national fertilizers ltd., panipat production department

23
National Fertilizers Ltd., Panipat Production Department Ref No: NFL/PT/Prod./PQ/CM (P)/2018 Dated: 29.01.2019 The prequalification job for ARC of 1. a) Up-keep of various Plant & Machinery in Ammonia, (b)Urea, (c) Handling of Ash spillage, Equipment cleaning, House-keeping activities and other Misc. jobs in CPP & SGP (d) O&U Plants (2) Unloading and Handling of Coal from Railway Wagons and related jobs. (3) Assistance in coal Bunkering, Handling of Coal Mill Rejects and related jobs and (4) High pressure water jet cleaning of Heat exchangers.” at NFL Panipat has been completed and parties have been shortlisted. Now, above mentioned NIT for prequalification of various contracts of Production department has been re-opened. Interested parties can apply for prequalification for these contracts till 18-01-2021 and their eligibility shall be decided during review of prequalification of contracts. Last date for application of prequalification and submission of required documents of the NIT of above mentioned contracts is 18-01-2021. (Rajan Kanwar) DGM (Production)

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Page 1: National Fertilizers Ltd., Panipat Production Department

National Fertilizers Ltd., Panipat

Production Department

Ref No: NFL/PT/Prod./PQ/CM (P)/2018 Dated: 29.01.2019

The prequalification job for ARC of 1. a) Up-keep of various Plant & Machinery in

Ammonia, (b)Urea, (c) Handling of Ash spillage, Equipment cleaning, House-keeping

activities and other Misc. jobs in CPP & SGP (d) O&U Plants

(2) Unloading and Handling of Coal from Railway Wagons and related jobs.

(3) Assistance in coal Bunkering, Handling of Coal Mill Rejects and related jobs and

(4) High pressure water jet cleaning of Heat exchangers.” at NFL Panipat has been

completed and parties have been shortlisted.

Now, above mentioned NIT for prequalification of various contracts of Production

department has been re-opened. Interested parties can apply for prequalification for these

contracts till 18-01-2021 and their eligibility shall be decided during review of

prequalification of contracts.

Last date for application of prequalification and submission of required documents of the

NIT of above mentioned contracts is 18-01-2021.

(Rajan Kanwar)

DGM (Production)

Page 2: National Fertilizers Ltd., Panipat Production Department

Page 1 of 22

(PRODUCTION DEPARTMENT)

DOCUMENTS

FOR

“Pre- qualification of the parties for ARC of i) Up-keep of various Plant & Machinery in

Ammonia, Urea , O&U Plants and Handling of Ash spillage, Equipment cleaning,

House-keeping activities and other Misc. jobs in CPP & SGP. ii) Unloading and

Handling of Coal from Railway Wagons and related jobs. iii) Assistance in coal

Bunkering, Handling of Coal Mill Rejects and related jobs. iv) High pressure water

jet cleaning.”

NIT No. NFL/PT/Prod./PQ/CM(P)/2018 DATED : 4.07.2018 DUE DATE OF SALE OF TENDER DOCUMENTS : 13.08.2018 UPTO 1230 Hr.

DUE DATE OF RECEIPT OF TENDER DOCUMENTS: 13.08.2018 UPTO 1500 Hr. DUE DATE OF OPENING OF TENDER DOCUMENTS : 13.08.2018 UPTO 1530 Hr. THIS DOCUMENT CONTAINS: TOTAL 22 PAGES (Signature of Issuing Authority)

Page 3: National Fertilizers Ltd., Panipat Production Department

Page 2 of 22

INDEX

SR.NO. PARTICULARS FROM PAGE

TO PAGE NO.OF PAGES

1. Covering page of tender document 01 01 01

2. Index 02 02 01

3. Notice Inviting Application for Pre-qualification 03 03 01

4. Enlistment Fees and Eligibility criteria (Annexure-A) 04 04 01

5. Estimated value of contracts (Annexure-B) 05 05 01

6. Conditions for prequalification (Annexure-C) 06 06 01

7. Application Form for registration/PQ of parties for various ARCs/categories of jobs (Annexure-D)

07 11 05

8. Bank reference letter/solvency certificate(Annexure-I) 12 12 01

9. Performa for Eligibility criteria of parties w.r.t. to experience (Annexure-II)

13 13 01

10. Information regarding Tenderer (Annexure-III) 14 14 01

11. Detail of experience(Annexure-IV) 15 15 01

12. Present Commitments(Annexure-V) 16 16 01

13 Information regarding Equipment (Annexure-VI) 17 17 01

14. Certificate for not black listed(Annexure-VII) 18 18 01

15. Submission of GST registration number(Annexure-VIII)

19 19 01

16. Submission of ESI registration number(Annexure-IX) 20 20 01

17. Submission of Labor License number(Annexure-X) 21 21 01

18. No relation certificate(Annexure-XI) 22 22 01

Total Page 22

NOTE:-

Parties are requested to see that all the papers of tender documents issued to them are intact as

per above index.

Page 4: National Fertilizers Ltd., Panipat Production Department

Page 3 of 22

National Fertilizers Limited: Panipat Unit

Production Department

No. NFL/PT/Prod/PQ/CM(P)/2018/ Dated: 4.07.2018

Applications are invited from reputed, experienced and competent contractors for empanelment for a

period of three years in NFL’s select panel of Contractors for execution of following works in

Production Department. Existing prequalified parties are also required to apply for pre-qualification:

i) Up-keep of various Plant & Machinery in Ammonia, Urea , O&U Plants and Handling

of Ash spillage, Equipment cleaning, House-keeping activities and other Misc. jobs in

CPP & SGP.

ii) Unloading and Handling of Coal from Railway Wagons and related jobs.

iii) Assistance in coal Bunkering, Handling of Coal Mill Rejects and related jobs.

iv) High pressure water jet cleaning

Requirement is for pre-qualification of works as per Annexure-A, depending upon the work

experience and financial capability. The various experience criteria according to nature of job to be

considered for pre-qualification as given in the enclosed Annexure-A. The intending contractors

may submit the following information/documents along with their application.

a) Name of the firm with full postal address, Phone No. and Fax No. etc.

b) Firm constitution i.e. Proprietary/Partnership/Private/Limited/Public Ltd., along with

partnership deed or memorandum of Articles of Association.

c) Firm’s organization structure along with Bio-data of key personnel.

d) PAN Number

e) Details of deposits, bank limits, latest solvency certificate etc. in the format of Annexure-I.

f) Provident Fund’s Registration Number.

g) GST Number, Sales Tax, CST No., Labour License No.

h) ESI Code Number

i) Details of works executed in the last seven years with copies of agreements, work

orders/completion certificates, performance certificates.

j) Details of annual turnover during last three years ending up to March, 2018.

k) Details of machines/equipments/staff etc. owned by the firm.

l) Any additional information in support of contractor’s credentials.

Applications shall be submitted along with the aforesaid documents/information. In case the

application has been down loaded from our web site the requisite amount of Application Fee in the

form of Demand Draft of any scheduled Bank drawn in favour of “National Fertilizers Limited-

Panipat”, payable at Panipat shall have to be submitted in separate envelope to reach to the office

of DGM (Production) on or before 13.08.2018 (1500 hrs.)

The empanelment of contractors shall be at entire discretion of NFL based on an objective

evaluation and financial competence and resourcefulness of the contractors.

NFL reserves the right to reject any or all the applications without assigning any reason thereof.

(Rajan Kanwar )

Dy. General Manager (Prod)

Page 5: National Fertilizers Ltd., Panipat Production Department

Page 4 of 22

Annexure-A

Enlistment Fees and Eligibility Criteria of Experience to be considered for Pre-qualification

S.

No.

Name of the Contract/Job Enlist-

ment Fee

including

of VAT

Estimated

Value based

on latest

awarded

value (Rs.in

lacs)

Average

Annual

Turnover

(Rs.in lacs)

30% of

Estimate

Required value of job executed

during last 7-years (Rs.in lacs)

Required experience/infrastructure

One

contract

(80% of

Estimate)

Two

contracts

each of

(50% of

Estimate)

Three

contracts

each of

(40% of

Estimate)

1. Up-keep of various plants

a) Up-keep of Ammonia Plant area &

Machinery

Rs.1000/-

25.00 7.5 20.00 12.50 10.0 Up-keep of Plant area and machineries by

deployment of labours.

b) Up-keep of Plant Machinery and

other misc. jobs in Urea Plant 33.00 9.9 26.40 16.50 13.20 Up-keep of Plant area and machineries by

deployment of labours.

c) Handling of ash spillage,

equipment cleaning, house-keeping

activities and other Misc. jobs in

CPP & SGP.

23.00 6.9 18.40 11.50 9.20 Up-keep of Plant area and machineries by

deployment of labours.

d) Up-keep of O&U Plants and

Machinery 13.00 3.9 10.4 6.5 5.2 Up-keep of Plant area and machineries by

deployment of labours.

2. Contract for Unloading and Handling of

coal from Railway Wagons and related

jobs. Rs.1000/-

55.00 16.50 44.00 27.50 22.00 Experience of having successfully completed

works of material handling.

3. Contract for Assistance in Coal

Bunkering, Handling of Coal Mill

Rejects and related jobs. Rs.1000/-

58.00 17.40 46.40 29.00 23.20 Up-keep of Plant area and machineries by

deployment of labours and machines.

4. High pressure water jet cleaning

Rs. 250/-

5.30 1.59 4.24 2.65 2.12 Cleaning of heat exchanger tubes with high

pressure water jet machine, electrical/diesel driven

of minimum 75 KW and cleaning of HPD Re-

boiler with 1000 kg. Pressure.

Page 6: National Fertilizers Ltd., Panipat Production Department

Page 5 of 22

Annexure-B

Estimated Value of the Contracts

S.No. Job/Contract Estimate based on latest

awarded Value (Rs.in lacs)

1. Plant up-keep contracts

a) Up-keep of Ammonia Plant area &

Machinery

25.00

b) Up-keep of Plant Machinery and other misc.

jobs in Urea Plant

33.00

c) Handling of ash spillage, equipment

cleaning, house-keeping activities and other

Misc. jobs in CPP & SGP.

23.00

d) Up-keep of O&U Plants and Machinery 13.00

2. Unloading and Handling of coal from

Railway Wagons and related jobs.

55.00

3. Assistance in Coal Bunkering, Handling of

Coal Mill Rejects and related jobs.

58.00

4. High pressure water jet cleaning 5.30

Page 7: National Fertilizers Ltd., Panipat Production Department

Page 6 of 22

Annexure-C

Conditions for prequalification. Applicant may read carefully and accept the same by putting

his/their signature and seal of the firm/company

1.The applications of only such agencies/ contractor shall be considered who has/have deposited the

Application fee in the requisite form as per our Notice and the required documents as per eligibility

criteria/ Application form.

2. The applications along with the documents submitted by the parties shall be scrutinized to ascertain

their suitability for pre-qualification for a particular category of work as per the Eligibility criteria

mentioned in this document. Accordingly he/ they, if found eligible, will be prequalified for such

applied category of work for which the submitted documents prove their eligibility for that particular

category as per the eligibility criteria.

3.The parties which are considered and pre-qualified for a particular estimated value of any category

of work, will be automatically pre-qualified for the other lower estimated values of the same category

of work, without depositing any extra application fee.

4. The registration/pre-qualification of the parties shall be valid for a period of 03 ( THREE YEARS)

from the date of written confirmation of the same by NFL.

5.The pre-qualification may be reviewed by NFL from time to time on yearly basis for inclusion of

new parties in the pre-qualified list as well deletion of non-responding parties against our NIT’s.

Interested parties may also apply after close date of this NIT. Applications so received may be

considered at the time of annual review of prequalification.

6.Applicants may apply for as many categories of pre- qualifications, as they feel to be considered for

the same, but they have to deposit required application fee as given against each category. The

application fee is non-refundable.

7.In case the application has been downloaded from our Website, the requisite amount of Application

fee in the form of Demand draft of any scheduled Bank drawn in favour of “ National Fertilizers

Limited- Panipat” , payable at Panipat shall have to be submitted in separate envelope in the absence

of which the application is liable to be rejected.

Dated:-----------------

SIGNATURE OF APPLICANT

With seal and address

Page 8: National Fertilizers Ltd., Panipat Production Department

Page 7 of 22

NATIONAL FERTILIZERS LIMITED - GOHANA ROAD PANIPAT 132 106

APPLICATION FORM FOR REGISTRATION / PREQUALIFICATION OF PARTIES FOR VARIOUS ARCs/CATEGORIES OF

JOBS IN PRODUCTION DEPT. Annexure-D

APPLICATION FORM FOR :

PQ No. :______________________________

CATEGORY :______________________________

PARTICULAR OF WORK :______________________________

1

Name of Applicant/Firm/Company

I) Nationality

ii) Full Address

iii) Phone No.

iv) Fax No

v) E-Mail ID

vi) Name of Contact Person

Sh. / M/s

STD Code Phone No.

Office :

Residence:

Sh.

2

Company Profile

Copy Enclosed

( YES/No)

A

Whether private Limited Company or

Un-divided Hindu Family/ Individual

or Partnership Firm

( Please attach certified copy of partnership

deeds/articles of association and

memorandum of association and power of

attorney who is signing documents on behalf

of applicant/firm/company.

(Strike out whichever is not applicable)

i) Individual

ii) Proprietorship Firm

iii) Partnership Firm

iv) Private Ltd. Firm.

v) Public Limited Firm

vi) Other

Page 9: National Fertilizers Ltd., Panipat Production Department

Page 8 of 22

B

Year of establishment

C

Name of Bankers and their full address.

(Latest Solvency Certificate to be submitted on

enclosed Annexure-I) Duly Certified Copy to

be enclosed

( Copy enclosed) YES / NO

D

Details of Construction Machinery /Tools etc.

owned by the Firms.

List of Plant & Machinery / Equipments for

carrying out the works is attached YES / NO

E

Detail of Staff Working with Firm

( Copy enclosed) YES / NO

F

Place of Business.

3

Provident Fund Code No

(duly certified copy to be enclosed.)

__________________________________

( Copy enclosed) YES / NO

4

ESI Code no.

(duly certified copy to be enclosed.)

__________________________________

( Copy enclosed) YES / NO

OR Enclose the undertaking that you will obtain the ESI

No whenever any work is awarded to you after registration

of your prequalification (As per ANNEXURE – “IX”.)

Page 10: National Fertilizers Ltd., Panipat Production Department

Page 9 of 22

5

Details of Labour License

(duly certified copy to be enclosed.)

__________________________________

( Copy enclosed) YES / NO

OR Enclose the undertaking that you will obtain the Labour

Licence No. ,If applicable, whenever any work is awarded to

you after registration of your prequalification (As per

ANNEXURE – “X”.)

6

Permanent Account No (PAN)

(duly certified copy to be enclosed.)

_____________________________________________

( Copy enclosed) YES / NO

7

GST Registration No.

(duly certified copy to be enclosed.)

__________________________________

( Copy enclosed) YES / NO

OR Enclose the undertaking that you will obtain the GST

No. whenever any work is awarded to you after

registration of your prequalification (As per ANNEXURE –

“VIII”.)

8

ELIGIBILITY CTETERIA

as per Annexure II

Annual Turnover during the last three financial

years

Ending 31.03.2016 (2015-16)

Ending 31.03.2017(2016-17)

Ending 31.03.2018 (2017-18)

(Certified copy of P&L Account and Balance

Sheet etc. are to be enclosed

i) ` Lac ( Copy enclosed) YES / NO

ii) ` Lac ( Copy enclosed) YES / NO

ii) ` Lac ( Copy enclosed) YES / NO

Page 11: National Fertilizers Ltd., Panipat Production Department

Page 10 of 22

9

Work Experience

a) Nature of Work

b) Completed Value of Work

(During last 7 years ending the of month

previous to the one in which the applications

are invited.)

(Certified copy of respective completion

certificates are to be enclosed )

______________________________________

______________________________________

_______________________________________

i) ` Lac (Comp. Cert. enclosed) YES / NO

ii) ` Lac (Comp. Cert. enclosed) YES / NO

iii) ` Lac (Comp. Cert. enclosed) YES / NO

10.

Whether the Applicant is already Registered in

this Undertaking Or elsewhere?

If YES, Mention

Name of Department

Category of work

Financial limit of Prequalification

YES / NO

11

Has the applicant or any of his partner or

shareholders been black listed or de-listed or

put on holiday list from the approved list of

contractors or demoted to lower class or Order

passed, banning /suspending business with the

Applicant etc. by any Deptt, in the past?

Affidavit as per Annexure-VII duly notarized

attached YES / NO

12

A list of those persons who are working with

the Applicant in any capacity and who are near

relatives to any of the employees of the Owner

(NFL) or in the concerned Ministry /

Department, should be submitted (Names are

to be intimated if employment given to such

persons at later date)

List attached YES / NO

OR

Annexure-XI signed and attached YES / NO

Page 12: National Fertilizers Ltd., Panipat Production Department

Page 11 of 22

13 The Applicant is required to furnish the details

regarding its status of Micro, Small and

Medium Enterprise under the MSMED Act,

2006 at the time of submission of the

Application. The benefits of the Public

Procurement Policy for MSEs Order, 2012 shall

be considered only if self- certified copy of

valid registration certificate of MSME as per

the MSMED Act, 2006 along with the status of

MSEs owned by SC/ST Entrepreneurs, if

applicable, is provided. In case no information

is given by the applicant, it will be presumed

that he is not covered by the Act and

consequently not eligible for any benefits

under the Act.

Self- certified copy of valid Registration Certificate of MSME

Copy of Registration attached

YES / NO

Status of MSEs owned by SC/ST Entrepreneurs

Copy of Certificate attached

YES / NO

NOTE:

1. All parties are requested to submit all the documents as required in one go incomplete application will be liable for rejection.

2. The enlistment of the contractor shall be at the entire discretion of NFL based on objective evaluation of the details regarding past experience, Technical & Financial competence and resource fullness of the contractors/firms/companies.

3. NFL reserve the right to reject any or all the applications and also do not bind to accept the same being poor response.

4. NFL has the right not to issue/consider the Tender/PQ request form to any particular contractor/firm/company in case of their/His suspension / removal / delisting / blacklisting done by NFL in any unit or elsewhere.

5. NFL may inspect the site/works of the party before prequalification if required.

FOLLOWING ARE ALSO DECLARED, ACCEPTED AND CERTIFIED That

All the information filled herein and attached hereto are true to the best of my / our knowledge and belief. I / We declare that in the event of finding the said information false, the enlistment / registration as pre-qualified party made by NFL, will stand cancelled without any notice or reference thereof. It is further certified that I / We will not get myself / ourselve registered under more than one name. NFL reserves the right to debar such tenderer from participation in the prequalification process/

present/future tenders up to a period of 2 years If a tenderer resorts to any frivolous, malicious or

baseless complaints / allegations with an intent to hamper or delay the tendering/prequalification

process or resorts to canvassing/ rigging/ influencing the tendering/ prequalification process,

I/We certify to adhere the Anti-Fraud Policy of the Company and not indulge or allow anybody

else working in the Company to indulge in fraudulent activities and would immediately apprise the

Company of the fraud/suspected fraud as soon as it comes to their notice. In case of failure to do so,

the Company may debar me/us for future transactions. This certification/condition shall form part

of documents both at the time of submission and execution of agreements and contracts with

suppliers and service providers, etc.

DATED :

SIGNATURE OF CONTRACTOR

With SEAL and Address

Page 13: National Fertilizers Ltd., Panipat Production Department

Page 12 of 22

Annexure-I

BANK REFERENCE LETTER / SOLVENCY CERTIFICATE

(On Banks Letter Head)

Certified that M/s _________________________________________ at (address)

_____________________________________________________________________ is having an

account in our bank as per following particulars: -

1. Type of Account _______________________ is Cash-Credit/Current/Savings.

2. Bank Account No.___________________

3. Cash-Credit/O.D. Limit (if any) ________________ NO/YES, for Rs.__________

4. Since when holding Account? ___________________

5. Financial Standing & Soundness _______________________ Sound/Poor.

6. Dealing & Conduct of the Party ________________ Satisfactory/Un-satisfactory.

7. Any other comments _______________________________________________

This is issued on the request of M/s _________________________________________ for

submission in NFL, Panipat.

Date: ___________ (Sign. of Bank Manager)

Place: __________ Seal:

Page 14: National Fertilizers Ltd., Panipat Production Department

Page 13 of 22

Annexure-II

(To be filled up separately with appropriate Tender Fee for each Pre-qualification of Job)

ELIGIBILITY CRITERIA OF PARTIES w.r.t. EXPERIENCE

Ref No. Name of Contract Estimated Cost A. Commercial Criteria S.

No. Description Financial Year Details & documents to be

submitted by the contractor 1 Average annual financial turnover during last

three years ending 31st March of the previous

financial year, at least 30% of estimated cost

i.e. Rs._____Lacs

2015-16

2016-17

2017-18

2 Experience of having successfully completed similar works during last seven years ending the day

of month previous to the one in which applications are invited should be either of the following :-

a. Three similar completed works

each costing not less than 40%

amount of the estimated cost.

(with performance/completion

certificate) i.e. Rs.____ Lacs or

more

1

Work Order Ref. No. Name of Company Contract Value

Contract Period 2 Work Order Ref. No.

Name of Company Contract Value Contract Period

3 Work Order Ref. No. Name of Company

Contract Value Contract Period

OR

b) Two similar completed work

each costing not less than 50%

amount of the estimated cost. (with

performance/completion

certificate).i.e. Rs._____ lacs or

more

1 Work Order Ref. No.

Name of Company

Contract Value

Contract Period

2 Work Order Ref. No.

Name of Company Contract Value Contract Period

OR c) One similar completed work

costing not less than 80% of

the estimated cost. (with

performance/completion certificate

i.e. Rs.____ lacs or more

1 Work Order Ref. No.

Name of Company

Contract Value

Contract Period B. Technical Criteria Work Order with detailed technical scope of work indicating experience related to scope of work should be

submitted along with Performance & Completion Certificate.

NOTE:

1. Similar Work means work employing same technology and skill but quantities can vary but should be ARC.

as given in Annexure-A

2. Self-attested documentary evidences for Annual Turnover to be enclosed.

3. Self-attested documentary evidences for Work Orders given above to be enclosed.

4. Self-attested documentary evidences for Performance/Completion Certificate of above given Work Orders to

be enclosed.

Signature of the party/ contractor with seal

Page 15: National Fertilizers Ltd., Panipat Production Department

Page 14 of 22

Annexure-III INFORMATION REGARDING TENDERER

A) In case of individual

i) Name of Business

ii) Whether his Business is registered

iii) Date of commencement of business

iv) Whether he pays Income-Tax over Rs. 10,000/- per year

B) In case of Partnership

i) Name of Partnership

ii) Whether the Partnership is registered

iii) Date of establishment of firm

iv) If each of the partners of the firm pays Income-Tax over Rs. 10,000/- a year and if not which of them pays the same

C) In case of Limited Liability Company or Company Limited by Guarantee

i) Amount of paid up capital

ii) Name of Directors

iii) Date of Registration of Company

iv) Copies of the last two years’ Balance Sheets of the Company

(SIGNATURE OF TENDERER)

Name ________________________

Dated _______________________

Page 16: National Fertilizers Ltd., Panipat Production Department

Page 15 of 22

DETAIL OF EXPERIENCE Annexure-IV Tenderer shall give information of similar works done during the past Seven years strictly as per Performa given below

Sr. No.

Full particulars of similar work carried out by Tenderer

Value of Contract

Contracted Completion time

Actual completion time

Year of completion

Name & Postal Address of Client

Certified that the above information is correct.

(SIGNATURE OF TENDERER)

Name ________________________

Date ________________________

Page 17: National Fertilizers Ltd., Panipat Production Department

Page 16 of 22

PRESENT COMMITMENTS Annexure-V Tenderer shall furnish the details of their present commitments strictly as per this Performa.

Sr. No.

Name of work Name & address of Client with the name of person under whom the work is being executed

Contract Value

Brief description of work

Contracted date of completion with the date of start of work

% age completed as on date

Expected date of completion of balance work with approx. value of such balance work

Certified that the above information is correct.

(SIGNATURE OF TENDERER)

Name: _________________________

Date : _______________________

Page 18: National Fertilizers Ltd., Panipat Production Department

Page 17 of 22

INFORMATION REGARDING EQUIPMENT WHICH THE TENDERER PROPOSES TO USE FOR THIS WORK

Annexure-VI

Sr. No

Description Qty Make Cap. Owner Approx. date when it will be

deployed at site

Period of attention

at site

Certified that the above information is correct.

(SIGNATURE OF TENDERER)

Name :______________________

Date : _______________________

Page 19: National Fertilizers Ltd., Panipat Production Department

Page 18 of 22

Annexure-VII

Party has to submit following Certificate on Non-Judicial stamp paper of Rs.10/-

verified by Notary Public/Ist Class Magistrate

I/We _______________________S/o Shri ___________________________ Resident of

_____________________________________________M/s______________________

___________________________.

Solemnly affirm and declare as under: -

a) That party/their associates/sister concerns etc. have not been black listed or put on

holiday by any Institutional Agency/Govt. Deptt./Public Sector Undertaking during

last two years for participating in the tender.

b) No other Firm/sister concerns/associates belonging to the same group is

participating/submitting the tender for the job.

c) That the information furnished by me/us in respect of above Tender is true and correct

and nothing has been concealed. In case any of information is found to be false and

incorrect at any stage, NFL shall be fully competent to take the necessary action as

deemed fit.

Deponent

(_____________)

Seal of the Party

Verification:

Verified that contents given in my/our above paragraphs are true and correct to the best of

my/our knowledge and belief.

Deponent

(_____________)

Seal of the Party

Dated: __________

(Attested by Notary Public)

Page 20: National Fertilizers Ltd., Panipat Production Department

Page 19 of 22

Annexure-VIII

Sub: Prequalification

Ref.: NFL/PT/Prod/PQ/CM(P)/2018 Date: ____________

SUBMISSION OF GST REGISTRATION NUMBER

It is certified that applicant at present has not got registered his firm/company under GST Act

and hereby do undertake in the capacity of proprietor/partner/authorized representative of the

firm/company to submit the GST Registration No. at the time of award of the job after the

subject prequalification.

The above statement is true and is submitted against NIT Ref.No.NFL/PT/Prod/PQ/CM(P)/

2018/ dated: _________ for prequalification for the job: _____________________________.

Signature of the Co./Firm

(Seal)

Dated: __________

Page 21: National Fertilizers Ltd., Panipat Production Department

Page 20 of 22

Annexure-IX

Sub: Prequalification

Ref.: NFL/PT/Prod/PQ/CM(P)/2018 Date: ____________

SUBMISSION OF ESI REGISTRATION NUMBER

It is certified that applicant at present has not got registered his firm/company under

ESI Act and hereby do undertake in the capacity of proprietor/partner/authorized

representative of the firm/company to submit the ESI Registration No. at the time of

award of the job after the subject prequalification.

The above statement is true and is submitted against NIT Ref.No.NFL/PT/Prod/PQ/CM(P)/

2018/ dated: _________ for prequalification for the job: _____________________________.

Signature of the Co./Firm

(Seal)

Dated: __________

Page 22: National Fertilizers Ltd., Panipat Production Department

Page 21 of 22

Annexure-X

Sub: Prequalification

Ref.: NFL/PT/Prod/PQ/CM(P)/2018 Date: ____________

SUBMISSION OF LABOR LICENSE NUMBER

It is certified that applicant at present has not got registered his firm/company under

LABOR LICENSE REGISTRATION Act and hereby do undertake in the capacity of

proprietor/partner/authorized representative of the firm/company to submit the

LABOR LICENSE Registration No. at the time of award of the job after the subject

prequalification.

The above statement is true and is submitted against NIT Ref.No.NFL/PT/Prod/PQ/CM(P)/

2018/ dated: _________ for prequalification for the job: _____________________________.

Signature of the Co./Firm

(Seal)

Dated: __________

Page 23: National Fertilizers Ltd., Panipat Production Department

Page 22 of 22

Annexure-XI

Sub: Prequalification

Ref.: NFL/PT/Prod/PQ/CM(P)/2018 Date: ____________

NO RELATION CERTIFICATE

It is certified that the applicant in any capacity and any employee of the applicant firm

do not have relationship with any of the employees working in NFL.

The above statement is true and is submitted against NIT Ref.No.NFL/PT/Prod/PQ/CM(P)/

2018 dated: _________ for prequalification for the job: _____________________________.

Signature of the Co./Firm

(Seal)

Dated: __________