SUPPLY OF FOR CONTINUOUS PURGING SYSTEM FOR SEVERE-SERVICE METAL-SEATED VALVES AND CRITICAL MEASURING INSTRUMENTS

SPECIAL TERMS & CONDITIONS OF THE TENDER

1 Type of Bid Two bid

2 Preferred delivery 04 months on FOB basis. However vendor to indicate best possible FOB delivery period

3 Performance Bank Guarantee Applicable for 10% PO value valid upto guaranteed life of catalyst

4 Earnest Money Deposit Applicable

5 Third Party Inspection Not applicable

6 IBR Not applicable

7 Evaluation criteria: On techno-commercially acceptable overall lowest evaluated price basis for total catalyst charge

8 Integrity Pact Agreement Not applicable

9 DMEP Not applicable

10 Sample Not applicable

Instruction to fill the format below-

Bidders to fill the format below( white cells) and submit with their offer. Please note that submission of this declaration is mandatory,otherwise offer shall be liable for rejection.

COMPLIANCE TO REQUIREMENT OF TENDER DOCUMENTS

[To be submitted by the bidder as a sheet of "Bid_Documents" in the Un-Priced Bid (Technical Bid) , otherwise the Offer shall be liable for rejection]

It is hereby declared that we have read and understood the entire tender documents available on CPP e-tender portal https://eprocure.gov.in/eprocure/app under-

Tender Reference Number TP/0200663C/NRL/1575-0012/1259

We hereby agree to fully comply with, abide by and accept without variation, deviation or reservation all technical, commercial and other condition whatsoever of the Bidding Documents including all Addenda / Corrigenda / Clarifications issued. We further, confirm that we have quoted the rates in the tender considering Inter-alia the 1. Tender Document(s) 2. Additional Document(s) (if any) 3. BOQ Document (Price Bid Format) 4. Corrigendum (if any) 5. Pre Bid Meeting Minutes (if any) We

Any and all deviations, variations, objections or reservations whatsoever hereto set out, given or indicated in our offer, clarifications, correspondence, communications, or otherwise stands null and void. hereby certify that we have fully read and thoroughly understood the tender requirements and accept all terms and conditions of the tender including all corrigendum/addendum issued, if any. Our offer is in confirmation to all the terms and conditions of the tender including all corrigendum/addendum, if any and minutes of the pre-bid meeting. In the event our offer is found acceptable and Order is placed /Contract is awarded to us, the complete tender document shall be considered for constitution of Order / Contract Agreement.

We further, confirm that we have quoted the rates in the tender considering Inter-alia the 1. Tender Document(s) 2. Additional Document(s) (if any) 3. BOQ Document (Price Bid Format) 4. Corrigendum (if any) 5. Pre Bid Meeting Minutes (if any) We XYZk hereby certify that we have fully read and thoroughly understood the tender requirements and accept all terms and conditions of the tender including all corrigendum/addendum issued, if any. Our offer is in confirmation to all the terms and conditions of the tender including all corrigendum/addendum, if any and minutes of the pre-bid meeting. In the event our offer is found acceptable and Order is placed /Contract is awarded to us, the complete tender document shall be considered for constitution of Order / Contract Agreement.

Offer Reference No. with date. 101

Bidder's Name XYZk

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk(mailto:afjls@gmk塹ᴻ䡿ⲯ嶂藄挧ꮥ)

Mobile No. (s) 88565686789k

Fax No. 58675876857k

Address rgrgfhrhbjjyfdrhk

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ACKNOWLEDGEMENT OF TENDER

Tender Reference Number TP/0200663C/NRL/1575-0012/1259

Offer Reference No. with date.

Bidder's Name XYZk

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk

Mobile No. (s) 88565686789k

Fax No. 58675876857k

Address rgrgfhrhbjjyfdrhk

Dear Sir, We acknowledge receipt of your above referred TENDER and confirm that ( CHOOSE THE APPLICABLE OPTION):

i) We will be submitting offer so as to reach you within the due date. Yes

ii) We regret to quote as: No

If regret to quote, reason:

Yours faithfully

(Authorized Signatory)

Annexure -1 (a)

AGREED TERMS & CONDITIONS (ATC) - INDIGENOUS

Tender Reference Number TP/0200663C/NRL/1575-0012/1259

1) Bidders to fill the format below (white cells) and submit with their offer. Please note that submission of this declaration is mandatory, otherwise offer shall be liable for rejection. All Annexures all mandatory to be submitted, else offer shall be liable for rejection. 2) This workbook is protected, except for cells where comments/confirmation is to be given by bidder. 3) Bidder is advised not to unprotect/tamper the sheet/ alter the terms mentioned in the sheet. 4) Any alteration to terms mentioned by NRL will be considered as tampering and bidder's offer shall be liable for rejection. 5) Bidders are advised to only fill the unprotected cells (white cells) by dropdown or writing the comments as applicable as their confirmation . Failure on the part of bidder in not returning this duly filled-up questionnaire with all the sets of unpriced quotation and/or submitting incomplete replies may lead to rejection of bidder’s quotation. 6) All the commercial terms and conditions shall be indicated by Bidder in this format only and nowhere else in his quotation. However, in case the space for Bidder’s reply is not sufficient against a particular question, the Bidder shall furnish same by way of separate annexure/sheet attached to this questionnaire, indicating cross-reference of respective clauses. 7) DEVIATIONS: Please provide technical / commercial deviations only in the Annexure captioned "Deviation Statement (Technical/Commercial)". Any deviations/notes/ comments/etc. given elsewhere in the Offer other than the Annexure "Deviation Statement (Technical/Commercial)" shall be null & void. 8) This is document needs to be submitted along with Un-Priced Bid (Technical Bid), Otherwise the Offer Shall be liable for Rejection.

Offer Reference No. with date.

Bidder's Name XYZk

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk

Mobile No. (s) 88565686789k

Fax No. 58675876857k

Address rgrgfhrhbjjyfdrhk

Sl. No Description of term Bidder’s confirmation/ acceptance/comments

1 (a) Confirm that no technical deviation has been taken in your Offer No Deviation

1 (b) Confirm that no commercial deviation has been taken in your Offer No Deviation

2 (a) Quoted Prices are on DAP Site basis . Owner reserves the option to exclude Freight charges from the scope. Confirm acceptance. CONFIRMED

2 (b) Indicate Dispatch point. ( Place from where the material shall be despatched)

2(c) Confirm that Quoted prices shall remain firm and fixed till complete execution of the order. CONFIRMED

COMMERCIAL TERMS:- Please Note if bidder does not mention anything against the below commercial terms, the same shall be considered as “nil” and no further confirmation from Bidder shall be sought. Evaluation and ordering shall be done considering commercial terms (charges) as Nil.

3(a) PACKING & FORWARDING CHARGES:- The Offer is inclusive of Packing and Forwarding (P&F) charges. CONFIRMED

3(b) Inspection and Testing Charges:- The Offer is inclusive of Inspection and Testing Charges CONFIRMED

3(c) THIRD PARTY INSPECTION CHARGES:- Quoted prices are: i) Third party inspection charges to be quoted in line with BOQ. TPIA Charges shall be inclusive of destructive testing charges (if any),all expenses like travel, incidental and fees payable to Third party inspectors.} . ii) Prices shall be Inclusive of all IBR/IGC/NACE/Radiography charges as per NRL’s technical specifications and the documents enclosed with the TENDER .( if applicable) CONFIRMED

3(d.2) If a supplier does not quote freight charges and indicates that the freight is on to pay basis or “extra at actual” then his ex-works price shall be loaded with the maximum freight charges quoted by other bidders or maximum pro-rated freight charges (with respect to approximate distance) quoted by other bidders or by 5% (for items other than pipes) or 7% (for pipes), whichever is most. After loading, if the same Bidder becomes L1 (lowest) then the order will be placed based on Freight Charges payable extra at actual subject to maximum freight charges by which the prices of the L1 bidder has been loaded.. CONFIRMED

3(d.3) If bidder has mentioned freight as “quoted” in the unpriced bid / Agreed terms & Conditions (ATC) but has not mentioned freight charges in priced bid , as asked to quote in the tender (bidder may be asked to quote freight charges in the priced bid or the bidder may be asked to quote freight charges in percentage of basic price in ATC), then the basic price quoted shall be considered as inclusive of freight charges and no further confirmation from vendor shall be sought. Evaluation and ordering shall be done considering freight charges as Nil. CONFIRMED

3(e) Transit Insurance: Transit risk insurance shall be covered by the Owner against their MCE (Marine cum Erection) Policy and the same shall not be included in the quoted prices CONFIRMED

APPLICABLE TAXES:-

4 (a) Type of Bidder:- If Bidder is GST Composition Scheme Bidder , Please submit the copy of the declaration i.e., FORM GST –CMP 01 or FORM GST CMP 02 alongwith the offer. Registered Vendor

4 (b) HSN & SAC CODE:- Please confirm that HSN (Harmonized System of Nomenclature) code of goods or SAC (Service Accounting Code) of services /PWCAMC/PWAMC if any are given below ( at the end of this sheet ). In case there are different HSN/SAC for different items, same may be indicated in the Unpriced BOQ. HSN/SAC given in Unpriced BOQ

4 (c) GOODS & SERVICE TAX (GST) RATES:- Please indicate whether quoted rate(s) of GST on the supplies (including spares) as well on Inspection & Freight Charges is Extra OR Inclusive in your quoted prices. The GST amount shall be released only on receipt of GST Invoice. GST EXTRA-Indicated below ( end of this sheet )

4(d) Only statutory variations, if any, in the present rate of GST, shall be reimbursed as under: 1. Any statutory increase in the GST or any new or additional taxes or duties imposed within the Contractual delivery Date or extended Contractual Delivery Date shall be to NRL’s account whereas if it is after contractual delivery it shall be to BIDDER’S account. Any corresponding decrease on account of above shall be passed on to NRL 2. Any variation in GST at the time of supplies for any reasons, other than statutory, including variations due to turnover, shall be borne by bidder. 3. In case GST or any taxes or duties is not applicable at present but becomes applicable at the time of contractual delivery period due to any reasons other than statutory, the same shall be borne by bidder. CONFIRMED

4(e) As You were not eligible for input tax credit of Central & State Taxes in pre-GST period but under GST you are entitled to full credit of GST paid and you shall have benefit of incremental input tax credit under the GST regime as above. As such you need to pass on the benefit of your incremental input tax credit to NRL. Accordingly, Please quote your best basic prices (In Priced BoQ ) CONFIRMED

4 (f) Please indicate whterher quoted rate(s) of GST on Installation and Commissioning charge /Supervision/Site Work/Training/PWCAMC/PWAMC ( If any ) is Extra OR Inclusive in your quoted prices. GST EXTRA-Indicated below ( end of this sheet )

COMMERCIAL LOADING :- Please note if bidder does not confirm acceptance for following terms as per tender then loading shall be done against following serial numbers as per ITB & this ATC read together or Offer may be rejected .

5 PAYMENT TERM: Please confirm acceptance to payment terms as per ITB. Initial Advance payment along with order is not acceptable. However, progressive payment as specified in the Commercial Terms enclosed on achievement of specific milestones (under applicable payment terms) shall be against equivalent Advance Bank Guarantee as per NRL format along with GST Invoice for all payments before despatch. Confirmed

5(a) Please confirm acceptance to applicable payment terms as per ITB Clause 14 ( Payment Terms) Confirmed

5(b) PAYMENT TERM FOR TRANSPORTATION AS FOLLOWS: 100% within 30 days after receipt of material at site. Confirmed

6 Contract Performance Security (CPS) / Warranty Bank Guarantee (WBG):- Please confirm that you will furnish Contract Performance Security (CPS) / Warranty Bank Guarantee (WBG) as per ITB. 1st Milestone payment shall be released only after receipt of CPS (wherever applicable) and manufacturing schedule. The CPS should be sent to us directly by your Banker and the bank should confirm regarding issue of BG on enquiry by NRL. Confirmed

6a) Contract Performance Security (CPS) / Warranty Bank Guarantee (WBG) i) CPS of 3% and WBG of 7% of the total order value (Supply Plus Site Work, where ever applicable ) shall be submitted by the Bidder (including MSEs, Public Sector Undertakings and other Government bodies) within 30 days from the date of award. ii) This bank guarantee shall be valid (shall remain in force) for guarantee period (as mentioned in the guarantee clause of the tender), with an invocation/claim period of 3 months thereafter or as per the guideline prevailing and applicable at that time. iii) Total Order value shall mean supply price including packing and forwarding charges/ TPI charges for (FOT dispatch point price for Indian bidder and FOB/ FCA price for foreign bidders) plus site work (wherever applicable) but excluding GST, transportation, Training services, PWAMC and supervision services. iv) Foreign Suppliers can submit Irrevocable Standby Letter of credit (SBLC) in place of Contract Performance Security (CPS) / Warranty Bank Guarantee (WBG). WBG shall be from any Indian scheduled bank (except Cooperative & Gramin Banks) or from any Indian branch of an International bank. v) MSE bidders are not exempted from submission of Contract cum Performance Bank Guarantee (CPBG). vi) Wherever supervision is included in the scope specified in the MR, Bidders shall provide additional BG for an amount equal to per diem charges for the number of days considered for evaluation over and above 3% CPS + 7% WBG to cover compensation for delay in mobilizing the erection/ personnel. This BG will be released to the Bidder upon the erection/ commissioning personnel reporting at site. This BG shall be furnished along with last 10% payment and shall be valid up to six months which shall be extended based on the request by NRL. vii) In case of package contract where scope of the purchase order also involve Post Warrantee Comprehensive Annual Maintenance Contract (PWCAMC), the bidder has to furnish WBG equivalent to 10% of the value of PWCAMC valid till expiry PWAMC period plus 3 months claim period. ITB ANNEXURES – Annexure - P BANK GUARANTEES AND INSURANCE SURETY BONDS (ISB) FORMATS. Confirmed

6b) Contract Performance Security (CPS) / Warranty Bank Guarantee (WBG) In case of non-submission of CPS /WBG within one month beyond the period stipulated for it, coupled with non-mobilization/ non-performance within the period stipulated for the same, the Termination action along with other contractual penal provisions shall be initiated, as per the contract provisions Confirmed

Please Note:- In case of non acceptance of the CPS / WBG , DAP Site price shall be loaded as per ITB.

7 PRICE REDUCTION SCHEDULE DUE TO DELAY IN DELIVERY :- As per GPC clause 15, In case of delay in execution of the order, NRL may at its option, recover from thevendor price reduction of 0.5% of the value of delayed goods per week of delay or part thereof subject to a maximum of 5% of the total order value of goods. Confirmed

8 DELIVERY PERIOD AND TIME PERIOD FOR SITE WORK:- Wherever MR contains packages/ equipment/Site work, delay for delivery shall be applicable for total order value (i.e., half percent (0.5%) of the Total Order Value (TOV) for every week of delay or part thereof, limited to a maximum of Five percent (5%) of the Total Order Value (TOV) Confirmed

9 Confirm that the goods shall be Guaranteed/Warrantied as per Clause 10 of GPC, unless otherwise specifically mentioned in the Tender Documents. CONFIRMED

10 Part Order: i. Acceptance of Part Order clause without any value / quantity limitation ii. Any charges quoted extra as lumpsum (like IBR, Testing, freight, etc.) shall be applicable prorata on value basis in the event of part order / part quantities / split order. Confirmed

11 Repeat Order: Confirm acceptance of Repeat Purchase order(s) as per NRL's requirement as stated in GPC & ITB read together, with the same rate and terms & conditions within 6 months from the date of original Purchase Order. Note: Acceptance of Repeat Order does not guarantee Repeat Ordering and is not a part of evaluation. Confirmed

EARNEST MONEY DEPOSIT (EMD):-

12(a) Please confirm having submitted Earnest Money Deposit (EMD) as per NIT, wherever called for. SELECT FROM DROP DOWN

12(b) PRN No.of Online submitted EMD OR Bank Guarantee No. with Date of Issue & Expiry OR On date valid MSE/UAM certificate No. with date of issue. SELECT FROM DROP DOWN

12(c) Bid Security Declaration on Bidders Letter Head AND Signed and Stamped Annexure L of ITB SELECT FROM DROP DOWN

GOVT OF INDIA POLICIES :-

Public Procurement Policy for Micro & Small Enterprises (MSEs) Order, 2012

13(a) Confirm whether the bidder is an MSE bidder or not SELECT FROM DROPDOWN

13(b) Confirm that you have attached the copy of certificate of registration with any one of the agencies stated in the tender document and specified by Ministry of MSME along with your bid to avail the benefits/preference to MSEs SELECT FROM DROPDOWN

13(c) In case the bidder is an MSE bidder; please further confirm whether it is an SC/ST owned MSE SELECT FROM DROPDOWN

13(d) Confirm that you have attached the copy of SC/ST certificate issued by District Authority. SELECT FROM DROPDOWN

13(e) In case the bidder is an MSE bidder; please further confirm whether it is an women owned MSE. If yes, then confirm submission of relevant documents SELECT FROM DROPDOWN

13(f) UDYOG AADHAR MEMORANDUM (UAM) Number or UDYAM Registration Number

13(g) Confirm that you are a Trader of the Quoted Items. In case being Trader, you shall not be eligible for Purchase Preference. SELECT FROM DROPDOWN

14(a) Confirm whether the bidder is a startup. The definition of startup shall be as per the latest Gazette Notification of Govt. of India. Not Applicable

14(b) If so, please confirm that you have submitted documents and Certificate of Recognition (generated by DPIIT, GoI/Certificate of incorporation/Audited P/L statement of all FY since incorporation) to prove your claim. Not Applicable

Purchase Preference linked with Local Content

15(a) Confirm whether you are eligible for Purchase Preference linked with Local Content. For details please refer ITB SELECT FROM DROPDOWN

15(b) If so please confirm that you have submitted "Calculation of Local Content for Goods/Services" in BoQ in Financial bid as per ITB SELECT FROM DROPDOWN

15(c) If so please confirm that you have submitted "Declaration Form for availing Purchase Preference" as per ITB SELECT FROM DROPDOWN

15(d) If so please confirm that you have submitted "Undertaking" from Authorized signatory of Supplier or Statutory Auditor / Chartered Accountant of the bidder ( as the case may be ) as per ITB SELECT FROM DROPDOWN

15(e) Please mention the percentage of Local Content

15(f) Bidder confirm that the bidder meets the minimum Local content requirement as specified for Class-I or Class –II local supplier specified for claiming Purchase Preference under policy to purchase preference SELECT FROM DROPDOWN

DOMESTICALLY MANUFACTURED ELECTRONIC PRODUCTS (DMEP)

16(a) Confirm whether you are eligible for Purchase Preference linked with Public Procurement policy ( Local content) Electronic Products. For details please refer ITB Not Applicable

16(b) If so please confirm that you have submitted "Undertaking" from Authorized signatory of Supplier or Statutory Auditor / Chartered Accountant of the bidder ( as the case may be ) as per ITB Not Applicable

DOMESTICALLY MANUFACTURED IRON & STEEL PRODUCTS (DMI&SP)

17(a) Confirm whether you are eligible as per Policy related to Domestically Manufactured Iron & Steel Products (DMI&SP) . For details please refer ITB SELECT FROM DROPDOWN

17(b) If so please confirm that you have submitted "Affidavit of Self-Certification" (Form -1) as per ITB SELECT FROM DROPDOWN

17(c) If Bidder is a Trader, please confirm that you have submitted "Authorization Certificate" as per ITB SELECT FROM DROPDOWN

Restrictions for bidders from countries which share land border with India

18 Confirm the Compliance of restrictions for bidders from Countries which share land border with India, as per Annexure-3 of ITB. CONFIRMED

VALIDITY OF OFFER:-

19(a) Validity: Validity of the offer shall be shall be as per ITB CONFIRMED

19(b) On account of exigencies, if the bidder is requested to extend the validity of their offer, the same should be extended with or without price implication. NRL will also have the option to cancel the tender in such cases and refloat the tender. CONFIRMED

IN CASE OF CHEMICALS:-

20 Certificate of Analysis (COA) will be sent along with consignment MSDS will be sent along with consignment Bidder to confirm that MSDS accompanies the consignment for incoming chemical material to Refinery / Project Site. Please confirm MSDS for return of empty cylinders will be same as that of incoming material Not Applicable

21 If Cylinder is used as mode of packing as per Tender Requirement: Please confirm rent-free period of cylinders as per tender conditions. Not Applicable

22 If Cylinder is used as mode of packing as per Tender Requirement: Please indicate per day per cylinder rent after expiry of offered rent-free period Not Applicable

23 Please confirm that the Shelf Life as sought in Technical Specification is complied with CONFIRMED

24 If no Shelf Life Clause is stated in Technical Specification, please indicate the same

25 Confirm that sample as required is submitted & submission proof of Tender Sample as per requirement in Technical section is attached. CONFIRMED

26 Please note that the best prices are given strictly as per Price BOQ CONFIRMED

27 Please note that you will dispatch the materials on “Freight paid basis” by NRL / Bank approved Transporter having delivery office at Refinery location. Pl. note & confirm. CONFIRMED

28(a) Commissioning Spares: Confirm that you have included / quoted for Commissioning spares as required in the tender documents. Confirmed

28(b) Mandatory Spares: Confirm that you have included / quoted for mandatory spares as required in the tender documents. Confirmed

28(c) Special Tools and Tackles: Special Tools and Tackles as specified in the MR/Technical Specification are included in the quoted prices. Confirmed

28(d) Recommended Spare Parts for Two Years: Confirm that item wise unit price of Recommended spare parts for two years’ operation have been quoted separately, indicating Dispatch quantity, as required in the tender document. Confirmed

29 Transit risk insurance shall be covered by the Owner against their MCE (Marine cum Erection) Policy and the same shall not be included in the quoted prices. CONFIRMED

30 Please note that unless otherwise specified, part dispatches will not be allowed and Bidder has to supply materials in one lot. CONFIRMED

31 Please note that all relevant Third Party Inspection Release Notes, IBR Certificate, Test Certificates etc. (as applicable) shall be submitted along-with the dispatch documents & supplied materials. CONFIRMED

32 Please confirm acceptance the following in toto. Bidder is not required to submit soft/ hard copy of them. a) NIT b) General Purchase Conditions (GPC) c) Instructions to Bidder (ITB) d) Terms & Conditions for supervision of Erection, Testing & Commissioning for Indigenous Bidders ( if applicable ) e) Terms & Conditions for Site Work / HSE ( if applicable ) f) Integrity Pact ( if applicable ) g) Special Purchase Conditions (SPC) ( if applicable ) CONFIRMED

33 DECLARATION:- Whether any of the Directors of BIDDER is a relative of any Director of Owner or the BIDDER is a firm in which any Director of Owner or his relative is a Partner or the BIDDER is a private company in which any director of Owner is a member or Director. NO RELATIONSHIP

34 Please confirm that you have not been banned or de-listed or Holiday/ Suspension/ banning list of or Black Listed by the EPCM/PMC Consultant for the job/ NRL. If you have been banned, then this fact must be clearly stated. Confirm that the Proforma Of Declaration Of Black Listing / Holiday Listing has been attached CONFIRMED

35 Bidder confirms that they are not under liquidation, insolvency, court receivership or similar proceedings. CONFIRMED

36 Deviations to Terms & Conditions shall lead to loading of prices as per Commercial Terms of TENDER or rejection of offer. Please confirm acceptance. CONFIRMED

37 Please confirm submission of details, documents self-certifications and declarations for meeting Net Worth condition as per ITB ( if applicable ) SELECT FROM DROPDOWN

38b Confirm Applicable Duty Rate included in the prices

38C Confirm Social welfare charges on Custon Duty Rate included in the prices

38d Confirm IGST included in the CIF Value

38e Confirm country of origin of imported material

38f Indicate classification with tariff no. under which Bidder intends to import.

38g Confirm prices shall be firm on account of variation in foreign exchange rate. CONFIRMED

38h If bidder does not furnish built in CIF value and confirm that quoted prices are firm and fixed, in that case bidder shall not be entitled to claim any variation in the custom duties even if bidder has quoted their prices considering custom duties. In case of wrong assessment of customs duties by the contractor/ Bidder, any additional liabilities towards taxes and duties shall be to Bidder’s account. Confirmed

38i Confirm acceptance of additional clause no-36 in SPC for Built in import content Confirmed

38g Confirm acceptance of Annexure X to ITB for TDS details Confirmed

BIDDER INPUTS :-

A SPECIFY DESPATCH POINT

B GSTIN NO. OF DESPATCH POINT

C SPECIFY INVOICING PLACE

D GSTIN NO. OF INVOICING PLACE

F HSN CODE OF GOODS

G GST APPLICABLE ON QUOTED FOT DESPATCH POINT PRICES

H GST RATE APPLICABLE ON FREIGHT be considered same as GST applicable on Materials/Supply. CONFIRMED

I SAC CODE FOR SITE SUPERVISION / SITE WORK / TRAINING CHARGES/ PWCAMC/PWAMC

J GST APPLICABLE EXTRA ON QUOTED SITE SUPERVISION / SITE WORK / TRAINING CHARGES/ PWCAMC/PWAMC

K CURRENCY OF QUOTE INR

L INDICATE ANY OTHER GOVERNMENT TAX/LEVY APPLICABLE AND ITS RATES.

In case of any conflict in the terms mentioned in this Agreed Terms and Conditions (ATC) and elsewhere in the Offer, the terms indicated in ATC shall supersede. However, in case any heirarchy is defined elsewhere in the tender documents then the heirarchy shall prevail in case of any conflict in terms and conditions. Printed terms and conditions, if any, appearing in quotation, shall not be applicable in the event of order. In case of contradiction between the confirmations given above and terms & conditions mentioned elsewhere in the offer, the confirmation given above in this ATC shall prevail.

We confirm that we have filled ATC indigenous as per sheet "BID DOCUMENTS" of this XL file. I, _____________________ , working as CEO/CFO/Company Secretary/ __________________________ (indicate, as applicable) of the Company _______________________________ certify that all the details including Information above ATC are true, authentic, genuine and it is certified. Signature & Stamp

DEVIATIONS STATEMENT- TECHNICAL

Tender No. TP/0200663C/NRL/1575-0012/1259

Bidder's Name XYZk

The bidder confirms that: Following are the only deviations to the technical terms and conditions if considered unavoidable . Bidder also confirms that any deviation taken anywhere else in the offer shall be considered as invalid.

Sl. No. Referred document name/ Tender document page no. Clause No. Description of Clause Deviation proposed by bidder

5 No Deviations

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DEVIATIONS STATEMENT- COMMERCIAL

Tender No. TP/0200663C/NRL/1575-0012/1259

Bidder's Name XYZk

The bidder confirms that: Deviations taken in Agreed Terms & Conditions, if any, and the below are the only deviations to the commercial terms and conditions, if considered unavoidable. Bidder also confirms that any deviation taken anywhere else in the offer shall be considered as invalid.

Sl. No. Referred document name/ Tender document page no. Clause No. Description of Clause Deviation proposed by bidder

5 No Deviations

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DECLARATION CUM UNDERTAKING ON MICRO & SMALL ENTERPRISES STATUS

Instruction to fill the format below- Please Select as Applicable

Bidders to fill the format below( white cells). MSE bidders who do not fill this declaration may not be considered for any benefits applicable for MSEs as per the Tender Conditions for Benefits/Preference for Micro & Small Enterprises (MSEs) Important Note: 1. Bidders registered as MSE in “ Service Category “ are not eligible for EMD exemption as well as Purchase preference for material procurement tenders. 2. Bidders participating in a tender as “trader” are not eligible for EMD exemption as well as Purchase preference for material procurement tenders. 3. Bidders participating in a tender as a manufacturer but MSE certificate does not include the tendered item shall be eligible for only EMD exemption for material Procurement tenders. 4. Bidders participating in a tender as a manufacturer and MSE certificate includes the tendered item shall be eligible for EMD exemption as well as purchase preferance for material Procurement tenders. We are manufacturer of quoted item(s) but not MSE

MICRO & SMALL ENTERPRISES STATUS We are neither MSE nor manufacturer of quoted item(s)

SELECT YOUR MSE STATUS FROM DROPDOWN OF CELL B6 Please Select as Applicable We are MSE bidder for Services

Please Select as Applicable We are MSE bidder but participating as Trader in this tender

We are participating as a manufacturer but MSE certificate does not include the tendered item

We are participating as a manufacturer and MSE certificate includes the tendered item

We know that IOCL in its capacity has full right to cross check the authenticity and validity of the MSE certificate submitted by us, and if it is found that there is any misrepresentation of facts by us, IOCL has a right to take actions against us including but not limited to putting us on holiday list, and rejection of our offer etc.

Tender Reference Number

Offer Reference No. with date.

Authorised Person's Name (s): In terms of Tender Conditions for Benefits/Preference for Micro & Small Enterprises (MSEs) attached with the Tender, we also declare as under- • We are a Micro / Small Enterprise, as on close date of this tender. • MSE certificate submitted by us is authentic and valid as on close date of the tender. • We ensure that the MSE certificate will be kept valid till the end of the contract period. • We have submitted notarized copy of the MSE certificate. • MSE certificate should clearly mention the nature of activity as "Manufacturing".

Designation In terms of Tender Conditions for Benefits/Preference for Micro & Small Enterprises (MSEs) attached with the Tender, we also declare as under- • We are a Micro / Small Enterprise, as on close date of this tender. • MSE certificate submitted by us is authentic and valid as on close date of the tender. • We ensure that the MSE certificate will be kept valid till the end of the contract period. • We have submitted notarized copy of the MSE certificate. • MSE certificate should clearly mention the nature of activity as "Manufacturing".

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Annexure - 3 : FORM A

DECLARATION FOR COMPLIANCE OF RESTRICTIONS FOR BIDDERS FROM COUNTRIES WHICH SHARE LAND BORDER WITH INDIA (On Company Letterhead)

To, CGM (Commercial) Numaligarh Refinery Limited Numaligarh, Assam.

Sub: Certificate of Compliance

Bidder's Name: XYZk

Job Name: SUPPLY OF HV CABLES

Tender No. : TP/0200663C/NRL/1575-0012/1259

Sr. No Bidder’s Undertaking Please Select (Yes or No) as applicable

1 (A) “I have read the clause regarding restrictions on procurement from a bidder of a country which shares a land border with India; I certify that this bidder is not from such a country”. YES

(B) Or, if from such a country, has been registered with the Competent Authority. I hereby certify that this bidder fulfills all requirements in this regard and is eligible to be considered. [If applicable, evidence of valid registration by the Competent Authority shall be attached.] NO

2 (A) “I 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; I certify that this bidder is not from such a country and will not sub-contract any work to a contractor from such countries unless such contractor is registered with the Competent Authority.” NO

(B) Or, if from such a country, has been registered with the Competent Authority and will not sub-contract any work to a contractor from such countries unless such contractor is registered with the Competent Authority. I hereby certify that this bidder fulfills all requirements in this regard and is eligible to be considered. [If applicable, evidence of valid registration by the Competent Authority shall be attached.] NO

3 (A) "I have read the clause regarding restrictions on procurement from a bidder having Transfer of Technology (ToT) arrangement. I certify that this bidder does not have any ToT arrangement requiring registration with the competent authority." NO

(B) "I have read the clause regarding restrictions on procurement from a bidder having Transfer of Technology (ToT) arrangement. I certify that this bidder has valid registration to participate in this procurement." [If applicable, evidence of valid registration by the Competent Authority shall be attached.] NO

Tender No. TP/0200663C/NRL/1575-0012/1259

Bidder's Name XYZk

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk

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Annexure- 4 " Unpriced BOQ"

Tender No. TP/0200663C/NRL/1575-0012/1259

Vendor's Name XYZk

Note: 1: bidders are requested to selcet from dropdown mentiong "Quoted" or "Not Quoted" in each cell, if bidder not selcted anything from quoted or not quoted same shall be considered as not quoted ietms & evaluation shall be done accordingly

Sl. No. Item Serial no. of BoQ Item Code / Make Quantity UoM HSN / SAC Code GST Rate as applicable Quoted Currency in INR BASIC UNIT RATE Please mention "Quoted" / "Not Quoted" TRANSPORTATION: Inland transportation by road of all supplies from Vendor’s works / shop to Project site, Numaligarh Refinery, Golaghat, Asaam/ Rail Transportation up to NMGS/Numaligarh Refinery Project Siding.( Excluding GST)- Bidder to furnish freight in % on the basis cost quoted. Please mention "Quoted" / "Not Quoted" THIRD PARTY INSPECTION CHARGES (Excluding GST) Please mention "Quoted" / "Not Quoted" Lumpsum CIF value of Import Content ( in INR) % of Custom Duty % of Social welfare charges % of IGST charges Total value of Import content including all taxes.(In INR) Indicate classification with tariff no. under which Bidder intends to import. Confirm country of origin of imported material

0.0 Supply of HP/MP/LP Continuous Purge system with all required Hardware including design, engineering, manufacture, procurement of materials and bought out items/components, assembly at shop, internal testing, inspection, factory testing and acceptance (FAT), packing etc. including supply of mandatory and commissioning spares, transportation as per MR HP/LP/MP Continuous Purge System 1 Lumpsum INR SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN

0.0 Mandatory Spares for Sr No 1.1 : Lumpsum Cost of Mandatory Spares , Scope as per material requisition. 1 Lumpsum INR SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN

0.0 TRANSPORTATION: For Indegenious Bidders : Inland transportation charges by road of all supplies from Vendor’s works / shop to Project site, Numaligarh Refinery, Golaghat, Asaam/ Rail Transportation up to NMGS/Numaligarh Refinery Project Siding. 1 Lumpsum INR SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN SELECT FROM DROPDOWN

0.9 Unit rate for Site supervision (for installation and commissioning / SAT) and training to client personnel at site by the expert of OEM/ OEM’s representative shall be considered for the entire scope subject to successful commissioning for complete package, which shall also be considered for commercial evaluation- Per Diem charges upto 8 hrs on normal working days. ( BIDDERS TO QUOTE UNIT RATE FOR DIEM CHARGES ) 1 Per Diem INR SELECT FROM DROPDOWN

0.0 Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour (beyond normal 8 hours on normal working days). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) 1 Per Hr INR SELECT FROM DROPDOWN

0.9 Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour for work on weekly off days / holidays (as applicable to Refinery Site). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) 1 Per Hr INR SELECT FROM DROPDOWN

Sl. No. Two Year Recommended Spares as per BOQ-2 Tag No Quantity Units HSN / SAC Code HSN / SAC Code GST Rate as applicable BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 1 (Mention the spare name and Qty in unpriced schedule) Quoted Currency in INR BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 1 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 2 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 3 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 4 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 5 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 6 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 7 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 8 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 9 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 10 (Mention the spare name and Qty in unpriced schedule)

0.0 Supply of HP/MP/LP Continuous Purge system with all required Hardware including design, engineering, manufacture, procurement of materials and bought out items/components, assembly at shop, internal testing, inspection, factory testing and acceptance (FAT), packing etc. including supply of mandatory and commissioning spares, transportation as per MR HP/LP/MP Continuous Purge System 1 Unit Rates INR

Sl. No. Addition / Deltion rates as per BOQ-4 Tag No Quantity Units HSN / SAC Code HSN / SAC Code GST Rate as applicable BASIC UNIT RATE Please mention "Quoted" / "Not Quoted" Quoted Currency in INR BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 1 (Mention the spare name and Qty in unpriced schedule)

1.01 HP Purge Panel with 2 Passes 1 Mtr. SELECT FROM DROPDOWN

1.02 HP Purge Panel with 3 Passes 1 Mtr. SELECT FROM DROPDOWN

1.03 HP Purge Panel with 5 Passes 1 Mtr. SELECT FROM DROPDOWN

1.04 MP Purge Panel with 2 Passes 1 Mtr. SELECT FROM DROPDOWN

1.05 MP Purge Panel with 3 Passes 1 Mtr. SELECT FROM DROPDOWN

1.06 MP Purge Panel with 4 Passes 1 Mtr. SELECT FROM DROPDOWN

1.07 MP Purge Panel with 5 Passes 1 No. SELECT FROM DROPDOWN

1.08 MP Purge Panel with 6 Passes 1 No. SELECT FROM DROPDOWN

MP Purge Panel with 7 Passes 1 No. SELECT FROM DROPDOWN

MP Purge Panel with 8 Passes 1 No. SELECT FROM DROPDOWN

LP Purge Panel with 2 Passes 1 No. SELECT FROM DROPDOWN

LP Purge Panel with 3 Passes 1 No. SELECT FROM DROPDOWN

LP Purge Panel with 4 Passes 1 SET SELECT FROM DROPDOWN

LP Purge Panel with 5 Passes 1 Mtr. SELECT FROM DROPDOWN

LP Purge Panel with 6 Passes 1 Mtr. SELECT FROM DROPDOWN

LP Purge Panel with 7 Passes 1 Mtr. SELECT FROM DROPDOWN

1.17 LP Purge Panel with 8 Passes 1 Mtr. SELECT FROM DROPDOWN

Annexure -5: FORMAT - 2C" Declaration of Minimum Local Content (item wise) (Applicable for Multiple Item Splitable Tender)"

( ON BIDDERS LETTER HEAD)

Tender No. TP/0200663C/NRL/1575-0012/1259

Vendor's Name XYZk

BOQ Sl. No. Item Description Ident no Quantity UOM Bidder's Declaration of Minimum Local Content (itemwise) (To be selected from drop down)

0.0 Supply of HP/MP/LP Continuous Purge system with all required Hardware including design, engineering, manufacture, procurement of materials and bought out items/components, assembly at shop, internal testing, inspection, factory testing and acceptance (FAT), packing etc. including supply of mandatory and commissioning spares, transportation as per MR HP/LP/MP Continuous Purge System 1 Lumpsum Class I Local Supplier (Min LC >= 50%)

Offer Reference No. with date.

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk

Mobile No. (s) 88565686789k

Fax No. 58675876857k

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Annexure -6: PROFORMA FOR SELF DECLARATION OF DEBARMENT /BLACK-LISTING / HOLIDAY LISTING & ALLIED FIRMS

SELF DECLARATION OF DEBARMENT / BLACK LISTING / HOLIDAY LISTING

I/We hereby declare that I am / we are currently not serving any holiday listing/ black-listing/ debarment orders issued by Numaligarh Refinery Limited (NRL) or Ministry of Petroleum & Natural Gas (MoPNG) debarring me/us from participation in tendering or carrying on business dealings with NRL / MoPNG. I/We understand that bids from the bidders who are on holiday list by NRL or MoPNG will not be considered. It is understood that any wrong declaration in this context shall make me / my agency / company liable for action under Holiday Listing procedure of NRL Note: “Ministry of Petroleum & Natural Gas (MoPNG)” is the Administrative Ministry of NRL and the term in this context shall mean the ministry itself and not the other PSUs or Departments under it.

DECLARATION OF ALLIED FIRMS OF THE BIDDER

I/We hereby declare that following are my/our allied firm(s) (as defined in NRL’s holiday listing policy)::- Name(s), PAN and GST number(s) of our allied firms are as follows:- Sl. No. Name of Allied Firm PAN GSTN 1. 2. 3. 4. is understood that in case of debarment of me / my agency / company by NRL, the debarment shall be automatically extended to my/our allied firms.

Note: Please refer NRL’s current “Policy for Holiday listing/ Banning/ Debarring of Contractors/ Suppliers” available in NRL website www.nrl.co.in for details. [www.nrl.co.in → Tenders → Download Manuals → Holiday Listing Policy]

Offer Reference No. with date.

Vendor's Name XYZk

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk

Mobile No. (s) 88565686789k

Fax No. 58675876857k

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GST REGISTRATION DETAILS

Name of the Vendor as registered:

Vendor Code with IOC

S.No Name of the State GST Number PAN Address of principal place of business in the state as per GST registration VENDOR CLASSIFICATION Type of business Contact Details of Concerned person(s)

Address City Postal Pin Code 0 Registered 1 Not Registered 2 Compounding Scheme 3 PSU/Government Organization Manufacturer/Trader / Service provider / works contractor / other (pls specify) Name Phone number E-mail id

[See sub-rule (1) of rule 21AB]

Information to be provided under sub-section (5) of section 90 or sub-section (5) of section 90A of the Income-tax Act, 1961

I *son/daughter of Shri

in the capacity of (designation) do provide the

following information, relevant to the previous year

*in my case/in the case of for the purposes of sub-section (5) of *

section 90/section 90A:-

Sl.No. Nature of information : Details#

(i) Status (individual; company, firm etc.) of the assessee :

(ii) Permanent Account Number (PAN) of the assessee if allotted :

(iii) Nationality (in the case of an individual) or Country or specified territory of incorporation or registration (in the case of others) :

(iv) Assessee’s tax identification number in the country or specified territory of residence and if there is no such number, then, a unique number on the basis of which the person is identified by the Government of the country or the specified territory of which the assessee claims to be a resident :

(v) Period for which the residential status as mentioned in the certificate referred to in sub-section (4) of section 90 or sub-section (4) of section 90A is applicable :

(vi) Address of the assessee in the country or territory outside India during the period for which the certificate, mentioned in (v) above, is applicable :

2. I have obtained a certificate to in sub-section (4) of section 90 of sub-section (4) of section 90A from

the Government of (name of country or

specified territory outside India)

Permanent Account Number:

I do hereby declare that to the best of my knowledge

and belief what is stated above is correct complete and is truly stated.

Verified today the day of

1. *Delete whichever is not applicable.

2. #Write N.A. if the relevant information forms part of the certificate referred to in sub-section (4) of section 90 or sub-section (4) of section 90A.

Offer Reference No. with date.

Vendor's Name XYZk

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk

Mobile No. (s) 88565686789k

Fax No. 58675876857k

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VENDOR BANK DETAILS

To M/s Numaligarh Refinery Limited NRP Complex, NRL site, Numaligarh, Golaghat, Assam-785699

Dear Sir, With reference to the P.O. / W.O / Contract if awarded to us by NRL against this tender, we hereby give our consent to accept the related payments of our claims/ bills on NRL through Cheques or Internet based online E-payments system at the sole discretion of NRL. Our Bank account details for the said purpose is as under:

Sl.No. Particulars : Details

i Name and address of the Beneficiary :

ii Account Number of Beneficiary :

iii Account Classification (CA/ CC -11 or 29) & SB- 10 as per Cheque leaf. :

iv Name and address of the Bank Branch (where payments are to be sent by NRL) :

v Branch Name / Code :

vi The 9 Digit MICR code of the Branch (as appearing on the MICR cheque) :

vii IFSC Code of the Bank Branch for RTGS mode. :

viii IFSC Code of the Bank Branch for NEFT mode :

ix E-mail ID of Beneficiary :

x Any other Particulars (to be advised by Beneficiary for E-payments) :

xi Vendor Code (to be filled by NRL’s Dept. Only) :

xii PERMANENT ACCOUNT NUMBER :

xiii MOBILE NUMBER (FOR SMS ALERTS) :

xiv CIN No. Of Company (If Any) :

I/We hereby declare that the particulars given above are correct and complete.

Encl.: (1) One cheque / photocopy of cheque duly cancelled relating to the above account (2) copy of PAN Card duly attested by authorized signatory (3)Certificate of Incorporation with CIN details

1. Verification from your bank on the above bank details required only in case : (a) Vendors not providing a cancelled cheque leaf or if vendors name is not printed / appearing on the cancelled cheque leaf submitted to NRL Office. (b) Change in existing bank details.

Offer Reference No. with date.

Vendor's Name XYZk

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk

Mobile No. (s) 88565686789k

Fax No. 58675876857k

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Declaration by the bidders regarding non-tampering of tender documents

Tender No. TP/0200663C/NRL/1575-0012/1259

Vendor's Name XYZk

We hereby declare that none of the tender documents have been tampered with. In case of tampering of tender documents, the bid shall be rejected outright and EMD forfeited without prejudice to any other rights or remedies available to NRL.

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk

Mobile No. (s) 88565686789k

Fax No. 58675876857k

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Contact Details of Vendor

Tender No. TP/0200663C/NRL/1575-0012/1259

Vendor's Name XYZk

Authorised Person's Name (s): ABCk

Designation jvsdjvk

Email ID (s) afjls@gmk

Mobile No. (s) 88565686789k

Fax No. 58675876857k

Please fill up the details below:

Designation Name Telephone Nos. Mobile nos. E mail ids

Country Manager

Marketing Manager

Contact Person(s) for this Tender

Note: 1. Designations are indicative only. Actual designations may please be mentioned. 2. All the concerned persons in the hierarchy must appear in the above list. 3. In case of multiple phone nos., mobile nos., e-mail IDs, the same may also please be given

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PEROFORMA FOR DECLARATION ON NCLT / NCLAT /DRT /DRAT/ COURT RECEIVERSHIP/ LIQUIDATION

Tender No. TP/0200663C/NRL/1575-0012/1259

Vendor's Name XYZk

I/ We hereby declare that I/We /M/s XYZk declare that :

(i) I / We am/are not undergoing insolvency resolution process or liquidation or bankruptcy proceeding as on date. Yes

(ii) I / We am/are undergoing insolvency resolution process or liquidation or bankruptcy proceeding as on date as per details mentioned below. (Attached detail with technical bid) No

Note:- Select the appropriate choice against sl no i. Option against Sl no ii is conditional to chosen Option against Sl No i

It is understood that if this declaration is found to be false, NRL shall have the right to reject my/our bid, and forfeit the EMD. If the bid has resulted in a contract, the contract will be liable for termination without prejudice to any other right or remedy (including black listing or holiday listing) available to NRL.

Name of Signatory :

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Bidder Qualification Criteria

Details of documents submitted against Tender "Bidder Qualification Criteria"

Tender No. TP/0200663C/NRL/1575-0012/1259

Vendor's Name XYZk

1.A BQC Technical : - Please refer NIT Document for applicablity

S.N. Name of Equipment Project / Refinery Unit, Location Year/Month of Delivery Mettalurgy Diameter & Thk & TL-TL length Weigt ( MT) Customer Name of Customer Contact Mobile number Contact Email ID

In addition to above bidder to ensure submission of compliance statement with all necessary documents for meeting any other Technical BQC of NRL tender document ( as applicable)

2 BQC Commercial -Experience- NOT APPLICABLE

A Meeting through 01(One) executed order:

S.N. Required exceuted order value as per NIT (INR) Executed order value ( On FOR despatch point / FCA )as per bidder (INR) Purchase order no. and date Purchase Order issued by (Client name) M/s Item description as per PO Documents submitted against completion/execution proof as specified in tender Full address of the client and contact person (Name & Details i.e. Mail ID, Mobile No. etc)

B Meeting through 02(Two) executed orders:

S.N. Required exceuted order value as per NIT (INR) Executed order value ( On FOR despatch point / FCA )as per bidder (INR) Purchase order no. and date Purchase Order issued by (Client name) M/s Item description as per PO Documents submitted against completion/execution proof as specified in tender Full address of the client and contact person (Name & Details i.e. Mail ID, Mobile No. etc)

C Meeting through 03(Three) executed orders:

S.N. Required exceuted order value as per NIT (INR) Executed order value ( On FOR despatch point / FCA )as per bidder (INR) Purchase order no. and date Purchase Order issued by (Client name) M/s Item description as per PO Documents submitted against completion/execution proof as specified in tender Full address of the client and contact person (Name & Details i.e. Mail ID, Mobile No. etc)

3 BQC Commercial-Financial ( Turnover )

S.N. Financial Year Average Annual Turnover required as per NIT (INR)- Annual turnover of your company (INR) Details of Documentary evidence ( i.e. audited balance sheet/ profit and loss statement of audited balance sheet / published anual report / balance sheet in public domain etc.) Remarks if any.

4 Net Worth Requirement

S.N. Financial Year Net Worth Positive/Negative Details of Documentary evidence ( i.e. audited balance sheet/ profit and loss statement of audited balance sheet / published anual report / balance sheet in public domain etc.) Remarks if any.

5 Working Capital

S.N. Financial Year Working Capital Requirement as per NIT(INR) Bidder Working Capital (INR) (Current Assets - Current liabilities) Details of Documentary evidence ( i.e. audited balance sheet/ profit and loss statement of audited balance sheet / published anual report / balance sheet in public domain etc.) If the bidder’s working capital is inadequate, the bidder should furnish a letter for line of credit from any scheduled bank in India or a commercial bank having net worth not less than INR 100 Crore, confirming the availability of the fund based line of credit for the respective amount specified above, irrespective of overall position of the working capital.

DECLARATION FORM FOR AVAILING PURCHASE PREFERENCE

Tender No. TP/0200663C/NRL/1575-0012/1259

Vendor's Name XYZk

S.N. Parameter Declaration Remarks

1 We confirm that our offer is in compliance to Policy to provide purchase preference (linked with local content) as per the provision of enquiry.

2 Please clarify whether the bidder is a Class-I Local Supplier OR a Class-II Local Supplier or Non-Local Supplier.

3 Bidder confirm that the bidder meets the minimum Local content requirement as specified for Class-I or Class–II local supplier specified for claiming Purchase Preference under policy to purchase preference (linked with local content).

4 **Mention the percentage of local content in the bid. ** Incase of Multiple Item Splitable Tender, bidder must indicate % of Min. LC item-wise as per format 2C enclosed with the tender Bidder to ensure that bidder’s % local content mentioned in Sr. 4, shall be in accordance with status mentioned as Class-I Local Supplier OR as Class-II Local Supplier (as applicable) in sr. no. 2 above.

5 We confirm that we have submitted the requisite documents, as per the PP-LC policy enclosed in the bidding document, to establish our status as Class-I or Class –II local supplier, as applicable. Failing to submit these documents will be liable for rejection/ non-consideration for purchase preference, as per the provisions defined in PP-LC policy enclosed in bidding document.

6 In case order is placed on us, we hereby declare to submit Local Content Certificate along with each Invoice raised in line with the Min Local Content declared by us in our offer against the tender.

7 Whether bidder is an MSE bidder If yes- Necessary documents to be attached along with unpriced part of the bid.

a) While evaluating the bids, the order of precedence shall be as under: 1. MSE bidder (PPP-2012) 2. Class-I Local supplier (as per PP-LC Policy) b) This undertaking shall be certified by the authorized signatory of the bidder having the Power of Attorney.

Net Worth Details

Tender No. TP/0200663C/NRL/1575-0012/1259

Vendor's Name XYZk

A. AUDITED ANNUAL TURNOVER REPORTS FOR THE LATEST FINANCIAL YEAR

Year TURNOVER (INR) PROFIT (INR) NET PROFIT – AFTER TAX, INTEREST& DEPRECIATION (INR) NET WORTH * (INR) Exchange rate(considered (if any currency other than INR.)

B. ENCLOSE AUDITED ANNUAL AND PUBLISHED FINANCIAL STATEMENTS (INCLUDING AUDITOR’S REPORT, BALANCE SHEET, PROFIT & LOSS ACCOUNT STATEMENT AND ALL OTHER SCHEDULES) FOR THE PRECEDING FINANCIAL YEAR

Net worth Calculation: Net worth means paid up share capital, Share Application Money pending allotment* and reserves # less accumulated losses and deferred expenditure to the extent not written off. # Reserves to be considered for the purpose of net worth shall be all reserves created out of the profits and securities premium account but shall not include reserves created out of revaluation of assets, write back of depreciation and amalgamation. *Share Application Money pending allotment will be considered only in respect of share to be allotted.

Accordingly, the definition of net worth shall be as follows:

Paid up share capital

Add: Share Application Money pending allotment

Add: Reserves (As defined Above)

Less: Accumulated Losses

Less: Deferred Revenue Expenditure to the extent not written off

FORMAT OF BID SECURITY DECLARATION FROM BIDDERS IN LIEU OF EMD

( ON BIDDERS LETTER HEAD)

Email: afjls@gmk

Vendor’s Ref. No.:

To : M/s Numaligarh Refinery Limited(NRL), Golaghat/ …………. Refinery

Attention: Tender inviting authority

Subject : Response against your “Tender” No.: __________for ___________ (specify item) for TP/0200663C/NRL/1575-0012/1259

Numaligarh Refinery expansion project

Dear Sir, I /We , the authorized signatory of M/s _________________________________ , Participating in the subject Tender No. _______________________________ for the job of _________________________________________________________, do hereby declare that

i.) that I / We have availed the benefits of waiver of EMD while submitting our offer against Tender and No EMD being deposited for the said Tender.

ii )That in the event we withdraw / modify our bid during the period of validity, OR I / We fail to execute formal contract agreement with in the given time line , OR I We fail to submit a performance security agreement within the given timeline, OR I /We commit any other breach of Tender Conditions / Contract which attracts penal action of forfeiture of EMD and I We will be suspended from being eligible for bidding / award of all future contract ( s) of Numaligarh Refinery Limited(NRL), Golaghat for a period of one year from the date of committing such breach.

Yours faithfully

(Authorized Signatory)

Designation: jvsdjvk

Company name, address and Seal: XYZk

E mail : afjls@gmk

Mobile no.: 88565686789k

Confirmation/Documents from vendors for availing EPCG benefits

Tender Ref.: TP/0200663C/NRL/1575-0012/1259

Vendor’s Ref. No.:

NRL shall be availing Export Promotion of Capital Goods (EPCG) benefits under Foreign Trade Policy on the procurements to be made for Numaligarh Refinery Expansion Project (NREP). For availment of aforesaid benefits, NRL shall be required to submit certain information/documents/confirmation to Director General of Foreign Trade (DGFT) for obtaining the EPCG authorization and its invalidation. Accordingly, vendor(s) is/are to provide the following required information/documents/confirmation within 15 days from receipt of Letter of Acceptance (LOA):

I. Documents required immediately on issue of PO: a) Pro-forma Invoice as per approved billing break-up (BBU) only–To be prepared by showing Goods and Spare Parts item-wise separately with HSN code, Product Description, Units, UoM & PO reference etc. Production description in the Tax Invoice and Proforma Invoice should be as per the description with tag number given in NRL PO issued to your organization. Also note that proforma invoice shall be in line with billing break-up wherever applicable. b) Copy of your active Import Export Code (IEC) and GSTIN c) Your Jurisdictional Regional Authority address (DGFT Regional Authority Address) d) Copy of Your IEM (Industrial Entrepreneur Memorandum)/IL (Industrial License) or Udyam Registration Certificate

II.Documents required immediately on delivery of goods at NRL Site after receipt of EPCG License and Invalidation Letter from NRL: a) Tax Invoice on delivery of goods with declaration in the tax invoice that “This supply is against EPCG authorization number: xxxxx and date: xx/xx/xxxx” having invalidation No. xxxx dated xx/xx/xxxx. Your tax invoice should be in line with the invalidation letter, Proforma Invoice and approved BBU. b) Copy of GSTR 1 and GSTR 3B declaring that the supply to NRL is under deemed export category. c) An undertaking to the effect that the supplier (your company) has paid the GST charged in the relevant tax invoice and will not be claiming refund of said GST charged in aforesaid tax invoice.

III. Built in Import content exist in Domestic PO: Supplier/Vendor has to declare import line items by showing the particulars such as currency of import, country of origin, description of capital goods, value of capital goods, HSN code & the country of supply etc. separately in the proforma invoice (referred in sl. no. ‘I’) and import the capital goods against EPCG license at zero customs duty including IGST & SWC. In such an arrangement, vendor has to enter into a high sea sale agreement with NRL. Alternatively, supplier can import the built-in import content by obtaining advance authorisation from its jurisdictional DGFT office against the EPCG license to be provide by NRL.

It is to be noted that in the absence of above said documents/undertakings, DGFT will not process EPCG application and therefore NRL will not get EPCG license against your supply. If, NRL sustains loss of the benefits so envisaged under EPCG scheme against your above supply due to non-receipt of documents/undertaking from your end, the same shall be passed on to you against the amount payable by NRL.

We hereby comply with above terms and confirmed submision of required document.

Company name, address and Seal: ABCk

E mail : afjls@gmk (Authorized Signatory)

Ph no.: 58675876857k Name:

Mobile no.: 88565686789kdn Designation:

Item Wise BoQ-1 for Supply"

Select, Excess (+), Less (-)

Tender Inviting Authority : Technip India Limited, Noida, INDIA.

Name of Work: Design, engineering, procurement, fabrication, inspection, testing, transportation, and SUPPLY FOR CONTINUOUS PURGING SYSTEM FOR SEVERE-SERVICE METAL-SEATED VALVES AND CRITICAL MEASURING INSTRUMENTS to be installed at Numaligarh Refinery Limited(NRL), Assam including Erection & Commissioning Spares, Mandatory Spares , Special Tools and tackles, Supervision / Training charges at site as per the enclosed Tender standard specifications, Job specification, data sheets etc. and other codes and standards attached or referred as per Material Requisition for Numailgarh Refinery Limited, Golaghat, Assam, India.

Notes:( BOQ for Indigenous Bidder) 1. Bid evaluation shall be done as Overall Basis as specified in SPC & ITB Document. Price Evaluation methodology shall be as follow. eg. For BOQ Sr No 1.0, Total Price Quoted against BOQ Sr no 1.1 (Quantity x Basic Unit Price) + 2.0 + 3.0 + 4.1 (Nos of days for supervision x Per diem charge) + Applicable taxes 2. Bidder to furnish Unit rate for Supply inclusive of Third Party Inspection Charges, Erection & Commissioning Spares, special Tools & tackles ( if applicable) and others scope as defined in material requisition excluding, Mandatory Spares , Supervision/ Trainings & Freight charges . 3. Mandatory Spares , Site Supervision / Training & Freight charges to quote separately as per the columns provided in the BOQ. These charges shall be part of price evaluation. 4.The owner has the right to exclude these Freight charges from the bidder scope. 5) Supervision Sevices charges charges on a DIEM basis for erection and commissioning / Performance testing as per details mentioned in material requisition shall be considered for evaluation. Total Twenty (20) man-days shall be considered for price evaluation, However payment shall be done as per the actual mandays certified by the engineer in charge. 6. Scanned / photocpoy of this Price BOQ is not acceptable. Such Bids shall be rejected. Bidder to submit price in this BOQ only and put their prices in cyan colored cell without changing the format. 7. If ‘Basic Unit Price’ of any line item of BOQ is left ‘blank’ or zero (0) by Bidder in Basic Cost ( Column 13) against S.no 1.0 , it shall be considered as ‘ITEM NOT QUOTED’. But in other columns, if bidders has mentioned "Quoted" in the unpriced bid and "left blank' or zero(0),It shall be considered as inclusive in the Basic Cost. 8. Bidder to note that the position of the bidders indicated in BOQ Comparative Chart in the CPPP is generated automatically by the system immediately after opening priced bid, and the same is not final. The actual position of the bidder will be decided only after scrutiny of the quote(s) in BOQ considering all loading factors as per terms and conditions of the bid. Accordingly, the comparative statement and L1 position published subsequently through an uploaded document should be considered as final. 9. Bidder to note that charges for Two year recommended spares for trouble-free operation shall be quoted in BOQ -2 and are not a part of the Evaluation. 10. Bidder to note that charges for Addition / Deletion be quoted in BOQ -4 and are not a part of the commercial Evaluation. 11. Bidder shall provide a detailed billing schedule for the material on the award of work( if required). 12. Bidders to submit CIF Value and applicable details in BOQ-3, if applicable 13. Transporation Chages- For Indigenous Bidders: Inland transportation charges by road of all supplies from Vendor’s works/shop to Project site, Numaligarh Refinery, Golaghat, Assam/ Rail Transportation up to NMGS/Numaligarh Refinery Project Siding.( Excluding GST). 14. GST @ 18% has been entered in BOQ (Column 37 for Supply / Mandatory Spare / Supervision/ Training / site work Charge etc) for calculation purposes however bidder can modify the same (if required).

Name of the Bidder/ Bidding Firm / Company :

Sl. No. Item Description Item Code / Make Quantity Units Estimated Rate in Rs. P Addition / Deduction Addition / Deduction Values Currency Convertion against each Item THIS COLUMN WILL ALWAYS BE HIDDEN Quoted Currency in INR LUMPSUM SUPPLY PRICE FOT Works for Indigenous bidder Lumpsum Cost of Mandatory spares as per TP-1ZZZA-PQ-PRC-0005 of SPE document attached with Material Requisition (Excluding GST) Lumpsum Cost of TRANSPORTATION: For Indigenous Bidders : Inland transportation charges by road of all supplies from Vendor’s works / shop to Project site, Numaligarh Refinery, Golaghat, Assam/ Rail Transportation up to NMGS/Numaligarh Refinery Project Siding. (Excluding GST) THIRD PARTY INSPECTION CHARGES (LUMPSUM) (Excluding GST) Training for 2 Instrumentation Engineers and 4 Operation/maintenance Engineers at Site for 7 days (rate to be quoted on per diem basis). THIRD PARTY INSPECTION CHARGES (LUMPSUM) excluding GST Lumpsum Charges for Post commissioning service support with residential staff till the completion of warrantee period details as per material requisition, Excluding GST % of Custom Duty considered in CIF import Content % of Social welfare charges considered on Custon Duty Rate included in the CIF import Content % of IGST charges on Custon Duty Rate included in the CIF import Content Per Diem Supervision charges in Foreign currency No of man days for Supervision of each line item Total Supervision charges Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Per Diem charges upto 8 hrs on normal working days. ( BIDDERS TO QUOTE UNIT RATE FOR DIEM CHARGES ) Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour (beyond normal 8 hours on normal working days). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour for work on weekly off days / holidays (as applicable to Refinery Site). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) Currency of Quote for Training charges Lumpsum Training charges in INR Currency of Quote for Training charges Lumpsum Training charges in Foreign currency Currency of Quote for AMC charges TOTAL AMC CHARGES IN INR (AS SPECIFIED IN TENDER) Currency of Quote for AMC charges Charges for recommended spares for two years trouble-free operation GST (%) GST (%) on Freight GST (AMOUNT) ONLY FOR FOREIGN BIDDER Ocean Freight FOREIGN BIDDER TO COMPULSORILY QUOTE IN ABSOLUTE VALUE (Please do not put in %age) ONLY FOR FOREIGN BIDDER Marine Insurance @ 1% of FOB cost ONLY FOR FOREIGN BIDDER CIF, Mumbai Port SUM OF FOB SUPPLY+MANDATORY SPARES+OCEAN FREIGHT+MARINE INSURANCE ONLY FOR FOREIGN BIDDER CELL TO BE LOCKED AND HIDDEN Assessible Value incl. Landing Charge @ 1% of CIF cost 1% OF COLUMN 35 NOT TO BE INCLUDED IN FINAL CALCULATION Port Handling charges( 3% of FOB rate) COMPULSORY INPUT BY FOREIGN BIDDER Custom Duty ( % ) ONLY FOR FOREIGN BIDDER Custom Duty Value Social Welfare Surcharge ( 10 % on Custom Duty ) COMPULSORY INPUT BY FOREIGN BIDDER IGST % ON SUPPLY FOR FOREIGN BIDDER VALUE OF IGST ON SUPPLY ( ON CIF +CUSTOM DUTY+INLAND FREIGHT) Inland freight charges from Port to project site COMPULSORY INPUT BY FOREIGN BIDDER IGST ON SUPERVISION+TRAINING+AMC

0.0 Supply of HP/MP/LP Continuous Purge system with all required Hardware including design, engineering, manufacture, procurement of materials and bought out items/components, assembly at shop, internal testing, inspection, factory testing and acceptance (FAT), packing etc. including supply of mandatory and commissioning spares, transportation as per MR HP/LP/MP Continuous Purge System 1 Lumpsum 0.0000 Excess(+) Full Conversion INR _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)

0.0 Mandatory Spares for Sr No 1.1 : Lumpsum Cost of Mandatory Spares , Scope as per material requisition. item-1 1 Lumpsum 0.0000 Excess(+) Full Conversion INR _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)

0.0 TRANSPORTATION: For Indegenious Bidders : Inland transportation charges by road of all supplies from Vendor’s works / shop to Project site, Numaligarh Refinery, Golaghat, Asaam/ Rail Transportation up to NMGS/Numaligarh Refinery Project Siding. item-2 1 Lumpsum 0.0000 Excess(+) Full Conversion INR _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)

0.9 Unit rate for Site supervision (for installation and commissioning / SAT) and training to client personnel at site by the expert of OEM/ OEM’s representative shall be considered for the entire scope subject to successful commissioning for complete package, which shall also be considered for commercial evaluation- Per Diem charges upto 8 hrs on normal working days. ( BIDDERS TO QUOTE UNIT RATE FOR DIEM CHARGES ) item-3 1 Per-diem 0.0000 Excess(+) Full Conversion INR _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)

0.0 Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour (beyond normal 8 hours on normal working days). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) item-4 1 Per Hour 0.0000 Excess(+) Full Conversion INR _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)

0.9 Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour for work on weekly off days / holidays (as applicable to Refinery Site). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) item-5 1 Per Hour 0.0000 Excess(+) Full Conversion INR _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)

Total in Figures

Quoted Rate in Figures Select %

Quoted Rate in Words

Item Wise BoQ-2 for Supply of 2 yrs O&M Spares"

Select, Excess (+), Less (-)

Tender Inviting Authority : Technip India Limited, Noida, INDIA.

Name of Work: Design, engineering, procurement, fabrication, inspection, testing, transportation, and SUPPLY FOR CONTINUOUS PURGING SYSTEM FOR SEVERE-SERVICE METAL-SEATED VALVES AND CRITICAL MEASURING INSTRUMENTS to be installed at Numaligarh Refinery Limited(NRL), Assam including Erection & Commissioning Spares, Mandatory Spares , Special Tools and tackles, Supervision / Training charges at site as per the enclosed Tender standard specifications, Job specification, data sheets etc. and other codes and standards attached or referred as per Material Requisition for Numailgarh Refinery Limited, Golaghat, Assam, India.

Notes: Note- 1)This is BOQ-2 for Two year operation & maintance spare prices recommended by bidder. 2) Two years operational & maintenance spares shall not be considered for evaluation. 3) Vendor to indicate the recommended spare parts name & qty in item desceription below and furnish unit rate for the same. 4) The prices quoted for recommended two years operation and maintenance spares shall remain valid for Two (2) years from the date of LOA/PO whichever is earlier

Name of the Bidder/ Bidding Firm / Company :

Sl. No. Item Description Item Code / Make Quantity Units Estimated Rate in Rs. P Addition / Deduction Addition / Deduction Values Currency Convertion against each Item THIS COLUMN WILL ALWAYS BE HIDDEN Quoted Currency in INR BASIC UNIT PRICE FOT Works for Indigenous bidder BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 2 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 3 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 4 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 5 (Mention the spare name and Qty in unpriced schedule) BASIC PRICE- 2 years Normal operational & maintenance spares (as per vendor recommendation) , as per BOQ-1, (Spare no. - 6 (Mention the spare name and Qty in unpriced schedule) Lumpsum Charges for Post commissioning service support with residential staff till the completion of warrantee period details as per material requisition, Excluding GST % of Custom Duty considered in CIF import Content % of Social welfare charges considered on Custon Duty Rate included in the CIF import Content % of IGST charges on Custon Duty Rate included in the CIF import Content Per Diem Supervision charges in Foreign currency No of man days for Supervision of each line item Total Supervision charges Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Per Diem charges upto 8 hrs on normal working days. ( BIDDERS TO QUOTE UNIT RATE FOR DIEM CHARGES ) Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour (beyond normal 8 hours on normal working days). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour for work on weekly off days / holidays (as applicable to Refinery Site). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) Currency of Quote for Training charges Lumpsum Training charges in INR Currency of Quote for Training charges Lumpsum Training charges in Foreign currency Currency of Quote for AMC charges TOTAL AMC CHARGES IN INR (AS SPECIFIED IN TENDER) Currency of Quote for AMC charges Charges for recommended spares for two years trouble-free operation GST (%) on Supply GST (%) on Freight GST on Supply + Freight (AMOUNT) ONLY FOR FOREIGN BIDDER Ocean Freight FOREIGN BIDDER TO COMPULSORILY QUOTE IN ABSOLUTE VALUE (Please do not put in %age) ONLY FOR FOREIGN BIDDER Marine Insurance @ 1% of FOB cost ONLY FOR FOREIGN BIDDER CIF, Mumbai Port SUM OF FOB SUPPLY+MANDATORY SPARES+OCEAN FREIGHT+MARINE INSURANCE ONLY FOR FOREIGN BIDDER CELL TO BE LOCKED AND HIDDEN Assessible Value incl. Landing Charge @ 1% of CIF cost 1% OF COLUMN 35 NOT TO BE INCLUDED IN FINAL CALCULATION Port Handling charges( 3% of FOB rate) COMPULSORY INPUT BY FOREIGN BIDDER Custom Duty ( % ) ONLY FOR FOREIGN BIDDER Custom Duty Value Social Welfare Surcharge ( 10 % on Custom Duty ) COMPULSORY INPUT BY FOREIGN BIDDER IGST % ON SUPPLY FOR FOREIGN BIDDER VALUE OF IGST ON SUPPLY ( ON CIF +CUSTOM DUTY+INLAND FREIGHT) Inland freight charges from Port to project site COMPULSORY INPUT BY FOREIGN BIDDER IGST ON SUPERVISION+TRAINING+AMC

0.0 2 years Normal operational & maintenance spares (as per vendor recommendation) for BOQ-1, item Sr No 1.1 (Spare no. - 1.01 (Mention the spare name and Qty in unpriced schedule) item1 1 Unit Rate 0.0000 Excess(+) Full Conversion INR _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)

0.0 Spare no. - 1.02 (Mention the spare name and Qty in unpriced schedule) item2 1 Unit Rate 0.0000 Excess(+) Full Conversion INR _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)

Total in Figures

Quoted Rate in Figures Select %

Quoted Rate in Words

Item Wise BoQ-3 for Built in Import Content"

Select, Excess (+), Less (-)

Tender Inviting Authority : Technip India Limited, Noida, INDIA.

Name of Work: Design, engineering, procurement, fabrication, inspection, testing, transportation, and SUPPLY FOR CONTINUOUS PURGING SYSTEM FOR SEVERE-SERVICE METAL-SEATED VALVES AND CRITICAL MEASURING INSTRUMENTS to be installed at Numaligarh Refinery Limited(NRL), Assam including Erection & Commissioning Spares, Mandatory Spares , Special Tools and tackles, Supervision / Training charges at site as per the enclosed Tender standard specifications, Job specification, data sheets etc. and other codes and standards attached or referred as per Material Requisition for Numailgarh Refinery Limited, Golaghat, Assam, India.

Notes:( BOQ for Built in Import Content) 1. Please submit details in this BOQ-3 as per the detials mentioned in point no-10 of SPC ( Special Purchase Conditions). 2. Lumpsum CIF value of Import Content should be quoted considering Merit Rate only. 3. These values will not be part of price evaluation

Name of the Bidder/ Bidding Firm / Company :

Sl. No. Item Description Item Code / Make Quantity Units Estimated Rate in Rs. P Addition / Deduction Addition / Deduction Values Currency Convertion against each Item THIS COLUMN WILL ALWAYS BE HIDDEN Quoted Currency in INR Lumpsum CIF value of Import Content ( in INR) Lumpsum Cost of Mandatory Spares , Scope as per material requisition. TRANSPORTATION: Inland transportation per Tag by road of all supplies from Vendor’s works / shop to Project site, Numaligarh Refinery, Golaghat, Asaam/ Rail Transportation up to NMGS/Numaligarh Refinery Project Siding.( Excluding GST) Third Party Inspection charges , Scope as per material requisition. Lumpsum Training charges , scope as defined in material requisition . Periodic visits of the expert of OEM/ OEM’s representative for preventive/ periodic maintenance/ healthiness checking/ troubleshooting etc. details as per material requisition Lumpsum CIF value of Import Content % of Custom Duty % of Social welfare charges % of IGST charges Total value of Import content including all taxes ( in INR) Indicate classification with tariff no. under which Bidder intends to import. Total Supervision charges Confirm country of origin of imported material Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour (beyond normal 8 hours on normal working days). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour for work on weekly off days / holidays (as applicable to Refinery Site). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) Currency of Quote for Training charges Lumpsum Training charges in INR Currency of Quote for Training charges Lumpsum Training charges in Foreign currency Currency of Quote for AMC charges TOTAL AMC CHARGES IN INR (AS SPECIFIED IN TENDER) Currency of Quote for AMC charges Charges for recommended spares for two years trouble-free operation TRANSPORTATION: Inland transportation per Equipment by road of all supplies from Vendor’s works / shop to Project site, Numaligarh Refinery, Golaghat, Asaam/ Rail Transportation up to NMGS/Numaligarh Refinery Project Siding.( Excluding GST) GST (%) GST on Supply+Mandatory Spares+Freight ONLY FOR FOREIGN BIDDER Ocean Freight FOREIGN BIDDER TO COMPULSORILY QUOTE IN ABSOLUTE VALUE (Please do not put in %age) ONLY FOR FOREIGN BIDDER Marine Insurance @ 1% of FOB cost ONLY FOR FOREIGN BIDDER CIF, Mumbai Port SUM OF FOB SUPPLY+MANDATORY SPARES+OCEAN FREIGHT+MARINE INSURANCE ONLY FOR FOREIGN BIDDER CELL TO BE LOCKED AND HIDDEN Assessible Value incl. Landing Charge @ 1% of CIF cost 1% OF COLUMN 35 NOT TO BE INCLUDED IN FINAL CALCULATION Port Handling charges( 3% of FOB rate) COMPULSORY INPUT BY FOREIGN BIDDER Custom Duty ( % ) ONLY FOR FOREIGN BIDDER Custom Duty Value Social Welfare Surcharge ( 10 % on Custom Duty ) COMPULSORY INPUT BY FOREIGN BIDDER IGST % ON SUPPLY FOR FOREIGN BIDDER VALUE OF IGST ON SUPPLY ( ON CIF +CUSTOM DUTY+INLAND FREIGHT) Inland freight charges from Port to project site COMPULSORY INPUT BY FOREIGN BIDDER IGST ON SUPERVISION+TRAINING+AMC

0.0 Supply of HP/MP/LP Continuous Purge system with all required Hardware including design, engineering, manufacture, procurement of materials and bought out items/components, assembly at shop, internal testing, inspection, factory testing and acceptance (FAT), packing etc. including supply of mandatory and commissioning spares, transportation as per MR HP/LP/MP Continuous Purge System 1 Lumpsum 0.0000 Excess(+) Full Conversion INR _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) _(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)

Total in Figures

Quoted Rate in Figures Select %

Quoted Rate in Words

Item Wise BoQ-4 for Addition Deletion prices"

Select, Excess (+), Less (-)

Tender Inviting Authority : Technip India Limited, Noida, INDIA.

Name of Work: Design, engineering, procurement, fabrication, inspection, testing, transportation, and SUPPLY FOR CONTINUOUS PURGING SYSTEM FOR SEVERE-SERVICE METAL-SEATED VALVES AND CRITICAL MEASURING INSTRUMENTS to be installed at Numaligarh Refinery Limited(NRL), Assam including Erection & Commissioning Spares, Mandatory Spares , Special Tools and tackles, Supervision / Training charges at site as per the enclosed Tender standard specifications, Job specification, data sheets etc. and other codes and standards attached or referred as per Material Requisition for Numailgarh Refinery Limited, Golaghat, Assam, India.

Notes:( BOQ for Indigenous Bidder) Note- 1)This is BOQ-4 for Addition/ Deletion of Prices . : “The lowest bidder shall match the lowest addition / deletion rates quoted by any bidder for the same item against the tender.

Name of the Bidder/ Bidding Firm / Company :

Sl. No. Item Description Item Code / Make Quantity Units Estimated Rate in Rs. P Addition / Deduction Addition / Deduction Values Currency Convertion against each Item THIS COLUMN WILL ALWAYS BE HIDDEN Quoted Currency in INR BASIC UNIT RATE FOT Works for Indigenous bidder Lumpsum Cost of Mandatory spares as per TP-1ZZZA-PQ-PRC-0005 of SPE document attached with Material Requisition (Excluding GST) Lumpsum Cost of TRANSPORTATION: For Indigenous Bidders : Inland transportation charges by road of all supplies from Vendor’s works / shop to Project site, Numaligarh Refinery, Golaghat, Assam/ Rail Transportation up to NMGS/Numaligarh Refinery Project Siding. (Excluding GST) THIRD PARTY INSPECTION CHARGES (LUMPSUM) (Excluding GST) Training for 2 Instrumentation Engineers and 4 Operation/maintenance Engineers at Site for 7 days (rate to be quoted on per diem basis). THIRD PARTY INSPECTION CHARGES (LUMPSUM) excluding GST Lumpsum Charges for Post commissioning service support with residential staff till the completion of warrantee period details as per material requisition, Excluding GST % of Custom Duty considered in CIF import Content % of Social welfare charges considered on Custon Duty Rate included in the CIF import Content % of IGST charges on Custon Duty Rate included in the CIF import Content Per Diem Supervision charges in Foreign currency No of man days for Supervision of each line item Total Supervision charges Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Per Diem charges upto 8 hrs on normal working days. ( BIDDERS TO QUOTE UNIT RATE FOR DIEM CHARGES ) Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour (beyond normal 8 hours on normal working days). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) Per Diem Unit rate for Supervision Sevices of erection and commissioning / Performance testing as per details mentioned in material requisition for quoted items as per enclosed instructions to vendor Overtime rate per hour for work on weekly off days / holidays (as applicable to Refinery Site). ( BIDDERS TO QUOTE OVER TIME RATE PER HOUR ) Currency of Quote for Training charges Lumpsum Training charges in INR Currency of Quote for Training charges Lumpsum Training charges in Foreign currency Currency of Quote for AMC charges TOTAL AMC CHARGES IN INR (AS SPECIFIED IN TENDER) Currency of Quote for AMC charges Charges for recommended spares for two years trouble-free operation GST (%) GST (%) on Freight GST (AMOUNT) ONLY FOR FOREIGN BIDDER Ocean Freight FOREIGN BIDDER TO COMPULSORILY QUOTE IN ABSOLUTE VALUE (Please do not put in %age) ONLY FOR FOREIGN BIDDER Marine Insurance @ 1% of FOB cost ONLY FOR FOREIGN BIDDER CIF, Mumbai Port SUM OF FOB SUPPLY+MANDATORY SPARES+OCEAN FREIGHT+MARINE INSURANCE ONLY FOR FOREIGN BIDDER CELL TO BE LOCKED AND HIDDEN Assessible Value incl. Landing Charge @ 1% of CIF cost 1% OF COLUMN 35 NOT TO BE INCLUDED IN FINAL CALCULATION Port Handling charges( 3% of FOB rate) COMPULSORY INPUT BY FOREIGN BIDDER Custom Duty ( % ) ONLY FOR FOREIGN BIDDER Custom Duty Value Social Welfare Surcharge ( 10 % on Custom Duty ) COMPULSORY INPUT BY FOREIGN BIDDER IGST % ON SUPPLY FOR FOREIGN BIDDER VALUE OF IGST ON SUPPLY ( ON CIF +CUSTOM DUTY+INLAND FREIGHT) Inland freight charges from Port to project site COMPULSORY INPUT BY FOREIGN BIDDER IGST ON SUPERVISION+TRAINING+AMC

Total in Figures

Quoted Rate in Figures Select %

Quoted Rate in Words

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