benar.

I/we solemly declare and confirm that the information given and copies of
documents submitted together with this application are true and correct.

Saya/kami dengan ini mengesahkan bahawa Saya / Kami akan mematuhi semua
kehendak dan ketetapan yang dinyatakan dalam Kod Etika Kontraktor (“Kod
Etika”). Saya/kami juga memahami bahawa jika saya/kami gagal mematuhi Kod
Etika ini, saya/kami boleh dikenakan tindakan tatatertib oleh CIDB.

I / We hereby certify that I / we will comply with all requirements and stipulations
specified in the Code of Ethics for Contractors ("Code of Ethics"). I / we also
understand that if I / we fail to comply with the Code of Ethics, I / we may be
subject to disciplinary action by CIDB.

Cop Syarikat/Firma
(firm/company chop)
Tandatangan:……………………………………
(Signature)

Nama:……………………………………………..
(Name)

Jawatan:………………………………………….
(Designation)

No. K/P./No. Pasport:........................................

(I/C No./ Pasport No.)

Tarikh:……………………………………………..
(Date)

5
6
A. Maklumat Pemohon BORANG UPP 1 / 2
Particulars of Applicant Bahagian Pembangunan
Personel Binaan
(Construction Manpower
Development Division)
No. Pendaftaran Perniagaan/Syarikat ...................................................................................................... Tingkat 7, Grand Seasons Avenue,
Registration No. Of Business/Company No. 72, Jalan Pahang, 53000 Kuala Lumpur,
P.O. Box. 12278, 50772 Kuala Lumpur.
Alamat berdaftar/registered address Alamat surat-menyurat
(Seperti dalam borang D/borang 44/Annual Returns) Correspondence address Tel : 603-4044 8808
(As stated in form D/form 44/Form 49) Fax : 603-4045 2808
...........................................................................
.......................................................................................... ...........................................................................
.......................................................................................... ........................................................................... MAKLUMAT PERSONEL BINAAN (CONSTRUCTION PERSONNEL INFORMATION)
...........................................................................
.......................................................................................... Kontraktor dikehendaki menyatakan maklumat semua kakitangan personel binaan di Syarikat di
........................................................................... bawah kategori Pengurus Tapak Binaan, Penyelia Tapak Binaan, Pekerja Mahir Binaan, Pekerja
.......................................................................................... ........................................................................... Separuh Mahir Binaan dan Pekerja Am Binaan dengan mengisi jadual di bawah. (Sila buat salinan, jika
.......................................................................................... perlu).
Poskod/Poscode: ................................................................
Tel: ....................................... Fax : ....................................
Contractors are required to declare the information regarding all construction personnel in the company
Poskod/Postcode: ............................................................
E-mail: ............................................................................... under the category of Construction Site Manager, Contruction Site Supervisor, Skilled Construction
Tel : ....................................Fax : .................................... Worker, Semi-skilled Construction Worker and General Construction Worker by filling up the following
Webpage: ..........................................................................
E-mail : ................................. table. (Please make copies, if required).
No. Pendaftaran
B. Gred, Kategori dan Pengkhususan Semasa Kategori / Tugas
Contoh: Pekerja Mahir Binaan/ Personel Binaan
CIDB (jika ada)
Current RegisterationGrade, Category and Specialization Bil. Nama No. K/P. (Baru & Lama) Alamat surat-menyurat Penerap Bata, Tukang Konkrit
CIDB Construction
No. Name atau No. Pasport Correspondence address Category /Task
I/C No. (New & Old) e.g.: Skilled Const. Worker/ Personnel Reg.
or Passport No. Bricklayer, Concretor No. (If any)

Gred Kategori Kod Pengkhususan

Grade Category Specialization Code
1.

CE

ME 2.

C. Kenaikan Gred dan/atau Tambah Kategori dan/atau Tambah Pengkhususan Dipohon

(Sila rujuk buku panduan sebelum mengisi bahagian ini)
Upgrading and/or Additional Category and/or Additional Specialization Applied For 3.
(Please refer the guide book before completing this section)

Gred Kategori Kod Pengkhususan

Grade Category Specialization Code
4.
B
CE
ME

D. Persijilan MS ISO 9002: (Tanda

 salah satu yang berkaitan) 5.
MS ISO 9002 Certification: (Mark  whichever applicable)

a) Ada b) Tiada c) Lain-lain: .........................................................................................................

Yes No Others

(Sila Kemukakan satu salinan sijil)

(Please submit a copy of certificate)

2 7
 CONSTRUCTION INDUSTRY
DEVELOPMENT BOARD MALAYSIA

HEAD OFFICE
Level 7, Grand Seasons Avenue,
No.72, Jalan Pahang
53000 Kuala Lumpur
MALAYSIA
Tel : 6 03-2617 0200
Fax : 6 03-2617 0220

CIDB Wilayah Persekutuan CIDB Pulau Pinang

Tingkat 7 Lot 9.01, Tingkat 9, Bangunan KWSP,
Grand Seasons Avenue No. 3009, Off Lebuh Tenggiri 2,
No. 72, Jalan Pahang Bandar Seberang Jaya,
53000 Kuala Lumpur. 13700 Seberang Jaya,
Tel : 03-4045 3800 Pulau Pinang.
Fax : 03-4045 3858 Tel : 04-390 2448
Fax : 04-390 7448
CIDB Kedah
Lot 7 & 8, Kompleks Perniagaan Asas Jaya CIDB Perak
Jalan Stadium Lot 5.02, Tingkat 5, Bangunan KWSP,
05000 Alor Setar Jalan Greentown,
Kedah 30450 Ipoh, Perak.
Tel : 04 – 733 1243 Tel : 05-2423 488
Fax : 04 – 733 1175 Fax : 05-2555 488

CIDB Johor CIDB Kelantan

Lot 2607, Batu 3, No U7.2, Tingkat 7, Menara Perbadanan
Jalan Tampoi, Jalan Tengku Petra, Semerak,
81200 Johor Bahru, Johor. 15000, Kota Bharu, Kelantan
Tel : 07-234 4808 Tel : 09-743 5311
Fax : 07-234 4807 Fax : 09-744 4311

CIDB Terengganu CIDB Tawau (Cawangan)

Tingkat 7, Menara Yayasan Islam Terengganu, Tingkat 1, Blok 35
Jalan Sultan Omar, Wisma Gek Poh, Batu 1
20300 Kuala Terengganu Jalan Dunlop/Kuhara
Terengganu Beg Berkunci No.7, 91009 Tawau, Sabah
Tel : 09-624 5311 Tel : 089-777 841/842
Fax : 09-623 8973 Fax : 089-777 840

CIDB Miri (Cawangan) CIDB Sabah

Tingkat 1, Wisma Rela Aman Blok A, Tingkat 4
Lot 1301, Blok 9, MCLD Bangunan KWSP
Miri Water Front 88100, Kota Kinabalu
98000 Miri, Sarawak Sabah.
Tel : 085-417 431 Tel : 088-235 060
Fax: 085-417 432 Fax : 088-242 481

CIDB Sarawak CIDB Melaka

Tingkat 1, Blok A, Kompleks CIDB, M1/3/40, Tingkat 2
Jalan Sultan Tengah, Bangunan Kota Cemerlang
93050 Kuching, Sarawak. Leboh Ayer Keroh
Tel : 06-232 8885 75450 Ayer Keroh, Melaka
Fax : 082-447 833 Tel : 082-445 833 / 446 833
Fax : 06-232 8950

CIDB Pahang
A1, Ground 1st, 2nd & 3rd Floor,
Jalan Seri Kuantan 2
Sri Kuantan Square
25050 Kuantan, Pahang
Tel : 09-517 8734/8953
Fax : 09- 517 8751