E NIT_CWC RO-MUM/Engg/ZMC/26-27/04)

Name of the Bidder,

Address,

(Proprietorship/Partnership/Private Limited/ Limited)

Attested copy of organization Details

Name of the person holding the power of attorney for this Bid

Contact details of person holding the power of attorney

Attested Copy of Power of Attorney details to sign the Tender Document

Earnest Money Deposit (EMD)of Rs.5.13 lakh:

Cost of Tender Documents: Nil

PF Registration code

GST Registration code

PAN No. of the Bidder

Contractor Registration enlistment with CPWD/

Financial Eligibility Criteria:

The Sum (Arithmetic sum) of tenderer’s turnover: revenue(income) from operations for the last three financial year should be of value not less than ₹. 230.77 Lakh (90% of Estimated Cost put on Tender).

Chartered Accountant’s Certificate for Annual financial turnover/ revenue(income)from operations of specified preceding three years

Annual Financial Turnover/Revenue (Income)from operations (as

Total Turn Over- RS…….

Total Turn Over- RS…….

Total Turn Over- RS…….

Total Turn Over- RS…….

Experience w.r.t. Similar Nature of Work:

Name of the works completed and presented against the criteria:

Work order/ contract agreement ref number and date

Name of client issuing the work order and completion certificate

Completion certificate -ref number and date

Total value of work completed (Rs.)

Stipulated date of completion

Actual date of completion

Amount / period of delay for which Liquidity damage levied by client (if any)

Work order/ contract agreement ref number and date

Name of client issuing the work order and completion certificate

Completion certificate -ref number and date

Total value of work completed (Rs.)

Stipulated date of completion

Actual date of completion

Amount / period of delay for which Liquidity damage levied by client (if any)

Work order/ contract agreement ref number and date

Name of client issuing the work order and completion certificate

Completion certificate -ref number and date

Total value of work completed (Rs.)

Stipulated date of completion

Actual date of completion

Amount / period of delay for which Liquidity damage levied by client (if any)

Bidder Office in the State

Bidder must have Office, on the latest due date of tender submission in the state where the site of works (as mentioned in Tender) is /are located. For this purpose, valid GST number shall be considered as proof of office address. Bidder would be required to submit the proof of office address at the time of contract signing.

GST Number

Eligibility declaration form as per NIT-clause 3 and ITB-clause 3.2 under form -E of this PQ Performa

Execution of Miscellaneous Repair /Maintenance, Upgradation and Construction works in Zone 4 – a cluster of central warehouses located at Thane, Raigad, Mumbai Sub Urban and Pune On Annual rate Contract basis

E NIT_ CWC RO-MUM/Engg/ZMC/26-27/04

Contractor Percentage (CP)

Above/ Below/ At Par of rates -mentioned in Price Schedule

Price Schedule:

Rs. (In figure)

Execution of Miscellaneous Repair /Maintenance, Upgradation and Construction works in Zone 4 – a cluster of central warehouses located at Thane, Raigad, Mumbai Sub Urban and Pune On Annual rate Contract basis

E NIT_ CWC RO-MUM/Engg/ZMC/26-27/04

Contractor Percentage (CP)

Above/ Below/At Par of rates -mentioned in Price Schedule

Price Schedule:

Rs. (In figure)

Execution of Miscellaneous Repair /Maintenance, Upgradation and Construction works in Zone 4 – a cluster of central warehouses located at Thane, Raigad, Mumbai Sub Urban and Pune On Annual rate Contract basis

E NIT_ CWC RO-MUM/Engg/ZMC/26-27/04

Contractor Percentage (CP)

Above/ Below/At Par of rates -mentioned in Price Schedule

Price Schedule:

Rs. (In figure)

Execution of Miscellaneous Repair /Maintenance, Upgradation and Construction works in Zone 4 – a cluster of central warehouses located at Thane, Raigad, Mumbai Sub Urban and Pune On Annual rate Contract basis

E NIT_ CWC RO-MUM/Engg/ZMC/26-27/04

Contractor Percentage (CP) Quoted Above/ Below/At Par of rates -mentioned in Price Schedule

Description

Price Sub Schedule A.I

Price Sub Schedule A.II

Price Sub Schedule A.III