Improvements to Athani Main Road to Rajkumar Layouts Main Road (connecting from Supreme Medical to Thoravi Atalatti Road) and internal roads in Vijayapura City.(5054-04-337-0-01-154 MDR Improvements)

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

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Address:…………………………

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

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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 2020 Remarks (Indicate contract reference)

January February march April May June July August September October November December

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GSB in cum Physical

Base Course (WMM/WBM) in cum Physical

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Others Specify Details Physical

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GSB in cum Physical

Base Course (WMM/WBM) in cum Physical

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GSB in cum Physical

Base Course (WMM/WBM) in cum Physical

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

Concrete in cum Physical

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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

Concrete in cum Physical

Steel in MT Physical

Others Specify Details Physical

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 * : 2020

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Progress * : 2021

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Progress * : 2022

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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 2024-25

Attach Chartered Accountant's Yearwise Statements.

Name of Work:-Improvements to Athani Main Road to Rajkumar Layouts Main Road (connecting from Supreme Medical to Thoravi Atalatti Road) and internal roads in Vijayapura City.(5054-04-337-0-01-154 MDR Improvements) PWD/2025-26/RD/WORK_INDENT34873

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 Mechanical Means 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, disposing off 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 m³ 2043 99.75 203789.25

2 Preparation and Surface Treatment of Formation. Preparation and surface treatment of formation by removing mud and slurry, watering to the extent needed to maintain the desired moisture content, trimming to the required line, grade, profile and rolling with 8-10 t smooth wheeled roller, complete as per clause 310. m² 0 0 0

3 Construction of Subgrade and Earthen Shoulders Construction of sub-grade and earthen shoulders with approved material obtained from borrow pits with all lifts & leads, transporting to site, spreading, grading to required slope and compacted to meet requirement of table No. 300-2 m³ 1132.7421875 517.65 586363.99

4 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 m³ 238 2476.95 589514.1

5 Wet Mix Macadam (Plant mix method) 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. m³ 649.625 2686.95 1745509.89 0

6 Providing and constructing un-reinforced plain cement concrete pavement, thickness as per design, over a prepared sub base, with 43 grade cement or any other type as per Clause 1501.2.2 M30 (Grade), coarse and fine aggregates conforming to IS:383, maximum size of coarse aggregate not exceeding 25 mm, mixed in a concrete mixer of not less than 0.2 cum capacity and appropriate weigh batcher using approved mix design, laid in approved fixed side formwork (steel channel, laying and fixing of 125 micron thick polythene film, wedges, steel plates including levelling the formwork as per drawing), spreading the concrete with shovels, rakes, compacted using needle, screed and plate vibrators and finished in continuous operation including construction joints, , primer, sealant , curing of concrete slabs for 14- days, and water finishing to lines and grade as per drawing and technical specification clause 1501 with all lead, lifts, loading & unloading charges, cost and conveyance of all materials, labour, equipments etc., complete. as per the directions of the Engineer-in-charge of the work. m3 1093.4375 6970.95 7622298.14

7 Tack coat on Bituminous surface Providing and applying tack coat with VG-10 Bitumen usingpressure distributor at the rate of 0.20 kg/m2 on the preparedbituminous surface cleaned with mechanical broom m2 1190 18.9 22491

8 Providing and laying Bituminous Macadam with 40/60 TPHcapacity hot mix plant using crushed aggregates of specifiedgrading premixed with bituminous binder VG-30 @ 3.4% byweight of mix, transported to site, laid over a previously preparedsurface with echanical paver finisher to the required grade,level and alignment and rolled as per clauses 501.6 and 501.7 toachieve the desired compaction m3 29.75 10391.85 309157.54

9 Semi Dense Bituminous Concrete Providing and laying Semi Dense Bituminous Concrete with40/60 TPH capacity hot mix plant batch type using crushedaggregates of specified grading premixed with bituminous binderVG-30 @ 5% by weight of mix and filler, transported to site,laid over a previously prepared surface with mechanical paverfinisher to the required grade, level and alignment and rolled asper MoRTH V revision. m3 14.88 14281.05 212502.024

10 Providing and constructing “WIRE CUT BRICK MACHINEHOLE CHAMBERS” using Portland/Pozzolana cement, conical in shape at top, with CC 1:3:6 foundation using 40mm and down size graded metal of approved quality and with an offset of 0.15M alround the chamber. Construct Brick masonry in CM 1:4, 340 mm thick, with wirecut bricks of approved quality, plaster inside and out side with CM 1:3, 12mm thick, except for the conical surface outside where the plaster thickness shall be 20mm. Slope inside to be 1:6 in the concrete towards central drain and finished smooth. Fixing of pipes in CC 1:2:4 with graded metal of 20mm and down size. Supplying and fixing SFRC Machinehole frame and cover (Heavy Duty) conforming to IS:12592 with latest amendment, in CC 1:2:4. Supplying and fixing footsteps made of 12mm dia. steel bars (Fe-500) with 3mm thick plastic encapsulation (IS-10910). The footsteps shall be fixed 30cms apart and on CC block embeded to masonry wall. The whole works include watering, curing, barricading, danger lighting, pouring tar over MH frame and cover, cost of tar, shoring, strutting, dewatering, engraving Machinehole number with flow direction on the inner conical surface etc. as per the drawing etc. as per technical specifications and for the following diameters and depth etc. for 1.2mm diaCirc. B M.H: Constructing Brick Masonry Circular Machinehole 1.2 m internal dia. , 1.0 M depth & SFRC cover & frame Each 16 30499.35 487989.6

11 Road Marking with Hot Applied Thermoplastic Compoundwith Reflectorising Glass Beads on Bituminous SurfaceProviding and laying of hot applied thermoplastic compound2.5 mm thick including reflectorising glass beads @ 250 g/m2area, thickness of 2.5 mm is exclusive of surface applied glassbeads as per IRC:35:2015.The finished surface to be level,uniform and free from streaks and holes. m² 249 556.5 138568.5

12 Supplying and Fixing of Molded Shank Raised Pavement Markers / Cat's Eye made of polycarbonate and ABS moulded body and reflective panels with micro prismatic lens capable of providing total internal reflection of the light entering the lens face and shall support a load of 16000 kg tested in accordance to ASTM D 4280 Type H and complying to Specifications of Category A of MORTH Circular No RW/NH/33023/10-97 DO III Dt 11.06. 1997. The height, width and length shall not exceed 50 mm, 100 mm and 102 +/- 2 mm and with minimum reflective area of 13 cm2 on each side and the slope to the base shall be 35 +/- 5 degree. The strength of detachment of the integrated cylindrical shanks, (of diameter not less than 19 +/- 2 mm and height not less than 30+/- 2 mm) from the body is to be a minimum value of 500 Kg. Fixing will be by drilling holes on the road for the shanks to go inside, without nails and using epoxy resin based adhesive as per manufacturer's recommendation and complete as directed by the engineer.The contractor shall submit a two year warranty for satisfactory field performance including stipulated retro-reflectance of the reflecting panel, to the Engineer Nos 172 383.25 65919

13 Providing and fixing of retro- reflectorised cautionary, mandatory and informatory sign as per IRC:67:2012 made of Class B Type IV retro reflective sheeting fixed over 2 mm thick aluminium sheeting vide clause 803.1, 3mm/4mm thick Aluminium composite material sheet depending on the size of the sign fixed over the back support frame of min 25 x 25 x 3mm angle mounted on a mild steel circular pipe 65 NB, 3.2 mm thickness firmly fixed to the ground by means of properly designed foundation with M25 grade cement concrete 45 cm x 45 cm x 60 cm, 60 cm below ground level as per approved drawing.The sign shall be maintained as per section 12 of IRC:67:2012. 60 cm equilaterial triangle Each 5 3740.1 18700.5

14 Direction and Place Identification Signs more than 0.9 m2 Size Board. Providing and erecting direction and place identification retro-reflectorised sign as per IRC:67:2012 made of high intensity grade sheeting vide clause 801.3, fixed over aluminium sheeting, 2 mm thick or Aluminium composite material sheet with overall thickness of 4mm with area not exceeding 0.9 m2 fixed over back support frame of min 35 x 35 x 3mm angle mounted on a mild steel circular pipe 65 NB, firmly fixed to the ground by means of properly designed foundation with M25 grade cement concrete 45 x 45 x 60 cm, 60 cm below ground level as per approved drawing m² 2.16 10168.2 21963.312

Month wise Amount Miles Amount Fenalty

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)