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1 National Highways Authority of India (Ministry of Road, Transport & Highways) Plot No. G-5 & 6, Sector 10, Dwarka New Delhi 110 075 Tender for providing Primary Healthcare Facilities to employees of NHAI at NHAI, HQ, Dwarka, New Delhi (Technical Bid) Volume-I DGM (HR & Admn)-IV National Highways Authority of India Plot No.: 5&6, Sector-10, Dwarka New-Delhi-110075.

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Page 1: Tender for providing Primary Healthcare Facilities to ... NHai.pdf · New Delhi – 110 075 Tender for providing Primary Healthcare Facilities to employees of NHAI at NHAI, HQ, Dwarka,

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National Highways Authority of India

(Ministry of Road, Transport & Highways)

Plot No. G-5 & 6, Sector – 10, Dwarka

New Delhi – 110 075

Tender for providing Primary Healthcare Facilities to employees of NHAI

at NHAI, HQ, Dwarka, New Delhi

(Technical Bid)

Volume-I

DGM (HR & Admn)-IV

National Highways Authority of India

Plot No.: 5&6, Sector-10, Dwarka

New-Delhi-110075.

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CONTENTS

Volume - I

TITLE PAGE NO

SECTION I NOTICE INVITING TENDER (E-Tendering Mode Only) - 3-6

SECTION II PROCEDURE FOR E TENDERING - 7-10

SECTION III INSTRUCTIONS TO BIDDERS - 11-14

SECTION IV TERMS OF REFERENCE - 15-23

SECTION V ANNEXURE, FORM OF APPLICATION, LOA & AGREEMENT- 24-35

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(SECTION-I)

NOTICE INVITING TENDER

(E-TENDERING MODE ONLY)

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SECTION-I

Notice Inviting Tender

(National Competitive Bidding through e-Tendering mode only)

The National Highways Authority of India (NHAI) invites bids from reputed healthcare service

providers (having back up hospitals in Delhi) to provide primary healthcare facilities to

employees at NHAI HQ, G-5&6, Sector-10, Dwarka, New Delhi.

Sl.

No.

Name of Work

Estimated

cost for Two

Year

Earnest

money

1. To provide primary healthcare facilities to

employees at NHAI HQ, G-5&6, Sector-10,

Dwarka, New Delhi

24,00,000/-

48,000/-

Bid Security / EMD : Rs. 48,000/-

Cost of Bid Documents (Non-Refundable) : Rs. 1,000/-

E-Tender Processing fee (Non-Refundable) : NIL

The preliminary requirements (detailed requirements are given in the Bid Document) of

bidding firm / contractor for above packages are mentioned as under:-

EMD / Bid

Security (Rs.)

Average Annual

Turnover during last 3

years (Rs.)

Work of similar nature

during last 7 years (Rs.

Lacs)

Period of

Contract

48,000/- 7,20,000/- one work of 80% of

estimated cost, i.e. Rs.

19.20 lacs OR

two works of 50% of estimated cost, i.e. Rs. 12 lacs OR

three works of 40% of

estimated cost, i.e. Rs.9.60

lacs

24 Months

2. The Scope of Work includes providing of primary healthcare facilities to the employees

of NHAI at its Corporate Office located at Dwarka, New Delhi, which includes the

following:

(i) A General Physician who shall visit the Medical Room for 3(three) hours a day

from Monday to Friday (5 working days) between 10:00 hrs to 13:00 hrs for

rendering following services:-

a.) To provide Basic Medical Facilities/first aid including for treating cuts,

bruises, fractures, sprains and minor burns and verification of all bills.

b) Additional services- General Physician is a member of Medical

Reimbursement Committee.

(ii) A qualified nurse who shall be on duty for 8(eight) hours a day from 9.30 hrs to

1800 hrs from Monday to Saturday.

(iii) A qualified physiotherapist who shall visit the Medical Room thrice a week

(Monday, Wednesday & Friday) for 3 hours a day from 14:00 hrs to 17:00 hrs.

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(iv) A qualified Ayurvedic and Homeopathic Doctors shall visit the Medical Room

once a week (Tuesday and Thursday) respectively for 3 hours from 14:00 hrs

to 17:00 hrs.

3. To participate in the E-Bid submission, it is mandatory for the bidders to get themselves registered with the NHAI e-Tendering Portal (https://etenders.gov.in) to get a user ID & Password free of cost through online mode only. Validity of online registration is one year. a) After making the online payment, bidders have to send an e-mail intimation at the e-

mail address: [email protected]. b) All profile activations will be done only during NHAI working days. c) No profile activations will take place during NHAI Holidays & gazetted holidays. d) The tender can be viewed/ downloaded from NHAI e-tendering portal

(https://etenders.gov.in) free of cost till prescribed last date & time for submission of the of the Bids. Following may be noted:- i) Applications can be submitted only during the validity of registration with the

NHAI e-Tendering Portal being managed by National Informatics Centre (NIC) i.e. https://etenders.gov.in

ii) The amendments/clarification to the tender, if any, will be posted on the NHAI website (www.nhai.gov.in) and NHAI e-Tendering Portal (https://etenders.gov.in).

e) To participate in bidding, bidders have to pay Application/Document Fee (non-refundable) to National Highways Authority of India (NHAI) as per the amount mentioned in the tender document through Demand Draft mode only (offline). ‘Application Fee’ is mentioned in individual tender document as published at

NHAI e-Tendering Portal (https://etenders.gov.in). f) Cost of Bid document is only DD mode (offline). g) Bid security is offline and through DD mode (offline). h) Bidders have to use CLASS III DSC with Signature and encryption Component. i) The authorized signatory holding Power of Attorney shall only be the Digital

Signatory. In the case of Authorized Signatory holding Power of Attorney and Digital Signatory are not the same the bid shall be considered as non-responsive.

If the Applicant has already registered with NIC for NHAI e-Tendering Portal usage and validity of registration has not expired, then such applicant does not require fresh registration. For any clarifications on the above, may contact 0120-4200462, 0120-4001002 or send email at the address: [email protected]

4. The detailed tender document can be viewed/downloaded from the website http://etenders.gov.in or (www.nhai.gov.in) free of cost from 11.01.2019 to 11.02.2019 (upto 14:30 hrs.) after furnishing the payment particulars. The bidders shall furnish the details of demand drafts against the cost of bid document and bid security at the time of submission of e-bid. For the above work, the pre-bid meeting will be held on 21.01.2019 at 11:30 Hrs in NHAI HQ.

5 The amendments/ addendums / clarifications to the bid document if any will be hosted on the above website.

6. The bid should be submitted online in the prescribed format given in the website. No

other mode of submission would be accepted. 7. The last date for online submission of the Bid is 11.02.2019 upto 14:30 Hrs (as

mentioned on the e-portal only) (“Bid Due Date”). The due date for physical submission of Technical Bid is 12.02.2019 upto 14:30 Hrs. The online bids would be opened on 12.02.2019. at 15:00 Hrs, at NHAI HQ on the date and time as mentioned

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above. However, such representatives shall be allowed to attend the opening of the bids only if they produce letter of authority on the letterhead of the bidder, at the time of opening of bids as mentioned above.

For any clarification, the office of the undersigned may be contacted.

Shri M. Sampurna Kumar, DGM (HR/Admn.)-IV National Highway Authority of India G-5&6, Sector-10, Dwarka New Delhi-110075 Tel: 25074100 Extn- 1503/2034 email : [email protected]

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(SECTION-II)

PROCEDURE FOR E -TENDERING

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SECTION-II

[A] PROCEDURE UNDER E-TENDERING

(Note: RFP stands modified to the extent required as per these instructions)

1. Accessing / Purchasing of bid documents

(i) To Participate in the E-Bid submission, it is mandatory for the bidders to get themselves registered with the NHAI e-Tendering Portal (https://etenders.gov.in) to get a user ID & Password free of cost through online mode only. Validity of online registration is one year.

a) After making the online payment, bidders have to send an e-mail intimation at the e-mail address: [email protected]. b) All profile activations will be done only during NHAI working days. c) No profile activations will take place during NHAI Holidays & gazetted holidays. d) The tender can be viewed/ downloaded from NHAI e-tendering portal

(https://etenders.gov.in) free of cost till prescribed last date & time for submission of the of the Bids.

Following may be noted:-

Applications can be submitted only during the validity of registration with the NHAI e-Tendering Portal being managed by National Informatics Centre (NIC) i.e. https://etenders.gov.in

The amendments/clarification to the tender, if any, will be posted on the NHAI website (www.nhai.gov.in) and NHAI e-Tendering Portal (https://etenders.gov.in).

e) To participate in bidding, bidders have to pay Application/Document Fee (non-

refundable) to National Highways Authority of India (NHAI) as per the amount mentioned in the tender document through DD mode only (offline). ‘Application Fee’ is mentioned in individual tender document as published at NHAI e-

Tendering Portal (https://etenders.gov.in). f) Cost of Bid document is only DD mode (offline). g) Bid security is offline and through DD mode (offline). h) Bidders have to use CLASS III DSC with Signature and encryption Component. i) The authorized signatory holding Power of Attorney shall only be the Digital

Signatory. In the case of Authorized Signatory holding Power of Attorney and Digital Signatory are not the same, the bid shall be considered as non-responsive.

ii) If the Applicant has already registered with NIC for NHAI e-Tendering Portal usage and validity of registration has not expired, then such applicant does not require fresh registration.

For any clarifications on the above, may contact 0120-4200462, 0120-4001002 or send email at the address: [email protected]

iii) The Complete Bid Document can be viewed / downloaded from the NHAI e-tendering portal free of cost (https://etenders.gov.in).orwww.nhai.gov.in after furnishing the payment particulars. The bidders shall furnish the details of demand draft against the cost of RFP at the time of submission of e-bid.

iv) Detailed tender document can be viewed/downloaded from e-tender portal of NHAI (https://etenders.gov.in) or www.nhai.gov.in from 11.01.2019 to 11.02.2019 (upto 14:30 Hrs.)

2. Preparation & Submission of bids:

(i) Detailed tender documents may be downloaded from e-tender portal of NHAI (https://nhai.eproc.in) or www.nhai.org from 11.01.2019 to 11.02.2019 (upto 14:30 hrs) and tender may be submitted online following the instructions

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appearing on the screen. A buyer manual containing the detailed guidelines for e-tendering system is also available on e-tendering portal of NHAI.

(ii) The following documents shall be prepared and scanned in different files (in PDF or JPEG format so that the file size is not more than 5 MB) and uploaded during the online submission of Bid. These documents shall also be submitted in ‘ORIGINAL’ to NHAI on or before 12.02.2019 (upto 14:30 Hrs).For submission

of Bids. (a) Bid security [Rs.48,000/-] in the form of DD in favour of NHAI payable at,

New Delhi; (b) Cost of tender document of Rs.1000.00 (Rs. One Thousand Only)

through offline mode only. (c) Power of Attorney duly notarized for signing of Bid in the format at

Annexure-I; (d) Affidavit in the format given at Annexure-II. (e) An Undertaking from the person having POA referred to in Sub.Cl. (d)

above that they agree and abide by the Bid documents uploaded by NHAI and amendments uploaded, if any (as per format given at Annexure-IV(A) & IV (B).

(iii) The bid (Price bid) should be submitted online only in the prescribed format

given in the website. No other mode of submission is accepted.

(iv) For documents except as mentioned at Sl.(ii) above of Bid, shall be digitally

signed by the Authorized Signatory of the bidder & submitted “on-line” only. No hard copy is required to be submitted.

(v) It may be noted that scanned copies can be prepared in different file format (PDF, JPEG) duly signed digitally.

(vi) It may also be noted that bidders can upload a single file of size of 5 MB only but can upload multiple files.

(vii) The Documents as specified in para 2 (ii) above shall be placed in a sealed envelope. The envelope superscribed the following:

ATTN. OF Shri M. Sampurna Kumar DESIGNATION DGM (HR/Admn.)-IV ADDRESS National Highways Authority of India G-5&6, Sector-10, Dwarka, New Delhi-110075 Phone No: 25074100 Extn: 1523 E-MAIL ADDRESS: [email protected]

3. Modification / Substitution / Withdrawal of bids:

(i) The Bidder may modify, substitute or withdraw its e-bid after submission, prior to the last date of Bid at 12:30 Hrs. No Bid shall be modified, substituted or withdrawn by the Bidder on or after the Bid Due Date.

(ii) Any alteration/ modification in the Bid or additional information supplied subsequent to the Bid Due Date, unless the same has been expressly sought for by the Authority, shall be disregarded.

(iii) For modification of e-bid, bidder has to detach its old bid from e-tendering portal and upload / resubmit digitally signed modified bid.

(iv) For withdrawal of bid, bidder has to click on withdrawal icon at e-tendering portal and can withdraw its e-bid prior to the Bid due date.

(v) Before withdrawal of a bid, it may specifically be noted that after withdrawal of a bid for any reason, bidder cannot re-submit e-bid again.

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4. Opening & Evaluation of bids.

(i) Opening and evaluation of bids will be done through online process. (ii) The authority shall open on-line received Bids at 15:00 Hrs. on the Bid Opening

Date, in the presence of the Bidders/ Authorised Signatory /Authorised representative who choose to attend. The Authority will subsequently examine and evaluate the Bids in accordance with the provisions set out.

(iii) Prior to evaluation of Bids, the Authority shall determine whether each Bid is responsive to the requirements of this RFP.

(iv) ‘Financial Bid’ of non-responsive bidders shall not be opened. (v) The bid shall be opened of those bidders only who submit bid documents in

original as mentioned in para 2(ii) above. The bid submitted on-line but without submission of original documents as required shall not be opened and same shall be rejected, if it contains additional documents other than those mentioned above.

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(SECTION-III)

INSTRUCTIONS TO BIDDERS (ITB)

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SECTION-III

INSTRUCTION TO BIDDERS

A.1 The name and address of the : Shri M. Sampurna Kumar

Institution inviting tender National Highways Authority of India

G – 5 & 6, Sector – 10, Dwarka

New Delhi 110 075

The Method of selection is : Minimum Cost (to NHAI) based

Selection (CBS)

A.2 Providing primary healthcare services to the employees of Authority at its Corporate

office located at Dwarka, New Delhi.

A.3 The Tender Document consisting of conditions, specification, schedule of quantum of

the work to be done etc. may be downloaded from the e-portal of NHAI, i.e. www.nhai.org

from 11.01.2019 to 11.02.2019 upto 1430 hrs.

A.4 A Tenderer shall be deemed to have full knowledge of the work and no extra charges

or compensation etc. whatsoever consequent on any misunderstanding or otherwise shall be

allowed.

A.5 Tenderer should quote in figures as well as in words the rates tendered. The amount

for each item should be worked out and requisite totals given. Special care shall be taken to

write rates in figures as well as in words and the amounts in figures only in such way that

interpolation is not possible. The total amount shall be written both in figures and in words.

A.6 Substantially responsive financial bids will be checked for any arithmetic errors.

Arithmetic errors will be rectified on the following basis:

a) If there is a difference between the amount of rate in figure and in words of an

item, and the total amount is worked out, then the rate which corresponds to

the amount worked by the bidder shall be taken as correct.

b) If the bidder has not worked out the amount of an item, or the same does not

correspond to the rates written either in figures or in words, then the rate

quoted by him in words shall be taken as correct.

c) If the rate quoted by the bidder in figures and in words tallies, but the amount

is not worked out correctly, the rate quoted by the contractor shall be taken as

correct and not the amount.

A.7 All rates must be quoted only in the Financial Bid.

A.8 A tenderer shall submit the tender which satisfies each and every condition laid down

in this notice, failing which, the tender will be liable to be rejected.

A.9 The employer does not bind themselves to accept the lowest or any tender or to give

any reasons for their decision in accepting/ rejecting any tender.

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A.10 The employer reserves to themselves the right of accepting the whole or any part of

the tender and tenderer shall be bound to perform the same at his quoted rates.

A.11 This notice of tender shall form part of the contract document to be executed and

signed later.

A.12 Bid opening shall be carried out in two stages: Stage – I : Technical bid, of all the

tenders received (except those received late) shall be opened on the date and time

mentioned in the advertisement. Stage – II: Financial Bid of successful bidders as per

technical evaluation criteria, mentioned at D.5, will be opened on specified date & time in

presence of bidder’s representatives & committee members of the employer.

A.13 NHAI will return earnest money to all unsuccessful tenderers soon after the signing of

the contract with the successful bidder.

A.14 Physical documents shall be received only at Ground Floor Reception of NHAI

Headquarters by the Receptionist and no bidder shall be allowed to enter NHAI building for

receipt of bids.

A.15 Bids received later than the last date & time for receipt of bids shall not be considered

or opened by NHAI.

B.1 The name & address of the official to whom the bids are to be submitted is :

Sh. M. Sampurna Kumar

Manager (HR & Admn)

NHAI, Plot No. 5 & 6, Sector – 10

Dwarka, New Delhi 110 075

Telephone No. : 25074100, Extn:1523/2034

C.1 The bidders shall state all costs in Indian Rupees only.

D.1 The proposal submitted by a bidder shall be in two separate parts. Part – I shall

comprise of bidding documents:

(i) It shall be named Technical Bid

(ii) Earnest money in a separate cover marked: “Earnest Money” shall

accompany the Technical Bid.

Part – II : It shall be named Financial Bid and shall comprise of priced bill of quantities.

D.2 Deleted.

D.3 Proposals must be submitted to the address shown at B.1 above not later than the

following date and time, i.e till 1500 hrs on 12.02.2019.

D.4 The proposals of the bidders will be valid for 180 days from the last date of

submission of Bids.

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D.5 Technical Evaluation Criteria

(i) Average Annual financial turnover during the last 3 years, ending 31st March of the

previous financial year, should be at least 30% of the estimated cost, i.e. Rs.

7,20,000/- (Rupees Seven Lakhs Twenty Thousand Only). The estimated cost of

work for the period of contract, i.e. for one year, is Rs. 12.00 lakhs (approx).

(ii) Experience of having successfully completed similar works during the last 7 years

ending last day of month previous to the one in which applications are invited should

be either of the following:

(a) One similar completed works costing not less than the amount equal to

80% of the estimated cost, i.e. Rs. 19.20 lakhs.

Or

(b) Two similar completed works costing not less than the amount equal to

50% of the estimated cost, i.e. Rs. 12.00 lakhs.

Or

(c) Three similar completed works costing not less than the amount equal

to 40% of the estimated cost, i.e. Rs. 9.60 lakhs.

Similar work means “providing of primary healthcare services” in Govt.

organizations, PSUs, Central Autonomous Bodies and it is mandatory to submit

certificate from employer / client regarding successfully completion of similar

works, in all aspect, within time and without any complaint. Further, the

successful completed means the work should have completed in all aspect

within time, without any complaint.

E.1 The tenders shall be accompanied by an earnest money of Rs. 48,000/- (Rupees

Forty Eight Thousand only) in the form of DD or Pay order in favour of National

Highways Authority of India, New Delhi.

E.2 Duly filled-in and signed copy of Tender Document shall be submitted. Failure to do

so shall mean disqualification of contractor.

E.3 In case of downloaded version of bid document, the cost of bid document of Rs.

1,000/- (Rupees One Thousand Only) to be paid online to National Highways

Authority of India.

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(SECTION-IV)

TERMS OF REFERENCE

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TERMS OF REFERENCE

1. SCOPE OF SERVICES

NHAI hereby agree to engage the Service Provider to provide the following Services

and the Service Provider agrees to provide the same to the Employee/Staff of NHAI.

The Service Provider does hereby agrees that it will provide the following Services:

(i) A General Physician who shall visit the Medical Room for 3(three) hours a day

from Monday to Friday (5 working days) between 10:00 hrs to 13:00 hrs for

rendering following services:-

a) To provide Basic Medical Facilities/first aid including for treating cuts,

bruises, fractures, sprains and minor burns and verification of all bills.

b) Additional Services- General Physician is a member of Medical

Reimbursement Committee

(ii) A qualified nurse who shall be on duty for 8(eight) hours a day from 9:30 hrs to

18:00 hrs from Monday to Saturday.

(iii) A qualified physiotherapist who shall visit the Medical Room thrice a week

(Monday, Wednesday & Friday) for 3 hours a day from 14:00 hrs to 17:00 hrs.

(iv) A qualified Ayurvedic and Homeopathic Doctors shall visit the Medical Room

once a week (Tuesday and Thursday) respectively for 3 hours from 14:00 hrs

to 17:00 hrs.

2. DURATION OF AGREEMENT:

The duration of this Agreement shall be for a period of 2 (two) years commencing from

Agreement Date and ending on a date two years after the date of signing of this

Agreement (both days inclusive) or early Termination thereof, as per the terms of this

Agreement. This Agreement is extendable for subsequent years, on yearly basis,

without any escalation of rates on any account whatsoever, subject to written approval

from NHAI and mutual consent of the Parties.

3. FEES TO BE PAID TO THE SERVICE PROVIDER

(i) In consideration of the Service Provider providing the Services, NHAI shall pay

to the Service Provider a consolidated monthly fee. The applicable tax shall be

borne by NHAI and is not included in the monthly fee payable to the Service

Provider.

(ii) The aforesaid fee shall be paid by the 10th ( Seventh)of each calendar month

by way of account payee Cheque/ DD/ECS in favour of the Service Provider,

upon submission of bill through BTS by the Service Provider at least 7 ( seven)

days in advance. .

4. RESPONSIBILITES AND OBLIGATIONS OF SERVICE PROVIDER

The Service Provider shall:

(a) be responsible for performing and discharging the Services, as per the

requirements of NHAI and in accordance with this Agreement.

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(b) engage external agencies as and when required, with prior written approval of

NHAI to complement the Services, so as to offer a comprehensive healthcare

delivery to the employees / staff of NHAI, in the areas of waste management,

infection and pest control, pathology services, ambulance services, tie ups with

referral facilities for services beyond the scope of the Services as defined in

this Agreement. The cost of such additional services shall be borne by NHAI.

(c) engage one Doctor, one Nurse and one Physiotherapist/Ayurvedic/

Homeopathic for the Medical Room to provide the Services, and make

available the aforesaid persons for the days and hours as specified herein

above in this Agreement.

(d) with the proper patient consent and in accordance with all governing laws

regarding confidentiality, make available to Employees/staff of NHAI, copies of

all medical records and shall not disclose the record to any third party without

the consent of the Employee.

(e) furnish, upon request and without charge, all information reasonably required

by NHAI to verify and substantiate its provision of Medical Services, the

charges for such Services.

5. RESPONSIBLITIES AND OBLIGATIONS OF NHAI

NHAI expressly agrees and undertakes that it shall:

(a) apply for and obtain all necessary permissions, sanctions, license, permits,

etc. from the appropriate authorities, Government, Municipal or otherwise, as

the case may be, in connection with the functioning of the Clinic and the

Service Provider shall not at any time be responsible for any consequences

arising out of the delay or failure on the part of NHAI to obtain such

permissions, sanctions, license & permits, etc;

(b) at its own expense, undertake all repairs and maintenance activities as may

be required and advised by the Service Provider which are essential for the

proper functioning of the Clinic and in connection thereto.

(c) bear all costs with relation to structural changes to the Clinic to maintain the

Clinic in good operational condition or by reason of any laws or conditions

applicable at the time of signing of this Agreement or hereinafter in force or by

reason of any governmental or any municipal order or otherwise, all such

repairs, changes and replacements with relation hereto shall be carried out by

NHAI.

(d) provide facilities such as housekeeping as per requirements of the Service

Provider, general maintenance and bear the cost of such engagement.

(e) provide for water, electricity etc. as required for the operation of the Clinic and

as per the requirements of the Service Provider.

(f) bear all costs with respect to providing operating supplies, consumables and

medicines as per the requirement of the General Physician on duty on a day to

day basis. The charges for the same shall be borne by NHAI.

(g) Make payments to the Service Provider in accordance with Article 4 above.

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6. OPERATING EXPENSES

NHAI shall bear all necessary working capital and all expenses for setting up the

Clinic during the Contract Period.

7. INDEMNITY

In taking any action pursuant to this Agreement, the Service Provider shall be

deemed to be acting entirely for the benefit of, and assistance to, NHAI and NHAI

shall indemnify the Service Provider and any of the Service Provider’s personnel/staff

acting under this Agreement harmless from and against any and all claims, actions

and demands, whatsoever, including costs, expenses and fees payable to any lawyer

or attorney or the like in defending such claims, and Service Provider shall not be

liable to NHAI for any action taken or admitted to be taken by Service Provider except

for any loss caused by Service Provider’s own willful misconduct or gross negligence.

NHAI hereby releases the Service Provider from any liability in connection with any

claim asserted against NHAI or by any third party including government of a State or

Central or Semi-governmental or local or municipal authority for any payment or non-

payment of taxes, levies specifically for the purpose of establishment of the Clinic.

8. INSURANCE

The Service Provider shall at its own expense at all times during the Contract Period

insure itself for any medico legal liabilities. In the event of the Service Provider fails to

provide such insurance as mentioned hereinabove, NHAI shall under no

circumstances be responsible for any liability arising out of any medico legal claim

arising due to such failure of the Service Provider and if any liability is placed on NHAI

due to negligent performance of the Services by the Service Provider, the Service

Provider shall indemnify NHAI.

9. IN THE EVENT OF BREACH

(i) In the event of any failure or default on the part of NHAI to observe discharge

perform carry out or fulfill any of the responsibilities obligations undertakings or

covenants herein contained or in the event of any default by NHAI in respect of

usage of trademarks signs, trade names, logos, emblems or any other

copyright, the Service Provider may without prejudice to its other rights, be

entitled to do one or more of the following, each of which shall be independent

to the other:-

(a) Discontinue after a notice of 30 days the Services to be rendered by it

under the terms mentioned herein and withdraw at the cost of NHAI

from the Clinic all staff seconded by the Service Provider to the Clinic

under these terms.

(b) Serve notice to rectify or cure such failure or default and if such failure

or default is rectified or cured by NHAI within 30 days of such notice

then the Service Provider will continue rendering the Services.

(c) If NHAI fails to comply with such notice and cure or rectify such failure

or default within 30 days of such notice, the Service Provider shall be

entitled to terminate this Agreement without any further notice. For the

avoidance of doubt it shall be clarified that the Service Provider shall

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not be entitled to any claim of damages whatsoever arising out of

NHAI’s such failure or default.

(ii) In the event of the Service Provider failing to meet its liabilities and entering

into a composition or arrangement with its creditors or in the event of

liquidation proceedings being commenced against the Service Provider or of a

receiver or liquidator being appointed of the whole or a substantial part of the

assets of the Service Provider then in any such event NHAI shall have the right

to terminate this Agreement without notice and without prejudice to its claims

for damages.

(iii) (a) In the event of any failure or default on the part of the Service

Provider to observe, discharge, perform, carry out or fulfill any of the

responsibility obligations undertakings or covenants on the Service

Provider herein contained, NHAI may, without prejudice to its other

rights, serve notice on the Service Provider to rectify or cure such

failure or default within 30 days of such notice.

(b) Upon receipt of such notice the Service Provider shall promptly rectify

or cure such failure or default or take action to rectify or cure such

failure or default. If such failure or default is not susceptible of being

cured within (30) days, NHAI shall be entitled to terminate this

Agreement without giving any further notice for the same.

(c) In such an event of Termination NHAI shall return the fixtures and

fittings being provided or belonging to the Service Provider.

(iv) The rights granted hereunder shall not be in substitution of, but in addition to,

any or all rights and remedies for breach of contract granted by the provisions

of law in force from time to time.

(v) Upon the Termination of this Agreement for any cause whatsoever all

accounts due and owning between the Parties shall become due and be paid

within sixty (60) days of the date of Termination of this Agreement.

10. FORCE MAJEURE

Neither Party shall be liable to the other Party on account of any loss, damage or

delay occasioned or caused by non-performance of any obligation under this

Agreement due to reasons attributed to acts of God or other causes beyond the

control of the Parties (Force Majeure). The Parties shall immediately, on the first clear

notice of Force Majeure inform each other of the Force Majeure circumstances and

discuss remedial measures. If Force Majeure conditions continue to affect a Party

beyond a period of 3 months, the other Party shall have a right to terminate this

Agreement.

11. TITLE TO THE CLINIC

It is agreed that NHAI has, and shall always have, throughout the terms of this

Agreement, full ownership and title to the Clinic and to the furniture, equipment etc.

supplied by NHAI for reasons mentioned herein.

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12. TRADE NAMES, MARKS, SIGNS, ETC.

(a) To facilitate recognition of quality of standing and acceptance of the Clinic, the

Service Provider may in its sole discretion allow the use of its trademarks,

signs, logos and emblems in respect of, and for use by, the Clinic. Such

permitted use by the Clinic is entirely at the Service Provider’s sole discretion.

Any use or the right to use by the Clinic of any such trade names, trademarks,

signs, logos, emblems and other identifying symbols shall cease upon the

Termination or earlier determination or expiry of this Agreement.

(b) The above stated trade names, trademarks, signs, logos, emblems and other

identifying symbols permitted by the Service Provider to be used as provided

herein shall at all times be and remain the exclusive property of the Service

Provider and NHAI undertakes not to sublease or sublicense or utilize any or

all of such trade name, trademarks, signs, logos, emblems, etc. for all the

benefit of any business of NHAI present or future.

(c) NHAI agrees that it will always acknowledge and recognize, both before and

after the expiration of this Agreement, exclusive right of the Service Provider to

use or to grant to others the right or license to use whether separately or as

part of or in connection with other words, slogans, symbols, designs, any of the

trade names, trademarks, emblems, signs, logos or other identifying symbols

which may now or in future be generally used in connection with the operation

of any of the Service Provider’s healthcare facilities.

(d) Upon Termination or earlier determination or expiry of this Agreement, NHAI

shall forthwith cease to use or utilize the above said marks in connection with

the Clinic or any of its operating supplies, operating equipment or furniture and

equipment.

(e) Parties acknowledge and agree that either Party shall not use the name of the

other Party or any of its holding, subsidiary or associated companies in any

manner whatsoever for raising any funds from financial institutions, banks

public and other without the prior written consent of the other Party.

13. DISPUTE RESOLUTION

CONCILIATION/ARBITRATION- Any dispute, difference or controversy of whatever

nature howsoever arising under or out of or in relation to this Agreement between the

parties, and so notified in writing by either Party to the other party (the “Dispute”) shall,

in first instance, be attempted to be resolved amicable in accordance with the

conciliation procedure i.e. either Party may require such Dispute to be referred to the

Member (Admn.) of the NHAI and the Promoter/Director/Chairman of the

Contractor/Company for amicable settlement, and upon such reference, the said

persons shall meet not later than 15 (Fifteen) days from the date of reference to

discuss and attempt to amicably resolve the Dispute.

If such Dispute is not amicably settled within 30 (thirty) of the meeting or the dispute is

not resolved as evidenced by the signing of written terms of settlement within 30

(thirty) days or such longer period as may be mutually agreed by the Parties, either

Party may refer the Dispute to arbitration to be decided by a Sole Arbitrator appointed

in accordance with the SAROD Arbitration Rules and subject to the provisions of the

Arbitration and Conciliation Act, 1996 as amended or to be amended from time to

time. The procedure, Fee(s), expenses/cost(s) incurred in the Arbitration, place of

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sitting and language of arbitration shall also be in accordance with SAROD Arbitration

Rules.

14. CONFIDENTIALITY

It is agreed that all written materials made available to a Party by the other Party in

furtherance of implementation of this Agreement are of strictly confidential nature and

shall always remain the property of Party providing such written materials and the

contents thereof shall not be disclosed by the receiving Party or any of its staff to any

third party or parties without the prior written permission of the Party providing such

written material and that upon the Termination of the operating term of this

Agreement or earlier determination thereof all of all such material shall be returned in

good order to the other Party.

15. TERMINATION:

(a) This Agreement may be Terminated by either party:

(i) if the other Party commits a breach of any of its obligations under this

Agreement and which is not remedied within thirty (30) days from the

date of written notice requiring such breach to be remedied; or

(ii) immediately and without notice, if either Party becomes insolvent,

makes any assignment for the benefit of its creditors, or is placed in

receivership, liquidation or bankruptcy; or

(iii) by giving two calendar month’s notice to the other Party without

assigning any reason whatsoever. For the avoidance of doubt it shall

be clarified that no further notice or communication shall be required

subsequent to the notice of Termination as mentioned hereinabove.

In the event of Termination of this Agreement the Service Provider shall cease

to use the premises of NHAI and the Clinic with immediate effect.

(b) Provided further that, in the event this Agreement is Terminated as set forth

herein, Clauses 8, 12, 13, 14, 15 and this Clause 16 (b) shall survive the

Termination of this Agreement.

16. MISCELLANEOUS

(a) NHAI and the Service Provider shall comply with, and abide by, all applicable

laws, regulations and ordinances for the time being in force in connection with

the rendering of any or all of the services under this Agreement.

(b) Any notice required to be given under this Agreement shall be in writing and

sent by post either registered or certified with return receipt requested and

addressed:

If to NHAI: Attn: Sh/Smt.----------------------------

General Manager (Administration)

G5 & 6, Sector-10

Dwarka, New Delhi – 110 075

If to the Service Provider: Attn: Sh./Smt. ………………………….

(The Second part),

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(c) The headings of the parts and articles of this Agreement are inserted for the

sake of convenience only and are not intended to affect the meanings of any of

the provisions hereof.

(d) his Agreement together with the Annexure hereto annexed constitutes the

entire Agreement between the Parties hereto relating to the subject matter

hereof superseding all prior agreements oral or written. This Agreement

together with other writings signed by the Parties expressly stated to be

supplementary hereto and together with any instruments in writing to be

executed and delivered shall constitute the entire Agreement superseding all

prior oral understandings and shall binding upon and inure to the benefit of

NHAI and the Service Provider. Any change in this Agreement shall only be

made in writing signed by Parties hereto.

(e) In no event shall either Party or any person or persons associated with

such Party shall make any claim against the other Party or any other Party’s

seconded staff on account of any alleged errors of judgment made in good

faith in connection with either Party rendering all or any of the Services

specified in this Agreement in respect of the Clinic.

(f) (i) All Services to be rendered by the Service Provider under this

Agreement shall be assignable by the Service Provider to any of its

holding, subsidiary or associated companies with prior written approval

of NHAI, provided that such companies agree in writing to be bound by

the terms hereof. Provided further that in all such cases NHAI reserves

the right to terminate this Agreement forthwith upon notice served on

the Service Provider according to the terms of this Agreement.

(ii) NHAI shall not assign its duties obligations and liabilities under this

Agreement to any person or persons without obtaining the prior

consent of the Service Provider in writing provided however that in all

such cases the Service Provider reserves the right to terminate this

Agreement forthwith upon notice served on NHAI according to the

terms of this Agreement.

(g) Nothing herein shall construe a partnership or JV between NHAI and the

Service Provider.

(h) This Agreement may be executed in number of counterparts, each of which

shall be deemed an original but all of such together shall constitute on and the

same instrument.

(i) Nondiscrimination: Service Provider agrees that it shall not exclude or deny

aid, care, Service or other benefits available under this Agreement in any other

way discriminate against any employee because of that person’s race, colour,

ancestry, marital status, national original, gender, age, economic status,

physical or mental disability, political or religious affiliation or beliefs in

accordance with Indian laws. In addition, Service Provider shall not

discriminate against beneficiaries in any manner, including, but not limited to,

admission practices, room selection and placement meals provision and

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waiting time for surgical procedures. Without exception, Service Provider shall

provide to employees their specific benefit in the same manner as Service

Provider also directly, or indirectly, renders those same Services to other

patients in their normal course of business, regardless of pay or source.

(j) Disclosure of Information: to NHAI. Service Provider agrees to disclose all

information as required under applicable laws and regulations and any other

information required by NHAI, and to respond to all requests from NHAI for

information. Service Provider further agrees that all bills or claims for payment

to NHAI by Service Provider shall not be due and owning to Service Provider

for any period(s) for which information was not reported or was reported falsely

to NHAI. Service Provider further agrees to reimburse those funds/payment

received during any period for which information was not reported, or reported

falsely, to NHAI.

(k) Service Provider Fraud and Abuse. Service Provider agrees that it shall not

engage in or commit fraud or abuse. “Fraud” means an intentional deception or

misrepresentation made by a person with the knowledge that the deception

could result in some unauthorized benefit to himself or herself or some other

person. It includes any act that constitutes fraud under applicable laws.

“Abuse” means either: (1) practices that are inconsistent with sound fiscal or

business practices and result in unnecessary cost to the NHAI. (2) practices

that are inconsistent with sound medical practices and result in reimbursement

by NHAI, for services that are unnecessary or for substandard items or

Services that fail to meet professionally recognized standards for health care.

(l) Severability. If one or more of the provisions of this Agreement shall be

invalid, illegal, void, or unenforceable, the validity, legality, and enforceability of

the remaining provisions shall not in any way be affected or impaired. Either

Party having knowledge of such a provision shall promptly inform the other

Party of the presumed non-applicability of such provision. Should the non-

applicable provision go to the heart of this Agreement, the Agreement shall be

Terminated in a manner commensurate with the interests of both Parties.

17 (i) In case of downloaded version of Bid Document, non refundable amount of Rs.

1,000/- in the form of Demand Draft favoring National Highways Authority of India will

have to be submitted alongwith the Technical Bid.

(ii) EMD for Rs. 48,000/- in the form of Demand Draft favoring National Highways

Authority of India to be enclosed alongwith the Technical Bid. The EMD of

unsuccessful bidders will be returned after the award of new contract & signing of the

Contract Agreement with the successful bidder.

(iii) The successful bidder will submit a performance bank guarantee for 10% of

contract value from the scheduled nationalized banks for a period of 02 years

or till the extended period of contract, whichever is later.

18 NHAI reserves the right to terminate the contract at any time without notice, and assigning,

any reason thereof.

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ANNEXURE – I

Power of Attorney for signing of Bid

[Refer Clause 5.1(c) of Section-III, ITB)]

(To be given on Non-judicial stamp paper and duly notarized)

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), son/daughter/wife of ……………………………… and

presently residing at ………………………………….., who is presently employed with us /

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 bid for providing Document Management

Services in National Highways Authority of India (the Authority) including but not limited to

signing and submission of all applications, bids and other documents and writings, participate

in bidders’ 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.

Accepted Notarized

(Signature, name, designation and address of the Attorney)

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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 executant(s) and when it is so required, the same

should be under common seal affixed in accordance with the required procedure.

The Power of Attorney should be executed on a non-judicial stamp paper of Rs. 50

(fifty) and duly notarized by a notary public.

Wherever required, the Bidder 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 Bidder.

For a Power of Attorney executed and issued overseas, the document will

also have to be legalised by the Indian Embassy and notarized in the jurisdiction

where the Power of Attorney is being issued. However, the Power of Attorney

provided by Bidders from countries that have signed the Hague Legislation

Convention, 1961 are not required to be legalized by the Indian Embassy if it

carries a conforming Appostille certificate.

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ANNEXUE-II

AFFIDAVIT

(To be given on a Non-judicial stamp paper and duly notarized)

1. I, the undersigned, do hereby certify that all the statements made in the required

attachments and bid application are true and correct. 2. The undersigned also hereby certifies that neither our firm ______________________

______________________ nor any of its constituent partners if any have abandoned any work or works on National Highway of India nor any contract awarded to us for such works has been rescinded during last five years prior to the date of this bid. We also hereby declare that neither our firm/ consortium firm nor any partner/ director has even been black listed by any Govt/PSU/Statutory Authority or suspended for any period of contract or penalized for any breech.

3. The undersigned also furnish undertaking that we are not declared by any court of law

as proclaimed offenders also that we are not convicted under any law for the offences punishable under Indian Penal Code, TADA, POTA, Negotiable Instruments Act or any Labour/employee beneficial legislation’s.

4. The undersigned hereby authorise(s) and request(s) any bank, person, firm or

corporation to furnish pertinent information deemed necessary and requested by NHAI to verify this statement or regarding my (our) competence and general reputation.

5. The undersigned understands and agrees that further qualifying information may be

requested, and agrees to furnish any such information at the request of the NHAI with in stipulated specified period.

___________________________________________ (Signed by an Authorised Officer of the Firm) ___________________________________ Title of Officer _____________________________ Name of the Firm ______________________

Date

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ANNEXURE- III

FORM OF LETTER OF APPLICATION

To The General Manager (HR/Admn.)-IV National Highways Authority of India G5 & G6, Sector – 10 Dwarka New Delhi – 110075.

Sub: Description of Works- Health Services in NHAI’s Corporate Office. Dear Sir, Having examined the Bid Document, Instructions to Bidders Qualification Information,

Scope of works, etc. for the subject work. We hereby submit our bid for the subject work.

It is certified that the information furnished in this document is true and correct. The proposal

is unconditional and unqualified. I/We, the undersigned unconditionally accept that NHAI

reserves the right to reject any or all application without assigning any reason.

Thanking you,

Yours faithfully,

(Authorized Signatory) for and on behalf of M/s_____________

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Annexure-IV

Experience-cum-Work completion Certificate

(To be issued by the Authorized Officer of the Organization where the agency has provided health services)

This is to certify that M/s .........................................(name of the agency) has provided .............................................. (name of the services) to this office from ............ to ......., as per details as under :-

1. Name of the work/contract agreement ...........................................................

2. Whether there is one contract agreement for the said work : Yes/No

3. Actual period of work as per initial contract agreement : From....... To .............

4. Estimated Cost of the Contract : Rs.....................................................

5. Payment made to M/s .................during the period of contract (amount paid to the

agency during the extended period of contract not to be included) : Rs................

6. Has the contract been extended beyond initially approved contract period : Yes/No

7. If yes, the date of effect of such extension : From .................. To .....................

8. Payment made to the firm during the extended period : Rs.................................

9. Performance of the firm during the contract period : Satisfactory/Not Satisfactory

Place: (Name, designation and signature of the authorized Officer) Date: Office Seal

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Annexure-V FORM OF LETTER OF ACCEPTANCE

No. …………………………. Dated ……….. To M/s………………………….

Sub.: …………………………. Name of Work …………………………………

Sir,

Based on your bid submitted on ………….. in compliance of bidding document of NHAI for execution of the work of ………………………………………………. , it is hereby notified that your bid for a contract price of Rs …………… (Rupees in words…………………………………………………………………..………) has been

accepted for and on behalf of NHAI You are hereby requested to sign the contract agreement failing which the actions as

stipulated in contract shall be taken.

Thanking you, Yours faithfully,

(………………..)

General Manager

(Admn.)

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Annexure-VI

FORM OF BANK GUARANTEE FOR PERFORMANCE SECURITY

To

National Highways Authority of India

G5 & 6, Sector – 10

Dwarka

New Delhi – 110075

WHEREAS……………………………… (name and address of contractor) thereinafter called

“the contractor” has undertaken, in pursuance of Contract No. ……………. Dated

……………….. to execute……………………….. (name of Contract and brief description of

Works) (hereinafter called “the contract”).

AND WHEREAS it has been stipulated by you in the said contract that the Contractor shall

furnish you with a Bank Guarantee by a Nationalised/Scheduled bank of India for the sum

specified therein as security for compliance with his obligations in accordance with the

Contract;

AND WHEREAS we have agreed to give the Contractor such a Bank Guarantee:

NOW THEREOF we hereby affirm that we are the guarantor and responsible to you on behalf

of the Contractor, up to a total of Rs……………… (amount of guarantee)

(Rupees……………………………………. (in words), such sum being payable in the types and

proportions of currencies in which the Contract Price is payable, and we undertake to pay

you, upon your first written demand and without cavil or argument, any sum or sums within

the limits of ……………….. (amount of guarantee) as aforesaid without your needing to prove

or to show grounds or reasons for your demand for the sum specified therein.

We hereby waive the necessity of your demanding the said debt from the Contractor before

presenting us with the demand.

We further agree that no change or addition to or other modification of the terms of the

contract or of the works to be performed there under or of any of the contract documents

which may be made between you and the Contractor shall in any way release us from any

liability under this guarantee, and we hereby waive notice of any such change, addition or

modification.

This guarantee shall be valid until 28 days from the date of expiry of the Defects Liability

Period of one month.

Signature and seal of the Guarantor………………………………………………………

Name of the Bank …………………………………………………………………………

Address……………………………………………………………………………………

Date…………………………..

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In the presence of ……………………………………………………………..

1…………………………………………………………………………………………

(Name of Occupation)

2…………………………………………………………………………………………

(Name of Occupation)

An amount shall be inserted by the Guarantor, representing the percentage of the Contract

Price specified in the Contract including additional security for unbalance bids, if any and

denominated in Indian Rupees.

Give names of all partners if the contractor is a Joint Venture

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Annexure-VII

FORM OF AGREEMENT

AGREEMENT

This agreement made the ______________day of ____________________ 2019_____________________ between the National Highways Authority of India, New Delhi (hereinafter called “the Authority” of the one part and _________________ (here in after called “the Facilitator”) of the other part. AND WHEREAS the Authority invited bids from eligible bidders for the execution of certain works, viz……………………………………………… AND WHEREAS pursuant to the bid submitted by the Facilitator, vide ____________ (here in after referred to as the “BID” or “OFFER”) for the execution of work, the Authority by his letter of acceptance dated ___________ accepted the offer submitted by the Facilitator for the execution and completion of such works and remedying of any defects thereon, on terms and conditions in accordance with the documents listed in para 2 below. AND WHEREAS the Facilitator by a deed of undertaking dated ________ has agreed to abide by all the terms of the bid, including but not limited to the amount quoted for the execution of Contract, as stated in the bid, and also to comply with such terms and conditions as may be required from time to time. AND WHEREAS the Facilitator has agreed to undertake such works and has furnished a Performance Security pursuant to clause 33 of the instructions to bidders (Section-III). AND WHEREAS the Facilitator (i.e. M/s …) agreed to provide their services at the total contract price of Rs…….for the period of two years. NOW THIS AGREEMENT WITNESSETH as follows:

1. In this agreement words and expressions shall have the same meaning as are respectively assigned to them in the Terms Conditions of contract hereinafter referred to;

2. The following documents shall be deemed to form and be read and construed as part of this agreement viz.

(a) Agreement, (b) Letter of Acceptance (c) Contractor's Bid, Bidding Documents, (d) Contract Data, (e) Conditions of Contract, General Conditions of Contract, Special Conditions

of Contract, Conditions of NIT. (f) Scope of Work (g) Any other document listed in the Contract Data.

3. The foregoing documents shall be construed as complementary and mutually explanatory one with another. Should any ambiguity or discrepancy be noted then the order of precedence of these documents shall be subject to the order as listed above and interpreted in the above order of priority.

4. In consideration of the payments to be made by the Authority to the Facilitator as

hereinafter mentioned, the Facilitator hereby covenants with the Authority to execute and complete the works and remedy any defects therein in conformity in all respects with the provisions of the contract.

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5. The Authority hereby covenants to pay the Facilitator in consideration of the execution and completion of the works and remedying of defects therein, the contract price or such other sum as may become payable under the provisions of the contract at the times and in the manner prescribed by the contract.

IN WITNESS WHEREOF the parties here to have caused this agreement to be executed the day and year above written. Signed, sealed and delivered by the said Authority through his Authorized Representative and the said Facilitator through his Power of Attorney holder. Binding Signature of Authority __________________________________ For and on behalf of National Highways Authority of India, New Delhi – 110 075 Binding Signature of Facilitator __________________________________ For and on behalf of M/s. _________________________________________ In the presence of In the Presence of 1. Name: 1. Name: Address: Address: 2. Name: 2. Name: Address: Address:

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Annexure-VIII

Tender for Providing Primary Healthcare Facilities to employees of NHAI at NHAI HQ, Dwarka, New Delhi

1. Name of Tendering Company/Firm/Agency with Regn. No., if any : (Attach Certificate of Registration/Certificate of Incorporation/MOU) (Pl. Indicate page. no. also)

2. (a) Name of the Proprietor/owner(s)/Active Partner(s)/Directors of the

Company/firm/agency :

(b) Name of the Officer/authorized representative as per POA (Annex.–I)

(c) Year of Constitution of company/firm etc.

(d) Legal status of Bidder (Proprietorship/Partnership or Pvt. Ltd. firm)

[Upload scanned copy of original]

(e) Place of registration: ____________________________

(f) Principal place of business: ____________________________

3. Complete address of the Registered Office of the Co./Firm/Agency : Telephone No./FAX No./E-Mail Address : 4. Complete address of Operating/Branch Office at Delhi/New Delhi : 5. Bank details of the Company/Firm/Agency :

(Name of the bank/branch/Account No./Type of Account IFSC Code/RTGS details etc.) (Attach cancelled cheque-(Indicate page. no. also)

6. (a) Details of Demand Draft towards Cost of Bid document

(DD/PO No. & Date Drawn on Bank) :

(Attach Copy and indicate page. no. also)

(b) Details of Demand Draft towards Earnest Money Deposit

(DD/PO No. & Date Drawn on Bank) :

(Attach Copy and indicate page. no. also)

7. Furnish the following information (Whichever is applicable)

i. PAN/GIR No. (Attach Copy and indicate page. no. also) :

ii. TIN No. (Attach Copy and indicate page. no. also) :

iii. GST No. (Attach Copy and indicate page. no. also) :

iv. Certificate of Incorporation (Attach Copy and indicate page. no. also) :

8. Detail of Work. (Attach work experience/contract agreement(s)/work completion certificate(s) issued by the organizations and indicate page. no. also)

Name of Organization

Period of Work

Experience

Value of Work

Whether value of work given in col. 3 of this table is against one work/contract agreement (Yes/No). If yes, enclose copy of agreement & satisfactory work completion certificate showing value of work also.

1 2 3 4

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9. Additional information, if any (Attach separate sheet, if required):- ................................

Signature of authorized person of the agency

Date: Full Name & Designation.:

Place: Seal:

Note : (i) A certificate shall be attached that details and documents as given in annexure

have been checked and verified and are found to be correct. This shall be signed by the authorized person on behalf of the bidder.

(ii) The documents/details provided in this annexure shall be taken on face. These are subject to verification by NHAI. In case of any document/information found false, at any stage, the tender of the bidder shall be summarily rejected besides any other remedy/penalty as deemed fit by Authority.