Package-A: Contract for Housekeeping, Mail management and miscellaneous services at Office Building of POWERGRID, Bhubaneswar (Under AM Budget BE 2019-20)

Annexure-I to SCC

PROFORMA FOR INFORMATION TO BE FURNISHED BY CONTRACTOR IN RESPECT OF THE PROCUREMENT MADE/SERVICES AVAILED FROM MSE VENDORS

In line with clause 10.9 of SCC and requirement of payment terms, we hereby furnish the following information regarding the procurement made/services availed by us from Micro and Small Enterprises (MSEs) directly or thorugh our sub-suppliers /sub-vendors as per details given herein below:

Sl. No. CA No./ LOA No./ PO No. Name of Contractor /Suppier Quantity Total Value Region (ER-II-Odisha Projects) Services sourced from MSE vendor for production of item at colum 4 Total value of Services used for item at colum no.4 Name of MSE Vendor Category (Only Micro or Small) Whether MSE owned by Person Belonging to SC/ST Category.

Further, we hereby declare and confirm that the information mentioned above is correct and complete to the best of our knowledge and the category of MSE vendors as mentioned in the table above has been ascertained at our end.

1 The Contractor / supplier shall be required to furnish the aforesaid information on semi-annual basis or with running bill/final bill in case completion period is shorter than six months and being completed before 30th September/31st March. The information as above shall be for period from 1st April to 30th September and from 1st October to 31st March for each financial year. In case of party has been awarded with more than one contract, the above information shall be submitted for all contracts indicating contract wise details.

2 Submission of aforesaid information for the preceding six months shall be condition for processing of bills by POWERGRID for payment after 30th September /31st March as the case may be.

3 Only those items of LOA/PO may be included which involves sourcing of services from MSEs.

Name of Contractor/Supplier:

Name of Authorised Person: