Execution of Internal Civil and MEP Works on the Fourth (4th) and Fifth (5th) Floors of Shantilal Shanghvi Paediatric Cancer Center (SSPCC) at ACTREC, Kharghar, Navi Mumbai

Percentage quote for the Execution of Internal Civil and MEP Works on the Fourth (4th) and Fifth (5th) Floors of Shantilal Shanghvi Paediatric Cancer Center (SSPCC) at ACTREC, Kharghar, Navi Mumbai.

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TECHNICAL DATA SHEET

PART I : DETAIL OF THE AGENCY

PART II : DOCUMENTS TO BE SCANNED AND UPLOADED.

Financial Turn Over Certified by CA

PL. FILL UP AMOUNT & UPLOAD SCANNED COPIES

Average of last 3 years

Profit & Loss Statement Certified by CA

PL.FILL UP AMOUNT & UPLOAD SCANNED COPIES

Latest Bank Solvency Certificate.

Name of Bank

Amount

Date of Issue

List of Similar Works carried out in last 7 years i) Agency for whom exceuted ii) Value of Work iii)Stipulated and Actual time of Completion.

3 similar works works a)

2 similar works works a)

1 similar works works

Bidding Capacity

List of all works in Hand indicating: i)Agency ii) Value of Work iii) Stipulated time of completion/ present position etc.

Typr of works executed since last seven years

List of Construction Plants and Machinery.

Maximum amount of single works executed since lats 7 years

List of Technical Staff.

i) Registration Certificate if any

ii) Certificates of Work Experience /Performance certificates

iii) PAN (Permanent Account Number)

PL. FILL UP REGD. NUMBER & UPLOAD SCANNED COPIES

PL. FILL UP REGD. NUMBER & UPLOAD SCANNED COPIES

PL. UPLOAD SCANNED COPY

Undertaking that the eligible similar work(s) have not been executed through another contractor on back to back basis:

UNDERTAKING

UNDERTAKING: I / We have read and examined the E-Tender Notice for Inviting Pre Qualification (PQ) of Contracting Agencies, Section I, II & III, & other documents and rules referred to and all other contents in the tender documents for the work AND ACCORDINGLY I / We, hereby submit credentials and other documents as are provided for, by, and in respects in accordance with, such conditions so far as applicable.

I/We have downloaded and gone through the pre-bid clarifications issued by the Department after close of sale of tenders and submitting tender accordingly.

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Form "A" & "B" Financial Information & Bank Solvency

SCAN COPY ATTACHED "YES" OR "NO"

Financial Turn Over Certified by CA

Latest Bank Solvency Certificate.

Financial Arrangements for carrying out the proposed work

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FORM C : Details of all similar works completed in all respect during the last seven years ending previous day of last date of submission of tenders.(Starting with latest work)

Name of the Agency

* Indicate gross amount claimed and amount awarded by the Arbitrator if any.

Notes:-

i) The agency may submit separate form for giving details of work (completed) for each year to fill up the details as above.

Separate sheets if any shall be numbered in sequence.

ii) The scanned copies of the work orders for each work be uploaded . BOQ shall be furnished at a later date on request.

iii) Certified that the above list of works is complete and no work has been left-out and the information given is correct to my

knowledge and belief.

iv) The hard copy all similar works completed during last seven years ending previous day of last date of submission of tenders.

shall also be submitted on or before due date.

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FORM D : Details of all works of any nature under execution or awarded (No work shall be left out).

Name of the Agency

i. The agency may submit separate form for giving details of each project (in progress/awarded) and fill up the details

as above. Separate sheets if any shall be numbered in sequence.

ii. The scanned copies of the work orders for each work be uploaded. BOQ shall be furnished at a later date on request.

iii. Certified that the above list of works is complete and no work has been left-out and the information given is correct

to my knowledge and belief

iv. The hard copy all works of any nature in hand and awarded shall also be submitted on or before due date. No works

shall be left out

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FORM E : Performance Reports of Works (Separate certificates for each work)

Name of the Agency

(i) Stipulated date of Completion

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FORM F: STRUCTURE AND ORGANISATION

Name & Postal Address of the applicant:

Telephone No./Telex No./Fax No.

Legal status of the applicant (Please tick and attach attested copies of original document defining the legal status)

(a) An individual; (b) A proprietary firm; (c) A firm in partnership (d) A limited company or Corporation

Particulars of registration with various Government bodies (scanned & uploaded photocopy)

Names and Titles of Director & Officers with designation proposed to be concerned with this work

Designation of individuals authorised to act for the organisation

Was the agency ever required to suspend construction for a period of more than six months continuously after you commenced the construction? If so, give the name of the project and reasons of suspension of work.

Has the agency or any constituent partner in case of partnership firm, ever abandoned the awarded work before its completion? If so, give name of the project and reasons for abandonment.

Has the agency, or any constituent partner in case of partnership firm, ever been debarred / black listed for tendering in any organisation at any time? If so give details.

Has the agency, or any constituent partner in case of partnership firm , ever been convicted by a court of law? If so, give details.

In which fields of Engineering construction the applicant has specialisation and interest?

Any other information considered necessary but not included above.

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Form "G"- DETAILS OF TECHNICAL & ADMINISTRATIVE PERSONNEL TO BE EMPLOYED FOR THIS WORK

Name of the Agency

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Form H- DETAILS OF CONSTRUCTION PLANT AND EQUIPMENT LIKELY TO BE USED IN CARRYING OUT THIS WORK

Name of the Agency

Presently owned

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