EOI cum PQ Bid for HFRR Project on EPC Mode I basis

FINANCIAL INFORMATION

I. Financial Analysis - Details to be furnished in this Form 'A' duly supported by figures in balance sheet/ profit and loss account for the last five years and Form 'A' to be duly certified by the Chartered Accountant along with valid UDIN (Copies of Audited Balance Sheets/ Profit and Loss account to be attached)

i) Gross Annual turnover on construction work Rupees (In Lakhs)

ii) Profit/Loss Rupees (In Lakhs)

iii) Certified by

Name and address of Chartered Accountant

Scanned copy on Banker's letter head to be uploaded

FORM OF BANKER’S CERFIFICATE FROM A SCHEDULED BANK

This is to certify that to the best of our knowledge and information that M/s / Shri _________________________ having marginally noted address, ______________ a customer of our bank are / is respectable and can be treated as good for any engagement upto a limit of Rs. _________________ (Rupees _______________________ __________________________________).

This certificate is issued without any guarantee or responsibility on the bank or any of the officers.

(1) Bankers certificates should be on letter head of the Bank, addressed to tendering authority.

(2) In case of partnership firm, certificate should include names of all partners as recorded with the Bank.

DETAILS OF ALL SIMILAR WORKS COMPLETED IN ALL RESPECTS DURING THE LAST TWELVE YEARS

S No. Name of work /project and location Owner or sponsoring organisation Cost of work Rupees Date of commencement as per contract Stipulated date of completion Actual date of completion Litigation / arbitration pending /in progress with details* Name & Address / Phone No. of officer to whom reference may be made. Remarks

* Indicate gross amount claimed and amount awarded by the Arbitrator.

a. Applicant may submit separate form for giving details of work (completed) for each year to fill up the details as above. Separate sheets if any shall be numbered in sequence.

b. The scanned copies of the work orders for each work along with completion certificate shall be uploaded.

c. Certified that the above list of works is complete and no work has been left-out and the information given is correct to my knowledge and belief.

Name of authorized signatory

PROJECTS UNDER EXECUTION OR AWARDED

Sl. No. Name of work/ project and location Owner or sponsoring organisation Cost of work in Lakhs Rupees Date of commencement as per contract Stipulated date of completion Up to date percentage progress of work Slow progress if any and reasons thereof Name and address / telephone number of officer to whom reference may be made Remarks

Name and address of the authorized signatory

Scanned copy of certificates containing following information from the clients to be uploaded

PERFORMANCE REPORT OF WORKS REFERRED TO IN FORM "C" OR FORM "D"

(Separate certificate for each work/ Project)

1. Name of work/Project & Location

2. Work order No/ Agreement No.

3. Work Order Value

4. Value of Completed Work (NA for ongoing works)

5. Date of start

6. Date of completion (NA for ongoing works)

(i) Stipulated date of completion

(ii) Actual date of completion (NA for ongoing works)

(iii) Present position of work, if in progress.

7. Amount of compensation levied for delayed completion, if any.

8. Amount of reduced rate items, if any.

9. Performance Report.

Quality of work Excellent/ Very Good/ Good/ Fair/ Satisfactory/ Poor

Dated: Executive Engineer or equivalent

Signature with Seal

STRUCTURE & ORGANISATION

1 Name & Postal Address of the applicant:

2 Telephone No./Telex No./Fax No.

3 Legal status of the applicant (Please tick and attach attested copies of original document defining the legal status)

(a) An individual; (b) A proprietary firm; (c) A firm in partnership

(d) A limited company or Corporation

4 Particulars of registration with various Government bodies (attach attested photocopy)

Dept./Organisation & Place of registration Registration No.

5 Names and Titles of Director & Officers with designation proposed to be concerned with this work

6 Designation of individuals authorised to act for the organisation

7 Was the applicant ever required to suspend construction for a period of more than six months continuously after you commenced the construction? If so, give the name of the project and reasons of suspension of work.

8 Has the applicant or any constituent partner in case of partnership firm, ever abandoned the awarded work before its completion? If so, give name of the project and reasons for abandonment.

9 Has the applicant, or any constituent partner in case of partnership firm, ever been debarred / black listed for tendering in any organisation at any time? If so give details.

10 Has the applicant, or any constituent partner in case of partnership firm , ever been convicted by a court of law? If so, give details.

11 In which fields of Engineering construction the applicant has specialisation and interest?

12 Any other information considered necessary but not included above.

Name and address of the authorized signatory