rfp document super speciality assam

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REQUEST FOR PROPOSAL FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP UNDER PPP MODE RFP DOCUMENT RFP reference: NRHM/TRB/ Super Speciality/ 540/ 2011-12/32315 Dt. 02.03.12 Last Date of Submission of RFP: 24.03.2012 up to 2.00 P.M NOT TRANSFERABLE

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Page 1: RFP Document Super Speciality Assam

REQUEST FOR PROPOSAL FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT

AMINGAON, KAMRUP UNDER PPP MODE

RFP DOCUMENT

RFP reference: NRHM/TRB/ Super Speciality/ 540/ 2011-12/32315 Dt. 02.03.12

Last Date of Submission of RFP: 24.03.2012 up to 2.00 P.M

NOT TRANSFERABLE

Page 2: RFP Document Super Speciality Assam

RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

UNDER PPP MODE

Page 2

OFFICE OF THE MISSION DIRECTOR NATIONAL RURAL HEALTH MISSION, ASSAM

Saikia Commercial Complex, Srinagar Path, Christianbasti, G.S.Road. Guwahati-781005

RFP for Establishment of Super-Speciality Hospital at Amingaon,

Kamrup under PPP Mode

RFP reference: NRHM/TRB/ Super Speciality/ 540/ 2011-12/32315 Dt. 02.03.12

Date of commencement of sale of RFP document : 03.02.2012

Last date for sale of RFP document : 23.03.2012

Date of Pre-bid meeting : 13.03.2012

Closing date & time of receipt of RFP : 24.03.2012 at 2 PM

Time and date of opening of Technical Bid : 24.03.2012 at 3 PM

Place of opening of RFP. : Office of the Mission Director,

National Rural Health Mission, Saikia Commercial Complex, Srinagar Path, Christianbasti, G.S

Road, Guwahati-781005, Assam.

Address for Communication : Mission Director, National Rural Health Mission, Saikia Commercial

Complex, Srinagar Path,

Christianbasti, G.S Road, Guwahati-

781005, Assam.

Bid Document issued to M/s ……………………………………………………………. On dated ……………………..

against the receipt of Rs 1000.00 (Rupees One Thousand Only) in the form of Bank Draft/

Banker’s Cheque, No:…………………….………………...……… dated………….…………………………………………

Page 3: RFP Document Super Speciality Assam

RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

UNDER PPP MODE

Page 3

Table of Contents

1 Introduction............................................................................................................................................................. 5

2 Instruction to Bidders: ......................................................................................................................................... 8

2.1 General Instructions: ................................................................................................................................... 8

2.2 Eligibility Criteria: ........................................................................................................................................ 8

2.3 Departments and services to be provided: ........................................................................................... 8

2.4 Responsibilities of Bidder to set up and run the Super-speciality Hospital: ............................. 9

2.5 Contribution from Govt. of Assam ........................................................................................................ 10

2.6 Performance Security ............................................................................................................................... 10

2.7 Arbitration ................................................................................................................................................... 11

2.8 Laws Governing the Contract & Jurisdiction ..................................................................................... 11

2.9 Other Condition .......................................................................................................................................... 11

3 Technical Bid (cover A) ..................................................................................................................................... 12

3.1 ITEM 1: Letter for Submission of RFP ................................................................................................. 13

3.2 ITEM 2: General Information about the Bidder ............................................................................... 14

3.3 ITEM 3: Financial Capability .................................................................................................................. 16

3.4 ITEM 4: Overview of Technical Capability ......................................................................................... 17

3.5 ITEM 5: Brief description about current activities ......................................................................... 18

3.6 ITEM 6: List of Services to be provided .............................................................................................. 19

3.7 ITEM 7: Details of Manpower to be deployed .................................................................................. 20

3.8 ITEM 8: Detailed plan of operation process ...................................................................................... 21

3.9 ITEM 9: Details of Civil works to be executed .................................................................................. 22

3.10 ITEM 10: Details of Equipment to be installed ................................................................................. 23

3.11 ITEM 11: Others ......................................................................................................................................... 24

4 Price Bid (cover B) ............................................................................................................................................. 26

5 Opening of RFP .................................................................................................................................................... 28

6 Bid evaluation ...................................................................................................................................................... 29

7 ANNEXURE............................................................................................................................................................ 30

7.1 Annexure I: Description of the Existing Hospital Building ........................................................... 30

7.2 Annexure II: Specification of additional works for Up-gradation of the existing

infrastructure ........................................................................................................................................................... 33

7.3 Annexure III: List of Essential Equipments. ...................................................................................... 34

7.4 Annexure IV: List of Manpower to be deployed. .............................................................................. 38

7.5 Annexure V: Format for Power of Attorney for Signing of Application.................................... 40

Page 4: RFP Document Super Speciality Assam

RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

UNDER PPP MODE

Page 4

7.6 Annexure VI: Format for Power of Attorney for Lead Member of Consortium .................... 42

7.7 Annexure VII:Format forUndertaking on Fraud and Corruption ............................................... 44

7.8 Annexure VIII:Format forNon Conviction Certificate .................................................................... 45

7.9 Annexure IX: Format of Price Bid ......................................................................................................... 46

7.10 Annexure X: Form of Contract Agreement ........................................................................................ 47

7.11 Annexure XI: CGHS Circular……………………………………………………………………………………..…51

Page 5: RFP Document Super Speciality Assam

RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

UNDER PPP MODE

Page 5

1 Introduction

Sealed RFPs are invited by the Mission Director, National Rural Health from the intended bidders

to participate in a Two Bid (Part-I: Technical Bid & Part-II: Price Bid) System for setting up and

operationalising a Super-speciality Hospital in PPP mode in Kamrup District of the State.

A newly constructed building having five floors with approximately 9674.60 Sq. m of floor area is

proposed to be provided by the State Government for this purpose on a long term lease of 30 years

which may be extended on mutual agreement. The aforesaid building shall have space available to

accommodate 300 (Three hundred) beds in different wards and 6 (six) numbers of Operation

Theatres etc. The details of the space proposed in the said building along with other details of the

location etc. are available at Annexure I of RFP document.

The Super-speciality hospital shall provide facilities and services in all of the following

departments:-

I. Cardiology

II. Cardio-Thoracic Surgery

III. Neurosurgery

IV. Neurology

V. Dialysis Unit

All services shall have to be provided as appearing in the list of services mentioned in CGHS

circular S .11011/23/2009-CGHS D.II/Hospital Cell (Part – III) dated 17th August 2010 (Annexure

XI) for the above mentioned departments.

The existing available infrastructure shall have to be upgraded as per the minimum specification

detailed in the Annexure II of the RFP document. Further the Super-speciality hospital will have to

be equipped with at least all the equipments etc. as detailed in the Annexure III of the RFP

document. Also all the minimum man power requirement envisaged for the Super-speciality

hospital and annexed at Annexure IV will have to be deployed.

In this PPP arrangement, Govt. of Assam will provide a contribution of Rs 22.00 crores in three

installments during execution of the project besides the existing building. Existing Civil Works have

been valued at Rs. 29.92 crores and the Land Value is Rs. 1.89 crores. The selected bidder shall bear

the remaining expenses in setting up the facilities mentioned above and thereafter run the hospital

on a day to day basis.

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RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

UNDER PPP MODE

Page 6

However, 50% of all Beds (50% in different wards and 50% in ICU/ITU/ICCU etc.) shall have to be

charged at a concessional rate which shall be arrived at through bidding herein after referred to as

“Bidded Rate”. The Bidded rate shall be determined through bidding - “PartII “ –Price Bid of this

RFP process where the bid shall be quoted as the percentage (%) below the CGHS rate existing as

on 1ST November 2011. (For example if the bidder wishes to provide 50% of the beds at the rates

which are 5% below CGHS rates, he / she shall bid as 5% below)

The above mentioned 50% of Hospital Beds (applicable for all department / Specialities /

Investigations) will be provided at the Bidded rate to any person notified by the State Govt. who is

a permanent resident of Assam belonging to BPL category or who is a State Govt. employee, or is a

Freedom Fighter, or is above 70 years of age or is a retired State Govt. employee.

The above mentioned 50% hospital beds at the bidded rate shall have to be filled up first. Only

after filling of these beds the remaining beds at different rate would be allowed to be filled up.

While for the remaining 50% beds the bidder will be free to decide the rates / charges.

50% of all OPD and Diagnostic services should be provided at the bidded rate to any person

notified by the State Govt. who is a permanent resident of Assam belonging to BPL category or who

is a State Govt. employee, or is a Freedom Fighter, or is above 70 years of age or is a retired State

Govt. employee.

OPD and Major Diagnostic services shall have to start within three (3) months from the date of

signing of the agreement and all services shall have to start within one (1) year from the date of

signing of the agreement

Persons notified by the State Govt. for availability of facilities at the bidded rate would include any

person notified by the State Govt. who is a permanent resident of Assam belonging to BPL category

or who is a State Govt. employee, or is a Freedom Fighter, or is above 70 years of age or is a retired

State Govt. employee.

The qualifying criteria for bidders to participate in this RFP are as follows:-

• Minimum Annual Turnover of Rs. 50.00 crores for last three years.

• The bidder has at least one existing Super-speciality Hospital in the country having all the

Super-specialities mentioned in this RFP i.e Cardiology, Cardio-Thoracic Surgery,

Neurosurgery, Neurology, Dialysis Unit.

• The existing hospital should be in operation for at least 5 years i.e shall have been in

operation on or before 1/11/2006

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RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

UNDER PPP MODE

Page 7

Government of Assam reserves the right to accept or reject any RFP and cancel the bidding process

at any time without any liability and assigning any reason thereof. The proposals retained after the

scrutiny will be considered for the pre-bid meeting and for subsequent process of bidding.

The RFP document can be obtained from the Office of the Mission Director, National Rural Health

Mission, Saikia Commercial Complex, Srinagar Path, Christianbasti, G.S Road, Guwahati-781005,

Assam during working days from 03.03.2012. to 23.03.2012 (10.00 am to 5.00 pm.) The bidding

document may also be downloaded from the official website www.nrhmassam.in

The price for the RFP document is Rs. 1000.00 (Rupees one thousands only) which should be paid

in form of Bank draft as RFP cost (non refundable). RFP document downloaded from the website

should be accompanied by a Bank draft of Rs. 1000.00 (Rupees one thousands only) as RFP cost

(non refundable). The drafts should be drawn in favour of in favour of State Health Society, Assam

payable at Guwahati.

All bids must be accompanied by EARNEST MONEY DEPOSIT (EMD) of Rupees Two Lakhs (Rs 2

Lakhs) only in the form of Bank guarantee/Demand Draft/Bankers Cheque from any Indian

Nationalized Bank, in favour in favour of State Health Society, Assam payable at Guwahati. EMD

submitted in any other form or bids without EMD shall not be accepted.

The EMD of the successful bidder shall be retained till completion of the bidding process but shall

not carry any interest. If the successful bidder fails to execute the agreement and/ or fails to

deposit the performance security within the specified time, or withdraws his bid within the validity

period of the bid, the EMD shall be forfeited. The EMD of the unsuccessful bidders will be returned

within 30 days after the finalization of the bid.

All RFPs should be submitted to the following address:

Office of the Mission Director,

National Rural Health Mission,

Saikia Commercial Complex, Srinagar Path,

Christianbasti, G.S Road,

Interested bidder may submit the RFP within 2 PM of 24.03.2012

For any further information please contact: Mission Director, National Rural Health Mission,

Assam, and Guwahati at Telephone. (0361) 2340236

Page 8: RFP Document Super Speciality Assam

RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

UNDER PPP MODE

Page 8

2 Instruction to Bidders:

2.1 General Instruction:

a. All bidders are required to submit all information in typed/ printed material as per RFP

document.

b. Details of project(s)/experience should be provided strictly in the format provided in the

RFP document (item no 4) along with supporting documents/ evidence for size of the

project ,facilities/components, organization’s role (owner/developer/operator

etc),photographs, accreditations, certifications etc.

c. In case of consortium, letter(s) of association/ Memorandum of Understanding (MoU)

signed by all members, specifying the Lead Member should be submitted.

d. Details of Contact person with address/contact details should be provided) Certified copy

of audited annual accounts and annual reports for the last three financial years ended on

March 31, 2011, along with an Auditor’s Certificate specifying the Annual Turnover for

relevant financial years should be submitted.

e. No bidder, applying individually or as a member of a Consortium, can be member of

another Applicant/ Consortium for this RFP.

f. Each page of the RFP shall be signed by the duly authorized Signatory of the Applicant

(Lead Member in the case of Consortium) and shall be legally binding on all the members of

the Consortium

g. Power of Attorney to be provided by other members of a consortium, authorizing the Lead

Member to acts, deeds and things as may be necessary in connection with the Consortium’s

RFP Application for the Project.

2.2 Eligibility Criteria:

The bidder should fulfill all of the following criteria for participation in the bidding process:

• The bidder should have a minimum Annual Turnover of Rs. 50.00 Crores during the last

three financial years i.e. 2008-09, 2009-10, 2010-11.

• The bidder should have operational (as on 1/11/11) at least one Super-speciality hospital

in the country having all the Super-specialities required in this RFP i.e Cardiology, Cardio-

Thoracic Surgery, Neurosurgery, Neurology, Dialysis Unit.

• The existing hospital should be in operation for at least last 5 years i.e in operation on or

before 1/11/2006

2.3 Departments and services to be provided:

The Super-speciality hospital shall provide facilities and services in at least all of the

following departments:-

I. Cardiology

II. Cardio-Thoracic Surgery

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RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

UNDER PPP MODE

Page 9

III. Neurosurgery

IV. Neurology

V. Dialysis Unit

From each department / speciality at least all the services detailed in the CGHS circular

S.11011/ 23 /2009-CGHS D.II/Hospital Cell (Part-III) dated 17th August 2010 (Annexure XI)

shall have to be provided.

2.4 Successful Bidders will have to sign an agreement with Govt. of Assam

covering the following commitments and responsibilities to set up and

run the Super-speciality Hospital:

1. From the existing hospital building (Newly Constructed, Details at Annexure I) the

successful bidder has to establish a Super-speciality hospital with at least all the above

mentioned services / Specialities.

2. In the process of developing the Super-speciality hospital the successful bidder will have to

undertake required additional civil works. However all civil works as detailed and specified

in the Annexure II shall have to be completed.

3. While making the hospital in the Standard of Super-speciality, the hospital needs to be

equipped with different equipments as required. However all the equipments as mentioned

in the Annexure III shall have to be provided

4. The entire minimum man power requirement envisaged for the Super-speciality hospital

and annexed at Annexure IV will have to be deployed.

5. Not less than 50% of all Beds (50% in different wards and 50% in ICU/ITU/ICCU etc.) shall

have to be charged at the Bidded rate. The bidded rate shall be quoted as the percentage

(%) below the CGHS rate existing as on 31st October 2011. (For example if the bidder

wishes to provide 50% of the beds at the rates which are 5% below CGHS rates, he / she

shall bid as 5% below)

6. The above mentioned 50% of Hospital Beds (applicable for all department / Specialities /

Investigations) will be provided at the Bidded rate to any person notified by the State Govt.

who is a permanent resident of Assam belonging to BPL category or who is a State Govt.

employee, or is a Freedom Fighter, or is above 70 years of age or is a retired State Govt.

employee.

7. The above mentioned 50% hospital beds at the bidded rate shall have to be filled up first.

Only after filling of these beds the remaining beds at different rate would be allowed to be

filled up.

8. While for the remaining 50% beds, the bidder will be free to decide the rates / charges.

9. 50% of all OPD and Diagnostic services should be provided at the bidded rate to any person

notified by the State Govt. who is a permanent resident of Assam who is either belonging to

BPL category or who is a State Govt. employee or is a Freedom Fighter, or is above 70 years

of age or is a retired State Govt. employee.

10. OPD and Major Diagnostic services to be started within three (3) months of signing of the

agreement and all services to start within one (1) year of signing of the agreement.

11. Computerized records clearly revealing services provided to any person belonging to BPL

population of the State, State Govt. employees, Freedom Fighters, Citizens above 70 years of

age, Retired State Govt. employee etc should be maintained.

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RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

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Page 10

12. NABL/ISO Certificate to be obtained within 1 year of commence of services.

13. Prior Approval from Govt. of Assam should be taken before accessing funds from outside

agencies.

14. All Labour laws including minimum wages, ESI, Provident fund etc and all other laws of the

Govt. in force has to be followed.

15. No Govt. Doctors will be allowed to be engaged or provide services in the Super Speciality

Hospital except with prior approval of Govt. of Assam in exceptional circumstances.

Recruitment of any doctor who has earlier worked in Govt. will be allowed only after a gap

of 5 years from the date of leaving the service.

16. Govt. of Assam shall notify a Monitoring Committee which will monitor the execution of

commitments made by the successful bidder. The Monitoring Committee will be headed by

the senior most Commissioner & Secretary to the Govt. of Assam, Health & FW Dept. , MD

NRHM Assam, one reputed medical professional nominated by Govt. of Assam and other

member (s) as felt appropriate by Govt. of Assam. The Monitoring Committee will meet

once every 6 (six) months to ensure that all the conditions and commitments are being

adhered to.

17. Govt. of Assam shall have the right of resumption in case of non-adherence to any

commitments mentioned in the agreement or as reported by the monitoring committee

after following due process of law.

18. The 50 bedded District Hospital adjacent to the proposed Super Spciality Hospital will

continue to be functional and run by the Govt. of Assam.

2.5 Contribution from Govt. of Assam

• Govt. of Assam will provide the existing building1 and land2 as a lease for a period of 30

(Thirty) years.

• Govt. of Assam will provide a contribution of Rs 22.00 crores in three installments

during execution of the project besides the existing building. The first installments of Rs

5.00 crores will be paid at the time of signing of Agreement. The next installments of Rs

7.00 crores will be paid on operationalization of OPD Services and procurement and

installation of equipment worth Rs 25.00 crores at least. The last installment of Rs

10.00 crores will be paid after operationalization of all the services. The Govt. of

Assam’s contribution shall be used for Civil Works first and then for the purchase of

equipments.

2.6 Performance Security

The successful bidder has to submit a performance security of Rs 3.00 crores in form of

Bank Guarantee from any Indian Nationalized bank within 15 days of signing of the

agreement.

1Existing Civil Works have been valued Rs.29.92 crores

2 The Land Value is Rs. 1.89 crores

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RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

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2.7 Arbitration

Every dispute, difference, or question which may at any time arise between the parties

hereto or any person claiming under them, touching or arising out of or in respect of the contract agreement or the subject matter thereof shall be referred to the arbitration of a sole arbitrator nominated by the Chief Secretary to the Govt of Assam and agreed upon

between the parties. The person so selected for arbitration shall be of a rank not less than a Commissioner & Secretary to the Govt. of Assam. There shall be no objection if the

arbitrator happens to be an employee of Govt. of Assam. The award of the arbitrator shall

be final, conclusive and binding on all parties.

2.8 Laws Governing the Contract & Jurisdiction

The agreement shall be governed by the laws in force in India. In the event of any dispute

arising out of the RFP such dispute would be governed by the laws in force in India. In the

event of any dispute arising out of the RFP such dispute would be subject to the jurisdiction

of the Civil Court within the city of Guwahati only.

2.9 Other Condition

As some of the equipment will be purchased from Govt. of Assam share of project,

equipment worth Rs 8.4 crores (i.e Govt. of Assam contribution less amount spent in Civil

works) will be earmarked in the inventory as Govt. of Assam property. Similar earmarking

shall be done in case of equipment procured through additional Govt. of Assam

contribution as and when received. All such equipment and building shall remain with

Govt. of Assam in case of termination of Agreement.

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RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

UNDER PPP MODE

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3 Technical Bid (cover A)

The bidder shall furnish the following items which constitute the “Technical Bid” in a separate

cover, hereinafter called Cover ‘A’

The items are as follows:

Item No Description

1 Letter for Submission of RFP

2 General Information about the Bidder

3 Financial Capability

4 Overview of Technical Capability

5 Brief description about current activities

6 List of Services to be provided

7 Details of Manpower to be deployed

8 Detailed plan of operation

9 Details of Civil Works to be executed

10 Details of Equipment to be installed

11 Others

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RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY HOSPITAL AT AMINGAON, KAMRUP

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3.1 ITEM 1: Letter for Submission of RFP

To be submitted with RFP Application by Applicant (Lead Member in the case of Consortium/JV)

To

The Mission Director, National Rural Health Mission,

Saikia Commercial Complex, Srinagar Path,

Christianbasti, G.S Road,

Sub: Submission of RFP for establishment of Super-speciality Hospital at Amingaon, Kamrup

Rural under PPP Mode

Sir,

With reference to the above Notice Inviting RFP, we have examined and understood the

instructions, terms and conditions provided in the RFP document. We hereby enclose our

Technical Bid (COVER A) and Price Bid (Cover B) in the prescribed format as mentioned in RFP

document.

We confirm that we agree with the instructions, terms and conditions provided in the RFP

document. The undersigned declares that the statements made and the information provided in the

duly completed applications are complete, true, and correct in very detail.

We also understand that Department of Health, Govt. of Assam is not bound to accept the offer

either in part or in full. If the Department rejects the offer in full or in part, it may do so without

assigning any reasons thereof.

Yours faithfully,

Authorized Signatory (Lead Member in case of Consortium)

(Name & Designation, seal of the firm)

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3.2 ITEM 2: General Information about the Bidder

1. NAME AND LEGAL STATUS OF APPLICANT:

Name of Applicant:

(Lead Member in the case of Consortium)

Legal Status of Applicant:

(Natural Person/Company/Non-Profit Trust/ Society/Section 25 Company/ Any

Other Specify)

2. WHETHER APPLICANT IS SINGLE ENTITY / CONSORTIUM: Please Specify?

(In case of Consortium, letter(s) of association signed by all members, specifying the Lead Member)

3. CONTACT DETAILS OF APPLICANT (LEAD MEMBER IN CASE OF CONSORTIUM):

Name of the Authorized

Contact Person

Postal Address

Telephone Number(s)

Mobile No.

Fax No.

Email ID

Website address

4. NAME AND LEGAL STATUS OF OTHER MEMBERS (IN CASE OFCONSORTIUM)

(To be filled by each member of the Consortium)

Name of Other Member (in the case of Consortium)

Legal Status of Other Member (Natural Person/Company/Non-Profit Trust/Society/Section 25 Company/ Any

Other Specify)

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5. CONTACT DETAILS OF OTHER MEMBERS (IN CASE OF CONSORTIUM):

(To be filled by each member of the Consortium)

Name of the Authorized Contact Person

Postal Address

Telephone Number(s)

Mobile No.

Fax No.

Email ID

Website

6. ORGANIZATIONAL PROFILES:

(For each member of Consortium)

7. CERTIFIED COPY OF CERTIFICATION OF REGISTRATION/ INCORPORATION:

(For each member of Consortium)

8. BACKGROUND OF PROMOTERS:

(For each member of Consortium)

9. MANAGEMENT STRUCTURE:

(For each member of Consortium)

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3.3 ITEM 3: Financial Capability

Financial Capability of (of Applicant / Lead Member)

FINANCIAL CAPABILITY( FOR LAST 3 Years)

ANNUAL TURNOVER (IN RS.CRORE)

2008-09 2009-10 2010-11

Single Entity Applicant or the Lead Member of Consortium

PLEASE ENCLOSE Certified Copy of Audited Annual Accounts and Annual Reports for the last three

Financial Years ended on March 31, 2011, along with the Statutory Auditor’s statement certifying

the Annual Turnover of the applicant.

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3.4 ITEM 4: Overview of Technical Capability

Name

&Address/(s)of

Hospital(s)

Role of

Applicant / Member of Consortiu

m

Date of Start of Operation

Total Beds

Capacity as on 1st April 2011

Major

Facilities Available

Details of Specialists(Ful

ltime) Names & Qualification to be mentioned

Ancillary

Clinical & Laboratory

Services

Note:

• The Single Entity Applicant or any single member of the Consortium is required to qualify

the Technical Capability specified in the Notice Inviting RFP.

• Role of Applicant or Member of Consortium could be that of owner, or BOT Concessionaire,

or operator or any other capacity. Please specify.

• Submit Project(s)/Experience for providing details of each hospital along with supporting

documents/ evidence for size of the project, facilities/components, organization’s role

(owner/developer/operator etc), photographs, accreditations, certifications etc.

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3.5 ITEM 5: Brief description about current activities

PROVIDE A ONE PAGE DESCRIPTION ON CURRENT ACTIVITIES INCLUDING EXPERIENCE AND

CAPABILITIES IN MAJOR SUPER SPECIALITY SURGERY/PROCEDURES ETC.

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3.6 ITEM 6: List of Services to be provided

(Mention the list of services proposed to be provided from the hospital. All the services as per

CGHS Circular shall have to be provided)

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3.7 ITEM 7: Details of Manpower to be deployed

(At least all the manpower mentioned in Annexure IV shall have to be necessarily deployed. If

any additional manpower is essential for providing the services offered, the same shall have to be

provided even if it does not appear in Annexure IV)

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3.8 ITEM 8: Detailed plan of operation process

(A write-up to be provided about the detail plan of operation. Maximum two pages)

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3.9 ITEM 9: Details of Civil works to be executed

(At least all the civil works as mentioned in Annexure II will have to be necessarily completed)

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3.10 ITEM 10: Details of Equipments to be installed

(At least all the equipment mentioned in Annexure III shall have to be necessarily be provided. In

addition if any equipment is essential for providing the services offered, the same shall have to be

provided even if it does not appear in Annexure III)

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3.11 ITEM 11: Others

a. Authorization like Power of Attorney or Resolution of the Board for the officer of the

company who have signed the RFP document and the bid.

b. An undertaking on fraud and corruption as per Annexure VII.

c. GRN/TIN and PAN

d. NABH / NABL / ISO and other quality certificate issued from competent authority (Copy to

be enclosed).

e. Non Conviction Certificate as per Annexure VIII.

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All the above documents mentioned under Para 4 i.e. ‘Cover A’, to be submitted in a sealed

envelope superscripted as “RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY

HOSPITAL AT AMINGAON, KAMRUP UNDER PPP MODE -- COVER A” and name and

address of the bidder.

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4 Price Bid (cover B)

Bid shall be type – written and correction, if any, in the bid shall invariably be attested with full

signature by the bidder with date, failing which the bid shall be considered ineligible for

evaluation. Corrections done with correction fluid shall also be duly attested as per Annexure

IX.

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The Cover ‘A’ and Cover ‘B’ shall be separately sealed and both these covers shall be put in

another sealed cover superscripted as “RFP FOR ESTABLISHMENT OF SUPER-SPECIALITY

HOSPITAL AT AMINGAON, KAMRUP RURAL UNDER PPP MODE” and name and address of the

bidder & addressed to Office of the Mission Director, National Rural Health Mission, Saikia

Commercial Complex, Srinagar Path, Christianbasti, G.S Road, Guwahati-781005, Assam

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5 Opening of RFP

• Cover ‘A’ i.e. Technical Bids shall be opened at the office of the RFP inviting agency, on the

date and time specified in presence of the intending bidders or their authorized

representatives

• Cover ‘B’ i.e. the Price Bids of the bidders who meet the eligibility criteria, evaluated based

on the details furnished in Cover ‘A’ shall only be opened and the date and time of opening

of Cover ‘B’ shall be intimated to the eligible/ shortlisted bidders

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6 Bid evaluation

Bids of all the eligible and technically qualified bidders will be evaluated with reference to

the rate quoted as the percentage (%) below the CGHS rate existing as on 1stNovember

2011.

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7 ANNEXURE

7.1 Annexure I: Description of the Existing Hospital Building

District Profile:

Kamrup district is situated between 25.460 & 26.490 north latitude and between 90.480 &

91.50east longitude. The greater parts of the district consist of wide plains, while the mighty

Brahmaputra River takes a steady course from the east to west through the lower portion of

the district.

The Kamrup district is bounded by:

North - Udalguri and Baska district

South - Meghalaya

East - Darrang district and Kamrup Metropolitan district

West - Goalpara district and Nalbari district.

Since 2005, the district of Kamrup was sub-divided into Kamrup (Metropolitan) and Kamrup

(Rural), the former comprising of the Metropolitan city of Guwahati and the latter the rest of

the district. The district headquarter is located at Amingaon, on the northern bank of the river

Brahmaputra.

The nearest railway station is the Guwahati Railway Station and the distance from district

headquarter is 17 kms.

The nearest airport is the Lokapriya Gopinath Bordoloi International Airport and the distance

from the district headquarter is 12 kms.

Location of the Hospital:

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The Hospital, is Situated on the National Highway 31 opposite of the newly constructed Assam

Dental College, Amingaon. Distance of some of the nearest Landmarks is Saraighat

Brahmaputra Bridge- 5km, IIT, Guwahati- 2km, Rajiv Gandhi Indoor Stadium, Amingaon- 3 Km,

and Police out Post, Gouripur- 4km, CIPET Institution of Plastic Engineering, Changsari- 9

km,etc.

MAIN HOSPITAL BUILDING (TOTAL 383 BEDDED)

A) TOTAL FLOOR AREA = 9674.60 SQM(104098.70 SQFT)

1. GROUND FLOOR (10 BEDS) PROVISIONS

PLINTH AREA =1537.00 SQM EMERGENCY WARD = 10 BEDS

RAMP AREA = 66.70 SQM X-RAY ROOM WITH DARK ROOM

PORCH AREA = 51.60 SQM ULTRASOUND ROOM, MAMOGRAPHY ROOM

ENT. RAMP = 23.50 SQM MRI ROOM, BLOOD BANK

TOTAL AREA =1678.80 SQM CT SCAN, RECEPTION, SECURITY, OFFICE AREA

10 OPD ROOMS, RADIOLOGIST ROOM, PUBLIC TOILETS

EMERGENCY AREA, MINOR OT, AMBULATORY CARE

EXAMINATION, DOCTOR’S DUTY ROOM

OFFICE AREA, CENTRAL MANIFOLD FOR GASES

2. FIRST FLOOR (117 BEDS) PROVISIONS

FLOOR AREA = 1572.00 SQM SURGERY GENERAL WARD MALE & FEMALE

RAMP AREA = 72.60 SQM ISOLATION WARD, PADAETRIC WARD

TOTAL AREA = 1644.60SQM POST PERTUM WARD

3. SECOND FLOOR (108BEDS) PROVISIONS

FLOOR AREA = 1572.00 SQM GENERAL MEDICINE MALE & FEMALE WARD

RAMP AREA = 72.60 SQM POST OPERATIVE SURGERY MALE & FEMALE

TOTAL AREA = 1644.60SQM BURN UNIT, OPHTHALMOLOGY WARD

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4. THIRD FLOOR (70 BEDS) PROVISIONS

FLOOR AREA = 1596.40 SQM GENERAL MEDICINE MALE & FEMALE WARD

RAMP AREA = 72.60 SQM OPHTHALMOLOGY MALE & FEMALE

TOTAL AREA = 1669.00SQM POST OPERATIVE, CARDIAC CARE

3 NOS OF OPERATION THEATRES WITH ANCILLIRAY

FACALITIES

5. FOURTH FLOOR (37 BEDS) PROVISIONS

FLOOR AREA = 1545.00 SQM SINGLE BED CABINS, DAILYSIS WARD

RAMP AREA = 72.60 SQM PRE OPERATIVE, POST OPERATIVE

TOTAL AREA = 1617.60SQM 3 NOS OF OPERATION THEATRES WITH ANCILLIRAY

FACALITIES

6. FIFTH FLOOR (41BEDS) PROVISIONS

FLOOR AREA = 1420 SQM SINGLE BED CABIN, SEMI PRIVATE CABIN

THORACIC MEDICINE MALE & FEMALE WARD

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7.2 Annexure II: Specification of additional works for Up-gradation of

the existing infrastructure

1) Dismantling work, partition wall, False ceiling, flooring

2) New Service Block (G+2 RCC Building) for CSSD, Main Panel room, Server room, Chiller

room and cooling towers etc.

3) Under ground water tank & Fire tanks

4) ASEB payment for 33 KV line & Load security etc.

5) Fire Hydrant sprinkler system, water supply RO treatment plant, Cooling tower & HVAC

etc

6) Administrative furniture

7) Medical gas pipe line, Medical air compressor, vacuum compressor, riser pipe, vacuum

medical air etc.

8) Electrical paneling, installation for DG set, Cath lab, MRI, CT Scan etc. including lifts.

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7.3 Annexure III: List of Essential/ Major Equipments.

MEDICAL EQUIPMENTS, BEDS, FURNITURES & IT CAPITAL COST FOR 300 BEDDED GUWAHATI HOSPITAL

Description

Total Qty

Floor Price

Unit Cost Total Cost

Operating

Theatres(6)

Operating Table - specialty 6 3,000,000 45,000,000

Ceiling Mounted lights[shadow less] 6 7,500,000 45,000,000

Anesthesia Machine 6 1,500,000 9,000,000

Defibrillators - OT 6 216,000 1,296,000

Monitors - Invasive + Slave 3 900,000 2,700,000

Monitors Invasive 3 698,200 2,094,600

Cautery machine High 6 693,885 4,163,310

Flash Sterilizer (for instruments) 2 400,000 800,000

Suction Machines 6 10,100 60,600

Laparoscopes 1 3,185,296 3,185,296

Heart Lung Machine 2 4,950,000 9,900,000

Microscope neuro 1 1,200,000 1,200,000

Midas Rex Craniotomy 1 743,800 743,800

Neuro Head Frame 2 700,000 1,400,000

Operating instruments Cardiac 2 2,000,000 4,000,000

Pacemakers - Single 2 60,000 120,000

Pacemakers - Dual 2 150,000 300,000

Operating instruments Neuro 2 2,500,000 5,000,000

Cardiac ITU (14

bedded)

Ventilators 14 2,000,000 28,000,000

IABP 1 1,400,000 1,400,000

ECG Machines 2 250,000 500,000

Monitors Invasive 14 698,200 9,774,800

Syringe Pumps 50 104,000 5,200,000

Infusion Pumps 5 170,000 850,000

Beds 14 20,473 286,622

Defibrillators 2 216,000 432,000

Slow dialysis machine 1 1,400,000 1,400,000

Medical ICU

(10bedded)

Ventilators 8 2,000,000 16,000,000

BIPAP 4 350,000 1,400,000

ECG Machines 1 250,000 250,000

Monitors Invasive 4 698,200 2,792,800

Monitors Non Invasive 2 173,800 347,600

Syringe Pumps 35 104,000 3,640,000

Infusion Pumps 2 170,000 340,000

Beds 10 20,473 204,730

Defibrillators 2 216,000 432,000

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MEDICAL EQUIPMENTS, BEDS, FURNITURES & IT CAPITAL COST FOR 300 BEDDED GUWAHATI HOSPITAL

Description

Total

Qty

Floor Price

Unit Cost Total Cost

Surgical ICU

(14 bedded)

Monitors Invasive 3 698,200 2,094,600

Monitors Non Invasive 11 173,800 1,911,800

Ventilators 6 2,000,000 12,000,000

ECG Machines 1 250,000 250,000

Beds 14 20,473 286,622

Syringe Pumps 20 104,000 2,080,000

Defibrillators 1 216,000 216,000

NICU (10bedded)

Ventilators High Frequency 2 1,600,000 3,200,000

Ventilators High Neonatal 2 1,256,700 2,513,400

ECG Machines 1 250,000 250,000

Monitors Invasive 2 698,200 1,396,400

Monitors Non Invasive 4 173,800 695,200

Syringe Pumps 10 104,000 1,040,000

Beds 10 20,473 204,730

Incubators 5 95,000 475,000

Open Care warmers 2 34,500 69,000

CCU (27

bedded)

Ventilators 8 2,000,000 16,000,000

IABP 1 1,400,000 2,800,000

ECG Machines 2 250,000 500,000

Monitors Invasive 10 698,200 6,982,000

Monitors Non Invasive 17 173,000 2,941,000

Beds 27 20,473 552,771

Syringe Pumps 50 104,000 5,200,000

Infusion Pumps 4 170,000 8,500,000

Defibrillators 2 216,000 432,000

ER (10

bedded)

Ventilators 2 977,812 1,955,624

Ventilators - Mobile 2 450,000 900,000

ECG Machines 2 250,000 500,000

Monitors Invasive 2 698,200 1,396,400

Monitors Non Invasive 9 173,800 1,390,400

Beds 10 20,473 204,730

Syringe Pumps 20 104,000 2,080,000

Defibrillators 2 216,000 432,000

Diagnostic Equipments

ECG Machines 2 250,000 500,000

TMT 2 560,000 1,120,000

Defibrillators - Diagnostic 2 216,000 432,000

Echo & Color Doppler with tissue tracking

1 3,500,000 3,500,000

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MEDICAL EQUIPMENTS, BEDS, FURNITURES & IT CAPITAL COST FOR 300 BEDDED GUWAHATI HOSPITAL

Description

Total

Qty

Floor Price

Unit Cost Total Cost

Echo & Color Doppler with TEEE 2 4,000,000 8,000,000

Portable Echo 1 552,000 552,000

Holter 1 500,000 500,000

USG 2 1,895,000 3,790,000

Endoscopic Equipments

Endoscopic Equipments 1 3,000,000 3,000,000

Radiology

CT 1 20,000,000 20,000,000

500 mA X Ray 1 1,200,000 1,200,000

Portable X Ray 100 mA 2 112,500 225,000

C-Arm 2 1,225,000 2,450,000

CR System 1 1,600,000 1,600,000

Radiology accessories 1 200,000 200,000

MRI machine 1 40,000,000 40,000,000

X-ray View Box 2 20,000 40,000

Mammography 1 1,398,000 1,398,000

Laboratory & Blood

bank with

component separation

All major Equipments 1

5,000,000 5,000,000

Neurology and

neurosurge

ry

Video EEG with Sleep Lab 1

2,700,000

2,700,000

Physiother

apy Physiotherapy equipment 1

125,000 125,000

CSSD

800 Liter Steam Sterilizer 1 500,000 500,000

400 Liter Steam Sterilizer 1 350,000 350,000

ETO 1 8,500,000 8,500,000

Washer Disinfector 1 2,000,000 2,000,000

Ultrasonic Cleaner (60 Ltr) 2 600,000 1,200,000

Roller Sealing M/c 1 100,000 100,000

Drier Cabinet 1 76,000 76,000

CSSD Work Table SS 1 50,000 50,000

Storage Racks (SS)& Miscellaneous 1 50,000 50,000

Cath-Lab Cath Lab 1 30,000,000 30,000,000

Pacemakers - Single 3 255,000 180,000

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MEDICAL EQUIPMENTS, BEDS, FURNITURES & IT CAPITAL COST FOR 300 BEDDED GUWAHATI HOSPITAL

Description

Total

Qty

Floor Price

Unit Cost Total Cost

Pacemakers - Dual 2 300,000 300,000

Defibrillators - Cath 1 200,000 216,000

EP System Diagnostic 1 4,500,000 4,000,000

Misc 1 1,000,000 1000000

EP ablator 1 800,000 800,000

Dialysis Unit

Dialysis Stations 10 900,000 9,000,000

Monitors 4 250,000 1,000,000

Dialysis Chairs 10 300,000 3,000,000

Reprocessing Machine 1 700,000 700,000

RO plant and Related equipments 1 2,000,000 2,000,000

Ambulance All major Equipments 1 2,000,000 2,000,000

Others

Laundry 1 2,000,000 2,000,000

Mortuary 1 4,000,000 4,000,000

Telemedicine 1 400,000 400,000

IT Hardware and software 5,200,000 5,200,000

Kitchen 1 2,000,000 2,000,000

Ward Beds 5,676,400 5,676,400

Fast tracks screens for critical beds 300 7,000 2,282,000

Ward furniture 2,000,000 2,000,000

GRAND TOTAL 47,55,76,235

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7.4 Annexure IV: List of Manpower to be deployed.

Sl No. Manpower Minimum Standards Total No.

1. Nurses 580 (75 / shift for ITUs/CCUs/ICUs, 43 /shift for ward beds, 5 /shift for Dialysis, 3 /shift for cathlab,36 / shift for Operation Theatre, 20 % additional nurses)

2. Sister-in-charge 20

3. Sr. Cardiac Surgeon MCH/DNB specialization in Cardiac Surgery/ Equivalent Degree, 5 – 7 years of work

experience after degree

1

4. Jr. Cardiac Surgeon MCH/DNB specialization in

Cardiac Surgery/ Equivalent Degree

2

5. Sr. Cardiologist DM/DNB specialization in

Cardiology / Equivalent Degree, 5 – 7 years of work experience after degree

2

6. Jr. Cardiologist DM/DNB specialization in

Cardiology / Equivalent Degree

4

7. Sr. Nephrologists DM/DNB specialization in

Nephrology / Equivalent

Degree, 5 – 7 years of work experience after degree

1

8. Jr. Nephrologists DM/DNB specialization in

Nephrology / Equivalent

Degree

2

9. Sr. Neurosurgeon MCH/DNB specialization in Neurosurgery/ Equivalent

Degree, 5 – 7 years of work

experience after degree

1

10. Jr. Neurosurgeon MCH/DNB specialization in Neurosurgery/ Equivalent

Degree

2

11. Sr. Neurologist DM/DNB specialization in Neurology / Equivalent Degree, 5 – 7 years of work

experience after degree

1

12. Jr. Neurologist DM/DNB specialization in

Neurology / Equivalent Degree

2

13. Sr. Urologist DM/DNB specialization in Urology / Equivalent Degree, 5 – 7 years of work experience

after degree

2

14. Jr. Urologist DM/DNB specialization in 2

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Urology / Equivalent Degree

15. Anesthetist DM in Anaesthesia / Fellowship with specialization

(cardiac surgery ) / Equivalent

Degree, 5 – 7 years of work

experience after degree

8

16. Intensivist DM in Critical Care /

Fellowship in Critical Care /

Equivalent Degree, 5 – 7 years

of work experience after degree

2

17. Other doctors (Resident and

Junior)

Minimum MBBS Degree 60

18. Paramedic 70

19. Admin/ General Staff/ Temporary Staff

170

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7.5 Annexure V: Format for Power of Attorney for Signing of Application

Know all men by these presents, we…………………………………………….. (name of the firm and address

of the registered office) do hereby irrevocably constitute, nominate, appoint and authorize Mr. /

Ms. (Name), ……………………………. who is presently employed with us, The Single Entity Applicant /

the Lead Member of our Consortium and holding the position of ……………………………. , as our true

and lawful attorney (hereinafter referred to as the “Attorney”) to do in our name and on our behalf,

all such acts, deeds and things as are necessary or required in connection with or incidental to

submission of our REQUEST FOR PROPOSAL (RFP) for the Development of Super Specialty

Hospital project proposed or being developed by the Department of Health, Government of Assam

(GoA) (the “Authority”) including but not limited to signing and submission of all applications, bids

and other documents and writings, participate in Pre-Applications and other conferences and

providing information/ responses to the Authority, representing us in all matters before the

Authority, signing and execution of all contracts including the Concession Agreement and

undertakings consequent to acceptance of our bid, and generally dealing with the Authority in all

matters in connection with or relating to or arising out of our bid for the said Project and/ or upon

award thereof to us and/or till the entering into of the Concession Agreement with the Authority.

AND we hereby agree to ratify and confirm and do hereby ratify and confirm all acts, deeds and

things done or caused to be done by our said Attorney pursuant to and in exercise of the powers

conferred by this Power of Attorney and that all acts, deeds and things done by our said Attorney in

exercise of the powers hereby conferred shall and shall always be deemed to have been done by us.

IN WITNESS WHEREOF WE, …………………, THE ABOVE NAMED PRINCIPAL HAVE EXECUTED THIS

POWER OF ATTORNEY ON THIS ……… DAY OF ………., 20.......

For …………………………..

(Signature, name, designation and address)

Witnesses:

1.

2. (Notarized)

Accepted

……………………………

(Signature) (Name, Title and Address of the Attorney)

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Notes:

• To be executed by the Single Applicant or the Lead Member in case of a Consortium as the case

may be.

• The mode of execution of the Power of Attorney should be in accordance with the procedure, if

any, laid down by the applicable law and the charter documents of the executants (s) and

when it is so required, the same should be under common seal affixed in accordance with the

required procedure.

• Wherever required, the Applicant should submit for verification the extract of the charter

documents and documents such as a board or shareholders’ resolution/power of attorney in

favour of the person executing this Power of Attorney for the delegation of power hereunder

on behalf of the Applicant.

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7.6 Annexure VI: Format for Power of Attorney for Lead Member of

Consortium

Whereas the Mission Director, NRHM, Assam (“the Authority”)has invited applications from

interested parties for the Development of Super Speciality Hospital (the Project”).

Whereas ……………………….. (Name of lead member) ……………………………. and ……………………………

(Name of first and second member)…… (collectively the “Consortium”) being Members of the

Consortium are interested in bidding for the Project in accordance with the terms and conditions of

the REQUEST FOR PROPOSAL document (RFP) Whereas, it is necessary for the Members of the

Consortium to designate one of them as the Lead Member with all necessary power and authority

to do for and on behalf of the Consortium, all acts, deeds and things as may be necessary in

connection with the Consortium’s bid for the Project and its execution.

NOW, THEREFORE, KNOW ALL MEN BY THESE PRESENTS

We, M/s …….. (Name of first member) ……….. having our registered office at…………………….., and

M/s. ………(Name of second member) …………….. having our registered office at ……………………..,

(hereinafter collectively referred to as the “Principals”) do hereby irrevocably designate, nominate,

constitute, appoint and authorize M/s. …… (Name of lead member) ……………….. having its

registered office at…………………….., being one of the Members of the Consortium, as the Lead

Member and true and lawful attorney of the Consortium (hereinafter referred to as the “Attorney”).

We hereby irrevocably authorize the Attorney (with power to sub-delegate) to conduct all business

for and on behalf of the Consortium and any one of us during the bidding process and, in the event

the Consortium is awarded the concession/contract, during the execution of the Project and in this

regard, to do on our behalf and on behalf of the Consortium, all or any of such acts, deeds or things

as are necessary or required or incidental to the pre-qualification of the Consortium and

submission of its RFP Application for the Project, including but not limited to signing and

submission of all applications, and other documents and writings, participate in bidders and other

conferences, respond to queries, submit information/ documents, sign and execute contracts and

undertakings consequent to acceptance of the bid of the Consortium and generally to represent the

Consortium in all its dealings with the Authority, and/ or any other Government Agency or any

person, in all matters in connection with or relating to or arising out of the Consortium’s bid for the

Project and/ or upon award thereof till the Concession Agreement is entered into with the

Authority.

AND hereby agree to ratify and confirm and do hereby ratify and confirm all acts, deeds and things

done or caused to be done by our said Attorney pursuant to and in exercise REQUEST FOR

PROPOSAL Development of Super-speciality Hospital at Kamrup District, Assam on PPP Basis

NOTE: No claims related to technical and financial capability etc. shall be solicited without

sufficient documentary proof of the powers conferred by this Power of Attorney and that all acts,

deeds and things done by our said Attorney in exercise of the powers hereby conferred shall and

shall always be deemed to have been done by us/ Consortium.

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IN WITNESS WHEREOF WE THE PRINCIPALS ABOVE NAMED HAVE EXECUTED

THIS POWER OF ATTORNEY ON THIS …………………. DAY OF ………., 20.....…

For ……………………..

(Signature)

……………………..

(Name & Title)

For ……………………..

(Signature)

……………………..

(Name & Title)

Witnesses:

1.

2.

………………………………………

(Executants)

(To be executed by all the Members of the Consortium)

Notes:

• The mode of execution of the Power of Attorney should be in accordance with the procedure, if

any, laid down by the applicable law and the charter documents of the executants (s) and

when it is so required, the same should be under common seal affixed in accordance with the

required procedure.

• Also, wherever required, the Applicant should submit for verification the extract of the charter

documents and documents such as a board or shareholders’ resolution/power of attorney in

favour of the person executing this Power of Attorney for the delegation of power hereunder

on behalf of the Applicant.

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7.7 Annexure VII: Format for Undertaking on fraud and corruption.

We M/s ……………………………………………………….….…………….do hereby undertake that, in competing for

(and, if the award is made to us, in executing) the subject contract for establishment of Super-

speciality Hospital at Amingaon, Kamrup Rural under PPP Mode under RFP reference no.

…….…………………………………..dt …………………. We shall strictly observe the laws against fraud and

corruption in force in the country.

Yours faithfully,

Authorized Signatory (Lead Member in case of Consortium)

(Name & Designation, seal of the firm)

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7.8 Annexure VIII: Format for Non Conviction Certificate.

We M/s ………………………………………………………………………………………………having registered office

at………………………………………………. hereby declare that there is no vigilance/CBI or court case

pending/contemplated against us at the moment.

Yours faithfully,

Authorized Signatory (Lead Member in case of Consortium)

(Name & Designation, seal of the firm)

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7.9 Annexure IX: Format of Price Bid.

PART – II: PRICED BID

Note: Bidders are required to quote percentage (above/below/at par) on the Schedule of Rates (on

overall basis, as per CGHS Circular). The percentage quoted should be in figures as well as in words.

Name of Work: Establishment of Super Speciality Hospital at Amingoan, Kamrup under PPP

Mode

RFP Reference. NRHM/TRB/ Super Speciality/ 540/ 2011-12

Our quoted rates for services are …………………………….% (In words …… ….... ……

… ……………………. ……. Point …………................... Percent) ………………….. (high /

low / at par)* with respect to the CGHS Schedule of Rates for NABH

Accredited Hosp. applicable as 1.11.2011

(Please note that up to two positions after the decimal point shall be considered

for evaluation)

Service tax and E Cess has not been considered by us.

* Please tick (√) the appropriate condition.

Yours faithfully,

Authorized Signatory (Lead Member in case of Consortium)

(Name & Designation, seal of the firm)

N.B.: To be submitted in a separate sealed envelope (PRICED BID).

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7.10 Annexure X: Form of Contract Agreement

AGREEMENT

This agreement is made on this ……………. Of ……… 2011 between Mission Director, NRHM, Assam

on behalf of Govt of Assam and having its office at Hengrabari, Guwahati, Assam hereinafter

referred to as “First Party” and M/s…………………………………, having his office at

………………………………………………………………………. (which terms included their authorized

representatives, successors, assignees, executers and administrators) hereinafter referred to as

“Second Party”.

The parties hereby agree on the following deliverables:

1. The First Party will provide the existing building (Existing Civil Works have been valued

Rs.29.92 crores) and land (The Land Value is Rs. 1.89 crores) as a lease for a period of 30

(Thirty) years.

2. The responsibility of the Second Party shall be to establish a Super-speciality hospital with

at least the mentioned services / Specialities as appeared in the RFP from the existing

hospital building (Newly Constructed, Details at Annexure I). The Second Party shall bear

the remaining expenses in setting up the facilities mentioned and thereafter run the

hospital on a day to day basis.

3. In the process of developing the Super-speciality hospital the Second Party will have to

undertake required additional civil works. However all civil works as detailed and specified

in the Annexure II shall have to be completed.

4. Also all the minimum man power requirement envisaged for the Super-speciality hospital

and annexed at Annexure IV will have to be deployed by the Second Party.

5. While making the hospital in the Standard of Super-speciality, the hospital needs to be

equipped with different equipments as required. However all the equipments as mentioned

in the Annexure III shall have to be provided by the Second Party.

6. Not less than 50% of all Beds (50% in different wards and 50% in ICU/ITU/ICCU etc.) shall

have to be charged at the Bidded rate by the Second Party.

7. The above mentioned 50% of Hospital Beds (applicable for all department / Specialities /

Investigation) will be provided at the Bidded rate by the Second Party to any person

notified by the State Govt. who is a permanent resident of Assam who is either belonging to

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BPL category or who is a State Govt. employee or is a Freedom Fighter, or is above 70 years

of age or is a retired State Govt. employee.

8. The above mentioned 50% hospital beds at the bidded rate shall have to be filled up first.

Only after filling of these beds the remaining beds at different rate would be allowed to be

filled up.

9. While for the remaining 50% beds, the Second party will be free to decide the rates /

charges.

10. 50% of all OPD and Diagnostic services should be provided at the bidded rate to any person

notified by the State Govt. who is a permanent resident of Assam who is either belonging to

BPL category or who is a State Govt. employee or is a Freedom Fighter, or is above 70 years

of age or is a retired State Govt. employee by the Second Party

11. OPD and Major Diagnostic services to be started within three (3) months of signing of this

agreement and all services to start within one (1) year.

12. Computerized records clearly revealing services provided to any person belonging to BPL

population of the State, State Govt. employees, Freedom Fighters, Citizens above 70 years of

age, Retired State Govt. employee etc should be maintained by the Second Part.

13. NABL/ISO Certificate to be obtained within 1 year of commence of services by the Second

Party.

14. Prior Approval from the First party should be taken before accessing funds from outside

agencies by the Second Party.

15. All Labour laws including minimum wages, ESI, Provident fund etc and all other laws of the

Govt. in force has to be followed by the Second party.

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16. No Govt. Doctors will be allowed to be engaged or provide services in the Super Speciality

Hospital except with prior approval of the First party in exceptional circumstances.

Recruitment of any doctor who has earlier worked in Govt. will be allowed only after a gap

of 5 years from the date of leaving the service.]

17. The First Party shall notify a Monitoring Committee which will monitor the execution of

commitments made by the Second Party. The Monitoring Committee will be headed by the

senior most Commissioner & Secretary to the Govt. of Assam, Health & FW Dept. , MD

NRHM Assam, one reputed medical professional nominated by Govt. of Assam and other

member (s) as felt appropriate by Govt. of Assam

18. The First Party shall have the right of resumption in case of non-adherence to any

commitments mentioned in this agreement or as reported by the monitoring committee

after following due process of law.

19. The 50 bedded District Hospital adjacent to the proposed Super Spciality Hospital will

continue to be functional and run by the Govt. of Assam

20. The First Party will provide a contribution of Rs 22.00 crores in three installments over a

period of one year during execution of the project besides the existing building. The

utilization of funds should be provided by the Second Party. The first installments of Rs

5.00 crores will be paid at the time of signing of Agreement. The next installments of Rs

7.00 crores will be paid on operationalization of OPD Services and procurement and

installation of equipment worth Rs 25.00 crores at least. The last installments of Rs 10.00

crores will be paid after operationalization of all the services.`

21. As some of the equipment will be purchased from Govt. of Assam share of project,

equipment worth Rs 8.4 crores (i.e Govt. of Assam contribution less amount spent in Civil

works) will be earmarked in the inventory as Govt. of Assam property. Similar earmarking

shall be done in case of equipment procured through additional Govt. of Assam

contribution as and when received. All such equipment and building shall remain with

Govt. of Assam in case of termination of Agreement.

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22. The Second Party has to submit a performance security of Rs 3.00 crores in form of Bank

Guarantee from Nationalized bank within 15 days of signing of the agreement

Arbitration

Every dispute, difference, or question which may at any time arise between the parties hereto or any person claiming under them, touching or arising out of or in respect of the

contract agreement or the subject matter thereof shall be referred to the arbitration of a

sole arbitrator nominated by the Chief Secretary to the Govt of Assam and agreed upon

between the parties. The person so selected for arbitration shall be of a rank not less than a Commissioner & Secretary to the Govt. of Assam. There shall be no objection if the arbitrator happens to be an employee of Govt. of Assam. The award of the arbitrator shall

be final, conclusive and binding on all parties.

JURISDICTION:

This Agreement shall be construed and interpreted in accordance with Indian law and the

Parties agree to the exclusive jurisdiction of the Guwahati High Court, Assam.

First Party Second Party

SIGNED by……………………………..

Designation……………………………..

Date:

SIGNED by……………………………..

Designation……………………………..

Date:

Witnesses:

1. ……………………………………

……………………………………

……………………………………

2. ……………………………………

……………………………………

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