EXPRESSION OF INTEREST FOR ROAD TRANSPORTATION OF BULK PETROLEUM PRODUCTS - MS HSD BRANDED FUELS for DEALERS AND CONSUMERS BY TOP LOADING TTs Ex LOCATION MANGALORE TERMINAL

S.NO BID NO NAME OF RO DEALER/DIRECT CUSTOMER Whether Bidding Firm is Proprietary Firm, Partnership Firm/LLP, Company, Co-operative Society VENDOR CODE RO/CONSUMER SAP CODE ADDRESS MOBILE NO. E-MAIL ID NO OF TTS OFFERED WHETHER OFFER IS FOR READY TT OR TT WITH PURCHASE INVOICE OR TT WITH BOOKING SLIP NO. PLEASE SPECIFY Ready TT Registration No. /PURCHASE INVOICE NO./ Booking Slip No. CAPACITY (KL) CHASSIS NO ENGINE NO. MAKE MODEL BS Status DATE OF MFG BS STATUS (BS III/BSIV/ BSVI) REGISTERED OWNER OF TT REGISTRATION CERTIFICATE (RC) OF TT PESO LICENSE NO PESO LICENCE VALID TILL RO DEALERSHIP AGREEMENT/ LETTER FROM CONCERNED DIVISIONAL OFFICE /LETTER FROM CONCERNED DIVISIONAL IB OFFICE ATTACHED (YES) Power of Attorney along with Registered deed of Partnership along with Registration Certificate from Registrar of Firms / LLP agreement attached (YES/NO/ NA) WHETHER EOI IS WITH CONSORTIUM OR NOT (YES /NO) NAME OF RO DEALER IN CONSORTIUM - RO-1 SAP CODE OF RO-1 NAME OF RO DEALER IN CONSORTIUM - RO-2 SAP CODE OF RO-2 TENDER ACCEPTANCE FORMAT ATTACHED (YES) EMD - BID SECURITY DECLARATION -Annexure – A ATTACHED (YES) EOI LETTER (ANNEXURE-1) ATTACHED (YES) DECLARATION (ANNEXURE-2) ATTACHED (YES/NO/ NA) DECLARATION (ANNEXURE-3) ATTACHED (YES/NO/ NA) EOI AFFIDAVIT (ANNEXURE-4) ATTACHED (YES/NO/ NA)