FORMS

Please return this form to: Sanjeev K Sinha General Manager (Marketing) Pavilions & Interiors (I) Pvt. Ltd. A-63, Sector 57, NOIDA (U.P.) Ph.: 0120-2581217-18 Fax: 0120-2581215 Mob.: 09310159101 Email: sanjeev.sinha@pavilionsinteriors.com

Last Date of Submission Oct. 1, 2011

FORM No. 10 Additional Furniture & Electrical Goods on Rental

S. No

Item code

Description

Size / Specification

Unit Cost in INR.

Unit Cost in US$

Qty.

Total

A
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Furniture / System Accessories/Electrical Equipment

PI-01 PI-02 PI-03 PI-04 PI-05 PI-06 PI-07 PI-08 PI-09 PI-10 PI-11 PI-12 PI-13 PI-14 PI-15 PI-16 PI-17 PI-18 PI-19 PI-20 PI-21 Executive Chair VIP Sofa (1 Seater) VIP Sofa (2 Seater) Visitor Chair Fibre Chair Wooden Chair Round Table (Wooden Top) Round Table Cross Leg (Glass Top) Bar Stool (Adjustable Chrome leg with Cup) Glass Showcase (Big with 2 downlights) Glass Showcase (Small) Glass Counter Centre Table (Black Glass Top) Standing Discussion Table System Counter (Table) Side Rack (Lockable) System Podium System Podium System Podium Brochure Rack Round Table (White Top) 80CM (dia) x 75CM (H) Black/red Black Black Black Black Wood color 70CM (dia) x 75CM (H) 90CM (dia) x 75CM (H) 50CM (H) 1M x 50CM x 2M (H) 50CM X 50CM X 2M (H) 1M X 50CM X 1M (H) 1.20M (L) x 45CM (W) 1.0M (H) x 70CM (Dia) 1.05M X 60CM X 75CM 40CM X 1M X 60CM (H) 50CM X 50CM X 1 M (H) 50CM X 50CM X 70CM (H) 50CM x 50CM x 50CM (H) 1,000.00 1,250.00 2,500.00 400.00 200.00 500.00 750.00 1,000.00 750.00 3,000.00 2,500.00 1,800.00 750.00 700.00 750.00 1,800.00 750.00 500.00 400.00 500.00 750.00 23.00 28.00 56.00 9.00 5.00 12.00 17.00 23.00 17.00 67.00 56.00 40.00 17.00 16.00 17.00 40.00 17.00 12.00 9.00 12.00 17.00

2 1

2 1

22 23 24 25 26 27 28 29 30 31 32

PI-22 PI-23 PI-24 PI-25 PI-26 PI-27 PI-28 PI-29 PI-30 PI-31 PI-32

Square Table Lockable Door System Panel Glass Shelf (each) Wooden Shelf Flat / Adjustable (each) Long Arm Halogen Light Spot Lights Metal Halide 5A/13A Power Socket Photo Clip / T-Bolt Waste Basket

1.2M X 45CM

600.00 2,500.00

14.00 56.00 18.00 6.00 5.00 9.00 6.00 27.00 6.00 1.00 2.00

1M x 2.5M (H) - White 30CM x 1M 30CM x 1M 150W 75W 150W

800.00 250.00 200.00 400.00 250.00 1,200.00 250.00 20.00 50.00

B
33 34 35

Power Load
Electrical Outlet (Temporary Connection) Power Load Single Phase Connection per KW Power Load Three Phase Connection per KW Per/KW/day excluding consumption excluding consumption 3,000.00 500.00 750.00 67.00 12.00 17.00

1 2 3 4

Please Note: Please make the order with the items code & name. Service Tax extra at 10.3% Cheque/DD payment to be made in favour of "Pavilions & Interiors (I) Pvt. Ltd." Bank Details Name of Company : Pavilions and Interiors (I) Pvt. Ltd. : 208000 Account No Swift Code Bank Name Bank Address : ABNAINBBDEL : ABN AMRO BANK : Hansalaya, 15 Barakamba Road, New Delhi - 01

Please fill and return this form along with full payment in favour of M/s Pavilions & Interiors (I) Pvt. Ltd. payable at New Delhi latest by October 1, 2011, otherwise there is no surety of the items to be provided. We are sending D.D. No....dtfor Rs. Drawn on. Contact Person KAMAL RAMANI Designation SALES EXECUTIVE Company Name FIBER TECH COMPOSITE PVT. LTD Address:Survey no.20-21, Kothariya-Kotda Sangani Road, Rajkot Stall Number 11-13 Hall Number 1 Signature Date 01.10.2011