PROCUREMENT OF SYNTHETIC RUBBER ADHESIVE

ADDITIONAL FORMAT & ITEM LIST

NOTE : THE BIDDERS SHOULD FILL THE DETAILS AS MENTIONED IN THE FORMAT AND THE SAME SHOULD BE UPLOADED IN THE E.PROCUREMENT PORTAL.

THE CONTROLLER OF STORES AND PURCHASES,

K.S.R.T.C., CENTRAL OFFICES,

K.H. ROAD, BANGALORE

Sub: Supply of 'Synthetic Rubber Adhesive'.

Ref: Tender No. KSRTC/2026-27/IND0304 Dated:03.06.2026

NAME & ADDRESS OF THE FIRM

Sl. No Item Code/ Part No. Nomenclature UOM Tendered Quantity (apprx) HSN Code ITEM WISE GST (5%/ 12%/ 18%/ 28%) Any other levies BRAND NAME PRODUCTION CAPACITY PER MONTH SUPPLY CAPACITY PER MONTH TO KSRTC

1 71070087 Synthetic Rubber Adhesive as per the Specification Ltrs 17300

A Prices F O R Destination to Regional Workshops of KSRTC (Kengeri & Hassan)

B Validity of the offer 180 days and will be extended till the completion of the Order in case the Purchase Order is awarded

C Lead Time required

D Distributors name (if any) Address of the Distributor

Signature of the Authorized Signatory with company seal

Mobile Number :

Environmental Management System

Name of the Tenderer

Sub: Supply of Synthetic Rubber Adhesive

Ref:Tender No. KSRTC/2026-27/IND0304 dated: 03.06.2026

Sl. No Points to be checked Status (Yes or No) Remarks Hints/Suggestions

1 Do you have processes that have significant impact on environment? List them in the remarks column 1. Heat treatment 2. Surface derangement. 3. Foundry

2 Do you use hazardous chemicals/ materials? List them in the remarks column Chemical/listed /falling under the criteria given in the hazardous chemicals Rules-1989

3 Leakage/spillage of oils and chemicals in the work environment. Good housekeeping ensures minimum impact on the environment

4 Have you obtained consent from statutory authorities? Consent under the Water& Air Acts & authorization under the hazardous wastes Rules(if applicable)from the pollution control board

5 Have you introduced air pollution control measures? List them in the remarks column Air pollution control measure(if required) like dust collector, scrubbers etc.,

6 Are Hazardous wastes generated from the process? Hazardous wastes listed in the schedules of Hazardous wastes Rules-1989

7 Do you facility for the storage/disposal of Hazardous wastes? Hazardous wastes like effluent treatment sludge, sludge from plating baths, spent oils, solvents etc.

8 Do you have any

Plans to reduce the waste generated Reduce, Recycle and Reuse

Noise level control measures Acoustic enclosures

Plans to conserve natural resources Water and energy conservation measures

Emergency preparedness and response plan Emergency preparedness in case of fire, accidents etc.,

9 Are employees regularly kept informed and trained in environmental protection issues. Awareness programmes

Version 24.08.2022

THE CONTROLLER OF STORES AND PURCHASES,

K.S.R.T.C., CENTRAL OFFICES,

K.H. ROAD, BANGALORE

Sub: Supply of Synthetic Rubber Adhesive

Ref: Tender No. KSRTC/2026-27/IND0304 Dated : 03.06.2026

1 NAME OF THE FIRM

2 Tender Processing Fee Details :- to be paid through e-payment mode only

a Mode of Payment

b Amount Rs: As charged by KPP Portal

c Bank Transaction No: (For NEFT / OTC )

3 EMD Details :- to be paid through e-payment mode only

a Mode of Payment

b Amount Rs: Rs: 10,000=00

c Bank Transaction No: (For NEFT / OTC )

4 Bank details of tenderer/ bidder

a Name of the Bank

b Branch Address

c Account Number

Signature of the Authorized Signatory with Company Seal

INFORMATION ABOUT THE TENDERER

THE CONTROLLER OF STORES AND PURCHASES

K.S.R.T.C., CENTRAL OFFICES

K.H. ROAD, BANGALORE-560 027

Sub: Supply of Synthetic Rubber Adhesive

Ref: Tender No. KSRTC/2026-27/IND0304 Dated : 03.06.2026

We hereby furnish the following details as under

1 NAME AND ADDRESS OF THE TENDERER

a Name of the firm

Office Address:

Telephone and Fax Number

b Works Address:

Telephone and Fax Number

c Name of the Authorized Signatory

Phone/ Mobile Phone No.

valid E-mail Address

d Name of the Contact person

Phone/ Mobile Phone No.

valid E-mail Address

2 GENERAL INFORMATION

Status of the firm (Enter any of the following options) Yes/ No

We are the Manufacturer of Tenedered items.

We are the Authorized Dealer of Tenedered items.

a The itemwise Production capacity and quantity offered to supply to KSRTC per month and other details given in Additional Format is to be filled & uploaded in the e.portal. (Say "Yes or No")

b We undertake to hold the quoted price for the period of Tender and to submit Security Deposit. (Say 'Yes' or 'No')

c We undertake to abide by all the terms and condions of the tender and to supply the entire Ordered quantity as per the Delivery Schedule furnished (Say "Yes" or "No")

4 DOCUMENTS ATTACHED ELECTRONIC MODE(SCANNED) FOR ELIGIBILTY CRITERIA

We have attached the following documents in Electronic Mode(Scanned) for following terms & conditions :(Fill 'Yes' or 'No')

a Certificate of Incorporation/ Certificate of Registration issued by the Registrar of Companies/ Industries and Commerce Dept in proof of manufacturing status (along with MOA or Annexures/ enclosures to certificate)

b Authorization Certificate issued by the Original Manufacturer to participate in the tender (in case of Authorised Dealer)

c Manufacturers need to submit the proof for the manufacturing of the tendered items like MSME certificate, NSIC certificate, SSI certificate or ISO certificate etc which covers the tendered items.

d GST Registration Certificate

e Declaration-I as per the format on Govt. stamp paper of Rs. 20/-

f Declaration-II as per the format on Govt. stamp paper of Rs. 20/- (In case the manufacturers/ Principal firm will execute supplies through their Channel Partner/ Authorized Dealer/ Distributor)

g Declaration-III as per the format on Govt. stamp paper of Rs. 20/-

h NSIC certificate (to avail exemption from the payment of Earnest Money Deposit)

k Additional Format

l Any other documents in respect of Eligibility Criteria and other Terms and conditions of tender.

5 We are aware of the fact that the Tender submitted by us through electronic mode is an valid offer. Any variation committed / observed compared to original documents and conditional offer regarding the payment terms submitted subsequently will lead to disqualification of our offer and also the Corporation reserves the right to Black list us apart from initiating other legal action.

Signature of the Authorized Signatory with Company Seal.