SUMMARY OF HEALTHCARE PPP

Transkript

1 SUMMARY OF HEALTHCARE PPP PROGRAM OF REPUBLIC OF TURKEY 2013 Group Law Firm Turkey faces a rapidly increasing demand for healthcare services. According to MoH more than new hospital beds are required until Moreover the government aims to increase hospital space per bed from m2 to m2. Investments totalling 14 billion USD are required just in the public sector for reaching these targets. The government relies to a PPP programme for the realization of this ambitious scheme. Fifteen Turkish hospitals and and one TPHA + TPMDA Campus total of sixteen campuses are currently under construction under a PPP framework, while one is in the contract stage, three in tender stage and more than ten are in earlier stages. These projects are expected to add more than 28,000 beds to Turkey s existing 200,000-bed capacity. This is only one part of Vision 2023 of the country, and Hospital PPPs are only a small part of total investment program of Republic of Turkey. Total investment requirement only in infrastructure is more than 500 Billion $. The said half a trillion $ investment program is expected to boom not only the life standards but also it is going to be a triggering effect to the economy. As. Prof.Dr. Ahmet T. KEŞLİ (LL.M., LL.D.) Vice-Chairman, United Nations International PPP Centre of Excellence Chairman of the Board, International PPP Platform Turkiye As.Prof.Dr. of Commercial Law, Fatih University Faculty of Law Founding Partner, Group Law Firm Istanbul September 2013

2 What we say about the firm's legal practice in Turkey: Group Law Firm s busy projects team has experience across a number of areas including energy and real estate developments. Ahmet Keşli is the main contact. Group Law Firm The Firm's broad project and project finance practice spans PPP and non-ppp mandates in energy, transportation, housing, water and waste facilities, and mining, among others, both in Turkey and internationally, particularly in the Gulf region. The Firm has built a strong record acting on all sides of privatisation transactions, particularly in energy, commodities and industrial sectors. It is currently advising on Turkey's largest ever privatisation project. Group Law Firm has been extensively involved in privatisation matters including in the electricity and commodity sectors. Founding partner Ahmet Kesli is highly regarded. Istanbul-based Group Law Firm has experience in civil litigation as well as local and cross-border arbitration and mediation. Ahmet Keşli has appeared before the ICC, and Ebru Eksioğlu is another busy practitioner. Group Law Firm's practice spans contentious and non-contentious work across the IP space, but particularly in trade marks and patents. Recent matters include representing a local company in a trade dress dispute with a multinational competitor Recommended by the Legal500 1

3 SUMMARY OF HEALTH PPP PROGRAM OF REPUBLIC OF TURKEY 2013 * TURKEY S NEW PPP LAW TO OPEN DOOR OF INVESTMENT FOR HEALTHCARE PROJECTS... 4 SHORT OVERVIEW OF TURKISH PPP HEALTH PROGRAM; WHAT TURKEY`S PPPS HEALTH PORTFOLIO INCLUDES... 6 SUMMARY OF THE PROJECTS... 8 PROJECTS IN THE CONSTRUCTION PHASE KAYSERI INTEGRATED HEALTH CAMPUS Current Project Status: ANKARA- ETLIK INTEGRATED HEALTH CAMPUS Current Project Status: ANKARA BILKENT INTEGRATED HEALTH CAMPUS Current Project Status: ELAZIĞ INTEGRATED HEALTH CAMPUS Current Project Status: ADANA INTEGRATED HEALTH CAMPUS Current Project Status: GAZIANTEP INTEGRATED HEALTH CAMPUS Current Project Status: ISTANBUL IKITELLI INTEGRATED HEALTH CAMPUS Current Project Status: KONYA KARATAY INTEGRATED HEALTH CAMPUS Current Project Status: MANISA EDUCATION AND RESEARCH HOSPITAL Current Project Status: MERSIN INTEGRATED HEALTH CAMPUS Current Project Status: YOZGAT EDUCATION AND RESEARCH HOSPITAL Current Project Status: TPHA + TPMDA CAMPUS Current Project Status: BURSA INTEGRATED HEALTH CAMPUS Current Project Status: ISPARTA CITY HOSPITAL Current Project Status: IZMIR BAYRAKLI INTEGRATED HEALTH CAMPUS Current Project Status: KOCAELI INTEGRATED HEALTH CAMPUS Current Project Status:

4 PROJECTS IN THE CONTRACT PHASE PTR, PSYCHIATRY AND HIGH SECURITY FORENSIC PSYCHIATRY HOSPITALS Current Project Status: PROJECTS IN THE TENDER PHASE ESKIŞEHIR CITY HOSPITAL Current Project Status: ISTANBUL BAKIRKÖY INTEGRATED HEALTH CAMPUS Current Project Status: ISTANBUL ÜSKÜDAR PUBLIC HOSPITAL Current Project Status: PROJECTS IN THE PIPELINE ANTALYA HEALTH CAMPUS DENIZLI CITY HEALTH CAMPUS DIYARBAKIR KAYAPINAR HEALTH CAMPUS DIYARBAKIR YENIŞEHIR HEALTH CAMPUS İZMIR GÜNEY HEALTH CAMPUS İZMIR TORBALI HEALTH CAMPUS SAMSUN HEALTH CAMPUS ŞANLIURFA HEALTH CAMPUS TEKIRDAĞ INTEGRATED HEALTH CAMPUS TRABZON MATERNITY HEALTH CAMPUS LIST OF BIDDERS ATT. AS. PROF. DR. AHMET T. KEŞLİ (LL.D., LL.M.) SOME OF THE PUBLICATIONS & PRESENTATIONS CONTACTS * Main Source is Republic of Turkey, Ministery of Health. [Group Law Firm is thankful for the contributions of Mr.Evren Güldoğan - Promaya and Mr.Orçun Makal - Ernst & Young, especially in the numerical figures given in the summary]. 3

5 Turkey s New PPP Law to Open Door of Investment for Healthcare Projects A widely anticipated law to regulate public-private partnerships (PPP's) in Turkish mega healthcare projects was passed by the parliament and published on 9 th March The Turkish government has shown its firm determination to transfer public sector-led development to a marketdriven economy, recognizing the opportunities in engaging in private sector enterprise and the speed at which healthcare projects could potentially be completed. The approval of new public-private partnerships law looks set to provide the missing link in the country s pursuit of private investment in health sector providing legal certainty, to cut the red tape, transparency and pave the way for government guarantees for international project financing investments. The new PPP law is cutting red tape, increasing transparency, and paving the way and it is a major step forward and it has been hailed as one of the key achievements to improve Turkey s investment climate in healthcare projects said Att.Ass.Prof. Dr. Ahmet T Keşli, Vice-Chairman of United Nations (UNECE) International PPP Centre of Excellence. The new regulation is going to open the door for multi-million dollar investment by local and foreign companies by taking active part in the PPP in the health sector. Since the PPP Hospitals are part of Vision 2023 of AK Party and Mr. Prime Minister Erdogan, this new legislation would be a substantial contribution towards the sector in terms of legal and institutional structure of the PPP program of the country he said further. Under the new law on public-private partnerships (PPP) the state will lease city hospitals built and run by the private sector for up to 30 years. The new law also empowers the cabinet to take decision on contracts which plegde investments and services worth at least $500 million Turkish Liras. The new rules aim to remove the delay, reduce the number of permission needed and also pave the way for government guarantees for international project financing investments in healthcare projects. Turkey s Ministry of Health PPP program covers approximately health campuses with a total bed capacity of including 12 4

6 physical therapy and rehabilitation hospitals, 8 psychiatric hospitals. Estimated time frame for almost healths Project is 5-8 years with total investment of more than USD 14 billion. Fifteen Turkish hospitals and and one TPHA + TPMDA Campus total of sixteen campuses are currently under construction under a PPP framework, while one is in the contract stage, three in tender stage and more than ten are in earlier stages. These projects are expected to add more than 28,000 beds to Turkey s existing 200,000-bed capacity. This is only one part of Vision 2023 of the country, and Hospital PPPs are only a small part of total investment program of Republic of Turkey. Total investment requirement in infrastructure only is more than 500 Billion $. The said half a trillion $ investment program is expected to boom not only the life standards but also it is going to be a triggering effect to the economy. 5

7 Short Overview of Turkish PPP Health Program; What Turkey`s PPPs Health Portfolio Includes Since, Turkey s Ministry of Health PPP program covers approximately health campuses with a total bed capacity of including 12 physical therapy and rehabilitation hospitals, 8 psychiatric hospitals and the estimated time frame for almost healths Project is 5-8 years with total investment: more than USD 14 billion, Turkey faces a rapidly increasing demand for healthcare services. According to MoH more than new hospital beds are required until Moreover the government aims to increase hospital space per bed from m2 to m2. Investments totalling more than 14 billion USD are required just in the public sector for reaching these targets. The government relies to a PPP programme for the realization of this ambitious scheme. Vision 2023 program of Turkey requires billions of dollars of investment in infrastructure development including mega health campuses. Under this scenario PPP are the best available alternative to meet these targets set by Turkish government. Turkish PPP schemes for hospitals may involve: Design Construction Provision of goods (equipment, furniture, consumables) Provision of services Operation of commercial areas At present there are many PPP projects in different sectors in every phase from design, tender to operation, and transfer. Turkey has been making use of PPPs since 1874 (three centuries ago). 6

8 PIPELINE TENDER PHASE CONTRACT PHASE CONSTRUCTION PHASE Antalya Health Campus Eskişehir City Hospital PTR, Psychiatry and High Security Forensic Psychiatry Hospitals Kayseri Integrated Health Campus Denizli City Health Campus Istanbul Bakirköy Integrated Health Campus Ankara- Etlik Integrated Health Campus Diyarbakır Kayapınar Health Campus Istanbul Üsküdar Public Hospital Ankara Bilkent Integrated Health Campus Diyarbakır Yenışehir Health Campus Elaziğ Integrated Health Campus İzmir Güney Health Campus Adana Integrated Health Campus İzmir Torbalı Health Campus Gaziantep Integrated Health Campus Samsun Health Campus Istanbul Ikitelli Integrated Health Campus Şanlıurfa Health Campus Konya Karatay Integrated Health Campus Tekirdağ Integrated Health Campus Manisa Education and Research Hospital Trabzon Maternity Health Campus Mersin Integrated Health Campus Yozgat Edu. and Research Hospital TPHA + TPMDA Campus Bursa Integrated Health Campus Isparta City Hospital Izmir Bayrakli Integrated Health Campus Kocaeli Integrated Health Campus 7

9 SUMMARY OF THE PROJECTS 1 CONSTRUCTION PHASE 1. Kayseri Integrated Health Campus: Contractors: 1. YDA İnşaat Sanayi Ticaret A.Ş. 2. INSO Sıstemı Per Le Infrastrutture Sociali S.P.A Total Bed Capacity: 1583 Total Fixed Investment (Pertaining to Best Offer-TL): TL Annual Lease Payment + P1 Services* (Offer-TL): NA P2, i.e. Optional Services* (Offer-TL): NA Note: The P1/P2 distinction was not developed in the Kayseri tender and the award criteria was the annual lease payment (which was TL as contracted). 2. Ankara- Etlik Integrated Health Campus: Contractors: 1. Astaldi SPA 2. Türkerler İnş. Turz. Mad. Enrj. Ürt. Tic. San. A.Ş. Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): Since Total Fixed Investment (Pertaining to Best Offer-TL), Annual Lease Payment + P1 Services* (Offer-TL), P2, i.e. Optional Services* (Offer-TL) figures are not officially declared transparently, the figures given should be taken as personal output. 8

10 3. Ankara Bilkent Integrated Health Campus: Contractors: 1. Ic İçtaş İnşaat San.Tic. A.Ş. 2. Dia Holding Fzco Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): Elazığ Integrated Health Campus: Contractors: 1. Sıla Dan. Bilş. Eğt. İnş. Taah. Tic. ve Sağ. Hizm. Ltd. Şti. 2. Şentürkler Müh. İnş. Taah. Turz. San. ve Tic. A.Ş. 3. Medical Park Sağ. Hizm. A.Ş. (Medical Park was replaced by Rönesans). Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): Adana Integrated Health Campus: Contractors: 1. Sıla Danışmanlık Bilişim Eğitim İnşaat Taahhüt Ticaret ve Sağlık Hizmetleri Limited Şirketi 2. Şentürkler Mühendislik İnşaat Taahhüt Turizm Sanayi ve Ticaret A.Ş. 3. Rönesans Holding A.Ş. (Medical Park was replaced by Rönesans.) 4. Rönesans Medikal Yatırımları A.Ş. (Medical Park was replaced by Rönesans.) 5. Şam Yapı Sanayi ve Ticaret Ltd. Şti. Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL):

11 6. Gaziantep Integrated Health Campus: Contractors: 1. Samsung C&T Corporation 2. Kayı İnş. San. ve Tic. A.Ş. 3. Salini S.P.A. 4. Simed International B.V. 5. Studio Altieri Spa 6. HAN Teknik Müşavirlik Mühendislik Mimarlık A.Ş. Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): İstanbul İkitelli Integrated Health Campus: Contractors: 1. Emsaş İnşaat Turizm Ticaret ve Sanayi Anonom Şti. 2. PBK Architects Inc. 3. Ascension Group Architects L.P. 4. Allen Shariff Corporation 5. Meinhardt Group 6. May Eczane 7. Forcimsa Empresa Constructora, S.A. 8. Sürat Bilişim - Consortio International Eng. Consult 9. Şahin Tıp San. ve Tic. Ltd. Şti. Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL):

12 8. Konya Karatay Integrated Health Campus: Contractors: 1. YDA İnş. San. ve Tic. A.Ş. 2. Inso Sistemi Per Le Infrastrutture Sociali S.P.A Total Bed Capacity: 838 Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): Manisa Education and Research Hospital: Contractors: 1. YDA İnş. San. ve Tic. A.Ş. 2. Inso Sıstemı Per Le Infrastrutture Socıalı S.P.A Total Bed Capacity: 558 Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): Mersin Integrated Health Campus: Contractors: 1. Dia Holding Fzco 2. Techint Compagnia Tecnica İnternazionale S.P.A. JV Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL):

13 11. Yozgat Education and Research Hospital: Contractors: 1. Sıla Dan. Bil. Eğt. İnş. Taah. Tic. Sağ. Hizm. Ltd. Şti. 2. Şentürkler Müh.İnş.Taah.Turizm ve Tic.A.Ş. 3. Medical Park Sağ.Hizm.A.Ş. Total Bed Capacity: 475 Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): TPHA + TPMDA Campus Contractors: 1. Yıldızlar İnşaat ve Ticaret A.Ş. Total Bed Capacity: NA Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): 13. Bursa Integrated Health Campus Contractors: 1. Şentürkler Müh. Müteahhitlik İnş. Taahhüt Turizm Sanayi ve Ticaret A.Ş. 2. Sıla Danışmanlık Bilişim Eğitim İnş. Taahhüt Tic. ve Sağlık Hizmetleri Limited Şirketi 3. Medical Park Sağlık Hizmetleri A.Ş. Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL):

14 14. Isparta City Hospital Contractors: 1. Akfen İnş. Tur. Ve Tic. A.Ş. Total Bed Capacity: 755 Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): İzmir Bayraklı Integrated Health Campus Contractors: 1. Türkerler İnş. Tur. Madencilik Enerji Üretim Tic. ve San. A.Ş. 2. Gama Holding A.Ş. Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): Kocaeli Integrated Health Campus Contractors: 1. Türkerler İnş. Tur. Madencilik Enerji Üretim Tic. ve San. A.Ş. 2. Gama Holding A.Ş. Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL):

15 CONTRACT PHASE PTR, Psychiatry and High Security Forensic Psychiatry Hospitals Contractors: 1. Sıla Dan.Bilş.Eğt.İnş.Taah.Tic.ve Sağ.Hizm.Ltd.Şti. 2. Şentürkler Müh. İnş. Taah. Turzm. San. Ve Tic. A.Ş. 3. Ş.A.M Yapı San. Ve Tic Ltd.Şti 4. Rönesans Medikal Yatırımları A.Ş.-Rönesans Holding A.Ş. Total Bed Capacity: Total Fixed Investment (Pertaining to Best Offer-TL): Annual Lease Payment + P1 Services* (Offer-TL): P2, i.e. Optional Services* (Offer-TL): TENDER PHASE Eskişehir City Hospital Contractors: Total Bed Capacity: İstanbul Bakırköy Integrated Health Campus Contractors: Total Bed Capacity: İstanbul Üsküdar Public Hospital Contractors: Total Bed Capacity:

16 PIPELINE 1. Antalya Health Campus 2. Denizli City Health Campus 3. Diyarbakır Kayapınar Health Campus 4. Diyarbakır Yenişehir Health Campus 5. İzmir Güney Health Campus 6. İzmir Torbalı Health Campus 7. Samsun Health Campus 8. Şanlıurfa Health Campus 9. Tekirdag Integrated Health Campus 10. Trabzon Maternity Health Campus * MoH awards tenders based on the sum of the lease payment and the service payments offered for P1 services. P1 services are those hard services that the contractors are obliged to provide. P2 services are the soft and medial support services that the MoH may decide to procure from third parties. 15

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19 PROJECTS IN THE CONSTRUCTION PHASE KAYSERI INTEGRATED HEALTH CAMPUS According to the information provided by the MoH (sic): In health sector, The Kayseri Integrated Health Campus has health facility investment of 1583 beds capacity with a construction area of m2. The campus also consists of commercial spaces, congress centers, recreation areas etc. It is most prominent PPP project, with the capacity of peoples per day to provide healthcare services and estimated investment for Kayseri Health Campus is more than $650 million over the 3 years of construction period plus 25 years for operation/lease. Hospital Type Bed Capacity General Hospital 899 Woman's Hospital 258 Psychiatric Hospital 126 High-Security Psychiatric Hospital 100 Physical Therapy and Rehabilitation Hospital 200 TOTAL Current Project Status: The bids were received on 14/09/2010 for the Work of Construction Works and the Provision of Products and Services for Kayseri Integrated Health Campus, as a result of evaluations, the bidders which take in first three place, were requested to give final bids on 07/02/

20 The list of the bidders which take in first 3 place, in order of bid receipt on 14/09/2010: 1. IC İçtaş İnşaat San. ve Tic. A.Ş 2. Astaldi S.P.A & Türkerler İnş. Enr. Ürt. Tic. San. A.Ş. Joint Venture 3. YDA İnşaat Sanayi Ticaret A.Ş. & Inso Sistemi Per Le Infrastrutture Sociali S.P.A Joint Venture The contract of "Work of Construction Works and the Provision of Products and Services for Kayseri Integrated Health Campus" with a total capacity of 1583 beds was signed between Ministry of Health Department of Public Private Partnership and YDA İnşaat Sanayi Ticaret A.Ş. & INSO Sistemi Per Le Infrastrutture Sociali S.P.A Joint Venture on 10 August

21 ANKARA- ETLIK INTEGRATED HEALTH CAMPUS According to the information provided by the MoH (sic): 3566 beds 987 million USD fixed investment, 25 years 153 million USD annual availability payment. The Project with a construction area of m2 would be covering a health campus investment with a total capacity of 3566 beds consisting of a 718-bed General Hospital, a 500-bed Woman s Hospital, a 508-bed Children s Hospital, a 362-bed Cardio-vascular Hospital, a 494- bed Oncology and Children's Oncology Hospital, a 478-bed Orthopedics Hospital, a 300-bed Physical Therapy and Rehabilitation Hospital, a 106- bed Psychiatric Hospital and a 100-bed High-Security Psychiatric Hospital. The campus also covers medical science university, high technolgy center and R&D center, commercial areas, congress centers, etc. Parkings are designed at basement floors. The campus project which shall have the highest technology and the biggest capacity in the World and Europe has been designed in colloboration with the local architectural and designing offices. The branch hospitals with their planned capacities of Ankara Etlik Integrated Health Campus; Hospital Type Bed Capacity General Hospital 718 Cardio-vascular Hospital 362 Neurological Sciences and Orthopedics Hospital 478 Woman's Hospital 500 Children's Hospital 508 Oncology Hospital 494 Physical Therapy and Rehabilitation Hospital 300 Psychiatric Hospital 106 High-Security Psychiatric Hospital 100 TOTAL

22 Current Project Status: The tender for the Work of Construction Works and the Provision of Products and Services for Ankara Etlik Integrated Health Campus was announced at 14/01/2010 and announcements have been published in both local and international press. The following 9 bidders were qualified for this pre-qualification stage. Qualified Bidders in Pre-Qualification Stage 1. Limak İnş. San. A.Ş. - Kur İnş. Tic. San.A.Ş. - İstanbul Memorial Sağ. Yat. A.Ş. Joint Venture 2. IC İçtaş İnş. San. ve Tic. A.Ş. - Dia Holding Fzco Joint Venture 3. Vamed Engineering GMBH&CO KG - Türk Philips Tic. A.Ş. Philips Medical Sys. Nederland B.V. Joint Venture 4. YDA İnş. San. Tic. A.Ş. - İnso Sistemi Perle İnfrastrutture Socıali SPA - Summa Turizm Yatırımcılığı A.Ş. Joint Venture 5. Impresa Pizzarotti&C. SPA- Yenigün İnşaat Sanayi Ve Ticaret A.Ş. Joint Venture 6. Obrascon Huarte Lain S.A 7. Güriş İnşaat ve Mühendislik A.Ş. 8. Alsim Alarko Sanayi Tesisleri ve Ticaret A.Ş 9. Astaldi SPA - Türkerler İnş. Turz. Mad. Enrj. Üretim Tic. San. A.Ş. Joint Venture The bids were received on for the work of the Construction Works and the Provision of Products and Services for Ankara Etlik Integrated Health Campus. The List of the Bidders 1. Astaldi SPA - Türkerler İnş. Turz. Mad. Enrj. Ürt. Tic. San. A.Ş. Joint Venture 2. YDA İnşaat Sanayi Ticaret A.Ş. - İnso Sistemi Per le İnfrastrutture Sociali S.P.A. - Summa Turizm Yatırımcılığı A.Ş. Joint Venture 3. IC İçtaş İnş. San. ve Tic. A.Ş. - Dia Holding Fzco Joint Venture 21

23 Letter of Thanks Presented Companies 1. Obrascon Huarte Lain S.A 2. Alsim Alarko Sanayi Tesisleri ve Ticaret A.Ş The bids were received on 28/01/2011 for the Work of Construction Works and the Provision of Products and Services for Ankara Etlik Integrated Health Campus, as a result of evaluations, the bidders which take in first five place, were requested to give final bids on 24/06/2011 at 3:00 pm. The list of the bidders which take in first 5 place, in order of bid receipt on 28/01/2011: 1. Astaldi SPA - Türkerler İnş. Turz. Mad. Enrj. Ürt. Tic. San. A.Ş. Joint Venture 2. YDA İnşaat Sanayi Ticaret A.Ş. - İnso Sistemi Per le İnfrastrutture Sociali S.P.A. - Summa Turizm Yatırımcılığı A.Ş. Joint Venture 3. IC İçtaş İnş. San. ve Tic. A.Ş. - Dia Holding Fzco Joint Venture Dutch auction of Work of Construction Works and the Provision of Products and Services for Ankara Etlik Integrated Health Campus was held on and the most advantageous (preferred) bidder is Astaldi SPA - Türkerler İnş. Turz. Mad. Enrj. Ürt. Tic. San. A.Ş. Joint Venture. Detailed examination on financial model, project proposal etc. of Astaldi SPA - Türkerler İnş. Turz. Mad. Enrj. Ürt. Tic. San. A.Ş. Joint Venture was initiated by the tender commission and tender process is still ongoig. Project is expected to reach financial closing shortly. 22

24 ANKARA BILKENT INTEGRATED HEALTH CAMPUS According to the information provided by the MoH (sic): The Project with a construction area of m2 would be covering a health campus investment with a total capacity of 3662 beds consisting of a 582-bed General Hospital, a 574-bed Woman s Hospital, a 514-bed Children s Hospital, a 425-bed Cardio-vascular Hospital, a 557-bed Oncology and Children's Oncology Hospital, a 412-bed Orthopedics Hospital, a 300-bed Physical Therapy and Rehabilitation Hospital, a 198-bed Psychiatric Hospital and a 100-bed High-Security Psychiatric Hospital. The campus also covers medical science university, high technolgy center and R&D center, commercial areas, congress centers, etc. Parkings are designed at basement floors. The campus project which shall have the highest technology and the biggest capacity in the World and Europe has been designed in colloboration with the local architectural and designing offices. The branch hospitals with their planned capacities of Ankara Bilkent Integrated Health Campus can be listed as; Hospital Type Bed Capacity General Hospital 580 Cardio-vascular Hospital 425 Neurological Sciences and Orthopedics Hospital 412 Woman's Hospital 574 Children's Hospital 514 Oncology Hospital 557 Physical Therapy and Rehabilitation Hospital 300 Psychiatric Hospital 198 High-Security Psychiatric Hospital 100 Total

25 Current Project Status: The tender for the Work of Construction Works and the Provision of Products and Services for Ankara Bilkent Integrated Health Campus was announced at 21/06/2010 and announcements have been published in both local and international press. The pre-qualification evaluation stage has been completed. Qualified Bidders in Pre-Qualification Stage 1. Alsim Alarko Sanayi Tesisleri ve Ticaret A.Ş. 2. Limak İnş. San. ve Tic. A.Ş. - Kur İnş. Tic. ve San. A.Ş. - İstanbul Memorial Sağlık Yatırımları A.Ş. Joint Venture 3. Yüksel İnşaat A.Ş. 4. Ic İçtaş İnşaat San.Tic. A.Ş. - Dia Holding Fzco Joint Venture 5. Yda İnş.San. Tic. A.Ş. - İnso Sistemi Per Le İnfrastrutture Sociali S.P.A - Summa Turz. Yatırımcılığı A.Ş. Joint Venture 6. Tepe İnşaat Sanayi A.Ş. 7. Vamed Engıneerıng Gmbh&Co Kg - Türk Philps Ticaret A.Ş. - Philps Medical Systems Nederland B.V. Joint Venture 8. Astaldi S.P.A - Türkerler İnş. Turz. Mad.Enr. Ürt.Tic. San. A.Ş. - Özkar İnş. San. Tic. A.Ş. Joint Venture The bids were received on for the work of the Construction Works and the Provision of Products and Services for Ankara Bilkent Integrated Health Campus. The List of the Bidders 1. Astaldi S.P.A - Türkerler İnş. Turz. Mad.Enr. Ürt.Tic. San. A.Ş. - Özkar İnş. San. Tic. A.Ş. Joint Venture 2. Tepe İnşaat Sanayi A.Ş. (Letter of Thanks Presented) 3. Yda İnş.San. Tic. A.Ş. - İnso Sistemi Per Le İnfrastrutture Sociali S.P.A - Summa Turz. Yatırımcılığı A.Ş. Joint Venture 4. Yüksel İnşaat A.Ş. (Letter of Thanks Presented) 5. Ic İçtaş İnşaat San.Tic. A.Ş. - Dia Holding Fzco Joint Venture 6. Alsim Alarko Sanayi Tesisleri ve Ticaret A.Ş. 24

26 The bids were received on 23/05/2011 for the Work of Construction Works and the Provision of Products and Services for Ankara Bilkent Integrated Health Campus, as a result of evaluations, the bidders which take in first three place, were requested to give final bids on 15/09/2011 at 3:00 pm. The list of the bidders which take in first 3 place, in order of bid receipt on 23/05/2011: 1. Astaldi S.P.A - Türkerler İnş. Turz. Mad.Enr. Ürt.Tic. San. A.Ş. - Özkar İnş. San. Tic. A.Ş. Joint Venture. 2. 2) Yda İnş.San. Tic. A.Ş. - İnso Sistemi Per Le İnfrastrutture Sociali S.P.A - Summa Turz. Yatırımcılığı A.Ş. Joint Venture 3. 3) Ic İçtaş İnşaat San.Tic. A.Ş. - Dia Holding Fzco Joint Venture The Final Bid Date for the Work of Construction Works and the Provision of Products and Services for Ankara Bilkent Integrated Health Campus is postponed to on 15:00. The final bids were received on 30/09/2011 for the Work of Construction Works and the Provision of Products and Services for Ankara Bilkent Integrated Health Campus and were declared in the presence of bidders. Dutch auction of "the Work of Construction Works and the Provision of Products and Services for "Ankara Bilkent Integrated Health Campus" done in Ceyhun Atıf kansu Street No:102/2, in the meeting room of Department of Public Private Partnership at 10/10/2011, 03:00 PM. Dutch auction of Work of Construction Works and the Provision of Products and Services for Ankara Bilkent Integrated Health Campus was held on and the most advantageous bidder is Ic İçtaş İnşaat San.Tic. A.Ş. - Dia Holding Fzco Joint Venture. Detailed examination on financial model, project proposal etc. of Ic İçtaş İnşaat San.Tic. A.Ş. - Dia Holding Fzco Joint Venture was initiated by the tender commission and tender process is still ongoig. Project is expected to reach financial closing shortly. 25