Disclaimer Stock Holding Corporation of India Limited SHCIL makes no representation or warranty and shall incur no liability under any law, statute, rules or regulations as to the accuracy, reliability or completeness of this form and the information herein. SHCIL may in its absolute discretion, but without being under any obligation to do so, update, amend or supplement the information in this form. Stock Holding Corporation of India Limited (SHCIL) reserves the right to amend/ update / modify / cancel the form and/or the empanelment process without assigning any reason(s) whatsoever. Name of Organization Stock Holding Corporation of India Limited Document Reference No. EMPForm/IT/2014-15/001 Date of issue of this document 12 th November 2014 Submission of this document (form) On Immediate basis (form will available on our website till 12 th December, 2014 12:00 noon Note: This document is not transferable This Form should be duly filled and send to the following postal address / email address: Vice President - IT, Stock Holding Corporation of India Limited SHCIL House, Plot No. P-51, T.T.C. Industrial Area, M.I.D.C., Mahape, Kalyan-Shil Road, Navi Mumbai PIN 400710. Ph. 61778001 Email: maherkumar.panchal@stockholding.com / rohit.sudan@stockholding.com 1. Name of the Vendor Company: 2. Address: 3. Registration Nos.: 4. Contact Person: a. Name: b. Phone Nos.: Page 1 of 5
5. Organization Type (Partnership/Ltd. Co/Sole Partnership etc): 6. Name of directors/partners/owners: 7. Total Employee Strength: a. Regular: b. Contract / Outsourced / Others: 8. Experience in Services (in years): 9. Whether you can take-up Software Application development (turnkey) projects (Yes/No)? 10. Development Services / Developers required for software application development in the following platforms: a. Oracle forms, reports, PL/SQL, SQL b. JAVA and JAVA platforms and technologies c. Mobile Platforms (Android, ios, WindowsPhone, etc) d..net platforms (Note: Software application development needs to be on-site) Page 2 of 5
11. Software Developers with the vendor in each category Category Oracle forms, reports, PL/SQL, SQL On Payroll (No. of Regular Employees) No. of personnel On Contract / Outsourced Average experience in years Brief Description of background verification process of employee / on contract personnel JAVA and JAVA platforms and technologies Mobile Platforms (Android, ios, WindowsPhone, etc).net platforms 12. Cost per Resource (Category-wise): Category Cost per Resource in INR (Rs.) Oracle forms, reports, PL/SQL, SQL JAVA and JAVA platforms and technologies Mobile Platforms (Android, ios, WindowsPhone, etc).net platforms 13. Copies of following Statutory Registrations viz: a. VAT Act b. Service Tax c. Provident Fund Act d. ESIC Act e. Labour License (Central / State) f. Company registration/incorporation certificate g. Signed copy of Company PAN Card h. Any other regulatory requirement or certification Page 3 of 5
14. Annual Turnover: Financial Year: F.Y. 2011-12 Annual Turnover INR (Rs.) 2012-13 2013-14 15. Important Clients / Customers: Name of the Client Contact Person Phone No. 16. Indicate past and pending cases, prosecution, fines, penalties, etc. against your organisation 17. Any civil or criminal suit(s) arisen against the applicant / owners / directors / proprietors / partners, etc. Page 4 of 5
18. Any other relevant information 19. Declaration: I / We hereby declare that the information furnished above is true and correct. I / We am /are aware that incorrectness of the aforesaid information shall result in immediate termination of the contract and SHCIL shall be entitled to recover the necessary costs and damages. I /We am/are complying with all the Regulatory Authorities / Provisions and will continue to do so if empanelled as our vendor. I / We confirm that we comply with the empanelment eligibility criteria and further understand and accept the disclaimer fully. Authorized Signature With Seal and Stamp Page 5 of 5