Improvements and Re-carpeting to the Huvin hipparagi-kudarisalawadagi-kamankeri-yalwar MDR road from km 4.77 to 6.77 (kudarisalawadagi village limit) H/A (3054-04-337-1-10-200) MDR maintenance

Information on litigation in which the Tenderer is involved:

Other Party/Parties Employer Details of Dispute Amount involved Remarks showing Present Status

BANKER’S CERTIFICATE

This is to certify that M/s. ………………………….. is a reputed company with a good financial standing. If the contract for this work, namely ……………………………… (Name of the work) is awarded to the above firm, we shall be able to provide overdraft/credit facilities to the extent of Rs. …………… to meet the working capital requirements for executing the above contract

Name of the Bank, Senior Bank Manger

Address:…………………………

List of Machinery

Item of Equipment Requirement Owned/ Hired/Leased Owned/ Hired/Lease and available Remarks

No. Capacity Number/Capacity Age/ Condition

Information of the works for which Tenderer has submitted Tender.

Project Name Name & Address of the Employer Name of Work Amount put to Tender in Rs lac. Specified period of completion (including/excluding Monsoon Prescribed last date of submission of tender Probable date of decision on the Tender Remarks if any.

Information of the works for which Tender acceptance letters are received.

Project Name Name & Address of the Employer Name of Work Tendered Amount in Rs lac Specified period of completion (including/excluding Monsoon Probable Date of Handing over of site

Attach letters of Acceptance received.

Information on works which are yet to be completed.

Project Name Name & Address of the Employer Name of Work Contract Number Value of contract Rs. Lakhs Date of Markout /Date of Handing over of site Specified period of completion (including/excluding Monsoon cost of balance works remaining Rs. in lac Probable date of completion

Attach Certificate for each work indicated above, in Format 3, obtained from the Competent Authority

Monthly Physical and Financial Progress Achieved in all Contracts which are referred to in Format 3

Names of Works Item of Work Names of Employers 2019 Remarks (Indicate contract reference)

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Earthwork & Embankment in cum Physical

GSB in cum Physical

Base Course (WMM/WBM) in cum Physical

Asphalt Quantities (MSS/BM/BC/SDBC/DBM) in cum Physical

Others Specify Details Physical

Earthwork & Embankment in cum Physical

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Earthwork & Embankment in cum Physical

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Base Course (WMM/WBM) in cum Physical

Asphalt Quantities (MSS/BM/BC/SDBC/DBM) in cum Physical

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Earthwork & Embankment in cum Physical

GSB in cum Physical

Base Course (WMM/WBM) in cum Physical

Asphalt Quantities (MSS/BM/BC/SDBC/DBM) in cum Physical

Others Specify Details Physical

Earthwork & Embankment in cum Physical

GSB in cum Physical

Base Course (WMM/WBM) in cum Physical

Asphalt Quantities (MSS/BM/BC/SDBC/DBM) in cum Physical

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Earthwork & Embankment in cum Physical

GSB in cum Physical

Base Course (WMM/WBM) in cum Physical

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FORMAT FOR WORK DONE CERTIFICATE TO BE OBTAINED FROM COMPETENT AUTHORITY

has executed/ is executing(strike off which ever is not applicable) the work of .............................................

in this Organisation. The details of the work is as under:

1 Name of the Project :

2 Name of the Work :

3 Contract Amount :

4 Date of signing the Agreement :

5 Date of handing over of the Site :

6 Progress * : 2019

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7 Stipulated Period of Completion (including monsoon)

8 Prescribed Date of completion

9 Actual Date of Completion/ Probable Date of Completion

10 Cost of balance work (if work is in progress) :

11 Reasons if any for delay in completion, if work completion is delayed :

12 Penalty if any imposed :

13 Any other information :

* Monthwise progress shall be furnished seperately.

Date: (Authorised Signatory)

Address for correspondence:

Work executed as prime contractor (in the same name) on works of similar nature during the five years specified)

Project Name Name & Address of the Employer Name of Work Contract Number Value of contract Rs. Lakhs Date of Markout /Date of Handing over of site Specified period of completion (including/excluding Monsoon Actual date of completion Remarks (appreciation letter received for early completion or reasons, if there is delay in completion)

Attach Workdone Certificate for each work indicated above, in Format 3, obtained from the Competent Authority

Financial Year Total value of Civil Engineering works executed and payments received in the last five years (in Rs. lac)

Billed upto date during 2025-26

Attach Chartered Accountant's Yearwise Statements.

Name of Work:-Improvements and Re-carpeting to the Huvin hipparagi-kudarisalawadagi-kamankeri-yalwar MDR road from km 4.77 to 6.77 (kudarisalawadagi village limit) H/A (3054-04-337-1-10-200) MDR maintenance PWD/2025-26/RD/WORK_INDENT34837

Sl No Description Unit Quantity Rate Amount Mile Stone no.1 Mile Stone no.2 Mile Stone no.3

Ist Month IIst Month Total IIInd Month IVnd Month Total V nd Month VI nd Month Total

Physical Financial Physical Financial Physical Financial Physical Financial Physical Financial Physical Financial Physical Financial Physical Financial Physical Financial

1 Tack coat on Bituminous surface Providing and applying tack coat with VG-10 Bitumen using pressure distributor at the rate of 0.20 kg/m2 on the prepared bituminous surface cleaned with mechanical broom m2 1642.5 12.6

2 Dense Graded Bituminous macadam Grading - ii for traffic >20 mSa Providing and laying Dense Graded Bituminous Macadam with 40/60 TPH capacity HMP using crushed aggregates of specified grading, premixed with bituminous binder VG-40, @ 4.5 per cent by weight of total mix and filler, transporting the hot mix to work site, laying with mechanical paver finisher to the required grade, level and alignment, rolling with smooth wheeled, vibratory and tandem rollers to achieve the desired compaction as per MoRTH specification clause No. 505 complete in all respects. m3 1.875 10928.4 20545.39

3 Bituminous Concrete Grading ii for traffic >20 MSA Providing and laying Bituminous Concrete with 40/60 TPH capacity hot mix plant using crushed aggregates of specified grading, premixed with bituminous binder VG-40, @ 5.4 percent of mix and filler, transporting the hot mix to work site, laying with mechanical paver finisher to the required grade, level and alignment, rolling with smooth wheeled, vibratory and tandem rollers to achieve the desired compaction as per MORTH specification clause No. 507 complete in all respects. m3 48.14999999999999 12736.5

1 Earth work in surface excavation by mechanical means for lowering & leveling the ground for all works other than foundation in all kinds of soils & upto depth not exceeding 300mm as per drawing and technical specifications, including setting out, shoring, strutting, barricading, caution lights, removal of stumps and other deleterious matter including dressing of excavated surfaces, disposingoff or levelling the excavated earth or sorting & stacking the selected earth for reuse in a radius of 50 m and lift upto 1.5 m including cost of labour, tools,usage of machinery & other appurtenances required to complete the work.In all kinds of soils upto 300 mm depth Cum 1250 99.75

2 Compacting Original Ground Loosening, leveling and Compacting original ground supporting embankment to facilitate placement of first layer of embankment, scarified to a depth of 150 mm, mixed with water at OMC and then compacted by rolling so as to achieve minimum dry density as given in Table 300-2 for embankment construction. Cum 750 110.25

3 Granular Sub-Base - By Mix in Place Method - Construction of Granular Sub-Base of required grading as per design spreading in uniform layers with motor grader on prepared surface mixing by mix in place method with front end loader at OMC and compacting with vibratory roller to achieve the desired density, complete as per clause 401 - For Grading -V Material. Cum 500 2476.95

4 Construction of dry lean cement concrete Sub- base over a prepared sub-grade with coarse and fine aggregate conforming to IS: 383, the size of coarse aggregate not exceeding 25 mm, aggregate cement ratio not to exceed 14:1, aggregate gradation after blending to be as per table 600-1, cement content not to be less than 140 kg/ m3 , optimum moisture content to be determined during trial length construction, concrete strength not to be lessthan 7 Mpa at 7 days, mixed in a batching plant, transported to site, laid with a paver with electronic sensor, compacting with 8-10 t vibratory roller, finishing and curing Cum 400 5119.8

5 Construction of un-reinforced plain cement concrete pavement using RMC M-30 grade with OPC @ 270 kg/m3 and GGBS@ 90 kg/m3 (75:25 proportion) as per approved mix design procedure and thickness as per design, over a prepared sub base. The superplastisiser confirming to IS 9103-1999 Reaffirmed-2008 ,Coarse aggregates and Fine aggregate confirming to IS:383-2016, transported to site, laid in approved fixed side form work (steelchannel, laying and fixing of 125 micron thick polythene film, wedges, steel plates including levelling the form work). Spreading the concrete with shovels, rackers and compacted using needle, suitable plate vibrator and finished in a continuous operationincluding provision of separation membrane and Hessian cloth finishing to lines and grades complete including cost of allmaterials, labour, all lead & lift, loading charges as per specification& direction of Engineer - incharge of the work Cum 920 6654.9

6 Providing, laying, spreading and compacting graded stone aggregate to wet mix macadam specification including premixing the Material with water at OMC in mechanical mix plant carriage of mixed Material by tipper to site, laying in uniform layers with paver/grader in sub-base / base course on well prepared surface and compacting with vibratory roller to achieve the desired density. Cum 200 2686.95

7 Providing and laying 80mm thick factory made precast M -30 grade Cement Concrete Paver Block as per IRC SP 63:2018 & IS 15658 for Commercial Traffic Axle load repetitions upto 10MSA & for Residential Streets of approved shape and colour, laid in required pattern and including over 40mm thick compacted bed of coarse sand, filling the joints with fine sand etc. all complete as per the direction of Engineer-in-charge. (WMM/WBM Base to be paid separately as per relevant technical specification) Sqm 1000 1219.05 0 0

Month wise Amount Miles Amount Penalty

1 Month 1 Miles (1 & 2 Month) Executive Engineer

2 Month PWD Division Viajayapur

3 Month 2 Miles (3 & 4 Month)

5 Month 3 Miles (5 & 6 Month)