Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities and various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Name of Package : OUTSOURCING OF SERVICES FOR OPERATION & L1 MAINTENANCE SUPPORT OF TELECOM NODES IN NR

Specification No. : NRTCC/C&M/19-20/OUTSOURCED SERVICES NR/1119

Completion Period: 3 Years

: Attachments : General guidelines for filling up the Attachments

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632

1 Fill up only green shaded cells in the relevent attachments.

2 Attachments 3, 4, 4(A), 5, 5(A), 6 (C), 6 (T), 7, 8, 9, 10, 11, 12, 13, 14-IP, 15, 16, 17, 18, 19,20, 21,22, 23, 24, 25, 26,27,28 and Bid Form for 1st Envelope are included here.

3 Attachment 1 Bid Security : To be submitted as per proforma provided in the bidding document.

4 Attachment 2 Power of Attorney : No specific format is provided by POWERGRID. Bidder may use their own format. However, the Power of Attorney should be tender-specific and made on non-judicial stamp paper of appropriate value, duly notarized. In case bidder is submitting General Power of Attorney, then it should be duly notarized.

5 Attachment-14 (Integrity Pact): Bidder has to submit the Integrity Pact in two original (both on original non-judicial stamp paper of INR 100/- each) duly signed & stamp on each page as per format given in attcahmnet-14.

6 Attachment-18 (Safety Pact): Bidder has to submit the Safety Pact in two original (both on original non-judicial stamp paper of INR 100/- each) duly signed & stamp on each page as per format given in attcahmnet-18.

7 Attachment-21 (Affidavit for Self Certification regarding local Content): Bidder has to submit the Affidavit in One original (on original non-judicial stamp paper of INR 100/- ) duly signed & stamp on each page as per format given in attcahmnet-21.

पावरग्रिड टेलीसर्विसेज लिमिटेड

PowerGrid Teleservices Limited

(A Wholly Owned Subsidiary of Power Grid Corporation of India Limited)

(A Government of India Enterprise)

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1 Select the type

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Proprietership Firm 1

Partnership Firm 2

Enter following details of the bidder Private Ltd

Type of Bidder manufacturer #REF!

Address of Registered Office

Is bidder MSE registered No No

Details of designated authority of GoI Not Applicable

Address of Communication Office

Name of Authorised Representative

Printed Name 31/Dec/14

Specification No. :NRTCC/C&M/19-20/OUTSOURCED SERVICES NR/1119 Attachment-3(JV) 0 #REF! 0

OUTSOURCING OF SERVICES FOR OPERATION & L1 MAINTENANCE SUPPORT OF TELECOM NODES IN NR

(Joint Venture Agreement and Power of Attorney for Joint Venture*)

Bidder’s Name and Address (Bidder ) : To:

Contract Services #REF!

Name : Power Grid Corporation of India Ltd.,

Address : "Saudamini", Plot No. 2, Sector 29

Gurgaon (Haryana) - 122001

Name(s) and Addresse(s) of other partner(s)

Name : #REF! #REF!

Address : #REF! #REF!

The Joint Venture Agreement (as per the proforma attached at no. 15 in Section-VI, Sample Forms and Procedures, Conditions of Contract, Vol.-I of the Bidding Documents) and Power of Attorney for Joint Venture (as per the proforma attached at no. 14 in Section-VI, Sample Forms and Procedures, Conditions of Contract, Vol.-I of the Bidding Documents) are enclosed herewith.

Date : Printed Name : #REF!

Place : Designation : 3 Years

Specification No. :NRTCC/C&M/19-20/OUTSOURCED SERVICES NR/1119 Attachment-3(QR)

OUTSOURCING OF SERVICES FOR OPERATION & L1 MAINTENANCE SUPPORT OF TELECOM NODES IN NR

(Qualifying Requirement Data)

Bidder’s Name and Address (Bidder ) : To:

DGM(Tele-Contracts)

Name : Power Grid Corporation of India Ltd.,

Address : 1st Floor, CF-17, New Town Action Area-IC

Rajarhat, Kolkata- 700 156

In support of the Qualification Requirements (QR) for bidders, stipulated in Annexure-A (BDS) of the Section - III (BDS), Volume-I & Additional Information required as per ITB clause 9.3(c) of the Bidding Documents, we furnish herewith our QR data/details along with other information, as follows herewith our stipulations have been reproduced in italics for ready reference, however, in case of any discrepancy the QR as given in BDS shall prevail).

We have submitted bid as individual firm.

We have submitted bid as joint venture of following firms :

In accordance with the QR specified in Section-II, Annexure-A to BDS (relevant extracts have been brought out in italics herein, however, in case of any discrepancy, QR specified in Section-II, Annexure-A to BDS of the bidding documents shall prevail), we are furnishing the following details/document in support of meeting the QR for the subject packages:-

[For details regarding Qualification Requirements of a Joint Venture, please refer para 4.0 below.]

We are furnishing the following details/document in support of Qualifying requirement for the subject package.

A Attached copies of original documents defining :

a) The constitution or legal status;

b) The principal place of business;

c) The place of incorporation (for bidders who are corporations); or the place of registration and the nationality of the Owners (for applicants who are partnerships or individually-owned firms).

B Attached original & copies of the following documents :

a) Written power of attorney of the signatory of the Bid to commit the bidder.

b) Joint Venture Agreement.

1.0 GENERAL INFORMATION

Bidder is required to provide general information as per the following format.

S No. Particulars Sole Bidder

1 Name of the Firm

2 Head Office/ Registered Office Address

5 Contact Person

6 Place of Incorporation/ Registration

7 Year of Incorporation/ Registration

8 Nationality of

2.0 TECHNICAL REQUIREMENTS {Reference para 1.1 of Annexure-A (BDS)}

2.1 The Bidder must have supplied at least nine (9) numbers of PUF Shelters, covered in one or more contracts in last seven (7) years, out of which at least five (5) numbers of PUF Shelters should have been in satisfactory operation# for at least one (1) year as on the originally scheduled date of bid opening i.e.11.06.2019. OR The Bidder must have installed, tested and commissioned at least nine (9) numbers of PUF Shelters, covered in one or more contracts in last seven (7) years, out of which at least five (5) numbers of PUF Shelters should have been in satisfactory operation# for at least one (1) year as on the originally scheduled date of bid opening i.e. 11.06.2019. # Satisfactory operation: Certificate issued by the Employer (an end user) certifying the operation without any adverse remark. a. Bidder shall furnish documentary evidence in support of meeting the qualification criteria as stated above like Copies of the work order, certificate from users towards satisfactory Execution/ performance etc.

“In case bidder is a holding company, the technical experience referred to in clause 2.1 above shall be of that holding company only (i.e. excluding its subsidiary/group companies). In case bidder is a subsidiary of a holding company, the technical experience referred to in clause 2.1 above shall be of that subsidiary company only (i.e. excluding its holding company)”.

2.2 On a separate page, using the following format, each Bidder (individual firms or partners of a joint venture) is requested to list the contracts of a nature similar to the proposed contract for which the Bidder wishes to qualify, undertaken during the last seven(07) years. The information is to be summarised for each such contract separately. (In case of Joint Venture bidder,if applicable, the information/details pertaining to each partners of the joint venture are to be furnished).

Bidder shall furnish documentary evidence in support of meeting the qualification criteria as stated above like Copies of the work order, certificate from users towards satisfactory performance etc. (The bidder shall attach documentary evidence, such as copies of utility certificates etc., in support of its general experience as listed in the following proforma for each experience/ Contract just below it)

Format:A (Format for individual firm):

Format for the Bidder for indicating its technical experience [ Qualifying Requirements in support of meeting Clause 1.1 of Annexure -A, BDS to be furnished, as applicable, using this format]

1 Bidder’s Name : 121

Single Firm/Lead Partner/Other Partners of a JV : #REF!

2 Name of Contract Undertaken

3 Contract Reference No. & Date of Award

4 Name and Address of the Employer/Utility for whom the Contract was executed by the firm

5 Scope of work executed under the above contract

6 Details/features of the Contract undertaken relevant to the stipulated QR

iii) Voltage level (kV)

iv) Satisfactory Operation of OPGW

v) Requirements for OPGW manufacturers

a) Manufacturing Experience in Years

b) Satisfactory Operation of Kms Months Kms Months

c) Date of use of fibre alongwith communication equipment

7 Capacity in which the Contract was undertaken (Check One)

(Tick whichever is/are applicable)

8 Date of Completion of Contract

9 Details of documents uploaded in support of the above stated experience

(Use separate sheet for each experience/ Contract)

3.0 FINANCIAL REQUIREMENTS :

3.1 Financial Position {Reference para 1.2 of Annexure-A (BDS)

a) Net Worth for last 3 financial years should be positive.

b) The Minimum Average Annual Turnover (MAAT)* for best 3 (three) years out of last 5 (five) financial years should be at least INR.5,04,86,851.00

* Note- Annual total income as incorporated in profit & loss account except non-recurring income e.g. sale of fixed assets.

c) Bidder shall have liquid assets (L.A.) or/and evidence of access to or availability of credit facilities of not less than INR. 84,14,475.00

In case bidder is a holding company, the financial position criteria referred to in clause 3 above shall be that of holding company only (i.e. excluding its subsidiary / group companies). In case bidder is a subsidiary of a holding company, financial position criteria referred to in clause 3 above shall be that of subsidiary company only (i.e. excluding its holding company).

3.2 {In support of its ‘Financial Position’, in line with the above, the Bidder (in case of bidding by single firm ) or Company/Constituents must provide the relevant information in support of the same, along with documentary evidence, in the following format}

Financial Qualification Data: 0

A Turnover details:

Sl No Financial year Turnover Details of documentary evidence submitted in support of Qualification Data

Turnover (in INR Lacs)

Sl No Financial year

Average Annual Turnover for best Three Years is

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

Sl No Financial year Net Worth Details of documentary evidence submitted in support of Qualification Data

C Liquid Assets LA Details of documentary evidence submitted in support of Qualification Data

Details of evidence of having Liquid assets (LA)

Details of evidence of access to or availability of credit facilities

A Turnover details:

Turnover Equivalent US$ (in Million) exchange rate* Details of documentary evidence submitted in support of Qualification Data

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

Average Annual Turnover for best Three Years is

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

B Net Worth (Paid Up Capital+Free Reserves and Surplus+Misc expenses to the extent not written off):

Net Worth Equivalent US$ (in Million) exchange rate* Details of documentary evidence submitted in support of Qualification Data

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

C Liquid Assets

Currency LA Equivalent US$ (in Million)

Details of evidence of having Liquid assets (LA)

Details of evidence of access to or availability of credit facilities

A Turnover details:

Turnover Equivalent US$ (in Million) exchange rate* Details of documentary evidence submitted in support of Qualification Data

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

Average Annual Turnover for best Three Years is

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

B Net Worth (Paid Up Capital+Free Reserves and Surplus+Misc expenses to the extent not written off):

Net Worth Equivalent US$ (in Million) exchange rate* Details of documentary evidence submitted in support of Qualification Data

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

Average Annual Turnover for best Three Years is

C Liquid Assets

Currency LA Equivalent US$ (in Million)

Details of evidence of having Liquid assets (LA)

Details of evidence of access to or availability of credit facilities

5.0 Joint Venture (JV) Firms {Reference para 1.4 of Annexure-A (BDS)}

5.1 In case a bid is submitted by a Joint Venture (JV) of two firms as partners, Joint Venture must comply with the following minimum criteria:

(i) All the partners of the JV shall meet individually the Financial Position criteria given at 3 (a) above.

(ii) The lead partner of Joint Venture shall meet not less than 40% and other partner shall meet individually not less than 25% of the Financial Position criteria given at para 3(b) &(c) above. For this purpose, the figure of average annual turnover and liquid assets/credit facilities for each of the partners of the JV shall be added together to determine the JV’s compliance with the minimum qualifying criteria set out in Para 3(b) &(c) above

(iii) (I) The lead partner should have installed, tested & commissioned at least Twenty (20) add-drop nodes of minimum 32 channel 10G DWDM System, covered in not more than two (2) contracts in the last seven (7) years, which should have been in operation for at least two (2) years as on the originally scheduled date of bid opening mentioned above.

(II) The other partner should have supplied at least Twenty (20) add-drop nodes of minimum 32 channel 10G DWDM System, covered in not more than two (2) contracts in the last seven (7) years, as on the originally scheduled date of bid opening mentioned above.

Format for the Bidder for indicating its technical experience in case of qualification through 1.4 of Annexure -A, BDS

1 Name of Lead Partner : #REF!

Single Firm/Lead Partner/Other Partners of a JV : #REF!

2 Name of Other Partner:

3 (a) Name of Contract Undertaken by the Lead Partner #REF!

3(b) Contract Reference No. & Date of Award

3(d) Scope of work executed under the above contract

3(e) Details/features of the Contract undertaken relevant to the stipulated QR

iii) Voltage level (kV)

iv) Satisfactory Operation of OPGW

v) Requirements for OPGW manufacturers

a) Manufacturing Experience in Years

b) Satisfactory Operation of Kms Months Kms Months

c) Date of use of fibre alongwith communication equipment

Number of add-drop nodes of minimum 32 channel 10G DWDM System executed under the contract

3(f) Capacity in which the Contract was undertaken (Check One)

(Tick whichever is/are applicable)

3(g) Date of Commissioning

3(h) Number of years of operation

4 (a) Name of Contract Undertaken by the Other Partner #REF!

4(b) Contract Reference No. & Date of Award

4(d) Scope of work executed under the above contract

4(e) Details/features of the Contract undertaken relevant to the stipulated QR

iii) Voltage level (kV)

iv) Satisfactory Operation of OPGW

v) Requirements for OPGW manufacturers

a) Manufacturing Experience in Years

b) Satisfactory Operation of Kms Months Kms Months

c) Date of use of fibre alongwith communication equipment

Number of add-drop nodes of minimum 32 channel 10G DWDM System supplied under the contract

4(f) Capacity in which the Contract was undertaken (Check One)

(Tick whichever is/are applicable)

4(g) Date of Commissioning

4(h) Number of years of operation

5 Is Power of Attoney for Joint Venture submitted along with the bid

6 Is Undertaking by Joint Venture Partners submitted along with the bid

7 Details of documents uploaded in support of the above stated experience

(Use separate sheet for each experience/ Contract)

5.3 In accordance with the above, in case of JV bidders, it should be ensured that necessary details including those pertaining to each JV partner are furnished and the documents are submitted alongwith the bid. Further, the JV bidders should also ensure that other requirements are complied with. The lists of documents furnished are to be indicated below :

4.0 The Bidder shall also furnish following documents/details with its bid. {Reference ITB clause 9.3 (c)}

4.1 The complete annual reports together with Audited statement of accounts of the company for last five years of its own (separate) immediately preceding the date of submission of bid.

Note I. In the event the bidder is not able to furnish the information of its own (i.e separate), being a subsidiary company and its accounts are being consolidated with its group/holding/parent company, the bidder should submit the audited balance sheets, income statements, other information pertaining to it only (not of its group/Holding/Parent Company) duly certified by any one of the authority [ (i) Statutory Auditor of the bidder /(ii) Company Secretary of the bidder or (iii) A certified Public Accountant] certifying that such information/documents are based on the audited accounts as the case may be.

II. Similarly, if the bidder happens to be a Group/Holding/Parent Company, the bidder should submit the above documents/information of its own (i.e. exclusive of its subsidiaries) duly certified by any one of the authority mentioned in Note-I above certifying that these information/documents are based on the audited accounts, as the case may be.

4.2 The Bidder should accordingly also provide the following information/documents:

The bidders should be Indian Companies registered to manufacture the tendered item in India and have obtained clearance from Reserve Bank of India, wherever applicable. In addition they should meet the following criteria: The Bidders should:

(Use separate sheet for each experience/ Contract)

3.0 FINANCIAL REQUIREMENTS :

3.1 {In support of its ‘Financial Position’, in line with the above, the Bidder (in case of bidding by single firm ) or Company/Constituents must provide the relevant information in support of the same, along with documentary evidence, in the following format}

Financial Qualification Data: Bidder shall furnish Annual report and/ or a report from its Bankers as evidence that he has financial capability to perform the Contract. 1

A Turnover details:

Turnover Equivalent US$ (in Million) exchange rate*

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

Average Annual Turnover for best Three Years is

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

B Net Worth (Paid Up Capital+Free Reserves and Surplus+Misc expenses to the extent not written off):

Net Worth Equivalent US$ (in Million) exchange rate*

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

C Liquid Assets

Details of evidence of having Liquid assets (LA)

Details of evidence of access to or availability of credit facilities

A Turnover details:

Turnover Equivalent US$ (in Million) exchange rate*

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

Average Annual Turnover for best Three Years is

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

B Net Worth (Paid Up Capital+Free Reserves and Surplus+Misc expenses to the extent not written off):

Net Worth Equivalent US$ (in Million) exchange rate*

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

Average Annual Turnover for best Three Years is

C Liquid Assets

Details of evidence of having Liquid assets (LA)

Details of evidence of access to or availability of credit facilities

5.0 Joint Venture (JV) Firms {Reference para 1.4 of Annexure-A (BDS)}

5.1 In case a bid is submitted by a Joint Venture (JV) of two firms as partners, Joint Venture must comply with the following minimum criteria:

(i) All the partners of the JV shall meet individually the Financial Position criteria given at 3 (a) above.

(ii) The lead partner of Joint Venture shall meet not less than 40% and other partner shall meet individually not less than 25% of the Financial Position criteria given at para 3(b) &(c) above. For this purpose, the figure of average annual turnover and liquid assets/credit facilities for each of the partners of the JV shall be added together to determine the JV’s compliance with the minimum qualifying criteria set out in Para 3(b) &(c) above

(iii) (I) The lead partner should have installed, tested & commissioned at least Twenty (20) add-drop nodes of minimum 32 channel 10G DWDM System, covered in not more than two (2) contracts in the last seven (7) years, which should have been in operation for at least two (2) years as on the originally scheduled date of bid opening mentioned above.

(II) The other partner should have supplied at least Twenty (20) add-drop nodes of minimum 32 channel 10G DWDM System, covered in not more than two (2) contracts in the last seven (7) years, as on the originally scheduled date of bid opening mentioned above.

Format for the Bidder for indicating its technical experience in case of qualification through 1.4 of Annexure -A, BDS

1 Name of Lead Partner : #REF!

Single Firm/Lead Partner/Other Partners of a JV : #REF!

2 Name of Other Partner:

3 (a) Name of Contract Undertaken by the Lead Partner #REF!

3(b) Contract Reference No. & Date of Award

3(d) Scope of work executed under the above contract

3(e) Details/features of the Contract undertaken relevant to the stipulated QR

iii) Voltage level (kV)

iv) Satisfactory Operation of OPGW

v) Requirements for OPGW manufacturers

a) Manufacturing Experience in Years

b) Satisfactory Operation of Kms Months

c) Date of use of fibre alongwith communication equipment

Number of add-drop nodes of minimum 32 channel 10G DWDM System executed under the contract

3(f) Capacity in which the Contract was undertaken (Check One)

(Tick whichever is/are applicable)

3(g) Date of Commissioning

3(h) Number of years of operation

4 (a) Name of Contract Undertaken by the Other Partner #REF!

4(b) Contract Reference No. & Date of Award

4(d) Scope of work executed under the above contract

4(e) Details/features of the Contract undertaken relevant to the stipulated QR

iii) Voltage level (kV)

iv) Satisfactory Operation of OPGW

v) Requirements for OPGW manufacturers

a) Manufacturing Experience in Years

b) Satisfactory Operation of Kms Months

c) Date of use of fibre alongwith communication equipment

Number of add-drop nodes of minimum 32 channel 10G DWDM System supplied under the contract

4(f) Capacity in which the Contract was undertaken (Check One)

(Tick whichever is/are applicable)

4(g) Date of Commissioning

4(h) Number of years of operation

5 Is Power of Attoney for Joint Venture submitted along with the bid

6 Is Undertaking by Joint Venture Partners submitted along with the bid

7 Details of documents uploaded in support of the above stated experience

(Use separate sheet for each experience/ Contract)

5.3 In accordance with the above, in case of JV bidders, it should be ensured that necessary details including those pertaining to each JV partner are furnished and the documents are submitted alongwith the bid. Further, the JV bidders should also ensure that other requirements are complied with. The lists of documents furnished are to be indicated below :

4.0 The Bidder shall also furnish following documents/details with its bid. {Reference ITB clause 9.3 (c)}

4.1 The complete annual reports together with Audited statement of accounts of the company for last five years of its own (separate) immediately preceding the date of submission of bid.

Note I. In the event the bidder is not able to furnish the information of its own (i.e separate), being a subsidiary company and its accounts are being consolidated with its group/holding/parent company, the bidder should submit the audited balance sheets, income statements, other information pertaining to it only (not of its group/Holding/Parent Company) duly certified by any one of the authority [ (i) Statutory Auditor of the bidder /(ii) Company Secretary of the bidder or (iii) A certified Public Accountant] certifying that such information/documents are based on the audited accounts as the case may be.

II. Similarly, if the bidder happens to be a Group/Holding/Parent Company, the bidder should submit the above documents/information of its own (i.e. exclusive of its subsidiaries) duly certified by any one of the authority mentioned in Note-I above certifying that these information/documents are based on the audited accounts, as the case may be.

4.2 The Bidder should accordingly also provide the following information/documents:

Audited balance sheet and income statements for the last five years as per the following:

A Years preceding to the bid opening Audited Balance Sheet and Income Statements enclosed

Note: If there is a conflict between of this Attachment-3 (QR) of Bid forms and Annexure-A of BDS (Qualifying Requirements), the Annexure-A of BDS (Qualifying Requirements) shall prevail.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 ATTACHMENT-3 (QR)

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Qualifying Requirement Data)

Bidder's name and Address To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

In support of the Qualification Requirements (QR) for bidders, stipulated in Annexure-A (BDS) of the Section - III (BDS), Volume-I & Additional Information required as per ITB clause 9.3(c) of the Bidding Documents, we furnish herewith our QR data/details along with other information, as follows herewith our stipulations have been reproduced in italics for ready reference, however, in case of any discrepancy the QR as given in BDS shall prevail).

We have submitted bid as individual firm.

We have submitted bid as joint venture of following firms :

(i) #REF! #REF!

(ii) #REF! #REF!

In accordance with the QR specified in Section-II, Annexure-A to BDS (relevant extracts have been brought out in italics herein, however, in case of any discrepancy, QR specified in Section-II, Annexure-A to BDS of the bidding documents shall prevail), we are furnishing the following details/document in support of meeting the QR for the subject packages:-

[For details regarding Qualification Requirements of a Joint Venture, please refer para 4.0 below.]

We are furnishing the following details/document in support of Qualifying requirement for the subject package.

A Attached copies of original documents defining :

a) The constitution or legal status;

b) The principal place of business;

c) The place of incorporation (for bidders who are corporations); or the place of registration and the nationality of the Owners (for applicants who are partnerships or individually-owned firms).

B Attached original & copies of the following documents :

a) Written power of attorney of the signatory of the Bid to commit the bidder.

b) Joint Venture Agreement.

1.0 GENERAL INFORMATION

Bidder is required to provide general information as per the following format.

[Where the Bidder proposes to use named subcontractor(s) for critical components of the works or for work contents in excess of ten (10) percent of the bid price, the following information should also be supplied for the subcontractor(s)].

S No. Particulars Sole Bidder

1 Name of the Firm 0 #REF!

2 Head Office/ Registered Office Address 0 #REF!

5 Contact Person

6 Place of Incorporation/ Registration

7 Year of Incorporation/ Registration

8 Nationality of

2.0 TECHNICAL REQUIREMENTS {Reference para 1.1 of Annexure-A (BDS)}

2.1 TECHNICAL EXPERIENCE

(a) The bidders shall have successfully completed the contracts (with a minimum duration of the 1-year period) of Routine Maintenance Breakdown Maintenance works of the Underground Fiber Optic cable system for at least 50 kms of cumulative length in not more than three contracts within the last seven (7) years as on the originally scheduled date of bid opening as per GeM Bid OR (b)The bidder shall have successfully completed the contracts of Erection, Testing & Commissioning of Underground Fiber Optic cable system for at least 10 kms of cumulative length of underground duct along with laying & testing of UGOFC therein, in not more than three contracts within the last seven (7) years as on the originally scheduled date of bid opening as mentioned above.

“In case bidder is a holding company, the technical experience referred to in clause 2.1 above shall be of that holding company only (i.e. excluding its subsidiary/group companies). In case bidder is a subsidiary of a holding company, the technical experience referred to in clause 2.1 above shall be of that subsidiary company only (i.e. excluding its holding company)”.

Bidder shall furnish documentary evidence in support of meeting the qualification criteria as stated above like Copies of the work order, certificate from users towards satisfactory performance etc. (The bidder shall attach documentary evidence, such as copies of utility certificates etc., in support of its general experience as listed in the following proforma for each experience/ Contract just below it)

Format:A (Format for individual firm):

Format for the Bidder for indicating its technical experience [ Qualifying Requirements in support of meeting Clause 1.1 of Annexure -A, BDS to be furnished, as applicable, using this format]

1 Bidder’s Name :

Single Firm/Lead Partner/Other Partners of a JV :

2 Name of Contract Undertaken

3 Contract Reference No. & Date of Award

4 Name and Address of the Employer/Utility for whom the Contract was executed by the firm

5 Scope of work executed under the above contract

6 Details/features of the Contract undertaken relevant to the stipulated QR

iii) Voltage level (kV)

iv) Satisfactory Operation of OPGW

v) Requirements for OPGW manufacturers

a) Manufacturing Experience in Years

b) Satisfactory Operation of Kms Months Kms Months

c) Date of use of fibre alongwith communication equipment

7 Capacity in which the Contract was undertaken (Check One)

(Tick whichever is/are applicable)

8 Date of Completion of Contract

9 Details of documents uploaded in support of the above stated experience

(Use separate sheet for each experience/ Contract)

3.0 FINANCIAL REQUIREMENTS :

Financial Position {Reference para 1.2 of Annexure-A (BDS)} For the purpose of this particular bid, bidders shall meet the following minimum criteria:

a) Net Worth for last 3 financial years should be positive.

a) Minimum Average Annual Turnover *(MAAT) for best three years i.e. 36 Months out of last five Financial years of the bidder should be at least INR 82,17,750/- *-Annual Gross Revenue from operations/ Gross operating income as incorporated in the profit and loss account excluding other operative income/ other income

1. In case bidder is a holding company, the financial position criteria referred to in clause 3 above shall be that of holding company only (i.e. excluding its subsidiary / group companies). In case bidder is a subsidiary of a holding company, the financial position criteria referred to in clause 3 above shall be that of subsidiary company only (i.e. excluding its holding company).

c) c. Bidder shall have liquid assets ( L.A) or/and evidence of access to or availability of credit facilities of not less than INR 8,58,795.00

In case bidder is a holding company, the financial position criteria referred to in clause 3 above shall be that of holding company only (i.e. excluding its subsidiary / group companies). In case bidder is a subsidiary of a holding company, financial position criteria referred to in clause 3 above shall be that of subsidiary company only (i.e. excluding its holding company).

2 RELAXATION FOR MSEs / START-Ups (i) Requirement of MAAT specified at Para 3 (a) above, shall be waived off for MSEs bidders . (ii) START-Ups shall also be considered qualified if they meet 80% (Eighty percent) of the requirements specified at Para 3 above in Financial Position. (iii) MSEs as defined in bidding documents. (iv) START-UPs as defined by DIPP, applicable as on the originally scheduled date of bid opening.

3.2 {In support of its ‘Financial Position’, in line with the above, the Bidder (in case of bidding by single firm ) or Company/Constituents must provide the relevant information in support of the same, along with documentary evidence, in the following format}

Financial Qualification Data: #REF!

A Turnover details:

Sl No Financial year Turnover Details of documentary evidence submitted in support of Qualification Data

Turnover (in INR Lacs)

Sl No Financial year

Average Annual Turnover for best Three Years is

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

Sl No Financial year Net Worth Details of documentary evidence submitted in support of Qualification Data

C Liquid Assets LA Details of documentary evidence submitted in support of Qualification Data

Details of evidence of having Liquid assets (LA)

Details of evidence of access to or availability of credit facilities

A Turnover details:

Turnover Equivalent US$ (in Million) exchange rate* Details of documentary evidence submitted in support of Qualification Data

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

Average Annual Turnover for best Three Years is

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

B Net Worth (Paid Up Capital+Free Reserves and Surplus+Misc expenses to the extent not written off):

Net Worth Equivalent US$ (in Million) exchange rate* Details of documentary evidence submitted in support of Qualification Data

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

C Liquid Assets

Currency LA Equivalent US$ (in Million)

Details of evidence of having Liquid assets (LA)

Details of evidence of access to or availability of credit facilities

A Turnover details:

Turnover Equivalent US$ (in Million) exchange rate* Details of documentary evidence submitted in support of Qualification Data

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

Average Annual Turnover for best Three Years is

*(Indicate the rate(s) of exchnage against US Dollar at the end of each year, which have been used for arriving the amount at equivalent US Dollar.)

B Net Worth (Paid Up Capital+Free Reserves and Surplus+Misc expenses to the extent not written off):

Net Worth Equivalent US$ (in Million) exchange rate* Details of documentary evidence submitted in support of Qualification Data

Currency Turnover (in Millions)

Sl No Financial year

Do you have audited results for FY 2013-14 Yes

Average Annual Turnover for best Three Years is

C Liquid Assets

Currency LA Equivalent US$ (in Million)

Details of evidence of having Liquid assets (LA)

Details of evidence of access to or availability of credit facilities

5.0 Joint Venture (JV) Firms {Reference para 1.4 of Annexure-A (BDS)}

5.1 In case a bid is submitted by a Joint Venture (JV) of two firms as partners, Joint Venture must comply with the following minimum criteria:

(i) All the partners of the JV shall meet individually the Financial Position criteria given at 3 (a) above.

(ii) The lead partner of Joint Venture shall meet not less than 40% and other partner shall meet individually not less than 25% of the Financial Position criteria given at para 3(b) &(c) above. For this purpose, the figure of average annual turnover and liquid assets/credit facilities for each of the partners of the JV shall be added together to determine the JV’s compliance with the minimum qualifying criteria set out in Para 3(b) &(c) above

(iii) (I) The lead partner should have installed, tested & commissioned at least Twenty (20) add-drop nodes of minimum 32 channel 10G DWDM System, covered in not more than two (2) contracts in the last seven (7) years, which should have been in operation for at least two (2) years as on the originally scheduled date of bid opening mentioned above.

(II) The other partner should have supplied at least Twenty (20) add-drop nodes of minimum 32 channel 10G DWDM System, covered in not more than two (2) contracts in the last seven (7) years, as on the originally scheduled date of bid opening mentioned above.

Format for the Bidder for indicating its technical experience in case of qualification through 1.4 of Annexure -A, BDS

1 Name of Lead Partner : #REF!

Single Firm/Lead Partner/Other Partners of a JV : #REF!

2 Name of Other Partner:

3 (a) Name of Contract Undertaken by the Lead Partner #REF!

3(b) Contract Reference No. & Date of Award

3(d) Scope of work executed under the above contract

3(e) Details/features of the Contract undertaken relevant to the stipulated QR

iii) Voltage level (kV)

iv) Satisfactory Operation of OPGW

v) Requirements for OPGW manufacturers

a) Manufacturing Experience in Years

b) Satisfactory Operation of Kms Months Kms Months

c) Date of use of fibre alongwith communication equipment

Number of add-drop nodes of minimum 32 channel 10G DWDM System executed under the contract

3(f) Capacity in which the Contract was undertaken (Check One)

(Tick whichever is/are applicable)

3(g) Date of Commissioning

3(h) Number of years of operation

4 (a) Name of Contract Undertaken by the Other Partner #REF!

4(b) Contract Reference No. & Date of Award

4(d) Scope of work executed under the above contract

4(e) Details/features of the Contract undertaken relevant to the stipulated QR

iii) Voltage level (kV)

iv) Satisfactory Operation of OPGW

v) Requirements for OPGW manufacturers

a) Manufacturing Experience in Years

b) Satisfactory Operation of Kms Months Kms Months

c) Date of use of fibre alongwith communication equipment

Number of add-drop nodes of minimum 32 channel 10G DWDM System supplied under the contract

4(f) Capacity in which the Contract was undertaken (Check One)

(Tick whichever is/are applicable)

4(g) Date of Commissioning

4(h) Number of years of operation

5 Is Power of Attoney for Joint Venture submitted along with the bid

6 Is Undertaking by Joint Venture Partners submitted along with the bid

7 Details of documents uploaded in support of the above stated experience

(Use separate sheet for each experience/ Contract)

5.3 In accordance with the above, in case of JV bidders, it should be ensured that necessary details including those pertaining to each JV partner are furnished and the documents are submitted alongwith the bid. Further, the JV bidders should also ensure that other requirements are complied with. The lists of documents furnished are to be indicated below :

4.0 The Bidder shall furnish documentary evidence in support of the qualifying requirements stipulated as above. Further, to establish the OEM experience, any of the following documents can be submitted by bidder: (a) Two-year-old ISO certificate with the product solution category. (b)Two-year-old purchase orders (PO) of the offered product. (c) Two-yearold Invoices of the offered product. (d) Two-year-old Product installation reports. (e) Two-year-old satisfactory operation certificate

5.0 The Bidder shall also furnish following documents/details with its bid. {Reference ITB clause 9.3 (c)}

5.1 The complete annual reports together with Audited statement of accounts of the company for last five years of its own (separate) immediately preceding the date of submission of bid.

Note I. In the event the bidder is not able to furnish the information of its own (i.e separate), being a subsidiary company and its accounts are being consolidated with its group/holding/parent company, the bidder should submit the audited balance sheets, income statements, other information pertaining to it only (not of its group/Holding/Parent Company) duly certified by any one of the authority [ (i) Statutory Auditor of the bidder /(ii) Company Secretary of the bidder or (iii) A certified Public Accountant] certifying that such information/documents are based on the audited accounts as the case may be.

II. Similarly, if the bidder happens to be a Group/Holding/Parent Company, the bidder should submit the above documents/information of its own (i.e. exclusive of its subsidiaries) duly certified by any one of the authority mentioned in Note-I above certifying that these information/documents are based on the audited accounts, as the case may be.

5.3 The Bidder should accordingly also provide the following information/documents:

Audited balance sheet and income statements for the last five years as per the following:

A Years preceding to the bid opening Audited Balance Sheet and Income Statements enclosed

Note: If there is a conflict between of this Attachment-3 (QR) of Bid forms and Annexure-A of BDS (Qualifying Requirements), the Annexure-A of BDS (Qualifying Requirements) shall prevail.

Date : 0 Printed Name : 0

Place : 0 Designation : 0

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-4

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Form of Certificate of Origin and Eligibility)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We hereby certify that equipment and materials to be supplied are produced in [Enter the name of country where from equipments & material shall be supplied] eligible source country. Equipments & Materials produced in [Name of countries] Company incorporated & registered in [Name of countries]

We hereby certify that our company is incorporated and registered in [Enter the name of country where from equipments & material shall be supplied] eligible source country.

Date : 00-Jan-00 Printed Name : 0

Place : 0 Designation : 0

country. country. [Enter the name of country where from equipments & material shall be supplied] [Enter the name of country where from equipments & material shall be supplied]

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-4(A)

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(List of Special Maintenance Tools & Tackles)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We are furnishing below the list of special maintenance tools & tackles for various equipment under the subject package. The prices for these tools & tackles are included in our lumpsum bid price. We further confirm that the list of special maintenance tools & tackles includes all the items specifically identified in your bidding documents as brought out below:

Notwithstanding what is stated above, we further confirm that any additional special maintenance tools and tackles, required for the equipment under this package shall be furnished by us at no extra cost to the employer.

S.No. For Equipment Item Description Unit Quantity

Date : 00-Jan-00 Printed Name : 0

Place : 0 Designation : 0

Specification No. :NRTCC/C&M/19-20/OUTSOURCED SERVICES NR/1119 Attachment-4(B) 0

OUTSOURCING OF SERVICES FOR OPERATION & L1 MAINTENANCE SUPPORT OF TELECOM NODES IN NR

(List of Special Maintenance Tools & Tackles)

Bidder’s Name and Address (Bidder ) : To:

Contract Services

Name : Power Grid Corporation of India Ltd.,

Address : "Saudamini", Plot No. 2, Sector 29

Gurgaon (Haryana) - 122001

We are furnishing below the list of special maintenance tools & tackles for various equipment under the subject package. The prices for these tools & tackles which are to be taken back after the completion of the work by us are not included in our lumpsum bid price. We further confirm that the list of special maintenance tools & tackles includes all the items specifically identified in your bidding documents as brought out below:

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-5

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Bought-out & Sub-contracted Items)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We hereby furnish the details of the items/ sub-assemblies, we propose to buy for the purpose of the subject Package:

Sl. No. Item Description Quantity proposed to be bought/sub-contracted Details of the proposed sub-contractor/sub-vendor

Name Nationality

We hereby furnish the details of the items/ sub-assemblies propose to supply from our own works (i.e. as direct transactions) in additiona to the supplies the same from other vendors (i.e. as Bought-out transactions) as detailed in the table given above.

Sl. No. Item Description Quantity proposed to be supplied Details of the plant from where supplies are proposed.

Name of Plant Address

Date : 00-Jan-00 Printed Name : 0

Place : 0 Designation : 0

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-5

(Bought-out & Sub-contracted Items)

Sl. No. Item Description Quantity proposed to be bought/sub-contracted Details of the proposed sub-contractor/sub-vendor

Name Nationality

Date : 00-Jan-00 Printed Name : 0

Place : 00-Jan-00 Designation : 0

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-5A

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Items, Components, Raw material, services proposed to be sourced form Micro & Small Enterprises)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

1. We hereby furnish the details of the Items, Components, Raw amterial, services which we propose to buy/ avail from Micro & Small Enterprises (MSEs) for the purpose of completion of works under the subject Package:

Sl. No. Item Description Quantity proposed to be bought/sub-contracted Name of Micro & Small enterprises (MSEs)

Name Category (Micro or small)

We hereby furnish the details of the items/ sub-assemblies propose to supply from our own works (i.e. as direct transactions) in additiona to the supplies the same from other vendors (i.e. as Bought-out transactions) as detailed in the table given above.

Sl. No. Item Description Quantity proposed to be supplied Details of the plant from where supplies are proposed.

Name of Plant Address

2. The above is a list of items we propose to procure from MSEs. However, based on the situations during the execution of the contract, the above list may undergo changes. We hereby confirm that the details regarding actual procurement from MSEs carried out by us, as per the format provided at Section-VI, forms & procedures, volume-I of bidding documents, shall be submitted alongwith the bills for payment against supplies made/ work done during execution of contract.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-5A

(Bought-out & Sub-contracted Items)

Sl. No. Item Description Quantity proposed to be bought/sub-contracted Details of the proposed sub-contractor/sub-vendor

Name Nationality

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-6 (C)

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Commercial Deviations)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

The bidder shall itemize any deviation from the Specifications included in his bid. Each item shall be listed (separate sheets may be used and enclosed with this Attachment) with the following information:

Sl. No. Reference clause in the Specifications Deviation Cost of withdrawal of the deviation

The above deviations and variations are exhaustive. We confirm that we shall withdraw the deviations proposed by us at the cost of withdrawal indicated in this attachment, failing which our bid may be rejected and Bid Security forfeited.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-6 (C)

(Commercial Deviations)

Sl. No. Reference clause in the Specifications Deviation Cost of withdrawal of the deviation

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-6 (T)

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Technical Deviations)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

The bidder shall itemize any deviation from the Specifications included in his bid. Each item shall be listed (separate sheets may be used and enclosed with this Attachment) with the following information:

Sl. No. Reference clause in the Specifications Deviation Cost of withdrawal of the deviation

The above deviations and variations are exhaustive. We confirm that we shall withdraw the deviations proposed by us at the cost of withdrawal indicated in this attachment, failing which our bid may be rejected and Bid Security forfeited.

Except for the above deviations and variations, the entire work shall be performed as per your specifications and documents. Further, we agree that any deviations, conditionality or reservation introduced in this Attachment-6 and/or in the Bid form, Technical Data Sheets and covering letter, or in any other part of the bid will be reviewed to conduct a determination of the substantial responsiveness of the bid.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-6 (T)

(Technical Deviations)

Sl. No. Reference clause in the Specifications Deviation Cost of withdrawal of the deviation

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-7

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Details of Alternative Bid)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

No Alternative Bid

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-8

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Manufacturer's Authorization Form)

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

Name of Manufecture Name/Description of Goods Factory Address Name & Address of Bidder package name alongwith project name

…(insert name and/or description of the goods) … Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

WE who are established and reputable manufacturers of …(insert name and/or description of the goods) …. having production facilities at , , , do hereby authorize , , , (hereinafter, the “Bidder”) to submit a bid, and subsequently negotiate and sign the Contract with you against IFB for Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1 including the above plant & equipment or other goods produced by us. 0

WE who are established and reputable manufacturers of …(insert name and/or description of the goods) …. having production facilities at We hereby extend our full guarantee and warranty for the above specified goods offered supporting the supply by the Bidder against these Bidding Documents, and duly authorize said Bidder to act on our behalf in fulfilling these guarantee and warranty obligations.

We hereby extend our full guarantee and warranty for the above specified goods offered supporting the supply by the Bidder against these Bidding Documents, and duly authorize said Bidder to act on our behalf in fulfilling these guarantee and warranty obligations. We also hereby declare that we and have entered into a formal relationship in which, during the duration of the Contract (including warranty/defects liability). We, the Manufacturer or Producer, will make our technical and engineering staff fully available to the technical and engineering staff of the successful Bidder to assist that Bidder, on a reasonable and best effort basis, in the performance of all its obligations to the Purchaser under the Contract. , , , do hereby authorize , , , (hereinafter, the “Bidder”) We also hereby declare that we and have entered into a formal relationship in which, during the duration of the Contract (including warranty/defects liability).

For and on behalf of the to submit a bid, and subsequently negotiate and sign the Contract with you against IFB for Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1 including the above plant & equipment or other goods produced by us. We, the Manufacturer or Producer, will make our technical and engineering staff fully available to the technical and engineering staff of the successful Bidder to assist that Bidder, on a reasonable and best effort basis, in the performance of all its obligations to the Purchaser under the Contract.

In the capacity of

Date : Printed Name :

Place : Designation :

Note :1 The letter of Undertaking should be on the letterhead of the Manufacturer and should be signed by a person competent and having Power of Attorney to legally bind the Manufacturer. It shall be included by the bidder in its bid.

2 Above undertaking shall be registered or notarized so as to be legally enforceable.

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-9

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Work Completion Schedule)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We hereby declare that the work completion schedule shall be followed by us as per the provisions of bidding document for the subject Package i.e., Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1 for the period commencing from the effective date of Contract to us.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-10

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Guarantee Declaration)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We conform that the equipments offered shall have minimum performance specified in Technical Specification. We further guarantee the performance/efficiency of the equipments in response to the Technical Specifications.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-11

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Information regarding Ex-employees of POWERTEL in our Organisation)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We hereby furnish the details of ex-employees of POWERTEL who had retired/ resigned at the level of General Manager and above from POWERTEL and subsequently have been employed by us:

Sl. No. Name of the person with designation in PowerTel/POWERGRID Date of Retirement/ resignation from PowerTel/ POWERGRID Date of joining and designation in our organisation

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-11

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Information regarding Ex-employees of POWERTEL in our Organisation)

Address of Communication Office To:

Manager(Tele-Contracts)

Name : 0 Power Grid Corporation of India Ltd.,

Address : 0 4th Floor, 14 Golf Club Road

0 Tollygunge, Kolkata- 700033

We hereby furnish the details of ex-employees of POWERTEL who had retired/ resigned at the level of General Manager and above from POWERTEL and subsequently have been employed by us:

Sl. No. Name of the person with designation in POWERTEL Date of Retirement/ resignation from POWERTEL Date of joining and designation in our organisation

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-12

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Price Adjustment Data)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We hereby furnish the relevant details pertaining to the price adjustment provisions for equipment as specified in your specifications and documents for the OUTSOURCING OF SERVICES FOR OPERATION & L1 MAINTENANCE SUPPORT OF TELECOM NODES IN NRThe necessary documentary evidence are enclosed :

Sl. No. Name of Materials Value of co-efficient Name of the published index * Value of index as 30 days prior to date set for opening of bids as on **

A ACSR BERSIMIS Conductor

1 EC grade aluminium ingots, co-eifciant a = 0.65 CACMAI

High Tensile Galvanised Steel wires , co-efficient b = 0.15 CACMAI FALSE FALSE

High Carbon Steel Rods , co-efficient b = High Tensile Galvanised Steel wires , co-efficient b =

High Grade Electrolytic Zinc , co-efficient c =

3 Labour, Co-efficient l= 0.05 Indian Labour Bureau, Shimla, Govt. of India (monthly) (Base: 2001 = 100) (www.labourbureau.nic.in)

B ACSR MOOSE Conductor

1 EC grade aluminium ingots, co-eifciant a = 0.65 CACMAI

High Carbon Steel Rods , co-efficient b = 0.13 FALSE FALSE

High Grade Electrolytic Zinc , co-efficient c = 0.02 High Carbon Steel Rods , co-efficient b = High Tensile Galvanised Steel wires , co-efficient b =

High Grade Electrolytic Zinc , co-efficient c =

3 Labour, Co-efficient l= 0.05 Indian Labour Bureau, Shimla, Govt. of India (monthly) (Base: 2001 = 100) (www.labourbureau.nic.in)

Note: * Indicate the publisher of the index.

** Indicate the date of indices for which the values are being furnished.

^ For bidders who intend to quote their prices based on High Tensile Galvanised Steel wire, the coefficient for the same (i.e. coefficient ’b’ for High Tensile Galvanised Steel wire) shall be 0.15 and coefficient ‘c’ shall not be applicable.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-13

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Declaration regarding Social Accountability)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We conform that we stand committed to comply to all requirements of Social Accountability Standards i.e., SA8000 (latest Standard available at www.sa-intl.org) and maintain the necessary records.

Date : Printed Name :

Place : Designation :

Specification No. :NRTCC/C&M/19-20/OUTSOURCED SERVICES NR/1119 Attachment-14 0

OUTSOURCING OF SERVICES FOR OPERATION & L1 MAINTENANCE SUPPORT OF TELECOM NODES IN NR

Bidder’s Name and Address (Bidder ) : To:

Cheif Manager(C&M)

Name : Power Grid Corporation of India Ltd.,

Address : Eastern Region Transmission System-II

J-1-15, Block ‘EP’, Sector-V,

Salt Lake City, Kolkata – 700 091.

Integrity Pact is annexed herewith this Volume.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-14

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Instruction for printing & submitting Integrity Pact

1 The requisite format of Integrity Pact is displayed here below:

2 Take print out of first page on a non-judicial stamp paper of Rs. 100/- and other pages on plain A4 size paper. Such two sets shall be prepared by the bidder.

3 All the pages of both the copies of the Integrity Pact shall be signed by the authorised representative of the bidder and duly stamped.

4 Both the original copies shall be submitted by the bidder in the form of Hard Copy as part of the first envelope before due date & time of submission of the bid.

5 For further details bidders may please refer ITB Clause 9.3 (o).

POWERTEL TELESERVICES LIMITED

Hereinafter referred to as

having its Registered office at

Hereinafter referred to as

“The Bidder/Contractor”

PowerTel intends to award, under laid-down organizational procedures, contact(s) for

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632

PowerTel values full compliance with all relevant laws and regulations, and the principles of economical use of resources, and of fairness and transparency in its relations with its Bidders/Contractors.

In order to achieve these goals, PowerTel and the above named Bidder/contractor enter into this agreement called ‘Integrity Pact’ which will form a part of the bid.

It is hereby agreed by and between the parties as under:

Section 1 – Commitments of PowerTel

1 POWERTEL commits itself to take all measures necessary to prevent corruption and to observe the following principles:

a) No employee of PowerTel, personally or through family members, will in connection with the tender, or the execution of the contract, demand, take a promise for or accept, for him/herself or third person, any material or other benefit which he/she is not legally entitled to.

b) PowerTel will, during the tender process treat all Bidder(s) with the equity and fairness. PowerTel will in particular, before and during the tender process, provide to all Bidder(s) the same information and will not provide to any Bidder(s) confidential / additional information through which the Bidder(s) could obtain an advantage in relation to the tender process or the contract execution.

c) PowerTel will exclude from evaluation of Bids its such employee(s) who has any personnel interest in the Companies / Agencies participating in the Bidding / Tendering process.

(2) If Chairman and Managing Director obtains information on the conduct of any employee of PowerTel which is a criminal offence under the relevant Anti-Corruption Laws of India, or if there be a substantive suspicion in this regard, he will inform its Chief Vigilance Officer and in addition can initiate disciplinary actions under its Rules.

Section II – Commitments of the Bidder/ Contractor

(1) The Bidder/Contractor commits himself to take all measures necessary to prevent corruption. He commits himself to observe the following principles during his participation in the tender process and during the contract execution :

a) The Bidder/Contractor will not, directly or through any other person or firm, offer, promise or give to POWRGRID, or to any of PowerTel’s employees involved in the tender process or the execution of the contract or to any third person any material or other benefit which he/she is not legally entitled to, in order to obtain in exchange an advantage during the tender process or the execution of the contract.

b) The Bidder/Contractor will not enter into any illegal agreement or understanding, whether formal or informal with other Bidder/contractors. This applies in particular to prices, specifications, certifications, subsidiary contracts, submission or non-submission of bids or actions to restrict competitiveness or to introduce cartelization in the bidding process.

c) The Bidder/Contractor will not commit any criminal offence under the relevant Anti-corruption Laws of India; further, the Bidder/Contractor will not use for illegitimate purposes or for purposes of restrictive competition or personal gain, or pass on to others, any information provided by PowerTel as part of the business relationship, regarding plans, technical proposals and business details, including information contained or transmitted electronically.

d) The Bidder/Contractor of foreign origin shall disclose the name and address of the Agents/representatives in India, if any, involved directly or indirectly in the Bidding. Similarly, the Bidder/Contractor of Indian Nationality shall furnish the name and address of the foreign principals, if any, involved directly or indirectly in the Bidding.

e) The Bidder/Contractor will, when presenting his bid, disclose any and all payments he has made, or committed to or intends to make to agents, brokers or any other intermediaries in connection with the award of the contract and / or with the execution of the contract.

f) The Bidder/Contractor will not misrepresent facts or furnish false/forged documents/ information in order to influence the bidding process or the execution of the contract to the detriment of PowerTel.

(2) The Bidder/Contractor will not instigate third persons to commit offences outlines above or be an accessory to such offences.

Section III – Disqualification from tender process and exclusion from future contracts

(1) If the bidder, before contract award, has committed a serious transgression through a violation of Section II or any other form such as to put is reliability or creditability as Bidder into question, POWERTEL may disqualify the Bidder from the tender process or terminate the contract, if already signed, for such reasons.

(2) If the Bidder/contractor has committed a serious transgression through a violation of Section II such as to put his reliability or creditability into question, POWRGRID/PowerTel may after following due procedures also exclude the Bidder/Contractor from future contract award process. The imposition and duration of the exclusion will be determined by the severity of the transgression. The severity will be determined by the circumstances of the case, in particular the number of transgressions, the position of the transgressors within the company hierarchy of the Bidder/contractor and the amount of the damage. The exclusion will be imposed for a minimum of 12 months and maximum of 3 years.

(3) If the Bidder/contractor can prove that he has restored/recouped the damage caused by him and has installed a suitable corruption prevention system, PowerTel may revoke the exclusion prematurely.

Section IV – Liability for Violation of Integrity Pact.

(1) If PowerTel has disqualified the Bidder from the tender process prior to the award under Section III, POWERTEL may forfeit the Bid Guarantee under the Bid.

(2) If PowerTel has terminated the contract under Section III, POWRGRID may forfeit the Contract Performance Guarantee of this contract besides resorting to other remedies under the contract.

Section V – Previous Transgression

(1) The Bidder shall declare in his Bid that no previous transgressions occurred in the last 3 years within any other Public Sector Undertaking or Government Department that could justify his exclusion from the tender process.

(2) If the Bidder makes incorrect statement on this subject, he can be disqualified from the tender process or the contract, if already awarded, can be terminated for such reason.

Section VI – Equal treatment to all Bidders/Contractors.

(1) PowerTel will enter into agreements with identical conditions as this one with all bidders.

(2) PowerTel will disqualify from the tender process any bidder who does not sign this Pact or violate its provisions.

Section VII – Punitive Action against violating Bidders / Contractors

If PowerTel obtains knowledge of conduct of a Bidder or a Contractor or his sub contractor or of an employee or a representative or an associate of a Bidder or Contractor or his Subcontractor which constitutes corruption, or if POWRGRID/PowerTel has substantive suspicion in this regard, PowerTel will inform the Chief Vigilance Officer (CVO).

(*)Section VII – Independent External Monitor/Monitors

(1) PowerTel has appointed a panel of Independent External Monitors (IEMs) for this Pact with the approval of Central Vigilance Commission (CVC), Government of India, out of which one of the IEMs has been indicated in the NIT/IFB

(2) The IEM is to review independently and objectively, whether and to what extent the parties comply with the obligations under this agreement. He has right of access to all project documentation. The IEM may examine any complaint received by him and submit a report to Chairman-cum-Managing Director, POWERGRID, at the earliest. He may also submit a report directly to the CVO and the CVC, in case of suspicion of serious irregularities attracting the provisions of the PC Act. However, for ensuring the desired transparency and objectivity in dealing with the complaints arising out of any tendering process, the matter shall be referred to the full panel of IEMs, who would examine the records, conduct the investigations and submit report to Chairman-cum-Managing Director, POWERGRID, giving joint findings.

(3) The IEM is not subject to instructions by the representatives of the parties and performs his functions neutrally and independently. He reports to the Chairman-cum-Managing Director, POWERGRID.

(4) The Bidder(s)/Contractor(s) accepts that the IEM has the right to access without restriction to all documentation of POWERGRID/PowerTel related to this contract including that provided by the Contractor/Bidder. The Bidder/Contractor will also grant the IEM, upon his request and demonstration of a valid interest, unrestricted and unconditional access to his documentation. The same is applicable to Subcontractors. The IEM is under contractual obligation to treat the information and documents of the Bidder(s)/Contractor(s)/ Subcontractor(s)with confidentiality.

(5) PowerTel will provide to the IEM information as sought by him which could have an impact on the contractual relations between PowerTel and the Bidder/Contractor related to this contract.

(6) As soon as the IEM notices, or believes to notice, a violation of this agreement, he will so inform the Chairman-cum-Managing Director, POWERGRID and request the Chairman-cum-Managing Director, POWERGRID to discontinue or take corrective action, or to take other relevant action. The IEM can in this regard submit non-binding recommendations. Beyond this, the IEM has no right to demand from the parties that they act in a specific manner, refrain from action or tolerate action. However, the IEM shall give an opportunity to POWERGRID/PowerTel and the Bidder/Contractor, as deemed fit, to present its case before making its recommendations to PowerTel.

(7) The IEM will submit a written report to the Chairman-cum-Managing Director, POWERGRID within 8 to 10 weeks from the date of reference or intimation to him by PowerTel and, should the occasion arise, submit proposals for correcting problematic situations.

(8) If the IEM has reported to the Chairman-cum-Managing Director, POWERGRID, a substantiated suspicion of an offence under relevant Anti-Corruption Laws of India, and the Chairman-cum-Managing Director, POWERGRID has not, within the reasonable time taken visible action to proceed against such offence or reported it to the CVO, the Monitor may also transmit this information directly to the CVC, Government of India.

(9) The word ‘IEM’ would include both singular and plural.

(*) This Section shall be applicable for only those packages wherein the IEMs have been identified in Section – I : Invitation for Bids and/or Clause ITB 9.3 in Section – III: Bid Data Sheets of Conditions of Contract, Volume-I of the Bidding Documents.

Section VIII – Pact Duration

This Pact begins when both parties have legally signed it. It expires for the Contractor after the closure of the contract and for all other Bidder’s six month after the contract has been awarded.

Section IX – Other Provisions.

1 (1) This agreement is subject to India Law. Place of performance and jurisdiction is the establishment of PowerTel. The Arbitration/Conciliation clause provided in the main tender document / contract shall not be applicable for any issue / dispute arising under Integrity Pact.

2 (2) Changes and supplements as well as termination notices need to be made in writing.

(3) If the contractor is a partnership firm or a consortium or Joint Venture, this agreement must be signed by all partners, consortium members and Joint Venture Partners

4 (4) Nothing in this agreement shall affect the rights of the parties available under the General Conditions of Contract (GCC) and Special Conditions of Contract (SCC)

(5) Views expressed or suggestions/submissions made by the parties and the recommendations of the CVO in respect of the violation of this agreement, shall not be relied on or introduced as evidence in the arbitral/conciliation or judicial proceedings (arising out of the arbitral/conciliation proceedings) by the parties in connection with the disputes/differences arising out of the subject contract.

(6) Should one or several provisions of this agreement turn out to be invalid, the remainder of this agreement remains valid. In this case, the parties will strive to come to an agreement to their original intentions.

(For & On behalf of PowerTel (For & On behalf of Bidder/Contractor)

(Official Seal) (Official Seal)

Designation: ……………………….. Designation:…………………………………

Witness 1: ……………………….. Witness 1:…………………………………

(Name & Address): ……………………….. (Name & Address):…………………………………

Witness 2: ……………………….. Witness 2:…………………………………

(Name & Address): ……………………….. (Name & Address):…………………………………

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-15

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Option for contract performance guarantee and Information for E – payment, PF details and declaration for Micro/Small and Medium Enterprise)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

I. We have read the provision in the Bidding Documents regarding furnishing of Contract Performance Guarantee.

we hereby confirm to opt the following:

I Contract performance Guarantee will be submitted:

(Select from drop down list)

II. We are furnishing the following details of Statutory Registration Numbers and details of Bank for electronic payment.

1. Name of the Supplier/ Contractor in whose favour payment is to be made

2. Address with PIN Code and State

Registered Office: 0

Correspondence Address: 0

3.(a) Status – Company/others

[Declaration of Micro/ Small/ Medium Enterprise under Micro/ Small & Medium Enterprises Development Act 2006, if applicable]

3.(b) Are you a MSE owned by SC/ST* entrepreneures in line with public Procurement Policy for Micro and Small Enterprises (MSEs) order 2012 including subsequent amendment/notification/order 2012 including susequent amendment/notification/order (Indicate Yes/No) Note:Documentary evidence is to be attached.Please refere remarks at the end of the attachment No

3.(c) If 3(b) is "Yes" please mention whether you are (Proprietary MSE/Partnership MSE/Private Limited Company) owned by SC/ST entrepreneures

3.(d) Are you a MSE owned by women in line with Public Procurement Policy for Micro and Small Enterprises (MSEs) order 2012,Public Procurement Policy for Micro and Small Enterprises (MSEs) order 2018 including susequent amendment/notification/order (Indicate Yes/No) Note:Documentary evidence is to be attached. Yes(Documentary evidence attached)

4. Permanent Account (PAN) No.

5. GSTIN Number

I GSTIN in the Sates/UT from where the supply of goods take place

Name of the States/UT GSTIN number

II GSTIN in the States/UT where the supply for services take place (states where sites under the subject package is situated)

Name of the States/UT GSTIN number

6 PF Registration No. of the Company

7 PF Regional Office covered (with Address)

8 Name of Contact Person

9 Telephone No(s)

10 Bank Details for Electronic Payment

Name of the Bank:

Address of Branch:

Type of Account: (Saving/Current)

11 9 digit MICR code printed at bottom in middle, next to cheque no.

12 IFSC (for RTGS)/NEFT Code (to be obtained from the Bank) Sample Cancelled Cheque to be enclosed

We hereby declare that the above information are true and correct and we agree that the payment on account of this Contract, in the event of award, be made in the above account maintained in the above mentioned Bank.

*The definition of MSEs owned by SC/ST is as given under:

a. In case of propritary MSE,propriator(s) shall be SC/ST.

b. In case of partnership MSE,the SC/ST partners shall be holding at lease 51% shares in the unit.

c. In case of Private Limited Companies, at least 51% share shall be held by SC/ST promoters.

Documentary evidence:Please provide scanned copy(ies) of SC/ST Certificate(s) issued by District Authority as applicable for ST/SC MSE Category as per the (a),(b) & (c) above

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-16

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Additional Information)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

In support of the additional information required as per ITB Sub-Clause 9.3 (q) of the Bidding Documents, we furnish herewith our data/details/documents etc., alongwith other information, as follows (the stipulations have been reproduced in italics for ready reference):

1.0 The Bidder shall furnish

A certificate from their Banker(s) (as per prescribed formats in Form 16, Section-VI: Sample Forms and Procedures) indicating various fund based/non fund based limits sanctioned to the Bidder and the extent of utilization as on date. Such certificate should have been issued not earlier than three months prior to the date of bid opening. Wherever necessary the Employer may make queries with the Bidders’ Bankers. [Reference ITB clause 9.3(p)(i)]

1.1 In accordance with 1.0, Certificate(s) from banker as per requisite format, indicating various fund based/non fund based limits sanctioned to the bidder or each member of the joint venture and the extent of utilization as on date is/are enclosed, as per following details:

Name of the Bidder(Sole Bidder)

Name of the Banker by whom Certificate Issued

Date of Certificate (Should not be earlier than 3 months prior to date of Bid Opening)

Weather fund based/non fund based limitsare indicated in the certificate

Weather extent of utilization is indicated in the Certificate

1.2 The Bidder should accordinglyalso provide the following information/documents:

(i) Detail of Banker

Name of the Banker

Address of the Banker

ContactName and Detail

(ii) As per Para1.0, Authorization Letter(s) from the bidder (in case of JV bidder, from all the partners)addressed to the Banker(s), authorizing POWERGRID to seek queries about the bidder with the Banker(s) and advising the Banker(s)to reply same promptly, is/are enclosed as per following details

S.No. Letter Ref Date Addressed to (Name of the Bank)

(iii) As per BDS/ITB Clause 9.3(q), bidder shall furnish the details of their provident fund code Number

S.No. Name of the Bidder/JV Partner Provident Fund Code Number Details

2.0 Litigation History

The bidder should provide detailed information on any litigation or arbitration arising out of contracts completed or under execution by it over the last five years. A consistent history of awards involving litigation against the Bidder or any partner of JV may result in rejection of Bid. [Reference ITB clause 9.3(q)(ii)]

2.1 Details of litigation history resulting from Contracts completed or under execution by the bidder over the last five years

Year Name of client, cause of litigation/arbitration and matter in dispute Details of Contract and date Award for or against the bidder Disputed amount

3.0 Details regarding previous transgressions of Integrity Pact

The Bidder should providethe detailed information regarding previous transgressions of Integrity Pact that occurred in the last 10Years with any other Public Sector Undertaking or Government Department or any other Company, in any country [Reference ITB clause 9.3(q)(iv)]

3.1 Details regarding previous transgressions of Integrity Pact that occurred in the last 10Years

Year Name of Client Details of Transgression of Integrity Pact by the Bidder

4.0 OTHER INFORMATION

4.1 Current Contract Commitments of works in progress

Bidders should provide information on their current commitments on all contracts that have been awarded, or for which a letter of intent or acceptance has been received, or for contracts approaching completion, but for which an unqualified, full completion certificate has yet to be issued.

Details of Contract Type of Work Ordered Quantity as per Contract Balance Work to be completed as on date Completion Period for balance quantity

Commencement Completion

4.2 Financial Data:

Details Actual (Previous five years) Projection for next five years

Total Liability

Current Liability

Profit before taxes

Profit after taxes

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-17

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Declaration for tax exemptions, reductions, allowances or benefits)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We confirm that we are solely responsible for obtaining following tax exemptions, reductions, allowances or benefits in respect of supplies under the subject package, in case of award. We further confirm that we have considered the same in our bid thereby passing on the benefit to POWERTEL while quoting our prices. In case of our failure to receive such benefits, partly or fully, for any reason whatsoever, the Employer will not compensate us.

We are furnishing the following information required by the Employer for issue of requisite certificate if and as permitted in terms of the applicable Govt. of India policies/procedures (in case of award):

Applicable Act, Notification No. and Clause Ref. No. Sl. No. Description of item on which applicable Country of origin Remarks, if any

(The requirements listed above are as per current Notification of Govt. of India indicated above. These may be modified, if necessary, in terms of the Notifications.)

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-18

Instruction for printing & submitting Safety Pact

1 The requisite format of Safety Pact is getting generated automatically and displayed here below:

2 Take print out of first page on a non-judicial stamp paper of Rs. 100/- and other four pages on plain A4 size paper. Such two sets shall be prepared by the bidder.

3 All the pages of both the copies of the Safety Pact shall be signed by the authorised representative of the bidder and duly stamped.

4 Both the original copies shall be submitted by the bidder in the form of Hard Copy as part of the first envelope before due date & time of submission of the bid.

5 For further details bidders may please refer ITB Clause 9.3 (u).

POWERTEL TELESERVICES LIMITED

Hereinafter referred to as

having its Registered office at

hereinafter reffered to as

“The Bidder/Contractor”

PowerTel intends to award, under laid-down organizational procedures, contact(s) for

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632

PowerTel values full compliance with all relevant laws and regulations, and the principles of economical use of resources, and of fairness and transparency in its relations with its Bidders/Contractors.

In order to achieve these goals, POWERTEL and the above named Bidder/contractor enter into this agreement called ‘Safety Pact’ which will form a part of the bid.

It is hereby agreed by and between the parties as under:

Section 1 – Commitments of PowerTel

1 PowerTel commits itself to take all measures necessary to prevent accidents duringConstruction and Operation of the Transmission Assets and to observe the following:

1) PowerTel recognizes and accepts its statutory responsibilities for ensuring construction, operation and maintenance of equipments and for the provision of safe methods of work and safe working conditions.

2) PowerTel recognizes and accepts its statutory responsibilities for ensuring safety of not only its employees but also that of the Contracting Agencies as Principal Employer.

3) PowerTel shall review the accidents in a structured manner and take necessary actions to ensure that the safety criteria are strengthened for safe construction as well as Operation & Maintenance of the Transmission Assets.

4) PowerTel shall conduct necessary awareness and training programmes to its Employees to augment the various safety requirements to be followed during Construction and Operation & Maintenance of the Transmission Assets from time to time

5) PowerTel shall, from time to time, issue necessary guidelines,instructions and deterrents to its employees as well as to the Contracting Agencies, to update them to take necessary preventive measures to avoid repetition of similar accident attributes.

6) PowerTel shall review and provide necessary guidance to the Contracting Agencies, as and when, any abnormality / special situations are brought to its notice by the Contracting Agencies during execution of the Transmission Projects being executed by them.

7) PowerTel shall conduct periodical surveillance site inspections / audits to identify the unsafe conditions and unsafe actions, and bring them to the knowledge of the Contracting Agencies for taking timely corrective actions.

8) PowerTel shall investigate all accidents, fatal as well as non-fatal, to identify the lapses, the reason for the accident / incident and suggest measures for prevention of recurrence of such accidents, and fix responsibility for the lapses leading to the accident.

9) PowerTel shall augment the training to the workers and supervising personnel of the Contracting Agencies, as per schedules, upon nomination by the Contracting Agencies in reasonable time frame.

10) PowerTel shall exercise the right to claim and recover compensation from the Contracting Agencies in case of any violation of the safety requirements / provisions during execution of the Transmission Projects, as built in the applicable Laws and contractual specifications / guidelines in vogue / issued by PowerTel from time to time.

Section II – Commitments of the Bidder/ Contractor

The Bidder / Contractor commits himself to take all measures necessary to prevent / minimise accidents at their construction / erection sites and to observe the following:

1) The Bidder / Contractor recognizes and acceptsthe statutory and comprehensive responsibility for ensuring safe construction and Testing & Commissioning in the Transmission Projects being executed by thembyproviding safe methods of work, working conditions and Tools & Plants for human safety.

2) The Bidder / Contractor recognizes and accepts the responsibilities for ensuring safety of not only their employees but also that of the Sub-contractors, Principal Employer and the general public during execution of the Transmission Projects / works.

3) The Bidder / Contractor shall review the accidents in a structured manner and take necessary actions to ensure that the safety criteria are strengthened for safe construction of the Transmission Assets.

4) The Bidder / Contractor shall endeavour continuous development of safe methods of work to ensure that the effect of risks and perils are minimised to the extent possible and implement the same at their worksites.

5) The Bidder / Contractor shall conduct periodical Training to their Employees as well as to that of their'Sub-contractors for safety awareness during construction works being executed by them.

6) The Bidder / Contractor shall provide all requisite Tools & Plants required for the work and ensure their healthiness by periodical inspections / testing as required. Unhealthy and sub-standard Tools & Plants will be immediately removed from site as and when they are identified.

7) The Bidder / Contractor shall,at their cost, provide all necessary Personal Protective Equipments such as Double Lanyard Safety Belts, Appropriate Fall Arrest Systems, Safety Helmets, Foot Wear, Hand Gloves, etc., as required for various activities pertaining to execution of the Projects / works, confirming to relevant Indian Standards.

8) The Bidder / Contractor shall ensure that dedicated qualified Safety Officers are posted in the construction projects being executed by them and ensure that the Safety Officer visits each and every gang periodically and conducts audits / inspections to identify the unsafe conditions and unsafe actions, to be rectified by the site supervising personnel promptly.

9) The Bidder / Contractor shall conduct appropriate medical checks-up for the workers before deploying them at their construction sites to ensure that only those who are medically fit are deployed in the Projects / works to be executed by them. The copy of the Medical Reports shall be provided by the Bidder / Contractor to PowerTel, whenever requested by PowerTel.

10) The Bidder / Contractor shall screen the workers before deploying them at their construction sites to ensure that only those with the skills, experience and competence to work at heightand also medically fitfor work at height are deployed for work at height in the Projects executed by them.

11) The Bidder / Contractor shall ensure daily before starting the work thattheir site Supervising Personnel/Safety Officer briefs the workers about the work for the day and the safety measures / precautions required to be taken by them.

12) The Bidder / Contractor shall investigate all the accidents at their working sites to ascertain the lapses leading to the incident and the precautionary / corrective measures required to be taken to avoid recurrence of such accidents. These accidents will be reviewed at the Board Management level of the Agencies and the findings / recommendations will be put up to POWERGRID Apex Safety Board within the stipulated period.

13) The Bidder / Contractor shall ensure that all accidents, whether fatal or non­fatal in nature, will be informed to POWERTEL, in writing, immediately on the occurrence of the same,and in any case, within not more than 24 hours of occurrence of the same.

14) The Bidder / Contractor shall ensure that in case of any accident, all necessary medical help / supportshall be provided to the victims / injured till they are completely fit to return to work.

15) The Bidder / Contractorshall ensure that in case of fatal accidents, all statutory Authorities, including Police, concerned Labour Dept. Officials, concerned Workmen Compensation Commissioner, etc., will be intimated in writing as required by the statutory Law, and followed up for compliance of all statutory obligations. The Bidder / Contractor shall own full responsibility of timely accident reporting to various authorities, including PowerTel.

16) The Bidder / Contractor shall ensure that in case of fatality or serious injury leading to permanent disablement of the victims, the compensation amount will be deposited with the concerned authorities, as required by the Laws, and followed up for early disbursement to the beneficiaries of the victims.

17) The Bidder / Contractor assures that they shall co-operate to the fu11est extent for carrying out any investigation of the accidents at their work sites byPowerTel to identify the lapses, the reason for the accident / incident and suggest measures for prevention of recurrence of such accidents. All factual details of the occurrence of the accident will be provided to PowerTel, as and when required.

18) The Bidder / Contractor assures that they take fu11 responsibility of meeting the statutory obligations in case of accidents, and in case of any reference by any Statutory Body at a later date also, they shall provide all information to PowerTel and meet all the statutory obligations, including payment of additional compensation, if any.

19) The Bidder / Contractor assures that in case of any inspection of their work site or Notice by any Statutory Authority, they shall comply promptly and inform PowerTel Site Officials of the same, and also provide all necessary information and assistance for smooth compliance of the observations / instructions of such Authorities.

20) The Bidder / Contractor accepts the provisions regarding safety, including payment of any sums to PowerTel, in case of any violation of the safety requirements / provisions during execution of the Transmission Projects, as built in the Contractual Conditions, Safety Planand the Safety Pact, and confirm to abide by the same.

Section III – Equal treatment to all Bidders/Contractors.

(1) POWERTEL will enter into agreements with identical conditions as this one with all Bidders.

(2) POWERTEL will disqualify, from the tender process, any bidder/ take punitive actions on the bidder, who does not sign this Pact or violate its provisions.

Section IV – Pact Duration

This Pact begins when both parties have legally signed it. It expires for the successful Bidder/Contractor after the closure of the contract and for all other Bidder’s after the contract has been awarded.

Section V – Other Provisions.

1 1) This agreement is subject to Indian Law. Place of performance and jurisdiction is the establishment of PowerTel. The Arbitration/Conciliation clause provided in the main tender document / contract shall not be applicable for any issue / dispute arising under the Safety Pact.

2 2) Changes and supplements need to be made in writing, which shall come into force only upon mutual agreement / acceptance.

3) If the Contractor is a partnership firm or consortium of Joint Venture, this agreement must be signed by all partners, consortium members and Joint Venue partners, as applicable as per the Tender Specifications.

4 4) Nothing in this agreement shall affect the rights of the parties available under General Conditions of Contract (GCC) and Special Conditions of Contract (SCC).

5) Should one or several provisions of this agreement turn out to be invalid, the reminder of this agreement remains valid. In this case, the parties will strive to come to an agreement to their original intentions.

(For & On behalf of PowerTel) (For & On behalf of Bidder/Contractor)

(Official Seal) (Official Seal)

Designation: ……………………….. Designation:…………………………………

Witness 1: ……………………….. Witness 1:…………………………………

(Name & Address): ……………………….. (Name & Address):…………………………………

Witness 2: ……………………….. Witness 2:…………………………………

(Name & Address): ……………………….. (Name & Address):…………………………………

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-19

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

Further, we hereby confirm that except as mentioned in the Attachment -6 (Alternative, Deviations and Exceptions to the Provisions) hereof , forming part of our First Envelope:

(i) there are no discrepencies/inconsistencies and deviations/omissions/reservations to the Bidding Documents, in the Second Envelope bid;

We also confirm that in case any discrepencies/inconsitencies and deviations/omissions/reservations, as referred to in para (i) and (ii) above, is observed in the Second Envelope, the same shall be deemed as withdrawn/rectified without any finacial implication, whatsoever to POWERTEL. However, in case of any artithmetical errors, the same shall be governed as per the provisions of ITB Sub-clause 27.2 read in conjuction with BDS.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-20

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Declaration of Key Managerial Person and Power of Attorney holder to be Submitted in Company Letter Head duly Signed & Sealed)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

1 We confirm that the declarations made in our bid, particularly Attachment-3 (QR) regarding eligibility/qualification data and documents submitted in our bid in support of the declarations, are true and correct to the best of our knowledge.

2 We further confirm that we have filled up Attachment-3(QR). We also confirm that in support of meeting the Technical experience requirement as per Annexure-A (BDS), we have enclosed self-certified copy of Contract/ Award Letter and certificate from the utility for which the contract has been executed

3 We shall furnish clarification to bid, if any sought by Employer pursuant to ITB clause 21.1. We understand that if we fail to rectify/furnish the requested documents if any, within 7 working days’ notice, our bid is liable to be rejected.

4 We understand that any false declaration and/or misrepresentation of facts and/or furnishing of false/forged documents /information may lead to our debarment from participation in Employer tenders and that our Bid Security/ Contract Performance Guarantee may be forfeited besides other actions as deemed to be appropriate as per the provisions of the Bidding Document/Integrity Pact/Employer’s policy.

5 Our Balance Bid Capacity net of works under execution, calculated as per Clause ITB 23.2.1 (i.e. 3T-B), as on 1st date** of the Quarter in which First Envelope Bids are to be opened i.e. 01st ……(month) 20.. (year) in equivalent Indian Rupees is ………….. Crore. The details of value used for working out the Balance Bid Capacity as above, are as follows:

A. Maximum value of similar works (e.g. value related to Telecom equipment/OFC AMC&LMC/Shelter costruction etc. respectively) executed during the last 5 financial years taking into account the completed as well as the works in progress(T).

Sl. No Financial year Value of Total Sales (including Taxes and Duties)(T)

B. Value of existing commitments and ongoing similar works yet to be completed as on the 1st date of quarter of the financial year in which the bids are opened(B) as on 1st date of the Quarter in which First Envelope Bids are to be opened

Sl.No Value of Balance Works (B1) against the Contracts awarded by Employer Value of Balance Works (B2) against the Contracts awarded by Utilities other than Employer Total value of Balance Works (B){B=B1+B2}

[**1st day of the quarter in which the first envelope bids are opened for e.g. If the actual date of opening of first envelope bids is 15th June 2016, the Balance bid capacity as on 01st April 2016 is to be declared)] *(Applicable only in case of package for which the stipulated Qualification Requirements in respect of Technical experience pertains primarily to erection, testing and commissioning/civil works viz. Telecom equipment/Telecom Repeater Shelter/transmission Line tower packages/Substation package/civil works package etc.)

6** Our/Our proposed manufacturer’s annual manufacturing capacity as certified by a Chartered Engineer or similar Professional/ Professional body/Govt Agencies is: ----- MT/annum (for tower/tower parts) [Certificate from Chartered Engineer or similar Professional/ Professional body/Govt Agencies in the country of the bidder/proposed manufacturer is to be enclosed along with this Attachment. Annual manufacturing capacity of all the manufacturers to be furnished separately] ***(Applicable only in case of Tower packages with scope for tower supply)

7 Notwithstanding above, we also understand that the Bid Capacity/Manufacturing Capacity as declared hereinabove, shall be subject to assessment, if any, by the Employer, which shall be final and binding. We also confirm that the Employer may verify the supporting documents/ details in connection with above declarations. We further understand that in case of any unethical practices inter-alia including any misrepresentation of facts, submission of false and/or forged details/ documents/ declaration by us, we may be debarred from the participation in Employer’s tenders in future as considered appropriate by Employer and our Bid Security/ Contract Performance Guarantee shall be forfeited besides taking other actions as deemed appropriate.

Note: Key Managerial Personnel (KMP) of the company shall include CEO/Managing Director/ Company Secretary/ Director/ CFO/any of the partner in case of partnership firm/any other officer entrusted with substantial powers of the management of the affairs of the company/firm.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-21

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Format for Affidavit of Self certification regarding Local Content in line with PPP-MII order and DoT Order, if applicable, to be provided on a non-judicial stamp paper of Rs. 100/-.

I S/o, D/o, W/o, Resident of_________________________________________________________ hereby solemnly affirm and declare as under:

That I will agree to abide by the terms and conditions of the Public Procurement (Preference to Make in India) Order, 2017 of Government of India issued vide Notification No:P-45021/2/2017 -BE-II dated 15/06/2017, its revision dated 19.07.2024 (hereinafter PPP-MII order) and Public Procurement (Preference to Make in India) to provide Purchase preference (linked with local content) Order, 2017- Notification of Telecom Products, Services or Works issued vide Notification No. 18-10/2017-IP dated 29.08.2018 by Department of Telecommunications (DOT) (hereinafter, DoT Order) and any subsequent modifications/Amendments, if any and

That the information furnished hereinafter is correct to the best of my knowledge and belief and I undertake to produce relevant records before the procuring entity/PowerTel or any other Government authority for the purpose of assessing the local content of goods/services/works supplied by me for ……………………………………............................................ (Enter the name of the package).

That the local content for all inputs which constitute the said goods/services/works has been verified by me and I am responsible for the correctness of the claims made therein

That the 'Local Content' as defined in the PPP-MII order and DoT Order in the goods/services/works supplied by me for ……………………………………………………………………………………... (Enter the name of the package) is…….. Percent (%).

That the goods/services/works supplied by me for ……………………………………………………………………………………... (Enter the name of the package) meet the 'Local Content' requirement as defined in the PPP-MII order and DoT Order for 'Class-I Local Supplier'/ 'Class-II Local Supplier' (Choose as applicable)

That the cost of locally sporced imported items(inclusive of taxes) along with the breakup of license/royalties paid/technical expertise cost etc. sourced from outside india for …............[Fill in the name of the package along with the specification number] is as given below a. Cost of Imported Items sourced locally from resellers/distributers(inclusive of taxes) is Rs........ b. Cost of license fee/royalties paid/technical expertise paid oot of India is Rs........ c. Cost of Procurement/Supply of repackaged/refurbished/rebranded imported product is Rs ........ That the OEM Certificate for country of origin is submitted along with this declaration[applicable only in case the bidder is a reselleras per the provision of PPP-MII order. The bidder shall attach the OEM Certificate along with this declaration. Delete in case it is not applicable]

[a] That the ggods/services/works supplied by me for …...........................................,,,,,,,,,[Fill in the Packagealong with specification no.], Meet the 'Local Content' requirement as defined in the PPP-MII Order and DOT Order for 'Class-I local suppliers'/'Class-II Local suppliers(Choose as applicable)

[b] That I have received incentive from the…....................[mention name of PLI ministry] Ministry for the goods/services/works supplied by me for….....................................................[Fill in the name of package with specification no.] under the Production Linked Incentive Scheme(PLI) of the Government of India and shall be considered as deemed'class-II Local supplier under PPP-MII Order.

[The bidder to strike out either [a] or [b] above as applicable]

[c] That the items supplied by me under…........................................................................[Fill in the name of Package along with specification no.] notified as having sufficient local capacity and competition by the Nodal ministries shall be sourced from Class-I local suppliers only.[Applicable in case of System integrators/EPC/Turnkey Projects/Service Tenders only. Delete if not applicable]

That the value addition for the purpose of meeting the ‘Local Content ‘has been made by me at ……………………… (Enter the details of the location(s) at which value addition is made)

That in the event of the local content of the Goods/Services/Works mentioned herein is found to be incorrect and not meeting the prescribed Local Content criteria, based on the assessment of procuring agency (ies)/POWERTEL/Government Authorities for the purpose of assessing the local content, action shall be taken against me in line with the PPP-MII order, DOT order and provisions of the Integrity pact/ Code of Integrity in Public Procurement/Bidding Documents.

I agree to maintain the following information in the Company's record for a period of 8 years and shall make this available for verification to any statutory authority

i Name and details of the Local Supplier (Registered Office, Manufacturing unit location, nature of legal entity)

ii Date on which this certificate is issued

iii Telecom Products/Services/Works for which the certificate is produced

iv Procuring entity to whom the certificate is furnished

v Percentage of local content claimed and whether it meets the Local Content prescribed for 'Class-I Local Supplier'/ 'Class-II Local Supplier' (Choose as Applicable)

vi Name and contact details of the unit of the Local Supplier (s)

vii Sale Price of the product

viii Ex-Factory Price of the product

ix Freight, insurance and handling

x Total Bill of Material

xi List and total cost value of input used to manufacture the Goods/to provide services/in construction of works

xii List and total cost of input which are domestically sourced. Value addition certificates from suppliers, if the input is not in-house to be attached

xiii List and cost of inputs which are imported, directly or indirectly

xiv Cost and break up of imported items(inclusive of taxes) sourced locally from resellers/distributors

xv Cost and break up of license fees/royalties paid/technical charges paid out of India

xvi Cost and break up of Procurement/supply of repackaged/ refurbished/ rebranded imported products

I hereby Certify that, having read all the provisions of the above order and priciples / basis of calculations, the local content calculations does not include the following: a. Imported items(inclusive of taxes) sourced locally from resellers/distributers. b. The license fees/ royalties paid/ technical chages paid out of India c. Procurement/ supply of repackaged/ refurbished/ rebranded imported products

Date : 0 For and on behalf of……………………………………………… (Name of firm/entity) Authorized signatory (To be duly authorized by the Board of Directors) <Insert Name, Designation and Contact No.>

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-22

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Certificate from statutory auditor or cost auditor of the company (in the case of companies) or from a practicing cost accountant or practicing chartered accountant (in respect of suppliers other than companies) giving the percentage of Local Content, in line with PPP-MII order and DoT Order, if applicable [to be submitted on the letter head of the issuer.]

We have read and understood the provisions of “Public Procurement (Preference to Make in India) Order, 2017” dated 15/06/2017, its revision dated 04/06/2020 [hereinafter, “PPP-MII Order”] issued by Department of promotion of Industry and Internal trade (DPIIT), Ministry of Commerce and Industry, Government of India and Public Procurement (Preference to Make in India) Order,2017-Notification of Telecom products, Services or Works issued vide Notification No.18-10/2017-IP dated 29.08.2018 by Department of Telecommunications (DoT) (hereinafter, DoT-Order)

In line with the provisions of the PPP-MII Order and DoT Order, M/s. ………......................[Enter the name of the Bidder] [hereinafter, “Class-I Local Supplier"/ "Class-II Local Supplier” (choose as applicable)] have submitted an Affidavit of self-certification to M/s. PowerGrid Teleservices Limited [hereinafter, POWERTEL] regarding Local Content in Goods/Services/Works to be supplied by the "Class-I Local Supplier"/ "Class-II Local Supplier" (Choose as Applicable) for ………………....................... [Enter the name of the package], wherein they have agreed to abide by the terms and conditions of the PPP-MII Order and DoT Order.

Further, in line with the PPP-MII Order, the statutory auditor or cost auditor of the company (in the case of companies) or a practicing cost accountant or practicing chartered accountant (in respect of suppliers other than companies) shall provide a certificate giving the percentage of Local Content in the Goods/Service/Works to be supplied by the "Class-I Local Supplier"/ "Class-II Local Supplier" (Choose as Applicable) for ………………............................................... [Enter the name of the package].

Accordingly, we, the Statutory Auditor(s) / Cost auditor of the "Class-I Local Supplier"/ "Class-II Local Supplier" (Choose as Applicable) / a practicing cost accountant or practicing chartered accountant (choose as applicable), certify that the Local Content as defined under the PPP-MII and DoT Order, in the Goodss/Services/Works to be supplied by the "Class-I Local Supplier"/ "Class-II Local Supplier" (Choose as Applicable) for ………………............................. [Enter the name of the package] is ……….. Percentage (Specify the percentage of local content).

Date : For and on behalf of……………………………………………… (Name of firm/entity) Authorized signatory (To be duly authorized by the Board of Directors) <Insert Name, Designation and Contact No.>

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-23

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Compliance to the process related to the e-RA Terms & Conditions and the Business Rules governing the e-RA)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

This has reference to the Terms & Conditions for the e-Reverse Auction mentioned in the Business Rules for

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

We confirm that

1. The undersigned is authorized representative of the Bidder.

2. We have studied the e-Reverse Auction Terms & Conditions and the Business Rules governing the e-Reverse Auction as mentioned in your letter and confirm our agreement to them.

3) We understand that ASP shall arrange to demonstrate/ train (if not trained earlier) bidders’ nominated person(s), without any cost. They will also explain all the Rules related to e-Reverse Auction/ Business Rules Document to be adopted along with bid manual. We have further noticed that we at own discretion may ask for additional training to use the e-RA platform well in advance before start of the e-RA event by contacting the ASP at any suitable time. All such additional trainings shall also be free of cost.

We We hereby confirm that we will honor the Bids placed by us during the auction process.

Date : Printed Name :

Place : Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-24

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Declaration regarding events encountered pursuant to ITB Clause 2.1)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

1.0 In accordance with the relevant provisions of the bidding documents inter-alia including for assessment of capacity and capability, we furnish herewith our data/details/documents alongwith other information, as follows

S. No. Event Select

1 Whether there was Termination# of Contract(s) due to Contractor’s default Yes

2 Whether there was Encashment of CPG(s) due to non-performance Yes

3 Whether there was repeated failure of major Equipment(s) while in service* Yes

4 Whether substantial portion of works (more than 50% of the Contract**) is sub-contracted, under an existing Contract Yes

5 Whether more than 25% of the Contract price (awarded value), in aggregate, is paid to sub-contractors/suppliers as Direct payment, under an existing Contract, due to financial position of Contractor Yes

6 Firm has been referred to NCLT under Insolvency & Bankruptcy Code (IRP has been appointed or Liquidation proceedings have been initiated under IBC) Yes@

1 Information regarding events at Sl. No. 1 to 5 shall be furnished for events occurred during last one year under the contract(s) executed by you for POWERGRID (Owned as well as Consultancy)

# Partial offloading under a contract and/or Facilitation beyond 10% of the Contract Price shall also be treated as Termination. For the said purpose, the Contract Price means the Contract Price of the Facilities notwithstanding the construction of the contract.

* In case POWERGRID has issued a letter in this regard wherein the firm has been put on hold from award of further contract(s) for a specified period and this specified period of hold is yet to expire, the bidder shall indicate “Yes” against this event.

** For thepurpose of working out 50% of the Contract, following shall be taken into account suitably:

(a) Scope of the contract which is permissible to be sub-contracted as per bidding documents, shall be excluded.

(b) Scope of the Contract which primarily relates to the Qualification Requirement (QR) of the bidder as illustrated below:

Sl. No. Type of Package/ Contract Main aspect of the QR Criteria for working out 50% of the Contract

1 Conductor/Insulator Package Manufacture & Supply 50% of the total supply of Conductor/Insulator under the Contract

2 Tower Package Construction of Transmission Line 50% of the total Transmission Line construction under the Contract

3 Substation(AIS) Package Construction of bays 50% of the total bays construction under the Contract

4 Transformer/Reactor Manufacture & Supply 50% of the total supply of Transformer/Reactor under the Contract

5 Substation(GIS) Package Manufacture & Supply of GIS bays 50% of the total supply of GIS bays under the Contract

The guiding principles as illustrated above shall be followed while dealing with other packages/contracts.

@ 4. Regarding Sl. No. 6, in case of ‘Yes’, following information shall be submitted additionally:

Date on which the firm has been referred to NCLT under Insolvency & Bankruptcy Code (IRP has been appointed or Liquidation proceedings have been initiated under IBC) …………………………………

Whether the process under IBC has been concluded (If yes, supporting documents be submitted) Yes

2.0 We confirm that the above information/declarations and documents submitted in support of the same are true and correct to the best of our knowledge. We understand that any false declaration and/or misrepresentation of facts and/or false/forged documents/information may lead to our debarment from participation in Employer tenders and that our Bid Security/Contract Performance Guarantee may be forfeited besides other actions as deemed to be appropriate as per the provisions of the Bidding Documents/Integrity Pact/Employer’s policy.

Date : 0 Printed Name :

Place : 0 Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-25

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Certification by the Bidder per order no. F.No.6/18/2019-PPD dated 23/07/2020 and F.No.7/10/2021-PPD(1) dated 23/02/2023 issued by Public Procurement Division, Department of Expenditure, Ministry of Finance, Government of India (DoE Order) in line with ITB 2.1

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We have read and understood the provisions of Order no. F.No.6/18/2019-PPD (Order Public Procurement no.1) dated 23/07/2020 regarding “Restriction under Rule 144(xi) of General Financial Rules” and F.No.6/18/2019-PPD (Order Public Procurement no.2) dated 23/07/2020 regarding “Exclusions from Restriction under Rule 144(xi) of General Financial Rules”, and F.No.7/10/2021-PPD(1) (order Public Procurement no.4) dated 23/02/2023 regarding “Restriction under Rule 144(xi) of General Financial Rules” issued by Public Procurement Division, Department of Expenditure, Ministry of Finance, Government of India [hereinafter collectively “DoE Order’’] and any subsequent modifications/Amendments, if any.

Particularly, we, the Bidder, have read the clause regarding restrictions on procurement from a ‘Bidder of a country which shares a land border with India’ and on sub-contracting to contractors from such countries, and on procurement from a bidder having Transfer of Technology (ToT) arrangement.We certify that we, the bidder [and our proposed Associates]* is/are not from such a country or, if from such a country, has been registered as per provisions of the Bidding Documents with the Competent Authority and will not subcontract any work to a subcontractor/sub vendor from such countries unless such subcontractor/sub vendor fulfils all requirement in this regard and is eligible to be considered. [Where applicable, evidence of valid registration by the Competent Authority shall be attached.]

* Applicable in case of packages under GCB

We certify that we, the bidder does not have any ToT arrangement requiring registration with competent authority.

We certify that we, the bidder has valid registration to participate in this procurement.

We further declare that any misrepresentation or submission of false/forged document/information in this regard shall be dealt with as per the provisions of Integrity Pact and/or Bidding Documents and/or PowerTel’s policy and procedures.

Date : 0 Printed Name :

Place : 0 Designation :

* Person signing the Bid shall have the power of attorney given by the Bidder attached to the Bid

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-26

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Declaration by the bidder for ‘Code of Integrity for Public Procurement’)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

1. We have read the provisions of the bidding documents regarding abiding by the ‘Code of Integrity for Public Procurement’. Accordingly, we hereby declare that we shall abide by the ‘Code of Integrity for Public Procurement’ as mentioned under Clause 36 of the Bidding Document The details of any previous transgressions of the code of integrity with any entity in any country during the last three years or of being debarred by any other Procuring Entity are as under: (a) (b) (c) (d)

2. We also accept that in case of violation/transgression of this code by us in competing for or in executing the Contract, Employer has the right to take punitive measures as per the provisions of the Bidding Documents and/or PowerTel’s policy and procedure.

Date : 0 Printed Name :

Place : 0 Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-27

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

(Declaration by the bidder regarding adherence to the POWERGRID Whistle Blower and Fraud Prevention Policy)

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

We, hereby, declare that we, along with our associate/ collaborators/ sub-contractors/ sub vendors/consultants/ service providers shall strictly adhere to the POWERGRID/ PowerTel Whistle Blower and Fraud Prevention Policy.

We, along with our associate / collaborator / subcontractors / sub-vendors / consultants / service providers shall observe the highest standard of ethics and shall not indulge or allow anybody else working in our organization to indulge in fraudulent activities during execution of the contract and would immediately apprise the Employer about any fraud or suspected fraud as soon as it comes to our notice.

Date : 0 Printed Name :

Place : 0 Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Attachment-28

Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1

Declaration by the bidder for Acknowledgement and Acceptance of the ‘Supplier Code of Conduct’

Bidder’s Name and Address (Bidder ) : To:

CHIEF MANAGER (CS) POWERGRID TELESERVICES LIMITED, Western Region Telecom Control Center, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, Andheri(East), Mumbai-400093

1. We hereby confirm that we have gone through the POWERGRID Supplier Code of Conduct, attached as Appendix-III to the Special Conditions of Contract and commit to comply with the same in letter and spirit, if awarded value of the subject package will be Rs. 250 Crore or above.

2.Upon the occurrence of any breach to the terms and conditions of POWERGRID Supplier Code of Conduct, we shall take all corrective actions in timely manner. Further, we also understand that in case of our failure to comply with this code, then POWERGRID may take action against us as per its extant Policies and Procedures including suspension or termination as POWERGRID’s supplier.

3.We also hereby confirm that in case we are awarded the subject package with an award value of Rs 250 Crore or above, we shall submit a signed copy of ‘Supplier Code of Conduct’ within 30days of the issuance of NOA/Contract.

Date : 0 Printed Name :

Place : 0 Designation :

Specification No.WR1/NT/S-MISC/DOM/ZA3/26/10632 Bid Form 1st Envelope 1 one 1 st 1 January

2 two 2 nd 2 February

BID FORM (First Envelope) 3 three 3 rd 3 March

4 four 4 th 4 April

Bid Proposal Ref. No. 5 five 5 th 5 May

Date : 6 six 6 th #VALUE! 6 June

7 seven 7 th #VALUE! 7 July

To: 8 eight 8 th #VALUE! 8 August

CHIEF MANAGER (CS) WESTERN REGION TELECOM CONTROL CENTRE POWERGRID TELESERVICES LIMITED, 1st Floor, Samruddhi Venture Park, MIDC Area, Marol, ANDHERI (EAST), MUMBAI-93 9 nine 9 th #VALUE! 9 September

10 ten 10 th 10 October

11 eleven 11 th 11 November

12 twelve 12 th 12 December

13 thirteen 13 th

14 fourteen 14 th

Name of Contract : Annual Maintenance Contract (including Preventive Maintenance) of Underground / Overhead OFC Links of Nagpur Intracity Network and LMC for providing last mile connectivities at Nagpur and nearby cities & various cities of Chhattisgarh state, for a period of Three Years under Pkg-F1 15 fifteen 15 th

Dear Ladies and/or Gentlemen, 16 sixteen 16 th

1.0 Having examined the Bidding Documents, including Amendments the receipt of which is hereby acknowledged, we the undersigned, offer to design, manufacture, test, deliver, install and commission (including carrying out Trial Operation, Performance & Guarantee Test as per provision of Technical Specification) the Facilities under the above-named package in full conformity with the said Bidding Documents. In accordance with ITB Clause 9.1 of the Bidding Documents, as per which the bid shall be submitted by the bidder under “Single Stage - Two Envelope” procedure of bidding. Accordingly, we hereby submit our Bid, in two envelopes i.e. First Envelope – Techno – Commercial Part & Second Envelope - Price Part (to be opened subsequently). the receipt of which is hereby acknowledged, we the undersigned, offer to design, manufacture, test, deliver, install and commission (including carrying out Trial Operation, Performance & Guarantee Test as per provision of Technical Specification) the Facilities under the above-named package in full conformity with the said Bidding Documents. In accordance with ITB Clause 9.1 of the Bidding Documents, as per which the bid shall be submitted by the bidder under “Single Stage - Two Envelope” procedure of bidding. Accordingly, we hereby submit our Bid, in two envelopes i.e. First Envelope – Techno – Commercial Part & Second Envelope - Price Part (to be opened subsequently). the receipt of which is hereby acknowledged, we the undersigned, offer to supply goods as per the provision of Technical Specification) the Facilities under the above-named package in full conformity with the said Bidding Documents. In accordance with ITB Clause 9.1 of the Bidding Documents, as per which the bid shall be submitted by the bidder under “Single Stage - Two Envelope” procedure of bidding. Accordingly, we hereby submit our Bid, in two envelopes i.e. First Envelope – Techno – Commercial Part & Second Envelope - Price Part (to be opened subsequently). 17 seventeen 17 th

1.1 We meet the eligibility requirement and have no conflict of interest in accordance with ITB Clause 2. Bank Draft 18 eighteen 18 th

2.0 Attachments to the Bid Form (First Envelope) Bank Draft 18 eighteen 18 th

In line with the requirement of the Bidding Documents, we enclose herewith the following Attachments: Pay Order 19 nineteen 19 th

(a) Attachment 1() : Not Applicable Banks certified Cheque 20 twenty 20 th

(b) Attachment 2() : A power of attorney duly authorized by a Notary Public indicating that the person(s) signing the bid have the authority to sign the bid and thus that the bid is binding upon us during the full period of its validity in accordance with the ITB Clause 14. Bank Guarantee #REF! 21 st

(c) Attachment 3() : The documentary evidence that we are eligible to bid in accordance with ITB Clause 2. Further, in terms of ITB Clause 9.3(c) & (e), the qualification data has been furnished as per your format enclosed with the bidding documents Attachment-3(QR) NSIC/MSE 22 th

Applicable 23 th

Not Applicable 24 th

(d) Attachment 4() : The documentary evidence establishing in accordance with ITB Clause 3, Vol.-I of the Bidding Documents that the facilities offered by us are eligible facilities and conform to the Bidding Documents has been furnished as Attachment 4. 25 th

(e) Attachment 5() : The details of all major items of services or supply which we propose subletting in case of award, giving details of the name and nationality of the proposed subcontractor/sub-vendor for each item. 26 th

(f) Attachment 5A() : (Items, Components, Raw amterial, services proposed to be sourced form Micro & Small Enterprises): The details of the Items, Components, Raw amterial, services which is proposed to bought/ availed from Micro and Small enterporises for the purpose of completion of works.

(g) Attachment 6() : The variation and deviations from the requirements of the Conditions of Contract, Technical Specification and Drawings (excluding critical provisions as mentioned at clause 6.0 below) in your format enclosed with the Bidding Documents, including, inter alia, the cost of withdrawal of the variations and deviations indicated therein. 27 th

(h) Attachment 7() : The details of Alternative Bids made by us indicating the complete Technical Specifications and the deviation to contractual and commercial conditions. 28 th

(i) Attachment 8() : Manufacturer’s Authorisation Forms. 29 th

(j) Attachment 9() : Work Completion Schedule. 30 th

(k) Attachment 10(): Guarantee Declaration. 31 st

(l) Attachment 11(): Information regarding ex-employees of Purchaser in our firm.

(m) Attachment 12(): Filled up information regarding Price Adjustment Data as per the format enclosed in the bidding documents[Not Applicable].

(n) Attachment 13(): Declaration regarding Social Accountability.

(o) Attachment 14-IP(): Integrity Pact, in a separate envelope, duly signed on each page by the person signing the bid

(p) Attachment 15(): Information for Contract performance guarantee, E – payment, PF details and declaration for Micro/Small and Medium Enterprise.

(q) Attachment 16(): Additional Information.

(r) Attachment 17(): Declaration for tax exemptions, reductions, allowances or benefits

(s) Attachment 18(): Safety Pact

(t) Attachment 19(): Declaration

(u) Attachment 20(): Declaration of Key Managerial Person and Power of Attorney holder

(v) Attachment 21 Affidavit of Self certification regarding Minimum Local Content in line with PPP-MII order and DoT-Order if applicable

(w) Attachment 22 Certificate from statutory auditor or cost auditor of the company (in the case of companies) or from a practicing cost accountant or practicing chartered accountant (in respect of suppliers other than companies) giving the percentage of Local Content, in line with PPP-MII order and DoT Order , if applicable [NOT APPLICABLE]

(x) Attachment 23 Compliance to the process related to the e-RA Terms & Conditions and the Business Rules governing the e-RA-NOT APPLICABLE

(y) Attachment 24 Declaration regarding events encountered pursuant to ITB Clause 2.1

(z) Attachment 25 Certification by the Bidder per order no. F.No.6/18/2019-PPD dated 23/07/2020 and F.No.7/10/2021-PPD(1) dated 23/02/2023 issued by Public Procurement Division, Department of Expenditure, Ministry of Finance, Government of India (DoE Order) in line with ITB 2.1

(aa) Attachment 26 Declaration by the bidder for ‘Code of Integrity for Public Procurement

(ab) Attachment 27 Declaration by the bidder regarding adherence to the POWERGRID Whistle Blower and Fraud Prevention Policy

(ac) Attachment 28 Declaration by the bidder for Acknowledgement and Acceptance of the ‘Supplier Code of Conduct’

3.0 We are not MSE registered

4.0 We are aware that, in line with Clause No. 27.1 (ITB), our Second Envelope (Price Part) is liable to be rejected in case the same contains any deviation/omission from the contractual and commercial conditions and technical Specifications other than those identified in this First Envelope.

5.0 We confirm that except as otherwise specifically provided our Bid Prices in Second Envelope include all taxes, duties, levies and charges as may be assessed on us, our Sub-Contractor/Sub-Vendor or their employees by all municipal, state or national government authorities in connection with the Goods, in and outside of India.

5.1 100% of applicable Taxes and Duties i.e. GST, which are payable by the Purchaser under the Contract, shall be reimbursed by the Purchaser on production of satisfactory documentary evidence by the Supplier in accordance with the provisions of the Bidding Documents.

5.2 We further understand that notwithstanding 4.0 above, in case of award on us, we shall also bear and pay/reimburse to us, GST in respect of supplies by us to you, imposed on plant and equipment including manadatory sapare parts to be incorporated in to the facilities specified in shedule No.3 of price shedule in Second Envelope, by the Indian Laws.

5.3 We confirm that we have also registered/we shall also get registered in the GST network with GSTIN, in all the states where the project located and the states froim which we shall make our supplies of our goods and services.

6.0 Construction of the Contract

6.1 We declare that we have studied clause GCC 2.1 relating to mode of contracting for Domestic Bidders and we are making this proposal with a stipulation that you shall award us the Contracts covering all goods and related services.

7.0 We have read the provisions of following clauses and confirm that the specified stipulations of these clauses are acceptable to us:

(a) ITB 13 Bid Security

(b) GCC 2.14 Governing Law

(c) GCC 8 Terms of Payment

(d) GCC 9.3 Performance Security

(e) GCC 10 Taxes and Duties

(f) GCC 21.2 Completion Time Guarantee

(g) GCC 22 Defect Liability

(h) GCC 25 Patent Indemnity

(j) GCC 26 Limitation of Liability

(k) GCC 38 Settlement of Disputes

(l) GCC 39 Arbitration

(m) GCC 40 Conciliation

(n) Appendix 2 to Form of Contract Agreement Price Adjustment

Further we understand that deviation taken in any of the above clauses by us may make our bid non-responsive as per provision of bidding documents and be rejected by you.

8.0 We undertake, if our bid is accepted, to commence the work immediately upon your Notification of Award to us, and to achieve the delivery of goods and related services within the time stated in the Bidding Documents.

9.0 If our bid is accepted, we undertake to provide an Advance Payment Security and Performance Security(ies) in the form and amounts, and within the times specified in the Bidding Documents.

10.0 We agree to abide by this bid for a period of six (06) months from the date fixed for opening of bids as stipulated in the Bidding Documents, and it shall remain binding upon us and may be accepted by you at any time before the expiration of that period.

11.0 Until a formal Contract is prepared and executed between us, this bid, together with your written acceptance thereof in the form of your Notification of Award shall constitute a binding contract between us.

12.0 We understand that you are not bound to accept the lowest or any bid you may receive.

13.0 Commissions or gratuities, if any, paid or to be paid by us to agents relating to this Bid, and to contract execution, if we are awarded the contract, are listed below:

Name and address of agent Amount and Currency Purpose of Commission or gratuity

(If none, state “none”)

14.0 We, hereby, declare that only the persons or firms interested in this proposal as principals are named here and that no other persons or firms other than those mentioned herein have any interest in this proposal or in the Contract to be entered into, if the award is made on us, that this proposal is made without any connection with any other person, firm or party likewise submitting a proposal is in all respects for and in good faith, without collusion or fraud.

Thanking you, we remain,

Yours faithfully,

For and on behalf of

Date : 00-Jan-00 Printed Name :

Place : 0 Designation :

Please provide additional information of the Bidder

Business Address :

Country of Incorporation :

State/Province to be indicated :

Name of Principal Officer :

Address of Principal Officer :

"Note: Bidders may note that no prescribed proforma has been enclosed for Attachment 2 : Power of Attorney. Bidders may use their own proforma for furnishing the required information with them .However Power of Attorney submitted by the bidders should be package specific

ElectronicForms™

View - Template of ElectronicForm™

To close this Screen, click on the [Close] button located on the bar above, or at the bottom of the Screen

Template of ElectronicForm™

Relevant Bid-Part Techical

ElectronicForm™ Template ID 7PG-2010-FT000010

Template Reference TECHNO-COMMERICIAL (First Envelope)

Template Description Tower Package Specification No. : NRTCC/C&M/19-20/OUTSOURCED SERVICES NR/1119

OUTSOURCING OF SERVICES FOR OPERATION & L1 MAINTENANCE SUPPORT OF TELECOM NODES IN NR

Bidders's Name #REF!

Section-2 (Outline of Requirements)

* 1 Integrity Pact Details

Submitted (Doc. Code No. DC-9008-April-2009-Rev-0) Yes

* 2 BID SECURITY DETAILS

2 (a) Submitted Yes

* 2 (b) Bid Security No.

* 2 (c) Issued by (Name of Bank)

* 2 (d) Bid Security Amount #REF! #REF!

* 2 (e) Valid upto

* 1. AUTHORIZED SIGNATORY (Sole Bidder / Lead Partner of JV)

1 (b) Designation

2. AUTHORIZED SIGNATORY (Other Partner of JV)

(If Bidder is JV)

2 (a) Name #REF!

2 (b) Designation #REF!

#REF! #REF! #REF!

#REF! #REF! #REF!

#REF! #REF! #REF!

#REF! #REF! #REF!

#REF! #REF! #REF!

#REF! #REF! #REF!

#REF! #REF! #REF!

#REF! #REF! #REF!

23 Twenty Three

27 Twenty Seven

28 Twenty Eight

33 Thirty Three

37 Thirty Seven

38 Thirty Eight

73 Seventy Three

74 Seventy Four

75 Seventy Five

77 Seventy Seven

78 Seventy Eight

79 Seventy Nine

83 Eighty Three

87 Eighty Seven

88 Eighty Eight

93 Ninety Three

97 Ninety Seven

98 Ninety Eight

100 One Hundred