Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

: Attachments : General guidelines for filling up the Attachments Package No.: N2JM/C&M/MM/36(26)

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

Package No.: N2JM/C&M/MM/36(26)

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

2 Attachments 3(QR), Attach QR, 4, 4(A), 4(B), 5, 5(A), 6, 9, 10, 11, 12, 13, 15, 16, 18. 19 and Bid Form for 1st Envelope are included here.

3 Attachment 1 Bid Security

4 Attachment 2 Power of Attorney : No specific format is provided by POWERGRID. Bidder may use their own format.

5 Attachment 20: Declaration of Key Managerial Person and Power of Attorney holder: Format is annexed Seperetely herewith this Volume

9 Attachment 22: Undertaking regarding submission of original/Hard copy part of the bid except for Bid Security: Format is annexed Seperetely herewith this Volume

6 Attachment 22: Declaration by the bidder regarding events encountered pursuant to ITB Clause 2.1: Format is annexed Seperetely herewith this Volume

11 Attachment 24: Compliance to the process related to the e-RA Terms & Conditions and the Bussiness Rules governing the e-RA: Format is annexed Seperetely herewith this Volume

7 Attachment 23: Certification by the Bidder per order no. F.No.6/18/ 2019-PPD dated 23/07/2020 issued by Public Procurement Division, Department of Expenditure, Ministry of Finance, Government of India (DoE Order) in line with ITB 2.1: Format is annexed Seperetely herewith this Volume

12 Attachment-25: Bid Securing Declaration to be submitted by the Bidder.

8 Attachment-26-Declaration by the bidder for ‘Code of Integrity for Public procurement

Note : Enable the Active X Control & Macros. Also ensure to keep option of "Trust acess to VBA project object Model" cheched [√]. Ensure that you work on MS Excel 2007 or higher version.

पावर ग्रिड कारपोरेशन ऑफ इण्डिया लिमिटेड

(भारत सरकार का उद्यम)

Power Grid Corporation of India Limited

(A Government of India Enterprises)

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

Package No.: N2JM/C&M/MM/36(26) Sole Bidder 1

JV (Joint Venture) 2 or More

Enter following details of the bidder

Specify type of Bidder SOLE BIDDER 0

Name of Sole Bidder

Address of Sole Bidder

Package No.: N2JM/C&M/MM/36(26) Attachment-3(QR)

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(Qualifying Requirement Data)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/CS/133(22) Attachment-QR

Tile work in Kitchen of Residential Colony and Main Hall of Field Hostel floor ( D-Type) at 400/220 KV Panchkula Sub Station

Qualifying Requirement Data

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

Dear Ladies and/or Gentlemen,

In support of the additional information required as per ITB clause 9.3(c) of the Bidding Documents, we furnish herewith our details/documents etc., alongwith other information, as follows:

We are furnishing the following details/document in support of qualifying requirement for the subject package(s).

Qualification of bidder will be based on meeting the minimum pass/fail criteria specified below regarding the Bidder’s technical experience and financial position as demonstrated by the Bidder’s responses in the corresponding Bid Schedules. Technical experience and financial resources of any proposed subcontractor(s) shall not be taken into account in determining the Bidder’s compliance with the qualifying criteria. The bid can be submitted by an individual/ joint venture firm. At any stage of evaluation if any shortcoming/ discrepancy/ deficiency is observed in the documents/ details submitted by the bidder and or it is observed that the bidder is not meeting the stipulated QR, respective bid shall be summarily rejected. The owner may assess the capacity and capability of the bidder, to successfully execute the scope of work covered under the package within stipulated completion period. This assessment shall inter-alia include (i) Document verification; (ii) Bidder’s works visit (if required), (iii) Details of works executed, works in hand, anticipated in future & the balance capacity for the present scope of work; (iv) Details of plants and machinery, manpower and financial resources; (v) Details of quality system in place; (vi) past experience and performance; (vii) customers feedback; (viii) Banker’s feedback; etc.

1.1 Technical Experience:

1.1.1 Bidder should have completed the work/ project of Similar Work# during the last seven years ending last day of month previous to the one in which NIT is being floated: (Cost of work/ Project should be excluding the cost of land) i. One single work/ project of a value of not less than Rs. 109.59 Lakhs (80% of estimated cost) or ii. Two works/ projects, each of a value of not less than Rs.68.49 Lakhs (50% of estimated cost) or iii. Three works/ projects, each of a value of not less than Rs. 54.79 Lakhs (40% of estimated cost) # Similar work shall imply “Building Works”

1 Name of the work

2 Name of the Client

3 Address of Client

4 Contact Details of Client Authorised Dealer/Sub dealer

5 Work Order Details Authorised Representative

Date Certificate of Authorized Dealership Submitted

Authorization of Manufacturer Submitted

6 Copy of Work order uploaded

Please upload Work Order Name of Manufacturer

7 Date of Completion of Work No

8 Completed amount for the work (Rs. Lakh) OBD 01-05-16

Five Years 01-06-11

7 Document submitted as Proof of Completion

Completion Cerificate No

8 Details of Document for Proof of Completion Any other document, authenticated by the client

Reference No. MAAT 127

9 Proof of Completion Uploaded Two Work

Please upload Proof of Completion

Work 2 (if any)

1 Name of the work

2 Name of the Client

3 Address of Client

4 Contact Details of Client

5 Work Order Details

6 Copy of Work order uploaded

Please upload Work Order

7 Date of Completion of Work

8 Completed amount for the work (Rs. Lakh)

7 Document submitted as Proof of Completion

8 Details of Document for Proof of Completion

9 Proof of Completion Uploaded

Please upload Proof of Completion

Work 3 (if any)

1 Name of the work

2 Name of the Client

3 Address of Client

4 Contact Details of Client Authorised Dealer/Sub dealer

5 Work Order Details Authorised Representative

Date Certificate of Authorized Dealership Submitted

Authorization of Manufacturer Submitted

6 Copy of Work order uploaded

Please upload Work Order Name of Manufacturer

7 Date of Completion of Work No

8 Completed amount for the work (Rs. Lakh) OBD 01-05-16

Five Years 01-06-11

7 Document submitted as Proof of Completion

Completion Cerificate No

8 Details of Document for Proof of Completion Any other document, authenticated by the client

Reference No. MAAT 127

9 Proof of Completion Uploaded Two Work

Please upload Proof of Completion

1.2 Financial position

Minimum Average Annual Turnover (MAAT)* of the bidder should be Rs. 205.47 Lakhs for best three financial years out of last five financial years commencing from Financial Year 2016-17. *Note: - Annual Gross revenue from operations/ gross operating income as incorporated in the profit & loss account excluding other income.

Performance Report from Client

Acceptance of Final Bill by Client

Sr. No. Financial Year Turnover (in Rs. Lakh) Copy of Balance Sheet & P/L Account Uploaded Certificate from CA

a 2016-17 Any Other (Please Specify)

Average Turnover for Best Three Years #NUM!

The bidder shall furnish following documents/details with its bid a) The bidder shall submit documents in support of meeting the technical experience mentioned at Para 1.1 above in the form of LOA/ Work order & completion certificate/payment certificate or any other document evidencing the same. b) The bidder shall submit audited / certified copies of Balance Sheet and Profit and Loss account in support of meeting the financial position as mentioned at Para 1.2 . 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 or (ii) Company Secretary of the bidder certifying that such information / documents are based on the audited accounts as the case may be). Note II: Similarly, if the bidder happens to be 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.

Relaxation for MSEs/ STARTUPS MSEs^/ START-UPs^^ meeting the necessary requirements shall also be considered qualified if they meet 80% (Eighty percent) of the requirements of Minimum Average Annual financial turnover (MAAT ) for the best three financial years out of the last five financial years as above. ^MSEs as defined in bidding documents. ^^START-Ups as defined by DIPP, applicable as on the originally scheduled date of bid

1 Copy of PAN Card Uploaded

Please upload Copy of PAN Card

1.1 PAN Card Number

2 Status of the Bidder

3 MOA & AOA/ Certificate of Incorporation Uploaded

Please upload Copy of Relevent Document

Date : Printed Name : #NUM!

Place : Designation : #NUM!

Private Limited Company

Public Limited Company

Affidavit of Proprietorship Uploaded

Parnership Deed Uploaded

MOA & AOA/ Certificate of Incorporation Uploaded

Package No.: N2JM/C&M/MM/36(26) Attachment-4

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(Form of Certificate of Origin and Eligibility)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

We hereby certify that equipment and materials to be supplied are produced in [Name of Countries], 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 [Name of Countries], eligible source country. [Name of Countries] [Name of Countries] [Name of Countries], [Name of Countries],

country. country. [Name of Countries], [Name of Countries],

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-4(A)

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(List of Special Maintenance Tools & Tackles)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

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:

S.No. For Equipment Item Description Unit Quantity

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.

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-4(B)

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(List of Special Maintenance Tools & Tackles)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

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 :

Package No.: N2JM/C&M/MM/36(26) Attachment-5

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(Bought-out & Sub-contracted Items)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

We hereby furnish the details of the items/ sub-assemblies, we propose to buy for the purpose of furnishing and installation 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 declare that, we would not subcontract the erection portion of the contract (if any) without the prior approval of Employer.

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-5(A)

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(Items, Components, Raw Material, Services proposed to be sourced from Micro and Small Enterprises)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

1. We hereby furnish the details of the items, components, raw material, services which we propose to buy / avail from Micro and 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 and Small Enterprises (MSEs)

Name Category (Micro or Small)

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-Iof Bidding Documents, shall be submitted along with the bills for payment against supplies made/works done during execution of contract.

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-6

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(Alternative, Deviations and Exceptions to the Provisions)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

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 :

Package No.: N2JM/C&M/MM/36(26) Annexure I toAttachment-6

(Alternative, Deviations and Exceptions to the Provisions)

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

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-9

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(Work Completion Schedule)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

We hereby declare that the following Work Completion Schedule shall be followed by us in furnishing and installation of the subject Package i.e., Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line for the period commencing from the effective date of Contract to us :

Sl. No. Description of Work Period in months from the effective date of Contract

1 Detailed Engineering and drawing submission Shall be as per Delivery Schedule (Completion Period) given in SCC. Hence Not Required to be Filled here.

a) commencement

2 Procurement of equipment/ components & assembly

a) commencement

a) commencement

4 Manufacturing

a) commencement

5 Shipments & Delivery

a) commencement

6 Establishment of site office

7 Installation at Site

a) commencement

8 Testing & Pre-commissioning

a) commencement

9 Trial Operation

a) commencement

Date : Printed Name :

Place : Designation :

Note : Bidders to enclose a detailed network covering all the activities to be undertaken for completion of the project indicating key dates for various milestones for each phase constituent-wise.

Package No.: N2JM/C&M/MM/36(26) Attachment-12

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(Price Adjustment Data)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

We hereby confirm that the prices of Services offered by us will remain FIXED & FIRM during the performance of the contract and will not subject to any variation on any account.

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-11

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

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

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

We declare that we are aware of and have gone through the "Code of Business Conduct and Ethics for Senior Management Personnel" and "Code of Business Conduct and Ethics for Board Members" of POWERGRID (hereinafter referred to as the "Code of Conduct"). We further understand that as per the "Code of Conduct", Senior Management Personnel including Board Members, who have retired / resigned from POWERGRID, shall not accept any appointment or post, as detailed in the referred "Code of Conduct", within 1 year from the date of cessation of service / directorship unless approved by the Competent Authority.

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

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

*In case the date of joining in the bidder's organization of such ex-employee is within 1 year from the date of retirement / resignation from POWERGRID, No Objection Certificate / approval from the Competent Authority must be furnished alongwith the bid or subsequent through clarification pursuant to ITB Clause 21.

In case of non-submission of No Objection Certificate / approval of the Competent Authority, as required, We understand that POWERGRID shall deal with such cases as per its Policy and Procedures in vogue, which may also result in rejection of our bid. We also confirm that POWERGRID shall be the sole judge in this regard.

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

Date : Printed Name :

Place : Designation :

1. "Code of Business Conduct and Ethics for Senior Management Personnel" and "Code of Business Conduct and Ethics for Board Members" are available on POWERGRID's website http://www.powergridindia.com.

2. The information in similar format should be furnished for each partner of joint venture in case of joint venture bid.

3. In case bidder has furnished no details on ex-employees of POWERGRID or has left blank or has indicated '-' against the same, it shall be deemed that they have not employed any such person in their organization.

Package No.: N2JM/C&M/MM/36(26) Attachment-13

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(Declaration regarding Social Accountability)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

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 :

Package No.: N2JM/C&M/MM/36(26) Attachment-14

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-15

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

Option for Initial Advance (either Interest Bearing Initial Advance or No Initial Advance) and Information for E – payment, PF details and declaration for Micro/Small and Medium Enterprise

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

I We have read the provisions in the Bidding Documents regarding furnishing the option for advance payment. Accordingly, as per ITB Clause 9.3 as provided in Section BDS, Section III, Vol.-I of the Bidding Documents, we hereby confirm to opt the following:

Interest Bearing Initial Advance

Supply Portion: NOT APPLICABLE No

Services Portion: NOT APPLICABLE No

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:

Correspondence Address:

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* entrepreneurs in line with Public Procurement Policy for Micro and Small Enterprises (MSEs) order 2012 including subsequent amendment/notification/order [Indicate Yes / No]

Note: Documentary evidence is to be attached. Please refer remarks at the end of the attachment.

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

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) Amendment Order 2018 including subsequent amendment/notification/order [Indicate Yes / No]

Note: Documentary evidence is to be attached.

4 Permanent Account (PAN) No.

5 GSTIN Numbers

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

9 PF Registration No. of the Company

10 PF Regional Office covered (with Address)

11 Name of Contact Person

12 Contact Details

13 Bank Details for Electronic Payment

Name of the Bank:

Address of Branch:

Type of Account: Saving Account

14 9 digit MICR code printed at bottom in middle, next to cheque no.

15 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.

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

a. In case of proprietary MSE, proprietor(s) shall be SC/ST.

b. In case of partnership MSE, the SC/ST partners shall be holding at least 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 the SC/ST certificate(s) issued by District Authority as applicable for SC/ST MSE category as per (a), (b) or (c) above.

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-16

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

(Additional Information)

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

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(q)(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 the 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)

Whether fund based/non fund based limits are indicated in the certificate

Whether extent of utilization is indicated in the certificate

1.2 The Bidder should accordingly also provide the following information/documents

(i) Details of Banker:

Address of Banker

Contact Name and Title

(ii) As per para 1.0, 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 the same promptly, is/are enclosed as per following details:

Sl. No. Letter Ref. Date Addressed to (name of the Bank)

(iii) As per para BDS/ITB clause 9.3 q, Bidder shall furnish the details of their Provident Fund Code Number

Sl. No. Name of Bidders/JV Partners 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 Details regarding previous transgressions of Integrity Pact

The bidder should provide detailed information on any transgression of Integrity Pact that occurred in the last 10 years with any other Public Sector Undertaking or Government Department or any other Company, in any country.

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

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 (individual firms or each partners of JV) 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 Value of outstanding work (Rs.) Estimated completion date

4.2 Financial Data:

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

Total Liability

Current Liability

Profit before taxes

Profit after taxes

Total Liability

Current Liability

Profit before taxes

Profit after taxes

4.3 Provident Fund Code Number of the Bidder:

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-17

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

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

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

1 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 POWERGRID 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.

2 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 :

Package No.: N2JM/C&M/MM/36(26) Attachment-17

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

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

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

Contract & Material Department

Name : …… ……. …….. …… ……. …….. Power Grid Corporation of India Ltd.,

Address : …… ……. …….. …… ……. …….. Northern Region Transmission System - II

…… ……. …….. …… ……. …….. Grid Bhawan, OB-26, Rail Head Complex,

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

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

Date : Printed Name : Printed Name :

Place : Designation : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-17

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

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

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

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

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

Date : Printed Name : Printed Name :

Place : Designation : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-18

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) Attachment-19

Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line

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

Contract & Material Department

Name : Power Grid Corporation of India Ltd.,

Address : Northern Region Transmission System - II

Grid Bhawan, OB-26, Rail Head Complex,

Jammu - 180 012 (J&K).

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 :

Date : Printed Name :

Place : Designation :

Package No.: N2JM/C&M/MM/36(26) 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 #REF! 6 June

7 seven 7 th #REF! 7 July

To: 8 eight 8 th #REF! 8 August

Contract & Material Department 9 nine 9 th #REF! 9 September

Power Grid Corporation of India Ltd., 10 ten 10 th 10 October

Northern Region Transmission System - II 11 eleven 11 th 11 November

Grid Bhawan, OB-26, Rail Head Complex, 12 twelve 12 th 12 December

Jammu - 180 012 (J&K). 13 thirteen 13 th

14 fourteen 14 th

Name of Contract : Procurement of E1 to FO media Convertor for DTPCs of 400 kV Kishenpur-Kishtwar line 15 fifteen 15 th

Dear Ladies and/or Gentlemen, Enter details here. 16 sixteen 16 th

1.0 Having examined the Bidding Documents, including Amendment Nos. ...[Enter the Amendment]… dated …[Enter the Date in dd-mm-yyyy]… 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 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 single envelope. ...[Enter the Amendment]… …[Enter the Date in dd-mm-yyyy]… 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 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 single envelope. 17 seventeen 17 th

1.1 We meet the eligibility requirements and have no conflict of interest in accordance with ITB Clause 2.

2.0 Attachments to the Bid Form Bank Draft 18 eighteen 18 th

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

(a) Attachment 1: Bid Security Bank Guarantee INR Banks certified Cheque Zero 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. Please note that if bid validity is less than 07 (seven) months, your bid may be rejected Bank Guarantee (0) 21 st

(c) Attachment 3 (QR) & Attach QR: 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). FDR 22 th

SOLE BIDDER CDR/TDR Applicable 23 th

(d) Attachment 4, 4A & 4B : 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. A list of Special Tools & Tackles to be used by us for erection, testing & Commissioning and to be handed over to Employer, the cost of which is included is our Bid Price, is also enclosed as per your format as Attachment 4A. A list of Special Tools & Tackles to be brought by the contractor for erection, testing & Commissioning and to be taken back after completion of work, whose cost in not included in our bid price, is enclosed as per your format as Attachment 4B. 0 Not Applicable 24 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. 25 th

(f) Attachment 5(A) : The details of the items, components, raw materials, services which we propose to buy / avail from Micro and Small Enterprises (MSEs) for the purpose of completion of works under the subject package in case of award, giving details of the name and category of the proposed Micro and Small Enterprises (MSEs).

(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. 26 th

(h) Attachment 7 : NOT APPLICABLE The details of Alternative Bids made by us indicating the complete Technical Specifications and the deviation to contractual and commercial conditions. (Not Applicable) 27 th

(i) Attachment 8 : Manufacturer’s Authorisation Forms. 28 th

(j) Attachment 9 : Work Completion Schedule. 29 th

(k) Attachment 10 : Guarantee Declaration. 30 th

(l) Attachment 11 : Information regarding ex-employees of Employer in our firm. 31 st

(m) Attachment 12 : Filled up information regarding Price Adjustment Data as per the format enclosed in the bidding documents.

(n) Attachment 13 : Declaration regarding Social Accountability.

(o) Attachment 14 : NOT APPLICABLE Integrity Pact, in a separate envelope, duly signed on each page by the person signing the bid.

(p) Attachment 15 : Option for Initial Advance (either Interest Bearing Initial Advance or No Initial Advance) and Information for 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 : NOT APPLICABLE Safety Pact

(t) Attachment 19 : Declaration.

(u) Attachment 20 : Declaration of Key Managerial Person jointly with Power of Attorney Holder

(v) Attachment 21 : NOT APPLICABLE Affidavit of Self certification regarding Minimum Local Content in line with PPP-MII Order and MoP Order, if applicable

(w) Attachment 22: Declaration by the bidder regarding events encountered pursuant to ITB Clause 2.1

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

NOT APPLICABLE Compliance to the process related to the e-RA Terms & Conditions and the Bussiness Rules governing the e-RA

(y) Attachment 24: NOT APPLICABLE Undertaking by the bidder regarding Compliance of DMI&SP policy

aa) Attachment 26: Declaration by the bidder for ‘Code of Integrity for Public procurement

3.0 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.

4.0 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 Facilities, in and outside of India.

4.1 100% of applicable Taxes and Duties i.e. GST, which are payable by the Employer under the Contract, shall be reimbursed by the Employer on production of satisfactory documentary evidence by the Contractor in accordance with the provisions of the Bidding Documents.

4.3 We also understand that, in case of award on us, you shall pay directly, if so required /reimburse to us octroi/entry tax as applicable for destination site/state on all items of supply including bought-out finished items, which shall be dispatched directly from the sub-vendor’s works to the Employer’s site (sale-in-transit). Further, Service Tax, if applicable, for the services to be rendered by us, the same is included in our bid price in Second Envelope.

4.2 We confirm that we have also registered/we shall also get registered in the GST Network with a GSTIN, in all the states where the project is located and the states from which we shall make our supply of goods.

4.5 We confirm that no Sales Tax/VAT in any form shall be payable by you for the bought out items which shall be despatched directly by us under the First Contract (as referred in para 5.1 below) [or Letter of Award, if 5.1 Not applicable] to the project site. However, you will issue requisite Sales Tax declaration/Vatable forms in respect of such bought out items, on production of documentary evidence of registration with the concerned Sales Tax Authorities.

5.0 Construction of the Contract

5.1 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 two separate Contracts viz ‘First Contract’ for ex-works supply of all equipment and materials including mandatory spares and ‘Second Contract’ for providing all the services i.e. inland transportation for delivery at site, insurance, unloading, storage, handling at site, installation, testing and commissioning including Trial operation in respect of all the equipment supplied under the ‘First Contract’ and other services specified in the Contract Documents. We declare that the award of two contracts, will not, in any way, dilute our responsibility for successful operation of plant/equipment and fulfillment of all obligations as per Bidding Documents and that both the Contracts will have a cross-fall breach clause i.e. a breach in one Contract will automatically be classified as a breach of the other contract which will confer on you the right to terminate the other contract at our risk and cost.

6.0 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 8.0 Terms of Payment

(d) GCC 9.3 Performance Security

(e) GCC 10.0 Taxes and Duties

(f) GCC 21.2 Completion Time Guarantee

(g) GCC 22.0 Defect Liability

(h) GCC 23.0 Functional Guarantee

(i) GCC 25.0 Patent Indemnity

(j) GCC 26.0 Limitation of Liability

(k) GCC 38.0 Settlement of Disputes

(l) GCC 39.0 Arbitration

(m) GCC 40.0 Conciliation

(n) Appendix 2 to the 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.

7.0 We undertake, if our bid is accepted, to commence the work immediately upon your Notification of Award/Letter of Award/Work Order to us, and to achieve the completion within the time stated in the Bidding Documents.

8.0 If our bid is accepted, we undertake to provide a Performance Security in the form and amounts, and within the times specified in the Bidding Documents.

9.0 We agree to abide by this bid for a period of 180 (One Hundred Eighty) days 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.

10.0 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.

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

12.0 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”)

13.0 # (For Joint Venture only) We, the partners of Joint Venture submitting this bid, do agree and confirm that in case of Award of Contract on the Joint Venture, we shall be jointly and severally liable and responsible for the execution of the Contract in accordance with Contract terms and conditions.

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 : Printed Name :

Place : Designation :

Please provide additional information of the Bidder

Business Address :

Country of Incorporation :

State/Province to be indicated : 2

Name of Principal Officer :

Address of Principal Officer :

Note: Bidders may note that no prescribed proforma has been enclosed for Attachment 2 (Package No.: N2JM/C&M/MM/36(26)) Power of Attorney. Bidders may use their own proforma for furnishing the required information with the bid.

Note: Bidders may note that no prescribed proforma has been enclosed for Attachment 2 (Package No.: N2JM/C&M/MM/36(26)) Power of Attorney. Bidders may use their own proforma for furnishing the required information with the bid.

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

Checklist for Bid Submission

1 Certificate regarding Constitution of firm/ Certificate of Incorporation/GST Certificate Applicable To be submitted in Soft Copy.

2 Affidavit of Proprietorship (applicable only for proprietorship firm) Duly notarized (on Stamp Paper of requisite value) Submission of Hard copy in ‘Original’ and uploading of Scanned Copy

3 Soft copy of Attachments & Bid Form Applicable Duly Filled Excel Sheet of Attachment and Bid Form to be uploaded in Soft Copy along with Bid. To be submitted in Soft Copy.

4 Power of Attorney (POA) Applicable Duly notarized (on Stamp Paper of requisite value), indicating that the person(s) signing the bid has(ve) the authority to sign the bid In case of bid submitted by a Joint Venture of two or more firms as partners, if allowed as per stipulated Qualification Requirements in Annexure-A (BDS), bidder shall submit. Power of Attorney for Joint Venture and Joint Venture Agreement as per given format Submission of Hard copy in ‘Original’ and uploading of Scanned Copy .

5 Tender Fees/ Cost of Bid Documents NOT Applicable ; Demand Draft or Online Payment Acknowledgement towards the cost of Bidding Documents pursuant to ITB 5.4 Submission of Hard copy in ‘Original’ and uploading of Scanned Copy

6 MSE Status Certificate if applicable In case of UAM/ Udyam Registration, Bidder has to submit the Complete Audited Account Statements (Balance Sheet and Profit and Loss Account) for verification purpose. To be submitted in Soft Copy.

7 Bid Security Applicable The bid security shall, at the bidder’s option, be in the form of a crossed bank draft/pay order /banker certified cheque in favour of Employer or a bank guarantee from a reputed bank selected by the bidder. The format of the bank guarantee shall be in accordance with the form of bid security included in the Bidding Documents. The Bid Security shall be in favour of Power Grid Corporation of India Limited payable at Jammu Submission of Hard copy in ‘Original’ and uploading of Scanned Copy

8 Deviations (Attachment-6 Applicable To be submitted in Soft Copy. To be submitted in Soft Copy.

9 Attachment-8: Manufacturer Authorization Form Applicable On Manufacturer’s Letterhead (The letter of Undertaking should be on the letterhead of the Manufacturer and should be signed by a person competent) To be submitted in Soft Copy.

10 Information Regarding Ex-Employee of POWERGRID (Attachment-11 in ) Applicable To be submitted in Soft Copy. To be submitted in Soft Copy.

11 Attachment 20: Declaration of Key Managerial Person jointly with Power of Attorney holder Applicable Signed by 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 and POA Holder Submission of Hard copy in ‘Original’ and uploading of Scanned Copy

12 Attachment-22: Declaration by the bidder regarding events encountered pursuant to ITB Clause 2.1. (In case of a Joint Venture bid, the declaration shall be given by all partners of the Joint Venture) Applicable On Firm/Company's Letterhead To be submitted in Soft Copy.

13 Attachment-23: Certification by the Bidder as per order no. F.No.6/18/2019-PPD dated 23/07/2020 issued by Public Procurement Division, Department of Expenditure, Ministry of Finance, Government of India (DoE Order) in line with ITB 2.1 (In case of a Joint Venture bid, the declaration shall be given by all partners of the Joint Venture) Applicable On Firm/Company's Letterhead To be submitted in Soft Copy.

14 Attachment-26: Declaration by the bidder for ‘Code of Integrity for Public procurement’ Applicable On Firm/Company's Letterhead To be submitted in Soft Copy.

NOTE: This checklist is not exhaustive and issued for the purpose of reference Only. In case of any ambiguity, the provisions of Bidding Documents shall prevail.