RATE CONTRACT REFILLING OF MEDICAL GAS CYLINDERS

Bidder's Firm Name : The Rate column shall be mandatorily filled. Blank, empty, or zero (0) values are not permitted.

CODE Item Names Specifications Original Manufacture Firm's name Annual Qty. Rate (Exluding GST) Total Value

01 Refilling of A-Type Medical Oxygen Cylinder Medical grade oxygen conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, transportation handling, complete in all respects. 400

02 Refilling of B-Type Medical Oxygen Cylinder Medical grade oxygen conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, transportation handling, complete in all respects. 15000

03 Refilling of D-Type Medical Oxygen Cylinder Medical grade oxygen conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, transportation handling, complete in all respects. 5000

04 Refilling of A-Type Medical Nitrous Oxide (N₂O) Cylinder Medical grade N₂O conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, and transportation handling, complete in all respects. 30

05 Refilling of D-Type Medical Nitrous Oxide (N₂O) Cylinder Medical grade N₂O conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, and transportation handling, complete in all respects. 10

06 Refilling of D-Type Medical CO₂ Cylinder Medical grade Carbon Dioxide conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, transportation handling, complete in all respects. 10

07 Refilling of D-Type Medical CO₂ Cylinder High-purity CO₂ gas (minimum 99.5%), including valve inspection, leakage testing, purity certification, labeling and safe handling, complete in all respects. 50

08 Refilling of D-Type Cylinder Medical Trigas Mixture comprising of CO₂ 6%, O₂ 5% and N₂ 89%, including valve checking, leakage test, purity certification, labeling and safe handling, complete in all respects. 30

09 Refilling of medical-grade Liquid Nitrogen In 55-liter cryo canister, including safe transfer, handling, leakage check and verification of purity, complete in all respects. 20

10 Refilling of medical-grade Liquid Nitrogen In 26-liter cryo canister, including safe transfer, handling, leakage check and verification of purity, complete in all respects. 25

11 Refilling of medical-grade Liquid Nitrogen In 11-liter cryo canister, including safe transfer, handling, leakage check and verification of purity, complete in all respects. 40

12 Refilling of D-Type Cylinder Ultra-high purity Helium gas (minimum 99.999%) for GCMS application, including valve inspection, leakage testing, purity certification, labeling and safe handling, complete in all respects. 10

13 Refilling of B-Type Cylinder with DLCO test gas mixture Composition: CO 0.3%, CH₄ 0.3%, O₂ 21%, balance N₂, including valve inspection, leakage testing, purity certification, labeling and safe handling, complete in all respects. 10

Calculation of Local Content

Name of manufacturer Calculation by Manufacturer (Cost per unit of product)

Cost Component Cost (Domestic Component) (a) Total Cost (b) Percentage of Local Content c=(a/b)*100

III. Total Cost (Excluding tax and duties)

1. Cost (Domestic Component): Cost of domestic component may be calculated based on one of the followings depending on data available. Each of these calculations should provide consistent result.

a. Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit/ set-off can be taken) and have not been imported directly or through a domestic trader or an intermediary.

b. Ex-Factory Price of product minus profit after tax minus sum of imported Bill of Material used (directly or indirectly) as inputs in producing the product (including duties and taxes levied on procurement of inputs except those for which: credit/ set-off can he taken) minus warranty costs.

c. Market price minus post-production freight, insurance and other handling costs minus profit after tax minus warranty costs minus sum of Imported Bill of Material used as inputs in producing the product (including duties and taxes levied on procurement of inputs except those for which credit / set-off can be taken) minus sales and marketing expenses.

2. Total Cost: Total cost may be calculated based on one of the following depending on data available. Each of these calculations should provide consistent result.

a. Sum of the costs of all inputs which go into the product (including duties and taxes levied on procurement of inputs except those for which credit / set-off can be taken).

b. Ex-Factory Price of product minus profit after tax, minus warranty costs.

c. Market price minus pent-production freight, insurance and other handling costs minus profit after tax, minus warranty costs minus sales and marketing expenses.

Bidder must submit financial bid in .xls (Excel workbook 97-2003 workbook) only

Sr. Details of the documents to be submitted Page Remarks of the bidder

1st BID SECURITY

2nd Form-A: AUTHORIZATION CERTIFICATE

3rd Form-B: CONTACT DETAILS

4th Form-C: TENDER ACCEPTANCE CERTIFICATE

5th Form-D: NO DEVIATION CERTIFICATE

6th Form-E: RATE REASONABLENESS CERTIFICATE

7th Form-F: NO DEBARMENT / NON-BLACKLISTING CERTIFICATE

8th Form-G: UNDERTAKING

9th Form-H: LAND BORDER DECLARATION

10th Form-I: Self Certification regarding Local Content - if applicable

11th Form-J: BANK DETAILS / MANDATE CERTIFICATE

12th Valid REGISTRATION CERTIFICATE / CERTIFICATE OF INCORPORATION

13th GST REGISTRATION CERTIFICATE

14th Valid DRUG MANUFACTURING OR SUPPLY LICENSE

15th OFFICE OR BRANCH OFFICE AT JODHPUR

16th INDIAN PHARMACOPEIA — 2022

17th FINANCIAL TURNOVER

18th INCOME TAX RETURN ACKNOWLEDGEMENT

19th PROFIT & LOSS A/C AND BALANCE SHEET

20th EXPERIENCE

21st NIT Document and its Corrigendum(s)

22nd Any other relevant document

TOTAL NUMBER OF PAGES IN TECHNICAL BID DOCUMENT

CODE ITEM NAME Specifications Original Manufacture Firm's name Whether complying with NIT’s Specs (Yes/No) Mention here - if bidder is quoting their item with any different specification or size ?

01 Refilling of A-Type Medical Oxygen Cylinder Medical grade oxygen conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, transportation handling, complete in all respects.

02 Refilling of B-Type Medical Oxygen Cylinder Medical grade oxygen conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, transportation handling, complete in all respects.

03 Refilling of D-Type Medical Oxygen Cylinder Medical grade oxygen conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, transportation handling, complete in all respects.

04 Refilling of A-Type Medical Nitrous Oxide (N₂O) Cylinder Medical grade N₂O conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, and transportation handling, complete in all respects.

05 Refilling of D-Type Medical Nitrous Oxide (N₂O) Cylinder Medical grade N₂O conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, and transportation handling, complete in all respects.

06 Refilling of D-Type Medical CO₂ Cylinder Medical grade Carbon Dioxide conforming to IP / BIS specifications, including filling, leak checking at valve, sealing, labeling, transportation handling, complete in all respects.

07 Refilling of D-Type Medical CO₂ Cylinder High-purity CO₂ gas (minimum 99.5%), including valve inspection, leakage testing, purity certification, labeling and safe handling, complete in all respects.

08 Refilling of D-Type Cylinder Medical Trigas Mixture comprising of CO₂ 6%, O₂ 5% and N₂ 89%, including valve checking, leakage test, purity certification, labeling and safe handling, complete in all respects.

09 Refilling of medical-grade Liquid Nitrogen In 55-liter cryo canister, including safe transfer, handling, leakage check and verification of purity, complete in all respects.

10 Refilling of medical-grade Liquid Nitrogen In 26-liter cryo canister, including safe transfer, handling, leakage check and verification of purity, complete in all respects.

11 Refilling of medical-grade Liquid Nitrogen In 11-liter cryo canister, including safe transfer, handling, leakage check and verification of purity, complete in all respects.

12 Refilling of D-Type Cylinder Ultra-high purity Helium gas (minimum 99.999%) for GCMS application, including valve inspection, leakage testing, purity certification, labeling and safe handling, complete in all respects.

13 Refilling of B-Type Cylinder with DLCO test gas mixture Composition: CO 0.3%, CH₄ 0.3%, O₂ 21%, balance N₂, including valve inspection, leakage testing, purity certification, labeling and safe handling, complete in all respects.