EMPANELMENT OF CONTRACTORS

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1 PARTICULARS OF THE FORM TO BE FURNISHED FOR THE PURPOSE OF EMPANELMENT OF CONTRACTORS CATEGORIES APPLIED FOR ( PLEASE TICK IN THE BOX) Tick i) For Civil work ii) For Interior work iii) For Electrical work a) Works up to Rs 25 lakhs b) Works up to Rs 75 lakhs a) Works up to Rs 25 lakhs b) Works up to Rs 75 lakhs a) Works up to Rs 5 lakhs b) Works up to Rs 15 lakhs iv) For Composite (civil, Furnishing, electrical) work a) Works up to Rs 25 lakhs b) Works up to Rs 75 lakhs v) For Maintenance (civil, Furnishing, electrical) work of owned properties vi) For Pest Control work a) Works up to Rs 1,00,000/- 1. Name of the organisation 1. Registered Address Full Address in Madhya Pradesh 3. Year of establishment 4. Status of the firm whether Company / Firm / Proprietary 5. Name of the Directors/Partners/ Proprietor Page 1 of 6

2 6. Whether registered with the Registrar of Companies / Registrar of Firms. If so, mention number and date (Documentary Proof Necessary) Furnish also copies of partnership deed 7. Name and address of Bankers (Enclose Solvency certificate from a Nationalized Bank for amount equal to 50% of outer limit under category applied for) 8. Whether registered for VAT/ Sales Tax purposes. If so, mention number and date. Furnish also copies of Sales Tax clearance Documentary Proof is at page no 9. Whether an assessee of Income Tax. If so, mention PAN number. Furnish copies of IT return certificates 10. Whether registered in the panel of other organizations / statutory bodies such as CPWD, PWD, MES, Banks etc. Furnish their names, category and date of registration 11. Whether willing to work anywhere in Madhya Pradesh or mention places where you are willing to work 12. Detailed description and value of works done during the last 5 years 13. Annual turnover for the last 3 years ( Documentary Proof -- C.A. s Certificate Necessary) Annexure A Name and addresses of the Two Senior Engineers who will be in a position to certify about the quality as well as performance of your organization Page 2 of 6

3 15 PAN, VAT, / Sales Tax No. SERVICE TAX number has to be given here by the Applicants NOTE: Necessary details and documentary proof, photographs if any etc. has to be enclosed as separate attachments serially numbered with cross references to the respective statements made in this Application. Any sort of negligence in this respect and in this application is likely to result in rejection of the application. Name of Signatory Page 3 of 6

4 PRE QUALIFICATION CRITERIA FOR CONTRACTORS FOR CIVIL, INTERIOR & ELECTRICAL WORK Minimum experience in the specified field for last 5 years continuously with. 1. Average annual financial turnover during the last 3 years, ending 31 st March of the previous year, should be at least 30% of the outer limit given in the respective categories for above works. 2. Experience of having successfully completed similar works during last 7 years ending last day of month previous to the date of advertisement should be either of the following:- Three similar completed works costing not less than the amount equal to 40% of the outer limit given in the respective categories for above works. Two similar completed works costing not less than the amount equal to 50% of the outer limit given in the respective categories for above works. One similar completed work costing not less than the amount equal to 80% of the outer limit given in the respective categories for above works. 3. Adequate organizational set up in Madhya Pradesh with qualified engineers, specialists and other technical officers and staff who have license and approval to execute work of nature & magnitude given in the respective categories. 4. Regular presence of the Applicant in Madhya Pradesh is essential. (The Works in Madhya Pradesh. The applicant should be thorough with Municipal Corporation of Madhya Pradesh rules, regulations, procedures etc and should have adequate experience.. 5. For electrical, composite work & maintenance work (wherever electrical work is involved) a qualified Electrical Engineer / Electrical supervisor with valid electrical license to be engaged for the execution & supervision of work. (Legible & attested copy of electrical license to be enclosed). 6. For civil, composite work & maintenance work (wherever plumbing work is involved) a qualified supervisor with valid plumbing license to be engaged for the execution & supervision of work. (Legible & attested copy of plumbing license to be enclosed). 7. Clarifications, if any required, may be obtained from AGM (General Administration Department) Dena bank Phone No /85 on all working days during office Hours only. Name of signatory: Page 4 of 6

5 PARTICULARS IN RESPECT OF WORKS EXECUTED FOR THE LAST 5 YEARS INCLUDING WORKS ON HAND ANNEXURE A Sl No. Name & address of the Employer Name of work / project Description of work executed Estimated Cost of the Work Period of completion as per the Contract Actual Period and date of completion Name of the Architect / consultant Reasons for delay / cost over run etc Penalty / litigation/ arbitration if any (please give details) Note: (i) The Work Order / credentials issued by the clients are serially attached at page nos. (ii) The work should have been executed in Madhya Pradesh by the firm under the name in which they are submitting the application. (iii)necessary details and documentary proof, photographs if any etc. has to be enclosed as separate attachments serially numbered with cross references to the respective statements made in this Application. Any sort of negligence in this respect and in this application is likely to result in rejection of the application. Name of signatory Page 5 of 6

6 OTHER RELEVANT INFORMATION ANNEXURE B Sl Particulars No. No. of years with the firm Any other in formation No. Technically qualified Skilled Work force permanently employed 2. List of major constructional equipment in possession of the firm NOTE (i) The Work Order / credentials issued by the clients are serially attached at page nos. (ii) The work should have been executed in Madhya Pradesh by the firm under the name in which they are submitting the application. (iii) Necessary details and documentary proof, photographs if any etc. has to be enclosed as separate attachments serially numbered with cross references to the respective statements made in this Application.. Any sort of negligence in this respect and in this application is likely to result in rejection of the application. Name of signatory Page 6 of 6

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