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DEVELOPMENT OF SUPER SPECIALTY HOSPITAL

IN KANPUR

Under Integrated Urban Rejuvenation Plan


ON DESIGN, BUILD, FINANCE, OWN AND OPERATE
BASIS UNDER PUBLIC PRIVATE PARTNERSHIP (PPP)

REQUEST FOR QUALIFICATION CUM PROPOSAL


DOCUMENT

JUNE 2009

Nodal Agency

AWAS BANDHU, UTTAR PRADESH,


HOUSING & URBAN PLANNING DEPARTMENT,
GOVERNMENT OF UTTAR PRADESH

IST FLOOR, JANPATH MARKET,


LUCKNOW-226001
TEL: 0522-2237161 FAX:0522-2612098,
E-MAIL: awasbandhu@gmail.com
WEB: awas.up.nic.in

Project Consultants

Darashaw & Company Private Limited


RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

NOTICE INVITING REQUEST FOR QUALIFICATION CUM REQUEST FOR


PROPOSAL

Awas Bandhu, Uttar Pradesh,


Housing & Urban Planning Department,
Government of Uttar Pradesh

DEVELOPMENT OF SUPER SPECIALTY HOSPITAL IN KANPUR as part of IURP Uttar Pradesh, India on
DBFOO basis

Government of Uttar Pradesh proposes development of Super Specialty Hospital in Kanpur. Awas Bandhu UP is
the nodal agency for the project.

There is a need to develop a Super Specialty Hospital in Kanpur. The Hospital is expected to be developed as
per the International standards/ Indian Public Health Standards. It is envisioned to provide Health care facilities in
selected disciplines. The broad scope of work is to develop of a 500 bed hospital at a site identified by KDA. The
Hospital may be upgraded to have research institutes along with training courses for nursing and paramedical
staff.

Kanpur Development Authority has identified and earmarked total 15 acres of plot situated opposite to Indian
Institute of Technology (IIT) Kanpur along the proposed Mandhana-Bhounti Byepass. The site shall be given on
lease for a concession period of 90 years and the lease is renewable twice during the concession period at every
30 years.

The successful bidders shall Design, Build, Finance, Own and Operate Super Specialty Hospital on the 15 acre
of plot earmarked for the purpose over the concession period of 90 years, after which the facility along with the
site shall be transferred to the Concessioning Authority. The maximum FAR allowable is 2.5 as per the prevailing
Development Control Regulations of KDA.

GoUP invites bids from the eligible developers either on their own or in consortium of up to four members for the
project in response to this RFQ cum RFP document.

The Eligibility Criteria and other terms and conditions are given in RFQ cum RFP Document. The RFQ cum RFP
may be obtained at the address given below on payment of Rs 25,000/- (Rupees Twenty Five Thousand only),
through account payee Demand Draft in favour of Awas Bandhu payable at Lucknow. The RFQ cum RFP may
also be downloaded from the web http//awas.up.nic.in and the Demand Draft as mentioned above shall be
submitted along with the Proposal.

The last date for submission of RFQ cum RFP is 1300 Hrs on 03.07.2009.
For further details please contact
The Executive Director, The Project Coordinator,
Awas Bandhu, Uttar Pradesh, Darashaw & Co. Pvt. Ltd.,
Housing & Urban Planning Department, 12th Floor, Regent Chambers,
Government Of Uttar Pradesh 208, Nariman Point, Mumbai 400021
Ist Floor, Janpath Market, Lucknow-226001 Tel: 022-66388900 Fax: 022-67470549
Tel: 0522-2237161 Fax:0522-2612098, team-consultancy@darashaw.com
E-Mail: awasbandhu@gmail.com,
Web : awas.up.nic.in
RFQ cum RFP for Design, Build, Finance, Own and Operate Super Speciality Hospital in Kanpur

Disclaimer
1. Though adequate care has been taken in the preparation of this RFQ cum RFP Document (Volumes I and
II), the Bidder should satisfy himself that the Document is complete in all respects including its legal
validity.
2. Neither Awas Bandhu, UP nor their employees or consultants make any representation or warranty as to
the accuracy, reliability or completeness of the information in this RFQ cum RFP (Volumes I and II) and it
is not possible for Awas Bandhu, UP to consider the investment objectives, financial situation and
particular needs of each party who reads or uses this document. Each prospective Bidder should conduct
his own investigations and analysis and check the accuracy, reliability and completeness of the
information in this RFQ cum RFP and obtain independent advice from appropriate sources.
3. Neither Awas Bandhu, UP nor their employees or consultants will have any liability to any prospective
bidder or any other person under the law of contract, tort, the principles of restitution or unjust enrichment
or otherwise for any loss, expense or damage which may arise from or be incurred or suffered in
connection with anything contained in this RFQ cum RFP, any matter deemed to form part of this RFQ
cum RFP, the award of the Project, the project information and any other information supplied by or on
behalf of Awas Bandhu UP, KDA or their employees, any consultants or otherwise arising in any way from
the selection process.
4. Awas Bandhu, UP reserves the right to reject any or all of the proposals submitted in response to this
RFQ cum RFP at any stage without assigning any reasons whatsoever.
5. Awas Bandhu, UP reserves the right to change any or all of the provisions of this RFQ cum RFP prior to
Proposal Due Date. Such changes would be intimated to all the parties being issued this RFQ cum RFP.
6. Awas Bandhu, UP reserves the right to change, modify, add to or alter the Selection Process including
inclusion of additional evaluation criteria at later stage, which in no event shall be later than the Proposal
Due Date. Any change in the Selection Process shall be intimated to all concerned parties.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Speciality Hospital in Kanpur

1 RFQ cum RFP DOCUMENT

Schedule of Bidding Process


(This RFQ cum RFP is issued to the applicant in response to the advertisement dated 04/06/2009)

1. Last date for receipt of queries 25.06.2009 at 1000 hrs


2.Last date for submission of RFQ Cum RFP 03.07.2009 at 1300 hrs at the office of the
Executive Director, Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government Of Uttar Pradesh
Ist Floor, Janpath Market,
Lucknow-226001
3.Date and time of Opening of RFQ cum RFP 03.07.2009 1400 hrs

4.Document Fees Rs. 25000 (Rupees Twenty Five Thousand),


through account payee Demand Draft in favour of
Awas Bandhu payable at Lucknow.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Table of Contents

1 RFQ cum RFP DOCUMENT 3


2 Salient Information 4
3 Abbreviations 5
4 Definitions 6
5 INTRODUCTION 9
5.1 Background of Kanpur 9
5.2 Kanpur Development Authority 9
5.3 Scope of the Project 9
5.4 Cost of the Project 11
5.5 Commercial Consideration 11
5.6 Project Implementation Mechanism 12
6 INFORMATION AND INSTRUCTION TO BIDDERS 13
6.1 Scope of Application 13
6.2 Eligible Bidders 13
6.3 Changes in Consortium Composition 14
6.4 Number of Applications 14
6.5 Application Preparation Cost 14
6.6 Project Inspection and Site Visit 14
6.7 Right to Accept or Reject any or all Applications 15
6.8 Contents of RFQ cum RFP Document 15
6.9 Clarifications 15
6.10 Amendment of RFQ cum RFP 16
6.11 Language 16
6.12 Currency 16
6.13 Validity of Application 16
6.14 Format and Signing of Application 16
6.15 Sealing and Marking of Applications 17
6.16 Submission of Bid 18
6.17 Application Due Date 18
6.18 Late Applications 18
6.19 Modifications/ Substitution/ Withdrawal of Proposals 18
6.20 Evaluation of Application - Due Date 19
6.21 Evaluation of Application - Criteria 19
6.22 Evaluation of Application - Supporting Documents 19
6.23 Evaluation of Application - Right to Reject 19
6.24 Confidentiality 19
6.25 Tests of responsiveness 19
RFQ cum RFP for Design, Build, Finance, Own and Operate Super Speciality Hospital in Kanpur

6.26 Clarifications 20
6.27 Qualification and Notification 20
6.28 RFQ cum RFP Document 20
6.29 Fees of the Consultants 20
7 Other Instructions 22
7.1 General Provisions 22
7.2 Confidentiality 22
7.3 Communication between Bidders and Awas Bandhu, UP 23
7.4 Interpretation of Documents 23
7.5 Enquiries concerning the RFQ cumRFP / Draft Concession Agreement 23
7.6 Amendment of RFQ cum RFP 24
7.7 Submission of Bids 24
7.8 Bid Opening 24
7.9 Earnest Money Deposit 24
7.10 Performance Security 25
7.11 Sources of Funds 26
8 DESCRIPTION OF THE SELECTION PROCESS 27
8.1 CRITERIA FOR EVALUATION 27
8.2 Evaluation of Financial Proposal (Assessment of Envelope B) 30
9 RULES REGULATING THE CONSORTIUM 31
9.1 Consortium of Bidders 31
10 METHODOLOGY & CRITERIA FOR EVALUATION OF FINANCIAL BID (ENVELOPE
B) 33
10.1 Financial Proposal Evaluation 33
APPENDICES 35
APPENDIX 1A FORMAT FOR POWER OF ATTORNEY FOR SIGNING PROPOSAL 35
APPENDIX 1B FORMAT FOR POWER OF ATTORNEY FOR LEAD MEMBER OF
CONSORTIUM 36
APPENDIX 2 DETAILS OF BIDDER 37
APPENDIX 3 FORMAT FOR LETTER OF APPLICATION 38
APPENDIX 4 INFORMATION RELATED TO EXPERIENCE 40
APPENDIX 5 FORMAT FOR ESTABLISHING FINANCIAL CAPABILITY OF THE BIDDER43
APPENDIX- 6 (INTENTIONALLY LEFT BLANK) 45
APPENDIX 7 GUIDELINES FOR PROVIDING INFORMATION RELATED TO FINANCIAL
CAPABILITY 46
APPENDIX 8 FORMAT FOR ANTI-COLLUSION CERTIFICATE 48
APPENDIX 9A FORMAT FOR PROJECT UNDERTAKING 49
APPENDIX 9B FORMAT FOR PROJECT UNDERTAKING [In case of Consortium] 50
APPENDIX 10 FORMAT FOR MEMORANDUM OF UNDERSTANDING (MOU) 51

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APPENDIX-11 (INTENTIONALLY LEFT BLANK) 53


APPENDIX-12 CONSULTANCY AND SUCCESS FEE COMMITMENT TO DARASHAW &
COMPANY PRIVATE LIMITED 54
APPENDIX-13 FORMAT OF LETTER OF ACCEPTANCE 55
APPENDIX-14 FORMAT OF LETTER OF COMMITMENT 57
APPENDIX-15 FINANCIAL PROPOSAL (FORMAT FOR INFORMATION SUBMISSION) 59
APPENDIX-16 PROFORMA FOR BANK GUARANTEE FOR PERFORMANCE SECURITY
KANPUR DEVELOPMENT AUTHORITY 60
EXHIBIT I PRINCIPLES OF THE MEMORANDUM OF UNDERSTANDING TO BE EXECUTED
BETWEEN THE MEMBERS OF A CONSORTIUM 62
CHECKLIST FOR PROPOSAL SUBMISSION 63
Annexure A - PROJECT SITE 64
Annexure B - TECHNICAL SCHEDULES 65

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2 Salient Information

Following are the salient aspects of information regarding this bid document (RFQ cum RFP):

i. This bid document comprises the following:


a. Information to Bidders (RFQ cum RFP Document-Vol I)
b. Draft Concession Agreement (RFQ cum RFP Document-Vol II)
c. Technical Schedule (RFQ cum RFP Document-Vol II)
TEFR is available with the Bid Documents for reference of the bidders.

ii. The following shall be the Schedule of the Bidding Process.

MILESTONE DATE
Issue of RFQ cum RFP Document to Bidders 04.06.2009
Last Date for request for clarifications/suggestions 25.06.2009 at 1000 hrs
Last Date for Submission up to 13:00 hrs. (Proposal Due 03.07.2009 at 1300 hrs
Date) at the office of the
Executive Director,
Awas Bandhu, Uttar
Pradesh, Housing &
Urban Planning
Department,
Government Of Uttar
Pradesh
Ist Floor, Janpath
Market,
Lucknow-226001
Opening of Envelope A 03.07.2009 1400 hrs
Opening of Envelope B 06.07.2009 1400 hrs

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

3 Abbreviations
ABUP Awas Bandhu, UP
BEC Bid Evaluation Committee
COD Commercial Operation Date
EMD Earnest Money Deposit
EOI Expression of Interest
EPC Engineering, Procurement and Construction
FDI Foreign Direct Investment
FAR Floor Area Ratio
GoI Government of India
GoUP Government of Uttar Pradesh
Ha. Hectare or Hectares
JCI Joint Commission International
LCM Lead Consortium Member
LOI Letter of Intent
LOA Letter of Award
KDA Kanpur Development Authority
MOU Memorandum of Understanding
RFP Request for Proposal
RFQ Request for Qualification
SPV Special Purpose Vehicle
TEFR Techno-Economic Feasibility Report
UP Uttar Pradesh

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

4 Definitions

Associates
For a Bidding Company or a Consortium Member, only those entities would be Associates who control and is
controlled by or is under the common control with such applicant/consortium member.
Bid Document
Bid Document shall mean any document issued by Awas Bandhu, UP as part of the Bid Process.
Bid Process
Bid Process shall mean various activities taken up by Awas Bandhu, UP leading up to the selection of the
Successful Bidder/s.
Bidder(s)
Bidder(s) shall mean Bidding Company or Bidding Consortium that has submitted a Proposal in response to this
RFQ cum RFP Document.
Bidding Company
Bidding Company shall mean a corporate entity (Public or Private Limited) registered under the Companies Act,
1956 or equivalent International law1 satisfying the basic eligibility criteria of bidding.
Bid Validity Period
Bid Validity Period shall mean the period stipulated in Clause 6.13 of Section 6 of this RFQ cum RFP Document, for
which the Proposal submitted is valid.
Bank
Bank shall mean any SBI, Nationalised Bank and Indian Scheduled Commercial Bank whose networth is not less
than Rs. 300 crores as on 31st March 2008.
Consortium
Consortium shall mean Group of Entities that have jointly submitted the proposal for the project.

Consortium Member
Each entity in the Bidding Consortium shall be referred to as a Consortium Member.
Earnest Money Deposit
Earnest Money Deposit or Bid Security shall have the meaning as referred in Section 7.10 of this document.
Effective Date

Effective Date means the date on which all the Conditions Precedent are satisfied or waived in writing by both the
Parties as per the Concession Agreement.

1 Relevant Act as applicable has to be provided along in Envelope A with extract of relevant sections attached to the Act.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Floor Area Ratio


Floor Area Ratio means the quotient of the floor space excluding the area specifically exempted from computation
under these regulations that can be constructed in a plot to the plot area.
FAR = Total covered floor area on all floors
Plot area

Financial Bid / Financial Proposal


Financial Bid / Financial Proposal shall mean the information submitted as per Appendix 15 of this document.

Good Industry Practice


Good Industry Practice shall mean practices, methods, techniques and standards as changed from time to time that
are generally accepted for use in the infrastructure, construction and real estate industry or any other good industry
practice which is relevant to the said project.

Lead Member / Lead Consortium Member (LCM)


In case of a Bidding Consortium, the Lead Member / Lead Consortium Member (LCM) shall be that Consortium
Member vested with the prime responsibility of developing the Project and holding not less than 51% stake in the
consortium.

Letter of Acceptance
Letter of Acceptance shall have a meaning as referred in Appendix 13 of this Document. It means Letter submitted
by the bidder accepting the Award or Intention to Award the Project to the bidder.

Letter of Commitment
Letter of Commitment shall have a meaning as referred Appendix 14 of this Document.

Project
Project shall mean Design, Build, Finance, Own and Operate of Super Specialty Hospital in Kanpur more
specifically as mentioned under Clause 5.3 of Section 5.

Project Site shall mean the area as given in annexure A.

Proposal
Proposal shall mean the Technical and Financial Proposal to be submitted by the Bidders in response to this
Request for Qualification cum Request for Proposal.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Proposal Due Date


Proposal Due Date shall have the same meaning as referred to in Clause 6.17 section 6 of this Document.

Responsiveness / Non-responsive
Responsiveness / Non-responsive shall mean as referred in Clause 6.25 of Section 6 of this document.

Revenue of the Hospital


Revenue of the Hospital shall mean registration fees, hospital bed revenue, diagnostics laboratory tests,
consultation charges, operation charges and lease rental from the commercial facilities like bank, restaurant etc. of
that Financial Year. Revenue of the Hospital shall not include revenue from pharmacy, service apartments, training
institutes and consumables cost directly reimbursed by the patients.

Request for Qualification cum Request for Proposal (RFQ cum RFP)
Request for Qualification cum Request for Proposal shall mean this document issued to Bidders inviting the
submission of Proposal to Design, Build, Finance, Own and Operate of Super Specialty Hospital in Kanpur.

Selection Process
Selection Process shall have the same meaning as the 'Bid Process'.

Subsidiary/Subsidiaries
For a Bidding Company or a Consortium Member, Subsidiary / subsidiaries shall mean only those entities in which
the Bidding Company / Consortium Member hold(s) more than 50% of the voting securities directly.

Successful Bidder
The Successful Bidder shall mean the bidder who has been issued Letter of Intent by Awas Bandhu, UP and Letter of
Award by KDA indicating him as the Successful Bidder.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

5 INTRODUCTION
5.1 Background of Kanpur
Kanpur is the biggest city of the
State of Uttar Pradesh, sprawling
over an area of 260 sq km. It is
also the main centre of
commercial and industrial
activities in state. It is known for
its cotton and woolen textile and
leather industries. Apart from
leather and textile industry, the
fertilizer, chemicals, two
wheelers, soaps, Pan Masala,
hosiery and engineering
industries are also operating
prominently in the city. Kanpur is
situated on bank of holy river
Ganga and is about 126 meters
above the sea level.

5.2 Kanpur Development Authority


Kanpur Development Authority was established under the Uttar Pradesh Urban Planning & Development Act 1973.
KDA has progressed from small beginnings to embrace an overreaching authority in the development scenario of
Kanpur. In consonance with the aspirations of modern India, KDA aims at coordinated and planned development of
this historical city and under which various projects are being undertaken. Taking forward this development process
to redress the bottlenecks in road infrastructure, the KDA has proposed to take up many road projects in Kanpur.

To fulfil its role, the Authority seeks to coordinate in accordance with a comprehensive Master Plan along with the
work of various other agencies involved in the creation and extension of urban infrastructure.

Taking forward this development process and to redress the lack of Super Specialty Hospital in the State of UP, KDA
has proposed to set-up a 500 Bed Super Specialty Hospital in Kanpur.

5.3 Scope of the Project

Government of Uttar Pradesh (GoUP) through Awas Bandhu, UP, Lucknow intends to undertake various
infrastructure projects for implementation on Public Private Partnership (PPP) Mode under Integrated Urban
Rejuvenation Plan (IURP) scheme for selected cities of the state. Projects to be developed on PPP mode are being
identified, developed and implemented in various cities of Uttar Pradesh namely Ghaziabad, Meerut, Agra, Aligarh,
Allahabad, Varanasi, Lucknow and Kanpur.

Under this a need to develop a Super Specialty Hospital in Kanpur was felt. The Hospital is expected to develop as
per the International standards/ Indian Public Health Standards. It is envisioned to provide Health care facilities in

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

selected disciplines and free/ subsidized treatment to BPL population within the city and the region. The broad scope
of work is to develop of a 500 bedded hospital at a site identified by KDA. The Hospital may be upgraded to have
super specialty courses along with training courses for nursing and paramedical staff.

Kanpur Development Authority has identified and earmarked total 15 acres of plot situated opposite to Indian Institute
of Technology (IIT) Kanpur along the proposed Mandhana-Bhounti Byepass. The site shall be given on lease for a
concession period of 90 years and the lease is renewable twice during the concession period at every 30 years.

The successful bidders shall Design, Build, Finance, Own and Operate Super Specialty Hospital on the 15 acre of
plot earmarked for the purpose over the concession period of 90 years, after which the facility along with the site shall
be transferred to the Concessioning Authority.

The maximum FAR allowable is 2.5 as per the prevailing Development Control Regulations of KDA.

Awas Bandhu, UP, through this RFQ cum RFP invites the Pre-Qualified bidders to participate in the bid to
Design, Build, Finance, Own and Operate Super-Specialty Hospital in Kanpur.

The successful bidder shall construct following facilities and get all the approvals for commercial operations within 36
months from the effective date:

Minimum Development Obligations (Essential Facilities):

To build and operate 500-bedded Super-specialty hospital as per the International standards / Indian Public
Health Standard (IPHS). However, the developer is allowed to construct 250 bed capacity in initial three
years and remaining 250 bed capacity in next two years.

Atleast four specialties from the following specialties shall be developed in the Hospital.
.
Departments / Specialties
Trauma Care
Cardio Thoracic care unit (ICCU- Intensive Cardiac Care Unit)
Intervention specialty and Cerebral Intervention
Kidney Transplant (Hemodialysis)
Neurology unit
Obs & Gynecology
Pediatric unit (with NICU Neonetal Intensive Care unit)
Dental unit for surgery
Ophthalmology and ENT
Cancer unit

The hospital shall also have a round the clock emergency unit.

Optional Facilities

Service Apartments can be provided within the hospital complex to cater to the needs of the patients and
their relatives.
Institute offering Laboratory Technician courses, Nursing courses can also be developed within the hospital
complex.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Restaurants, ATMs, Pharmacy for the convenience of the patients can be provided within the hospital
complex.
Research Institutes can also be setup in the hospital complex.
Helipad for picking up patients may be provided.

All the facilities are to be developed as per the minimum quality standards set out for the purpose in the technical
schedule appended as Annexure B with this document.

While undertaking development of the Project, the Successful Bidder shall adhere to latest amended National
Building Code of India, other relevant IS Codes and practices, Development Control Rules, FAR Limits, statutory
requirements, guidelines and approvals of the Health Department of the Government of Uttar Pradesh, laws of land,
the principles of good industry practices and any other norms as applicable from time to time. The Successful Bidder
shall also take into account the guidelines issued by the State Health Department and obtain the necessary
approvals.

The successful bidder shall be responsible for all the clearances as may be required for the development and
operations of the project. Government, through UP Awas Bandhu will facilitate for single window clearance for all the
necessary approvals for the project from various authorities. The project shall be ready for operation after taking all
the clearance(s) within 36 months of the effective date.

For the purpose of providing subsidized health services to poor, the Concessionaire shall provide 1% of the revenues
of the hospital every year to the State Health Department. Revenue of the Hospital shall mean Registration Fees,
Hospital Bed Revenue, Diagnostics Laboratory tests, Consultation Charges, Operation Charges and lease rental
from the commercial facilities like Bank, Restaurant etc. Revenue of the Hospital shall not include revenue from
Pharmacy, Service Apartments, Training Institutes and Consumables cost directly reimbursed by the patients.

5.4 Cost of the Project

The project is estimated to cost Rs 2,40,00,00,000/-( Rupees Two hundred and Forty Crores Only).

5.5 Commercial Consideration

In consideration of the designated plot of land given on lease for a period of 90 years, the Successful bidder shall
quote the percentage revenue that will be shared with the Concessioning Authority beginning from the eleventh year
of signing of the agreement.

The Concessionaire shall pay to the Concessioning Authority an annual lease rental equivalent to 2% of the land cost
(considered as present circle rate) per acre of land on the 15 acre land earmarked for Super Specialty Hospital for
the entire concession period of 90 years.

Bidders may please note that in case of failure of the bidder in completion of the project, as mentioned in the scope
of work and as per the minimum standards and specifications as per the technical schedule appended with this
document as Annexure B, within 36 months, the performance security furnished on the execution of the Agreement
shall be forfeited by KDA and blacklisted, as per the Provision of the draft Concession agreement. Additional
measures as the Govt. may deem fit would be applicable on such a bidder.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

However, bidders may note that in case the work is being executed as per the minimum technical specifications in
Annexure B but delayed due to Force Majeure Event as defined in the Draft Concession Agreement, the remedies
pertaining to such Force Majeure Event shall be applicable as per the provisions in the Draft Concession Agreement.

5.6 Project Implementation Mechanism


The successful bidder in case of a consortium shall form a Special Purpose Vehicle (SPV) in the form of
limited company under Companies Act, 1956, registered in UP for the purpose of implementation of the
project. The Concession Agreement shall be signed between the SPV and KDA. In case, the successful
bidder is a single entity, the Concession Agreement shall be signed between the Single Entity and KDA. No
SPV shall be formed in case Single Entity is the Successful Bidder.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

6 INFORMATION AND INSTRUCTION TO BIDDERS

6.1 Scope of Application

6.1.1 ABUP wishes to receive Applications from experienced and capable Bidders for proposal in respect of the
Project(s)..

6.2 Eligible Bidders

6.2.1 The Bidder may be a single company or a group of maximum 4 companies (hereinafter referred to as
Consortium), coming together to implement the Project. The term Bidder used hereinafter would therefore
apply to both a single entity and/or a Consortium.

6.2.2 The Bidder should submit a Power of Attorney as per the format enclosed at Appendix 1A, authorizing
the signatory of the Application to commit the Bidder.

6.2.3 Applications submitted by a Consortium should comply with the following additional requirements:

a. Number of members in a consortium would be limited to maximum of 4;

b. The Application should contain the information required for each member of the Consortium

c. The purchaser of the RFQ CUM RFP document must be the Bidder itself or member of the consortium
submitting the application.

d. An individual Bidder cannot at the same time be member of a Consortium applying for this Project. Further,
a member of a particular Consortium cannot be member of any other Consortium applying for this Project;
an undertaking towards this end needs to be submitted by all members.

e. Members of the Consortium shall nominate one member as the Lead Member. The nomination shall be
supported by a Power of Attorney as per the format enclosed at Appendix 1B

f. Members of the Consortium shall enter into a Memorandum of Understanding (MOU) as per the format
enclosed at Appendix 10 and duly notarized for the purpose of making the Application and submitting a
Proposal. The MOU shall, inter alia:

i. Convey the intent to form a Special Purpose Vehicle with shareholding commitment(s) as stipulated in this
document, which would enter into the Concession Agreements and subsequently carry out all the
responsibilities as Concessionaire in terms of the Concession Agreement, in case the Concession to
undertake the Project is awarded to the Bidder.

ii. Clearly outline the proposed roles and responsibilities of each member in case of Consortium at each
stage,

iii. Commit the minimum equity stake as stipulated, and

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

iv. include a statement to the effect that all members of the Consortium shall be liable jointly severally for the
execution of the Project in accordance with the terms of the Concession Agreement

g. In case of consortium, the Lead Member shall hold at least 51% share in the shareholding.

h. The other members of the consortium shall hold a minimum of 11% share each in the shareholding.

6.2.4 Notwithstanding anything stated elsewhere in this document, ABUP shall have the right to seek updated
information from the Bidders to ensure their continued eligibility. Bidders shall provide evidence of their
continued eligibility in a manner that is satisfactory to ABUP. Bidder may be disqualified if it is determined
by the ABUP, at any stage of the process, that the Bidder will be unable to fulfil the requirements of the
Project or fails to continue to satisfy the Eligibility Criteria. Supplementary information or documentations
may be sought from Bidders at any time and must so be provided within a reasonable time frame as
stipulated by ABUP.

6.2.5 Any entity which has been barred or disqualified either by GOI or GOUP or their Departments or agencies
from participating in projects (BOT or otherwise) and such disqualification subsists as on the Application
date, would not be eligible to submit an Application, either individually or as member of a Consortium.
Bidder to submit an affidavit to this effect

6.3 Changes in Consortium Composition

6.3.1 No change in Consortium Members shall be allowed till the completion of the project or a minimum of 3
years (whichever is later). However, the Lead Consortium Member shall not be allowed to be changed over
the entire Concession Period and shall continue to hold 51% stake in the Consortium till the start of
Commercial Operations. The Lead Consortium Member shall be allowed to dilute the stake after the
commercial operations date with the approval of the Concessioning Authority such that the stake of the
Lead Consortium Member in the consortium shall not fall below 26% at any time till the end of Concession
Period.

6.4 Number of Applications

Each Bidder shall submit only one (1) Application in response to this RFQ cum RFP. Any Bidder, which submits or
participates in more than one Application will be disqualified and will also cause the disqualification of the
Consortiums / Bidder of which it is a member as the case may be.

6.5 Application Preparation Cost

The Bidder shall be responsible for all of the costs associated with the preparation of its Application and its
participation in the Selection process. ABUP will not be responsible or in any way liable for such costs, regardless of
the conduct or outcome of the qualification process.

6.6 Project Inspection and Site Visit

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6.6.1 It is desirable that each Bidder submits its Application after inspecting the sites; and ascertaining for itself
the location, surroundings, access, transport, right of way or any other matter considered relevant by it.

6.6.2 Site visit may be facilitated by ABUP. A prospective Bidder may notify ABUP in writing 3 days prior to
planned visit. ABUP would endeavour to facilitate the site visit depending upon the availability of the
concerned officials.

6.6.3 It would be deemed that by submitting the Application, Bidder has:

(a) Made a complete and careful examination of the RFQ CUM RFP and
(b) Received all relevant information requested from ABUP.

6.6.4 ABUP shall not be liable for any mistake or error on the part of the Bidder in respect of the above.

6.7 Right to Accept or Reject any or all Applications

6.7.1 Notwithstanding anything contained in this RFQ cum RFP, ABUP reserves the right to accept or reject
any Application and to annul the bidding process and reject all Applications / Proposals, at any time
without any liability or any obligation for such acceptance, rejection or annulment, without assigning any
reasons.

6.7.2 ABUP reserves the right to reject any Application if:

(a) At any time, a material misrepresentation is made or uncovered, or

(b) The bidder does not respond promptly and thoroughly to requests for supplemental information required for the
evaluation of the Application.

Such misrepresentation / improper response would lead to the disqualification of the Bidder. If the Bidder is a
Consortium, then the entire Consortium would be disqualified / rejected.

6.8 Contents of RFQ cum RFP Document

The RFQ cum RFP Document comprises the contents as given in the Table of Contents and would additionally
include any Addenda issued in accordance with the provisions of this Document.

6.9 Clarifications

Interested parties may address their queries relating to the RFQ cum RFP Document by email only at
awasbandhu@gmail.com with a mandatory copy to consultants at team-consultancy@darashaw.com. The queries
should reach the above latest by 1000 hrs on 25.06.2009.

ABUP would endeavour to respond to the queries by the date mentioned in the Schedule of Bidding Process. The
responses will be sent by fax/ email.

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6.10 Amendment of RFQ cum RFP

6.10.1 At any time prior to the deadline for submission of Application, ABUP may, for any reason,
whether at its own initiative or in response to clarifications requested by any Bidder, modify the
RFQ cum RFP Document by the issuance of an Addendum.

6.10.2 Any Addendum thus issued will be sent in writing to all those who have purchased the RFQ cum
RFP Document and shall also be uploaded on www.awas.up.nic.in

6.11 Language

The Application and all related correspondence and documents should be written in the English language.
Supporting documents and printed literature furnished by Bidder with the Application may be in any other language
provided that they are accompanied by appropriate translations of the pertinent passages in the English language
duly certified appropriately. Supporting materials, which are not translated into English, may not be considered. For
the purpose of interpretation and evaluation of the Application, the English language translation shall prevail.

6.12 Currency

The currency for the purpose of the Application shall be the Indian Rupee (INR). The conversion to Indian Rupees
shall be clearly indicated in the Appendix 4. In all such cases, the original figures in the relevant foreign currency and
the INR equivalent thereof must be given. The exchange rate(s) applied shall be clearly stated. The conversion to
Indian Rupees shall be based on the closing exchange rate published by the Reserve Bank of India as on 31st
December 2008. ABUP reserves the right to use any other suitable exchange rate for the purposes of uniform
evaluation for all Bidders.

6.13 Validity of Application

Applications shall remain valid for a period not less than 180 days from the Application Due Date. ABUP reserves the
right to reject any Application, which does not meet this requirement.

6.14 Format and Signing of Application

6.14.1 The Bidder would provide all the information as per this RFQ cum RFP Document. ABUP would
evaluate only those Applications that are received in the required format and are complete in all
respects.

6.14.2 The Bidder shall prepare one original of the documents comprising the Application and clearly
marked "ORIGINAL". In addition, the Bidder shall make two copies of the Application, clearly
marked "COPY". In the event of any discrepancy between the original and the copies, the original
shall prevail.

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6.14.3 The Application and its copies shall be typed or written in indelible ink and each page shall be
initialled and stamped by the Bidder. All the alterations, omissions, additions, or any other
amendments made to the Application shall be initialled by the person(s) signing the Application.

6.15 Sealing and Marking of Applications

6.15.1The First Envelope should be marked as Envelope A (original and copy) and shall contain:

a) Power of Attorney for the signing authority as per the format enclosed at Appendix 1A,

b) Power of Attorney for the Lead member of the consortium as per the format enclosed at Appendix
1B, in case of Consortium;

c) Bidder details (Appendix 2)

d) Application in the prescribed format (Appendix 3) along with supporting documents;

e) Completed Format for Experience as in Appendix 4 (BRS 1 to 2), along with supporting
documents.

f) Completed Format for Financial Capability Evaluation as in Appendix 5 (BRS3 &4) and Appendix
7, along with supporting documents.

g) Format of Anti collusion certificate as in Appendix 8.

h) Format of Project Undertaking as in Appendix 9A.

i) In case of a Consortium, an undertaking from each member of Consortium certifying that it is an


exclusive member of that particular consortium alone and not a member of any other consortium
nor an independent Bidder, bidding for this project and has submitted only one (1) Application in
response to this RFQ CUM RFP. (Appendix 9B)

j) MOU in case of a Consortium (Appendix 10);

k) Earnest Money Deposit


l) Letter of Undertaking for the success fee of 1% of the Project Cost net of taxes, and Consultancy
Fees as per Appendix-12
m) Letter of Acceptance as per Appendix-13
n) Letter of Commitment as per Appendix-14

o) Documentary evidence, if applicable, relating to experience of group companies/associates as per


clause 8.1.2.

6.15.2 The second Envelope should be marked as Envelope B and shall include:
Financial Proposal as per Appendix-15.

Please note that Awas Bandhu, UP retains the right to ask for any further information/ clarification during the Bid
Process.

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6.15.3 The Bidder shall also enclose in a separate envelope, enclosed in the outer envelope, a demand draft for
Rs 25,000/- (Rupees Twenty Five Thousand Only), through account payee Demand Draft in favour of
Awas Bandhu payable at Lucknow on any scheduled bank towards non refundable Document Fee.
Application unaccompanied by this demand draft will not be considered for evaluation and short-listing.

6.16 Submission of Bid

Both the Envelopes A and B shall be put together in one envelope and be sealed properly. The Bidder shall
seal the original and copy duly marking the envelopes as "ORIGINAL" and "COPY" the envelopes shall then be
sealed in an outer envelope superscribing RFQ cum RFP for DEVELOPMENT OF SUPER SPECIALTY
HOSPITAL IN KANPUR, UTTAR PRADESH and also the name(s) of bidder/consortium

The envelope shall be addressed to:

The Executive Director,


Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government Of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001 India
Tel: 0522-2237161 Fax:0522-2612098,
E-Mail: awasbandhu@gmail.com, Web: awas.up.nic.in

If the envelope is not sealed and marked as instructed above, ABUP assumes no responsibility for the misplacement
or premature opening of the contents of the Application submitted.

6.17 Application Due Date

Applications should be submitted before 1300 hours IST on the Application Due Date mentioned in the Schedule of
Bidding Process, at the address provided above in the manner and form as detailed in this RFQ cum RFP.
Applications submitted by either facsimile transmission, telex or e-mail will not be considered for evaluation and short
listing. However ABUP reserves the right to extend the Application Due Date and Time, at any time prior to opening
of RFQ cum RFP Applications; in such cases the applications received prior to such extension shall not be opened.
Further if the RFQ cum RFP document is materially modified along/during such extended period, the RFQ cum RFP
application received prior to extension shall be returned to the applicants and appropriate time shall be allowed for
resubmission of the Applications.

6.18 Late Applications

Applications received after the Application Due Date shall not be considered.

6.19 Modifications/ Substitution/ Withdrawal of Proposals


The Bidder may modify, substitute or withdraw its Proposal after submission, provided that written notice of the
modification, substitution or withdrawal is received by ABUP before the Proposal Due Date and time. No Proposal
shall be modified or substituted or withdrawn by the Bidder after the Proposal Due Date and time

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6.20 Evaluation of Application - Due Date

ABUP would open the Applications after 1400 hours IST on the Application Due Date mentioned in the Schedule of
Bidding Process, for the purpose of evaluation.

6.21 Evaluation of Application - Criteria

ABUP would subsequently examine and evaluate Applications in Accordance with the criteria set out in Section 8.

6.22 Evaluation of Application - Supporting Documents

ABUP reserves the right to call for supporting documentation to verify the data provided by Bidders, at any time
during the bidding process. The Bidder in such cases would need to provide the requested clarification / documents
promptly and within the stipulated time failing which the Bidder is liable to be disqualified at any stage of the bidding
process.

6.23 Evaluation of Application - Right to Reject

ABUP reserves the right to reject any Application if:

(a) At any time, a material misrepresentation is made or uncovered; or


(b) The Bidder does not respond promptly and thoroughly to requests for supplemental information required for the
evaluation of the Application.

6.24 Confidentiality
Information relating to the examination, clarification, evaluation, and recommendation for the short-listed Bidders
shall not be disclosed to any person not officially concerned with the process. ABUP will treat all information
submitted as part of Application in confidence and would require all those who have access to such material to treat
the same in confidence. ABUP will not divulge any such information unless it is ordered to do so by any authority that
has the power under law to require its disclosure.

6.25 Tests of responsiveness

6.25.1 Prior to evaluation of Applications, ABUP will determine whether each Application is responsive to the
requirements of the RFQ cum RFP. An Application shall be considered responsive if the Application:

a) is received by the Application Due Date (Clause 2.16) including any extension thereof pursuant to
Clause 2.17
b) is accompanied by MOU in case of a Consortium ( Appendix 10), if applicable, duly supported by
Board resolution and charter documents
c) contains information required as per Appendix 3, 4(BRS 1 to2), 5(BRS 3 to 4) and 7.
d) It is accompanied by Bid Document Fee of Rs. 25,000/-
e) It is accompanied by a valid Earnest Money Deposit ;
f) Letter of Undertaking for the Success fee of 1% of project cost (net of taxes) to the consultants
and Consultancy Fees as per Exhibit 10.
g) Letter of Acceptance as per Appendix-13

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h) Letter of Commitment as per Appendix-14


i) Contains all the documents which were to be submitted as per the provisions of Section 6.15 of this
Document.

ABUP reserves the right to reject any Application which is non-responsive and no request for alteration, modification,
substitution or withdrawal shall be entertained by ABUP in respect of such Applications.

6.26 Clarifications

To facilitate evaluation of Applications, ABUP may at its sole discretion, seek clarifications in writing from any Bidder
regarding its Application.

6.27 Qualification and Notification

After the evaluation of Applications, ABUP would announce a list of successful Bidders (Bidders) who meet
the Qualification Criteria. At the same time, ABUP would notify the other Bidders that their Applications
have been unsuccessful.

6.28 RFQ cum RFP Document

RFQ cum RFP Document contain the following:


Volume I - Instruction to Bidders
Volume II - Draft Concession Agreement, Technical Schedule
TEFR is available with the above documents for the reference of the bidder. However the bidder has to conduct his
own feasibility before submitting the bids.

6.29 Fees of the Consultants

Darashaw & Company Private Limited has been appointed as a Consultant to assist Awas Bandhu, UP in handling
the bid process management for the selection of the Successful bidder.

The Success Fee of 1% of the project cost exclusive of taxes at applicable rates has been agreed by Awas Bandhu
UP, to be paid to Darashaw & Company Private Limited for providing the above mentioned advisory services. The
Success Fee shall be net of all taxes (1% of Project Cost is net of all taxes).

Every bidder shall therefore submit along with the Proposal, an undertaking as per Appendix-12 for the Success
Fees of the Consultants (calculated at the rate of 1% of the project cost as mentioned in Section 5.4 of this RFQ cum
RFP document, plus taxes as applicable) and the Consultancy fees of Rs. 1, 00,000/- (Rupees One Lakh only) to be
reimbursed to Awas Bandhu, UP.

This success fee shall be paid in the form of a Demand Draft issued by a Bank in favour of Darashaw & Company
Private Limited. Such a Demand Draft shall be extendable for a further period of 6 months by replacing it with a fresh
Demand Draft after 5 months of its issue if required and asked by Awas Bandhu, UP due to delay in signing of

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Concession Agreement or otherwise beyond a period of 5 months from the date of issue of the said Demand Draft.
The Success Fee in the form of Demand Draft shall be handed over to Awas Bandhu, UP by the Successful Bidder
before the signing of the Concession Agreement. The successful bidder shall pay and deposit the amount of
withholding or other taxes to the credit of the relevant tax authorities and issue a certificate of deduction and payment
to Darashaw & Company Private Limited.

The Consultancy Fee of Rs. 1,00,000/- (Rupees One Lakh only) paid by Awas Bandhu,UP to the Consultants will be
reimbursed by the bidder to Awas Bandhu, UP within 2 weeks of signing the concession agreement between KDA
and Bidder, on receipt of invoice from Awas Bandhu, UP.

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7 Other Instructions

7.1 General Provisions

7.1.1 Non-Discriminatory and Transparent Bidding Proceedings

Awas Bandhu, UP shall ensure that the rules for the Bid Process for the Project are applied in a non-discriminatory,
transparent and objective manner. Awas Bandhu, UP shall not provide to any Bidder, information with regard to the
Project or the Bidding Process, which may have the effect of restricting competition.

7.1.2 Prohibition against Collusion with other Bidder

Each Bidder shall warrant by its Bid that the contents of its Bid have been arrived at independently. Any Bid which
has been arrived at through consultation, collusion, or understanding with any other prospective Bidder for the
purpose of restricting competition shall be deemed to be invalid and the Bidder shall lose its Earnest Money Deposit.
The anti-collusion certificate submitted at the time of submission of RFQ CUM RFP shall be applicable.

7.1.3 Inducements
Any effort by a Bidder to influence processing of Bids or award decision by Awas Bandhu, UP or any officer, agent or
Advisor thereof may result in the rejection of such Bidders Bid. In such a rejection of Bid, the Bidder shall lose its
Earnest Money Deposit.

7.2 Confidentiality
7.2.1 Awas Bandhu, UP shall treat all Bids and other documents, information and solutions submitted by Bidders
as confidential, and shall take all reasonable precautions that all those who have access to such material, treat this in
confidence. Awas Bandhu, UP will not divulge any such information unless it is ordered to do so by any authority,
which has the power to require its release.

7.2.2 Each Bidder shall, whether or not it submits a Bid, treat the RFQ cum RFP Documents and other
documents, information and solutions provided by Awas Bandhu, UP in connection with the Project or the bidding
proceedings as confidential for a period of five (5) years from the issuance of the RFQ cum RFP Documents. During
this period, the Bidder shall not disclose or utilize any such documents, information without the written approval of
Awas Bandhu, UP or as required by law or any governmental authority.

7.2.3 Awas Bandhu, UP shall have the right to release the Bid information provided by the Bidders to its Advisors for
the purpose of Bid evaluation and negotiations. Each Bidder shall have the right to release these RFQ cum RFP
Documents and other Documents to its advisors and to financial institutions for the purpose of Bid preparation,
negotiations and financing. Both Awas Bandhu, UP and the Bidder shall ensure that their Advisors and/ or financial
institutions treat this information in confidence.

7.2.4 Any information relating to examination, clarification, evaluation and comparison of bids and
recommendations for the award of a contract shall not be disclosed to Bidders or any other person not officially

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concerned with the Bid Process until the award to the Successful Bidder has been communicated, except of reasons
of public transparency.

7.3 Communication between Bidders and Awas Bandhu, UP


All communication, unless specified otherwise, on these RFQ cum RFP Documents to Awas Bandhu, UP shall be
addressed to:
The Executive Director,
Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001
Tel: 0522-2237161 Fax:0522-2612098,
E-Mail: awasbandhu@gmail.com
Web: http://awas.up.nic.in

All communication to the Bidder shall be sent to the Authorised Representative & Signatory at the addresses
mentioned in the covering letters to this RFQ cum RFP, unless Awas Bandhu, UP is advised otherwise.

7.4 Interpretation of Documents

Awas Bandhu, UP will have the sole discretion in relation to:


The interpretation of this RFQ cum RFP, the Proposals and any documentation provided in support of the
Proposals; and
All decisions in relation to the evaluation and ranking of Proposals, whether or not to request for any
clarifications or additional information from Bidder in relation to its Proposal and the selection of the
Successful Bidder.
Awas Bandhu, UP will have no obligation to explain its interpretation of this RFQ cum RFP, the Proposals or
their supporting documentation and information or to explain the evaluation process, ranking process or the
selection of the Successful Bidder.

7.5 Enquiries concerning the RFQ cumRFP / Draft Concession Agreement


7.5.1 Awas Bandhu, UP encourages a careful review of these RFP Documents and preparation of the
observations/ comments by the Bidder. The Bidder should send their comments in writing at least by 10.0
am 25th June 2009. Inquiries/ comments received after the set time limit may not be addressed by Awas
Bandhu, UP.
7.5.2 Awas Bandhu, UP at its discretion, may respond to inquiries submitted by any Bidder after the date of
submission. Such a response will be sent in writing to all the Bidders and will qualify as an Addendum.
7.5.3 All inquiries should be submitted to the Awas Bandhu, UP in writing by e-mail to
awasbandhu@gmail.com with a copy marked to team-consultancy@darashaw.com
7.5.4 No interpretation, revision or other communication regarding this solicitation is valid unless in writing and
is signed by an officer so designated by the Executive Director of Awas Bandhu, UP. Written copies of

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Awas Bandhu, UP responses, including a description of the inquiry but without identifying its source, will
be sent to all the Bidder(s) and will qualify as an Addendum

7.6 Amendment of RFQ cum RFP


7.6.1 On its own initiative or any further discussions with any/ all Bidder(s), Awas Bandhu, UP may at its own
discretion make changes in the technical/commercial parameters for the Project, which would be
common for all the Bidders. Such changes in the technical / commercial parameters of the Project will
qualify as an Addendum.
7.6.2 The Addendum will be posted on the website of Awas Bandhu, UP http://awas.up.nic.in and will be
binding on the bidders. Each such Addendum shall become part of the RFP Documents.
7.6.3 In order to offer prospective Bidders a reasonable time to take into account an Addendum while
preparing their Proposals, or for any other reason, Awas Bandhu, UP may, at its discretion, extend the
Proposal Due Date.

7.7 Submission of Bids

7.7.1 Document Fee


The Bidder shall submit Document Fee of Rs. 25,000/- (Rupees Twenty Five Thousand only) along with the
Proposal.
The Bid Document Fee shall be in the form of a Demand Draft in favour of Awas Bandhu, UP, payable at
Lucknow.
The Bid Document Fee is non-refundable.
Bids not accompanied by Bid Document Fee shall be rejected.

7.8 Bid Opening


All Bids received by Awas Bandhu, UP will remain sealed and unopened in Awas Bandhu, UPs possession
until the Proposal Due Date. Awas Bandhu, UP shall open all Bids, received on or prior to the Proposal Due
Date mentioned under Schedule of Selection Process or on any date as extended by Awas Bandhu, UP and
communicated to the bidders. The Bids shall be opened in the presence of Bidders representatives, who
choose to attend. Bidders representatives attending the Bid Opening shall register to evidence their
presence.

The following information will be announced at the Bid Opening and recorded:
Bidders names
Names of Consortium Members

After the Bid Opening, information relating to the examination, clarification and evaluation of Bids and
recommendations concerning the Bid Award shall not be disclosed.

7.9 Earnest Money Deposit

The Bidder shall submit an Earnest Money Deposit (EMD) for an amount of Rs.2,40,00,000/- (Rs. Two
Crores and Forty Lakhs only) along with its Proposal.

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The Earnest Money Deposit shall be in the form of a Bank Guarantee from SBI or any Nationalised Bank or
Indian Scheduled Commercial Bank whose networth is not less than Rs. 300 crores as on 31st March 2008.
The EMD shall be valid for a minimum period of 90 days more than Bid Validity Period. Upon any extension
of the Bid Validity Period, the validity of the EMD shall be extended by the corresponding period.
Awas Bandhu, UP shall have the right to reject the Proposal, which does not include the Earnest Money
Deposit as non-responsive.
The EMD of Unsuccessful Bidders, except the second successful bidder will be returned within a period of
ten (10) days from the date of acceptance of Letter of Intent by the Successful Bidder. However, the EMD of
second successful bidder shall be returned on signing of the concession agreement by the successful
bidder.
The EMD of the Successful Bidder shall be returned on submission of Performance Security by the
Successful Bidder to the Concessioning Authority.
In addition to the above, Awas Bandhu, UP will promptly release EMD of all the Bidders in the event Awas
Bandhu, UP decides to terminate the Bidding Process.
The EMD shall be forfeited by Awas Bandhu, UP, in any of the following case:
The Bidder withdraws his bid after the Proposal Due Date
Successful Bidder fails to accept Letter of Intent
Successful Bidder fails to submit the Performance Security or
As per the provisions of Draft Concession Agreement

7.10 Performance Security


The Successful Bidder shall for due and faithful performance of its obligations during the Project completion, provide
to KDA a performance security of Rs. 12,00,00,000/- (Rupees Twelve Crores only) in the form of Bank Guarantee (in
the format prescribed in the RFP) from SBI or any Nationalised Bank or Indian Scheduled Commercial Bank whose
networth is not less than Rs. 300 crores as on 31st March 2008.

The performance security shall be provided within 15 days of issue of Letter of Award by KDA. The Performance
Security shall be released to the Successful Bidder as per provisions of the Draft Concession Agreement as follow:

25% of the Performance Security in the form of bank guarantee shall be released to the Concessionaire on the
issuance of Construction Completion Certificate by the Concessioning Authority. The next 25% of the Performance
Security in the form of bank guarantee shall be released to the Concessionaire on the start of Commercial Operation.
The balance 50% of the Performance Security in the form of bank guarantee shall remain in force and effect beyond
the period of six months from the date of the expiry of the Concession Period It shall be duly discharged and released
to the Concessionaire beyond the period of six months from the date of the expiry of Concession Period and transfer
of the Super Specialty Hospital to KDA.

If the Agreement is terminated due to any event other than a Concessionaire Event of Default, the Performance
Security shall, subject to the Concessioning Authoritys right to receive or recover amounts, if any, due from the
Concessionaire under this Agreement, be duly discharged and released to the Concessionaire.

Upon occurrence of a Concessionaire Default, the Concessioning Authority shall, without prejudice to its other rights
and remedies hereunder or in law, be entitled to invoke and appropriate the relevant amounts from the Performance
Security as Damages for such Concessionaire Default. Upon such invocation and appropriation from the

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Performance Security, the Concessionaire shall, within 15 (fifteen) days thereof, replenish, in case of partial
appropriation, the Performance Security to its original level, and in case of appropriation of the entire Performance
Security provide a fresh Performance Security, as the case may be, and the Concessionaire shall, within the time so
granted, replenish or furnish fresh Performance Security as aforesaid failing which the Concessioning Authority shall
be entitled to terminate this Agreement in accordance with Article 13 of the Concession Agreement.

In case the successful bidder fails to furnish the Performance Security within the stipulated time as mentioned herein,
the LOA shall stand void and LOI may be issued to the second successful bidder.

7.11 Sources of Funds

The responsibility to raise funds for the Project would rest with the Successful Bidder.

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8 DESCRIPTION OF THE SELECTION PROCESS


8.1 CRITERIA FOR EVALUATION

8.1.1 Evaluation Parameters

The Bidder's competence and capability is proposed to be established by the following parameters:

(a) Technical Experience


(b) Financial capability factor, in terms of:
i. Turn over
ii. Net worth
iii. Operating Profit

8.1.2 On each of these parameters, the Bidder would be required to meet the evaluation criteria as detailed in this
Section . Bidders meeting all the criteria only will be qualified for further evaluation of the Proposal.

8.1.2 Eligible Experience

Technical Experience

For the purpose of this RFQ cum RFP, the applicant which could be single entity or the consortium shall be evaluated
on the following:

(i) Development or construction of core infrastructure projects (either individually or as a consortium


member) each having a minimum project cost of Rs 30 croress
(ii) Development or construction of similar Infrastructure projects ( either individually or as a
consortium member) each having a minimum project cost of Rupees 25 crores

Eligible project:
a) Projects awarded/awarded and under execution/completed during the last seven financial years, not
before 31st March 2001, shall only be considered.
b) Only eligible projects should be considered for category (i) above for estimation of the technical
experience. An eligible project would have minimum project cost of at least Rupees 30 crores. For such
category (i) evaluation, core infrastructure projects would mean national highways and expressway,
airports, refineries and pipelines thereof, railways, ports, power, telecom, industrial parks, SEZs, Group
Housing and Integrated/Hi-tech Township.
c) More weightage will be given to experience of similar kind of infrastructure projects or category (ii)
above than to experience of infrastructure projects. Similar kind of Infrastructure: Hospitals and medical
institutions of 100 or more beds.
d) Experience as a consortium member will be considered in proportion to the equity holding in the project
at the time of execution /construction of the Project.

Documentary evidence in the form of a CA certificate (Appendix 4) must be submitted along with the proposal:

a) a certificate from the appropriate authorities of respective clients should be submitted in support of the
above in case of completed projects.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

b) Relevant pages of the Contract Agreement in projects which are awarded and under execution as per
clause 8.1.2 (a). Relevant pages shall mean the Preamble of this CA detailing the Parties and the last
pages detailing the signatories.
c) A copy of the Work Order/Letter of Award in cases where the work has been awarded within three
months before the RFQ CUM RFP application due date.

8.1.3 Details of Experience

The Bidder should furnish details of technical experience as on the date of submission of RFQ cum RFP as per
Appendix 4, Bid Response Sheet No. 1.

The Bidder must provide the necessary project specific information as per Appendix 4, Bid Response Sheet No. 2.

8.1.4 Financial Capability

The financial capability of the bidder / consortium will be evaluated on the basis of

(a) Turnover
(b) Net Worth and
(c) Operating Profit

The Bidders should provide information regarding the above based on audited annual accounts.

The Application must be accompanied by the audited Balance Sheet and Profit and Loss Account of the Bidder (of
each member in case of a consortium) as per Appendix 5 for the last three (3) Financial Years not prior to 2004-05.

8.1.5 Evaluation Criteria for Financial Capability

For the purpose of Qualification, the applicant a single entity or a consortium should demonstrate the Threshold
Financial Capability measured on the following criteria:

1. Minimum Turnover of Rs. 80 crores in each of the last three financial years not earlier than 2004-05
2. Minimum Net worth of Rs. 50 Crores as on 31st March 2008 as certified by Chartered Accountant.
3. Annual Operating Profit for 3 out of last 5 years not prior to 2002-03 should be positive.
4. Single entity bidder and all members of the consortium, if applicable, should be profit-making concerns for
the last 3 yrs not prior to 2004-05.

8.1.6 Special Conditions for a Consortium

In case the Bidder is a Consortium, turnover, net worth and operating profit would be taken as an arithmetic
sum of net worth, turnover and operating profit of each member of the Consortium, calculated in the ratio of
their stake in the consortium/JV. The Consortium would be required to meet the threshold criteria on the
basis of aggregate figures subject to provisions of this Clause.

8.1.7 Evaluation methodology

The technical and financial capacity of the bidder will be evaluated as per following:

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

S.No Criteria Marks Marking System


1. Technical criteria 65%
1a. Core infrastructure 30 marks Number of eligible 3 marks for initial
projects 15 project and 1.5
marks marks for every
addl project.
Cumulative cost- 1.5 marks for
15 marks initial Rs 30
crores and 0.75
marks for every
addl. comleted
Rs. 30 crs. or 0.50
marks for every
other addl. Rs. 30
crs.
1b. Similar infrastructure 35 marks Number of eligible 4 marks for initial
projects 20 project and 2
marks marks for every
addl project.
Cumulative cost- 3 marks for initial
15 marks Rs 25 crores and
2 marks for every
completed addl
Rs. 25 crs or 1.5
marks for every
other addl. Rs. 25
crs.
2 Financial criteria 35%
2a. Networth 15 marks 10 marks for the
initial Rs 50
crores and 5
marks for addl Rs.
50 crs
2b. Turnover 10 marks 7 marks for the
initial Rs 80
crores and 3
marks for addl Rs
80 crs
2c. Average Operating 10 marks 10 marks if it is
Profit positive for 3 out
of last 5 years not
prior to 2002-03

8.1.8 For evaluation of technical experience as per clause 8.1.2 and of financial capability as per clause 8.1.5, the
financial and technical capabilities of the group companies/associates shall also be considered (for Projects
costing Rs.200.00 cr or more). For these purposes group companies/associates shall mean the following
For the purposes hereof, associate means, in relation to the applicant/consortium member a person who
controls and is controlled by or is under the common control with such applicant/consortium member. As

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used in this definition, the expression control means, with respect to a person, which is company or
corporation, the ownership, directly or indirectly of more than 50% of the voting shares of such person, and
with respect to a person which is not a company or corporation, the power to direct the management and
policies of such a person, whether by operation of law or by contract or otherwise.

In case the RFQ CUM RFP applicant claims the technical and/or financial capacity of its group
companies/associates, the applicant shall necessarily submit documentary evidence in proof of such claims.
Such documentary evidence shall consist of CA certificates to support such capacity and also to establish
requisite Control relationship as defined in 8.1.8 above.

8.1.9 The scores for the technical and financial capacity evaluated as per clause 8.1.7 shall be added to arrive at
combined score of each applicant against maximum total marks of 100. Applicants scoring 50% or more in
the combined scores shall be eligible to be shortlisted for opening of Financial Proposal.

8.2 Evaluation of Financial Proposal (Assessment of Envelope B)

Financial Proposal of the Bidders only who have secured 50 % or more marks (Clause 8.1.7) on the evaluation of
envelope A would be evaluated. The evaluation criteria for assessment of the Financial Proposals are described in
Section 10 of this RFQ cum RFP. In case of ambiguity between the amount in words and figures the former shall
prevail.

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9 RULES REGULATING THE CONSORTIUM


The objective of this stage is to outline the Rules regarding the Consortium. The Envelope A shall contain the
information in respect of the Bidder/Consortium as per Clause 6.15 of this RFP document. Following are the rules
which shall guide the operation of the Consortium:

9.1 Consortium of Bidders

9.1.1 Rules Regulating the Participation of a Consortium of Companies

Awas Bandhu, UP may also consider a bid submitted by a consortium of companies subject to the following
conditions:
1. The Consortium Members should not exceed four.
2. The foreign construction company / Developer may apply directly for the project or in association
with Indian Partner subject to the prevailing GoI, FDI and Indian Laws.
3. The members of the Consortium must form a Special Purpose Vehicle (SPV) and submit an MoU
to that extent as per Clause 9.1.3 below.
4. The commercial arrangements and roles and responsibilities between the consortium partners
should be specified in Memorandum of Understanding and duly executed copy of MOU should be
submitted along with the proposal. The MOU to be entered into between the Consortium Members
as per Appendix 10 of this RFP Document shall reflect the above.
5. The members of the consortium shall designate among themselves one member as Lead
Consortium Member.
6. Lead Consortium Member shall hold a minimum of 51% equity in the SPV and each of the other
Consortium Member shall hold a minimum of 11% in the SPV.
7. The Members of the Consortium shall execute Power of Attorney as per the format enclosed in
Appendix 1B of RFQ cum RFP Document.
8. A bidder who has applied for a project in its individual capacity or as a part of a consortium cannot
participate as a Member of any other Consortium applying for this Project.

9.1.2 Change in Composition of Consortium

No change in Consortium Members shall be allowed till the completion of the project or a minimum of 3 years
(whichever is later). The Lead Consortium Member shall not be allowed to be changed over the entire Concession
Period and shall continue to hold 51% stake in the Consortium till the start of Commercial Operations. However, the
Lead Consortium Member shall be allowed to dilute the stake after the commercial operations date with the approval
of the Concessioning Authority such that the stake of the Lead Consortium Member in the consortium shall not fall
below 26% at any time till the end of Concession Period.

9.1.3 Other Conditions in Respect of Consortium

Each Consortium Member shall have a minimum of 11% stake in the SPV formed. None of the Consortium Member
shall be allowed to dilute its stake till the completion of the project or a minimum of 3 years (whichever is later).

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Lead Consortium Member shall invest minimum 51% of the equity towards the project. Lead Consortium Member
shall not be allowed to dilute its stake to a level below 51% till the start of Commercial Operations. The Lead
Consortium Member shall be allowed to dilute the stake after the commercial operations date with the approval of the
Concessioning Authority such that the stake of the Lead Consortium Member in the consortium shall not fall below
26% at any time till the end of Concession Period.

Any change in Consortium members may be allowed only if equal or better replacement is there. However, any
change in consortium shall be at the discretion of the Concessioning Authority.

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10 METHODOLOGY & CRITERIA FOR EVALUATION OF FINANCIAL BID


(ENVELOPE B)

10.1 Financial Proposal Evaluation

This part of the Request for Qualification cum Request for Proposal provides information on the
methodology that will be used to evaluate the Financial Proposals received.

The Project will be awarded to such Eligible Bidder, which submits a responsive Bid and offers to enter into
a Draft Concession Agreement on the best financial terms with KDA.

These RFQ cum RFP Documents stipulate the minimum qualification for the Project. These RFQ cum RFP
Documents may be amended or technical and financial parameters of the Project may be changed by Awas
Bandhu, UP by issue of an Addendum. Such an Addendum will form part of these RFQ cum RFP
Documents and would be common for all the Bidders. Bid Evaluation Committee reserves the right to reject
the Proposals, which do not conform to the provisions stipulated in the RFQ cum RFP Documents.

Financial Proposal of only the Bidders who have achieved on 50% or more marks after evaluation of
Envelope A, would be opened and evaluated. The Financial Proposals of the non-responsive Bidders would
be returned to the respective Bidders unopened.

Bid Evaluation Committee shall evaluate and submit its recommendations to the competent authority.

10.1.1 Responsiveness of Financial Proposal

BEC through Awas Bandhu, UP will open Envelope B of only who have achieved on 50% or more marks
after evaluation of Envelope A as per Section 8.1.7 of this document. Any bid containing caveats/ deviations
from RFQ cum RFP Documents is liable to be rejected by BEC/ Awas Bandhu, UP.
Bidders shall be ranked as per the percentage revenue quoted that will be shared with the Concessioning
Authority beginning from the eleventh year of signing of the agreement. The proposal of the bidder quoting
the highest percentage revenue sharing shall be considered as the proposal having highest financial score.
The proposal with highest financial score would be ranked first.

10.1.2 Determination of Preferred Bidder

Awas Bandhu, UP shall issue a Letter of Intent to the Successful Bidder after obtaining approval from the
Competent Authority which needs to be accepted within 7 days of issuance of Letter of Intent.
KDA shall issue a Letter of Award (LOA) after getting the approval of the Board to the successful bidder
within 7 days of issuance of LOI by Awas Bandhu, UP.
The Successful Bidder shall enter into Concession Agreement with KDA for the implementation of the
project within 30 days of issuance of LOA.
The successful Bidder shall be required to give performance security before signing of the Concession
Agreement within 30 days of issue of Letter of Award. If the Successful Bidder fails in entering into contract
(Concession Agreement) as required without giving the required clarifications to the satisfaction of Awas

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Bandhu UP, Awas Bandhu UP reserves the right to begin negotiations with the next highest ranked Bidder
and so on.

Awas Bandhu, UP also reserves the right to reject any Proposal if:
- At any time, a material misrepresentation is made or uncovered, or
- The Bidder does not respond promptly and thoroughly to the requests for supplementary
information required for evaluation of the Proposal.
- The Proposal deviates from the commercial parameters of these RFP Documents.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDICES

APPENDIX 1A FORMAT FOR POWER OF ATTORNEY FOR SIGNING PROPOSAL


(On a Stamp Paper of appropriate value)

POWER OF ATTORNEY

Know all men by these presents, we ____________ (name and address of the registered office) do hereby
constitute, appoint and authorize Mr./Ms. _____________________ (name and address of residence) who is
presently employed with us and holding the position of __________________ as our attorney, to do in our name and
on our behalf, all such acts, deeds and things necessary in connection with or incidental to our proposal for Super
Specialty Hospital in Kanpur on Design, Build, Finance, Own and Operate (DBFOO) basis in the state of Uttar
Pradesh, including signing and submission of all documents and providing information/ responses to Awas Bandhu,
Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh, (ABUP), representing us in all
matters before GOUP, and generally dealing with ABUP in all matters in connection with our proposal for the said
Project.

We hereby agree to ratify all such acts, deeds and things lawfully done by our said attorney pursuant to this Power of
Attorney and that all such acts, deeds and things lawfully done by our aforesaid attorney shall and shall always be
deemed to have been done by us.

For ------------------------

(Signature)
(Name, Title and Address)
Accepted

________________ (Signature)
(Name, Title and Address of the Attorney)

Company seal & stamp

Notes:
1. To be executed by the sole Bidder or the Lead Member in case of a Consortium duly supported .by a Board Resolution

2. The mode of execution of the Power of Attorney should be in accordance with the procedure, if any, laid down by the applicable law and
the charter documents of the executant(s) and when it is so required the same should be under common seal affixed in accordance with
the required procedure.

3. Also, where required, the executants(s) should submit for verification the extract of the charter documents and documents such as a
resolution / power of attorney in favour of the Person executing this Power of Attorney for the delegation of power hereunder on behalf of
the Bidder.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX 1B FORMAT FOR POWER OF ATTORNEY FOR LEAD MEMBER OF CONSORTIUM


(On a Stamp Paper of appropriate value)

POWER OF ATTORNEY

Whereas Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh.,
(ABUP) has invited Proposals from interested parties for the Super Specialty Hospital in Kanpur on Design, Build,
Finance, Own and Operate (DBFOO) basis ("the Project").
Whereas, the members of the Consortium are interested in bidding for the Project and implementing the Project in
accordance with the terms and conditions of the Bid Document and other connected documents in respect of the
Project, and
Whereas, it is necessary under the Bid Document for the members of the Consortium to nominate one of them as the
Lead Member with all necessary power and authority to do for and on behalf of the Consortium, all such acts, deeds
and things as may be necessary in connection with or incidental to the Consortiums proposal for the Project.
NOW THIS POWER OF ATTORNEY WITNESSETH THAT:
We, M/s. _________________, and M/s. ________________ (the respective names and addresses of the registered
office) do hereby constitute, appoint and authorize M/s. __________________________ as the Lead Member of the
Consortium and as our attorney, to do on behalf of the Consortium, all or any of such acts, deeds or things as may be
necessary in connection with or incidental to the Consortiums proposal for the Project, including submission of
application/ proposal, participating in conferences, responding to queries, submission of information/ documents and
generally to represent the Consortium in all its dealings with Awas Bandhu, Uttar Pradesh, Housing & Urban
Planning Department, Government Of Uttar Pradesh., (ABUP), or any other Government Agency or any person, in
connection with the Project until culmination of the process of bidding and thereafter till the Concession Agreement is
entered into with Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar
Pradesh., (ABUP).
We hereby agree to ratify all such acts, deeds and things lawfully done by Lead Member as our said attorney
pursuant to this Power of Attorney and that all acts deeds and things lawfully done by our aforesaid attorney shall
and shall always be deemed to have been done by us/Consortium.
Dated this _______ Day of ________ 200_.
(Executants)
(To be executed by all the members of the Consortium)
Company seal & stamp
Note:

1. The mode of execution of the Power of Attorney should be in accordance with the procedure, if any, laid down by the applicable law
and the charter documents of the executant(s) and when it is so required the same should be under common seal affixed in
accordance with the required procedure.

2. The executant(s) should submit for verification the extract of the charter documents and documents such as Board Resolution and
Power of Attorney in favour of the person executing this Power of Attorney in favour of the Lead Member.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX 2 DETAILS OF BIDDER


1. (a) Name
(b) Country of Incorporation
(c) Address of the corporate headquarters and its branch office (s), if any, in India
(d) Date of incorporation and / or commencement of business

2 Brief description of the Company including details of its main lines of business and proposed roles
and responsibilities in this Project.

3 Name, Designation, Address and Phone Nos. of Authorized Signatory of the Bidder
(a) Name:
(b) Designation:
(c) Company:
(d) Address:
(e) Telephone No:
(f) E-mail Address:
(g) Fax No:

4 Details of individual (s) who will serve as the point of contact / communication for ABUP, within the
Company
(a) Name:
(b) Designation:
(c) Address:
(d) Telephone No.
(e) E-mail address:
(f) Fax No.

5 In case of Consortium:

(a) The information above (1-4) should be provided for all the Members of the Consortium
(b) Information regarding role of each Member should be provided as per table below:

Sl. No. Name of Member Role of the Member*


1
2

Specify whether Lead Member, Associate Member

(Signature of Authorised Signatory)

Company seal & stamp

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX 3 FORMAT FOR LETTER OF APPLICATION


[On the Letter Head of the Bidder (in case of Single Bidder) or Lead Member (in case of a Consortium)]

Date: ------------

The Executive Director,


Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government Of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001 India

Super Specialty Hospital in Kanpur on Design, Build, Finance, Own and Operate (DBFOO) basis

Sir,

Being duly authorized to represent and act on behalf of _________________ (hereinafter referred to as "the Bidder"),
and having reviewed and fully understood all of the qualification requirements and information provided, the
undersigned hereby expresses its interest and apply for qualification for the Super Specialty Hospital in Kanpur.

We are enclosing our Proposal, in one Original and two Copies, with the details as per the requirements of the Bid
Document, for your evaluation.

The undersigned hereby also declares that the statements made and the information provided in the Proposal are
complete, true and correct in every detail.

We confirm that the application is valid for a period of 180 days from the due date of submission of application and
unconditional.

We hereby also confirm the following:

1. The Proposal is being submitted by (name of the biding Company/Lead Consortium member) who is the
Bidding Company/the Lead Consortium Member of the Bidding Consortium Comprising (mention the names
of the entities who are the Consortium Members), in accordance with the conditions stipulated in the RFP.
2. As the Bidding Company/Lead Consortium Member (in case of a Bidding Consortium), we hereby confirm to
abide by the roles and responsibilities assigned to us as per the MoU between the Consortium Members
and as outlined in this RFP.
3. We have examined in detail and have understood the terms and conditions stipulated in the RFP Document
issued by Awas Bandhu, UP and in any subsequent communication sent by Awas Bandhu, UP. We agree
and undertake to abide by all these terms and conditions. Our Proposal is consistent with all the
requirements of submission as stated in the RFP or in any of the subsequent communications from Awas
Bandhu, UP.
4. We confirm that there are no conditions in Envelope B: Financial Proposal.
5. The information submitted in our Proposal is complete, is strictly as per the requirements stipulated in the
RFP, and is correct to the best of our knowledge and understanding. We would be solely responsible for any
errors or omissions in our Proposal.
6. We confirm that we have studied the provisions of the relevant Indian laws and regulations required to
enable us to prepare this Financial Proposal and as required to Design, Build, Finance, Own and Operate
Super Specialty Hospital in Kanpur, in the event that we are finally selected.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

7. We confirm that all the terms and conditions of the Proposal are firm and valid for acceptance for a period of
180 days from the Proposal due date.

Our PAN number is -----------------


Our TAN number is -----------------

Thanking You,

Yours Sincerely,

For and on behalf of : (name of the Bidding Company / Lead Consortium Member and the Company Seal)

Signature : (Authorised Representative & Signatory)

Name of the Person :

Designation :

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX 4 INFORMATION RELATED TO EXPERIENCE

GUIDELINES

1. Member Code : NA= Not Applicable in case of a single entity Bidder, LM =Lead member, AM= Associate
Member

2. The Chartered Accountant issuing the certification for Experience of the Bidder must hold a valid Certificate
of Practice.

3. Any Bidder consisting of a Single Entity should fill in details as per the row titled Single Entity Bidder and
ignore the other rows mentioned below. In case of a Consortium, the details need to be provided as per the
lower rows and the row titled Single Entity Bidder may be ignored.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

FORMAT FOR ESTABLISHING EXPERIENCE OF BIDDER

BID RESPONSE SHEET 1

Project Date of

Authority for whom

Equity holding at the


Type: Similar or core

time of execution/
Name of the Project

Estimated Marks
Cost Rs. crores
infrastructure

Commence-

construction
Completion

carried out
Location

Award
S.No

ment
Tota
l

Note:
1. Only the eligible projects that satisfy technical criteria shall be included.
2. All the Financial numbers are to be given in INR
3. The format shall be filled up for each member of the consortium and as a cumulative experience for the consortium

(Signature of Authorised Signatory)

Company seal & stamp

Signature , Name, Address and Membership No. of Chartered Accountant

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Bid Response Sheet 2

Member Code:
Name of Bidder:
Category:
1. Name of Contract
Country
2. Name of Employer
3. Employers address, telephone and fax no.)
4. Role (strike out whichever is not applicable)
Developer/Prime contractor/ Subcontractor

5. Value of the Total Contract (in specified currencies and INR)


6. Value of the Bidders Contract (in specified currencies and INR)
7. Certified Billings till date (in specified currencies and INR and exchange rate)
8. Date of Award
9 Date of Commencement of Project/ Contract
10. Date of Completion/ Commissioning

(Signature of Authorised Signatory)

Company seal & stamp

Instructions

1. Information provided in this section is intended to serve as a back up for information provided in accordance
with Appendix 4, Bid Response Sheet 1.

2. The Projects cited must comply with the eligibility criteria specified in Clause 8.1.

3. A separate sheet should be filled for each of the Eligible Projects.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX 5 FORMAT FOR ESTABLISHING FINANCIAL CAPABILITY OF THE BIDDER

Bid Response Sheet 3


Format for Financial Capability of Single Entity Bidder

Turnover, Net Worth and Operating Profit

Net Worth Operating Profit Turnover


(Rs. Crores ) (Rs. Crores) ( Rs. Crores)
As on 31.3.08 Year Year Year Year Year Year

(Signature of Authorised Signatory)

Company seal & stamp

Signature , Name, Address and Membership No. of Chartered Accountant

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

BID RESPONSE SHEET 4


Format for Financial Capability of Consortium

Turnover, Net Worth and Operating Profit

Net
Turnover Worth Operating Profit
( Rs Crores) (Rs. (Rs. crores)
Equity Crores)
Bidder Type
share (%) Year Year year As on Year Year Year Total
31st CA
March
2008
Consortium
Member 1
Consortium
Member 2
Consortium
Member .
Total

Aggregate Turnover = Rs ---------------- crores


Aggregate Net worth = Rs ________ crores
Average Operating Profit = Rs ________ crores (Positive / Negative)

(Signature of Authorised Signatory)

Company seal & stamp

Signature , Name, Address and Membership No. of Chartered Accountant

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APPENDIX- 6 (INTENTIONALLY LEFT BLANK)

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APPENDIX 7 GUIDELINES FOR PROVIDING INFORMATION RELATED TO FINANCIAL CAPABILITY

1. The Bidder should provide the Financial Capability based on its own audited financial statements. Financial
capability of the Bidder's parent company or its subsidiary or any associate company (who are not Members of
the Consortium) will not be considered for computation of the Financial Capability of the Bidder.

2. Member Code LM = Lead member, AM = Associate Member

3. Instructions for calculation of Financial Capability:

(a) Operating Profit = (Profit After Tax + Interest + Tax)

(b) Net Worth = Subscribed and Paid-up Equity (including Share Premium, if any) + Reserves - Revaluation
Reserves - Miscellaneous expenditure not written off-Deferred Revenue Expenditure-Deficit in Profit & Loss
Account

(c) The financial year would be the same as followed by the Bidder for its annual report. Year 1 will be the last
Financial Year. Year 2 shall be the year immediately preceding Year 1.

(d) The Bidder shall provide audited Annual Reports as required under this Bid Document. For a Consortium,
audited Annual Reports of all Members shall be provided.

(e) In case of a Consortium comprising of members with holdings in each other, the cross holdings between the
group companies comprising part of the Consortium will be deducted for the purpose of Net Worth
calculations.

4. Financial details of the Bidder. If the Bidder is a consortium the Financial Details of all the members. The
Financial Details should be provided in the following manner.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Name of Member: Role of Member:

SN Particulars as per the Audited Year 3 Year 2 Year 1 TOTAL


Balance Sheet

1 Profit After Tax (PAT)


2 Depreciation
3 Other non-cash expenditure
4 Subscribed and Paid up Equity
5 Reserves
6 Revaluation reserves
7 Miscellaneous expenditure not
written off
8 Deferred Revenue Expenditure
9 Deficit in Profit & Loss Account
10 Interest Expense
11 Tax
12 Operating Profit = (1+10+11)
13 Net Worth = (4+5-6-7-8-9)

(Signature of Authorised Signatory)

Company seal & stamp

Signature , Name, Address and Membership No. of Chartered Accountant

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX 8 FORMAT FOR ANTI-COLLUSION CERTIFICATE


[To be submitted on the letter heads of the bidders separately]
Anti-Collusion Certificate

Date: ------------
The Executive Director,
Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government Of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001 India

Sub: Super Specialty Hospital in Kanpur on Design, Build, Finance, Own and Operate (DBFOO) basis

Sir,

We hereby certify and confirm that in the preparation and submission of this Bid, we have not acted in concert or
in collusion with any other Bidder or other person(s) and also not done any act, deed or thing which is or could
be regarded as anti-competitive, restrictive or monopolistic trade practice.

We further confirm that we have not offered nor will offer any illegal gratification in cash or kind to any person or
agency in connection with the instant Bid.

Dated this ______________ Day of ________________, 200_

Name of the Bidder


Signature of the Authorised Person

Note:
To be submitted by each Member in case of Consortium.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX 9A FORMAT FOR PROJECT UNDERTAKING


[To be submitted on the letter heads of the bidders separately]

The Executive Director,


Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government Of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001 India

Super Specialty Hospital in Kanpur on Design,Build, Finance, Own and Operate (DBFOO) basis

Sir,

We have read and understood the Bid Document in respect of the captioned project provided to us by the Executive
Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh

We hereby agree and undertake as under:

(a) Notwithstanding any qualifications or conditions, whether implied or otherwise, contained in our Bid we
hereby represent and confirm that our Bid is unqualified and unconditional in all respects.

(b) We are not barred by the Government of India or the Government of Uttar Pradesh or their Departments or
Agencies from participating in any projects (DBFOO or otherwise).

Dated this ___________________ Day of _______________, .

Name of the Bidder


_________________________________
Signature of the Authorised Person

Company seal & stamp

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX 9B FORMAT FOR PROJECT UNDERTAKING [In case of Consortium]


[To be submitted on the letter heads of the bidders separately]

The Executive Director,


Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government Of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001 India

Super Specialty Hospital in Kanpur on Design, Build, Finance, Own and Operate (DBFOO) basis

Sir,

We have read and understood the Bid Document in respect of the captioned project provided to us by the Executive
Director, Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government Of Uttar Pradesh
We hereby agree and undertake to be an exclusive member of the consortium and not a member of any other
consortium nor an independent Bidder, bidding for this project and has submitted only one (1) Application in
response to this RFQ CUM RFP

Dated this ___________________ Day of _______________, .

Name of the Bidder


_________________________________
Signature of the Authorised Person

Company seal & stamp

RFQ cum RFP Volume I- Instruction to Bidder Page 50


RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX 10 FORMAT FOR MEMORANDUM OF UNDERSTANDING (MOU)


(On Non judicial stamp paper of Rs 100/- or such appropriate document duly attested by notary public)

This Memorandum of Understanding (MOU) entered into this _____day of _______ 2008 at ______ Between
_______________(hereinafter referred as________) and having office at _______, India Party of the First Part
And
________(hereinafter referred as__________) and having office at ____________, India Party of the Second
Part

The parties are individually referred to as Party and collectively as Parties.

WHEREAS Awas Bandhu, Uttar Pradesh, Housing & Urban Planning Department, Government of Uttar Pradesh,
(ABUP) has invited RFQ cum RFP from entities interested in Super Specialty Hospital in Kanpur Project

AND WHEREAS the Parties have had discussions for formation of a Consortium for bidding for the said Project and
have reached an understanding on the following points with respect to the Parties rights and obligations towards
each other and their working relationship.

IT IS HEREBY AS MUTUAL UNDERSTANDING OF THE PARTIES AGREED AND DECLARED AS FOLLOWS:

1. That the Parties will form a Special Purpose Vehicle (SPV) with the shareholding commitments expressly
stated. The said SPV shall not undertake any other business during the Concession Period, to domicile the
Project prior to the start of implementation of the Project.

2. That the equity share holding of the Parties in the issued and paid up capital of the SPV shall not be less
than as Specified Under Evaluation Criteria Mentioned in RFQ CUM RFP Document during the Concession
Period.

3. That M/s____________, and M/s____________, who are Members of the Consortium commit to hold the
following equity stake in the SPV which are in line with the requirements of Clause 3 of Evaluation criteria of
the RFQ Document at all times during the Lease Period
Name of Member Type of Member % of shareholding

1. M/s.

2. M/s.

4. That any dilution in the equity holding by the Parties in the SPV shall be as per the provisions of the
Concession Agreement that will be executed on award of the Project to us.

5. However the parties undertake that there shall be no change in respect of the lead member in case of a
consortium till the execution of the concession agreement.

6. That the Parties shall carry out all responsibilities as Concessionaire in terms of the Concession Agreement.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

7. That the roles and the responsibilities of each Party at each stage of the Bidding shall be as follows:

Name of Member Type of Member Role & Responsibility


1. M/s.
2. M/s.

8. That the Parties shall be jointly and severally liable for the execution of the Project in accordance with the
terms of the Concession agreement to be executed on award of the Project.

9. That the Parties affirm that they shall implement the Project in good faith and shall take all necessary steps to
see the Project through expeditiously. They shall not negotiate with any other party for this Project.

10. That this MOU shall be governed in accordance with the laws of India and courts in Lucknow shall have
exclusive jurisdiction to adjudicate disputes arising from the terms herein.

In witness whereof the Parties affirm that the information provided is accurate and true and have caused this MOU to
be duly executed on the date and year above mentioned.

Witness:

1. First Party
2. Second Party

Company seal & stamp

RFQ cum RFP Volume I- Instruction to Bidder Page 52


RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX-11 (INTENTIONALLY LEFT BLANK)

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX-12 CONSULTANCY AND SUCCESS FEE COMMITMENT TO DARASHAW & COMPANY


PRIVATE LIMITED
The Executive Director,
Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001
Uttar Pradesh

Sub: Commitment to pay the Success Fee and Consultancy Fee to Darashaw & Company Private
Limited

Sir,

We ___________( the Member), /[ our consortium consisting of the following members ( the Member)]

1 [Lead party]
2 [ ]
3 [ ]

Have /[Has] submitted our/ [its] Bid for the development of Super Specialty Hospital in Kanpur on Design Build
Finance Own and Operate basis in Kanpur.

We hereby write to inform you that if the Single Entity / Consortium is selected as the successful bidder for
implementing the project, the Concessionaire shall pay Darashaw & Company Private Limited a Success fee
at the rate of 1% of the cost of the project (clause 5.4). The Demand Draft in favour of Darashaw & Company
Private Limited for the said fee shall be handed over to Awas Bandhu UP before the signing of the Concession
Agreement.

The Consultancy Fee of Rs. 1,00,000/- (Rupees One Lakh only) paid by Awas Bandhu to the Consultants will be
reimbursed to Awas Bandhu, UP within 2 weeks of receipt of invoice from Awas Bandhu, UP.

SIGNATURE _____________

NAME _____________

DESIGNATION _____________

COMPANY SEAL COMPANY ______________

DATE _______________

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX-13 FORMAT OF LETTER OF ACCEPTANCE

(The Letter of Acceptance is to be submitted by EACH Consortium Member of the Bidding Consortium)

Date:
Place:

The Executive Director,


Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001
Uttar Pradesh

Sub: Proposal for selection of Successful Bidder to Design, Build, Finance, Own and Operate Super Specialty
Hospital in Kanpur

Dear Sir,

This has reference to the Proposal being submitted by (name of the Lead Consortium Member of the Bidding
Consortium), as Lead Consortium Member of the Bidding Consortium comprising (mention name(s) of the
Consortium Members) in respect of selection of Successful Bidder to Design, Build, Finance, Own and Operate
Super Specialty Hospital in Kanpur in response to the RFQ cum RFP Document issued by Awas Bandhu, UP
dated.

We hereby confirm the following:

(a) We (name of the Consortium Members furnishing the Letter of Acceptance), have examined in detail
and have understood and satisfied ourselves regarding the contents including in respect of the
following:
a. The RFQ cum RFP Document issued by Awas Bandhu, UP;
b. All subsequent communication between Awas Bandhu, UP and the Bidder, represented by
(Mention name of the Lead Consortium Member)
c. The Proposal being submitted by (name of the Lead Consortium Member)

(b) We agree to abide by the terms and conditions of the RFQ cum RFP Document and the Proposal being
submitted by the Lead Consortium Member in respect of the Project.

(c) We also reaffirm that (name of the Lead Consortium Member) continues to be the Lead Consortium
Member and that (please give name, designation and address of authorized representative and
signatory here) designated as the authorized representative and signatory of the Lead Consortium
Member of the Bidding Consortium is the authorized representative and signatory in respect of all
matters concerning our Proposal for this Project and contractual commitments thereof.

Thanking You,

Yours Sincerely,

For and on behalf of : (name of the Bidding Company / Lead Consortium Member and the Company Seal)

RFQ cum RFP Volume I- Instruction to Bidder Page 55


RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Signature : (Authorised Representative & Signatory)

Name of the Person :

Designation :

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX-14 FORMAT OF LETTER OF COMMITMENT

(The Letter of Commitment is to be submitted by EACH Promoter(s) and/or Associate(s) and/or Subsidiary (ies)
of the Bidding Company / Consortium Members of the Bidding Consortium whose strength have to be credited
for)

Date:
Place:

The Executive Director,


Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001
Uttar Pradesh

Sub: Proposal for selection of Successful Bidder to Design, Build, Finance, Own and Operate Super Specialty
Hospital in Kanpur

Dear Sir,

This has reference to the Proposal being submitted by (name of the Lead Consortium Member of the Bidding
Consortium), as Lead Consortium Member of the Bidding Consortium comprising (mention name(s) of the
Consortium Members) in respect of selection of Successful Bidder to Design, Build, Finance, Own and Operate
Super Specialty Hospital in Kanpur in response to the Request for Qualification cum Request for Proposal
(RFP) Document issued by Awas Bandhu, UP dated.

We hereby confirm the following:

1. We (name of the Promoter/Affiliate/Subsidiary), have examined in detail and have understood and
satisfied ourselves regarding the contents including in respect of the following:
a. The RFP Document issued by Awas Bandhu, UP;
b. All subsequent communication between Awas Bandhu, UP and the Bidder, represented by (name
of the Bidding Company or of the Lead Consortium Member in case of a Bidding Consortium);
c. The Financial Proposal being submitted by (name of the Bidding Company or of the Lead
Consortium Member in case of a Bidding Consortium)

2. We agree to abide by the terms and conditions of the RFP Document and the Proposal being submitted
by the Bidding Company / Lead Consortium Member in respect of the Project.

3. We also reaffirm that (please give name, designation and address of authorized representative and
signatory here) designated as the authorized representative and signatory of the Bidding Company /
Lead Consortium Member of the Bidding Consortium is the authorized representative and signatory in
respect of all matters concerning our Proposal for this Project and contractual commitments thereof.

Thanking You,

Yours Sincerely,

For and on behalf of : (name of the Bidding Company / Lead Consortium Member and the Company Seal)

RFQ cum RFP Volume I- Instruction to Bidder Page 57


RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Signature : (Authorised Representative & Signatory)

Name of the Person :

Designation :

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX-15 FINANCIAL PROPOSAL (FORMAT FOR INFORMATION SUBMISSION)

(To be provided on the letterhead of the Bidder)

Date:
Place:

The Executive Director,


Awas Bandhu, Uttar Pradesh,
Housing & Urban Planning Department,
Government of Uttar Pradesh
Ist Floor, Janpath Market, Lucknow-226001
Uttar Pradesh

Dear Sir,

Sub: Proposal for selection of Successful Bidder to Design, Build, Finance, Own and Operate Super Specialty
Hospital in Kanpur

1. We the undersigned Bidder, submit the following as our Financial Proposal in response to the RFQ cum
RFP issued by Awas Bandhu, UP.

% ( percentage only) of the annual Revenue of the Hospital to be given to KDA every
year, beginning from 11th year from the date of signing the agreement till the end of concession period.

2. We confirm that the Financial Proposal conforms to all the terms and conditions stipulated in the Request for
Proposal Document.
3. We confirm that our Financial Proposal is FINAL in all respects and contains NO conditions.
4. We confirm that in the event of more than one Responsive Bidders quoting the same annual lease rental,
Awas Bandhu, UP shall break the tie by way of draw between such Bidders.
5. We confirm that, the information submitted in our Financial Proposal is complete and is correct to the best of
our knowledge and understanding. We would be solely responsible for any errors or omissions in our
Proposal.
6. We confirm that we have studied the provisions of relevant Indian laws and regulations required to enable us
to prepare this Financial Proposal and as required to Design, Build, Finance, Own and Operate the Project,
in the event that we are finally selected.

Thanking You,

Yours Sincerely,

For and on behalf of : (name of the Bidding Company / Lead Consortium Member and the Company Seal)

Signature : (Authorised Representative & Signatory)

Name of the Person :

Designation :

RFQ cum RFP Volume I- Instruction to Bidder Page 59


RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

APPENDIX-16 PROFORMA FOR BANK GUARANTEE FOR PERFORMANCE SECURITY KANPUR


DEVELOPMENT AUTHORITY

[To be issued by SBI or any Nationalised Bank or Indian Scheduled Commercial Bank whose Net Worth
is not less than INR 300 crores as on 31st March 2008]

From:
[Name and Address of Bank/ Financial Institution]

The Vice Chairman,


Kanpur Development Authority,
Kanpur
Uttar Pradesh

1. In consideration of the Governor of Uttar Pradesh represented by ________________ (hereinafter called the
Government) having agreed to exempt _________________ (hereinafter called the said
Bidder(s)) from the demand, under the terms and condition of an Agreement, dated _________made between
____________________and Kanpur Development Authority for Design, Build, Finance, Own and Operate
Super Specialty Hospital in Kanpur (hereinafter called the said Agreement), of performance security for the
due fulfilment by the said Developer(s)of the terms and conditions contained in the said Agreement , on
production of a bank guarantee for Rs. (Rupees only).

We, _____________________ (hereinafter referred to as the Bank) at the request of


______________/ Bidder(s)/ do hereby undertake to pay to the Government an amount not exceeding Rs.
/- against any loss or damage caused to or suffered or would be caused to or suffered by the Government by
reason of any breach by the said Developer(s)of any of the terms or conditions contained in the said Agreement.

2. We __________________________ (indicate the name of bank) do hereby undertake to pay the


amounts due and payable under this guarantee without any demur, merely on a demand from the Government
stating that the amount claimed is due by way of loss or damage caused to or would be caused to or suffered by
the Government by reason of breach by the said Bidder(s) of any of the terms or conditions contained in the said
agreement or by reason of the Bidder(s) failure to perform the said Agreement. Any such demand made or the
bank shall be conclusive as regards the amount due and payable by the Bank under this guarantee. However,
our liability under this guarantee shall be restricted to an amount not exceeding Rs. /-.

3. We undertake to pay to the Government any money so demanded notwithstanding any dispute or
disputes raised by the Bidder(s) in any suit or proceeding pending before any court or Tribunal relating to our
liability under this present being absolute and unequivocal, unless otherwise directed by such Court or Tribunal.

The payment so made by us under this bond shall be a valid discharge of our liability for payment there
under and the Bidder(s) supplier (s) shall have no claim against us for making such payment.

4. We __________________________________ (Indicate the name of bank) further agree that the


guarantee herein contained shall remain in full force and effect during the period that would be taken for the
performance of the said Agreement and that it shall continue to be enforceable till all the dues of the Government
under or by virtue of the said Agreement have been fully paid and its claims satisfied or discharged or till Govt
certifies that the terms and conditions of the said Agreement, have been fully and properly carried out by the said
Bidder(s)and accordingly discharges this guarantee, however not exceeding six months beyond the date of
expiry of the Concession Period. Unless a demand or claim under this guarantee is made on us in writing on or
before the date of expiry of we shall be discharged from all liability under this guarantee thereafter.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

5. We _____________________ (indicate the name of Bank) further agree with the Government that
the Government shall have the fullest liberty without our consent and without affecting in any manner our
obligations hereunder to vary any of the terms and conditions of the said Agreement or to extend time of
performance by the said Bidder(s)from time to time or to postpone for any time or from time to time any of the
powers exercisable by the Government against the said Bidder(s) and to forbear or enforce any of the terms and
conditions relating in the said agreement and we shall not be relieved from our liability by reason of any such
variation or extension being granted to the said Bidder(s)or for any forbearance act or commission on the part of
the Government or any indulgence by the Government to the said Bidder(s)or by any such matter or thing
whatsoever which under the law relating to sureties would, but for this provision, have effect of so relieving us.

6. This guarantee will not be discharged due to the change in the constitution of the Bank or the
Bidder(s)/ Supplier(s).

7. We, __________________________ lastly undertake not to revoke this guarantee during (indicate
the name of bank) its currency except with the previous consent of the Government in writing.

SEAL OF [BANK/FINANCIAL INSTITUTION] ..

NAME OF [BANK/FINANCIAL INSTITUTION] ..

SIGNATURE ..

NAME ..

TITLE ..

DATE ..

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

EXHIBIT I PRINCIPLES OF THE MEMORANDUM OF UNDERSTANDING TO BE EXECUTED BETWEEN THE


MEMBERS OF A CONSORTIUM

In case of a Bidding Consortium, the principles according to which the Memorandum of Understanding (MoU)
shall be executed between/among the Consortium Members, are stated below:

1. The MoU should clearly specify the roles and responsibilities of each of the Consortium Members, along
with their proposed equity contribution. It is expected that the individual members have role definitions
not conflicting with those of the other Consortium Members.

2. The MoU should clearly designate one of the Consortium Members as the Lead Consortium Member.

3. The Lead Consortium Member shall be responsible for:


a. Tying up finances for the Project
b. Liasoning with the lending institutions and mobilizing debt resources for the Project.
c. Ensuring the individual and collective commitment of each of the Consortium members in
honouring the Developers obligations towards KDA. The Lead Consortium Member would be
responsible for the overall execution of the Project. All Consortium Members shall be jointly and
severally responsible for the same.

4. The MoU shall be duly signed by each of the Consortium Members

5. The MoU should be executed an appropriate stamp paper

6. The MoU should be specific to this Project

7. The MoU should be valid for a minimum period of twelve months from the Last Date for submission of
the Request for Proposal. The validity period of the MoU should be extendible on the original terms, if
required by KDA.

8. MoU should clearly specify that in case of award of the project each consortium member will invest at
least 11% equity for project.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

CHECKLIST FOR PROPOSAL SUBMISSION

Bidder(s) are requested to organize their Proposals as per the following checklist:
ENVELOPE A
(a) Original Power of Attorney authorizing Authorised Representative & Signatory to act on behalf of the
Bidding Company / Bidding Consortium on all matters relating to the Project as per the format
specified in Appendix 1A
(b) Original Power of Attorney authorizing Lead Consortium Member to act on behalf of the Bidding
Consortium on all matters relating to the Project as per the format specified in Appendix 1B
(c) Details of the Bidder in Appendix 2
(d) Letter of Application as per format in Appendix 3
(e) Information Related to Experience in Appendix 4 (BRS1& BRS2)
(f) Establishing Financial Capability of the Bidder as per format in Appendix 5 (BRS 3 & BRS 4)
(g) Guidelines for providing information related to Financial Capability in Appendix 7
(h) Anti-collusion certificate in Appendix 8
(i) Project Undertaking as per format in Appendix 9 A and 9B
(j) Memorandum of Understanding executed between the Consortium Members on the principles as
stated in Exhibit 1
(k) MOU as per format as stated in Appendix 10
(l) Consultancy and Success Fee Commitment to Darashaw & Co Pvt Limited as per format stated in
Appendix 12
(m) Letter of Acceptance as per format stated in Appendix 13
(n) Letter of Commitment as per format in Appendix 14
(o) A Bank Guarantee towards Earnest Money Deposit

ENVELOPE B
(a) Financial Proposal as per format specified in Appendix 15

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Annexure A - PROJECT SITE

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Annexure B - TECHNICAL SCHEDULES


The proposed Super specialty hospital at Kanpur shall have 500 beds. Atleast four specialties from the following
disciplines shall be developed in the Hospital.
Sr. No. Departments / Specialties
1 Trauma Care
2 Cardio Thoracic care unit (ICCU- Intensive Cardiac Care Unit)
3 Intervention specialty and Cerebral Intervention
4 Kidney Transplant (Hemodialysis)
5 Neurology unit
6 Obs & Gynecology
7 Pediatric unit (with NICU Neonetal Intensive Care unit)
8 Dental unit for surgery
9 Ophthalmology and ENT
10 Cancer unit

The Concessionaire may also develop additional specialties other than those mentioned above. The hospital
shall also have a round the clock emergency unit.

A. Planning

The Concessionaire shall plan the facilities, manpower and the service as per the Indian Public Health Standard
(IPHS).
The hospital shall be developed with 500 bed capacity within 36 months from the Effective Date.
However, the developer is allowed to construct 250 bed capacity in initial three years and remaining 250
bed capacity in next two years time.
The hospital shall be planned in accordance with the Development Control Regulations applicable to the
region and norms if any prescribed by the Medical Council of India, Ministry of Health and Family
Welfare and the State Health Department.
The developer shall obtain necessary clearances and approval for the plans from the relevant authority
as per the requirements.
Service Apartments can be provided within the hospital complex to cater to the needs of the patients
and their relatives.
Institute offering Laboratory Technician courses, Nursing courses can also be developed within the
hospital complex.
Restaurants, ATMs, Pharmacy for the convenience of the patients can be provided within the hospital
complex.
Research Institutes can also be setup in the hospital complex.
Helipad for picking up patients may be provided.

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RFQ cum RFP for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

B. Designing

Modular design to enable addition of new departments, least disturbance to existing facilities, quality,
and added benefits of economy of scale shall be preferred.
Architectural design norms as per NBC (National Building Code 2005)
Structural Design norms as per NBC and BIS (Bureau of Indian Standards)
Services design norms as per CPEEHO (Central Public Health and Environmental Engineering
Organisation), NBC and BIS

In case of contradiction between the IPHS Accreditation standards and the Design Norms specified above, the
former shall prevail.

C. Construction

The construction shall be strictly as per the design norms specified above.

RFQ cum RFP Volume I- Instruction to Bidder Page 66


Draft Concession Agreement for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

VOLUME II

Draft Concession Agreement

Between

Kanpur Development Authority

And

____________________________

Request for Proposal Volume II 1


Draft Concession Agreement for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

Index
Article 1. Definitions and Interpretation 6
1.1. Definitions 6
1.2. Interpretation 9
1.3. Measurements and Arithmetic Conventions 11
1.4. Priority of Agreements and Errors/Discrepancies 11
Article 2. Scope of the Project 13
2.1. Scope of the Project 13
Article 3. Consideration of the Contract 15
3.1. The Consideration 15
Article 4. Conditions Precedent to the Agreement 16
4.1. Conditions Precedent 16
4.2. Compliance Certificate 16
4.3. Non-Fulfillment of the Conditions Precedent 16
Article 5. Obligations of the Concessionaire 18
5.1. Obligations of the Concessionaire 18
5.2. Obligations relating to Other Agreements 19
5.3. Obligations relating to Change in Ownership 19
Article 6. Obligations of the Concessioning Authority 21
6.1. Obligations of the Concessioning Authority 21
Article 7. Representations and Warranties 22
7.1. Representations and Warranties of the Concessionaire 22
7.2. Representations and Warranties of the Concessioning Authority 23
7.3. Disclosure 24
Article 8. Disclaimer 25
8.1. Disclaimer 25
Article 9. Performance Security 26
9.1. Performance Security 26
9.2. Appropriation of Performance Security 26
9.3. Release of Performance Security 26
Article 10. Access on Project Site 27
10.1. Project Site 27
10.2. Others 27
Article 11. Construction on the Project Site 28
11.1. Obligations prior to the commencement of any work 28
11.2. Project Start and Completion date 28
11.3. Completion Certificate 28
Article 12. Force Majeure 29
12.1. Force Majeure 29
12.2. Force Majeure Events 29
12.3. Duty to Report Force Majeure Event 29
12.4. Effect of Force Majeure Event 29
12.5. Allocation of Costs Arising out of Force Majeure 30
12.6. Dispute Resolution 30
Article 13. Termination 31
13.1. Termination for Concessionaire Default 31
13.2. Procedure to issue Termination Notice 32
13.3. Effect of Termination 32

Request for Proposal Volume II 2


Draft Concession Agreement for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

13.4. Other Rights and Obligations of the Concessioning Authority 32


Article 14. Liability and Indemnity 33
14.1. General indemnity 33
14.2. Liability of Concessioning Authority 33
14.3. Indemnity by the Concessionaire 33
14.4. No consequential claims 34
14.5. Survival on Termination 34
Article 15. Dispute Resolution 35
15.1. Dispute resolution 35
15.2. Conciliation 35
15.3. Arbitration 35
Article 16. Miscellaneous 37
16.1. Governing Law and Jurisdiction 37
16.2. Waiver of Immunity 37
16.3. Delayed Payments 37
16.4. Waiver 37
16.5. Liability for Inspection of Documents 37
16.6. Exclusion of Implied Warranties etc. 38
16.7. Survival 38
16.8. Entire Agreement 38
16.9. Severability 38
16.10. No partnership 38
16.11. Third Parties 39
16.12. Successors and Assigns 39
16.13. Notices 39
16.14. Language 39
16.15. Counterparts 40
16.16. Validity 40
Schedule 1. Project Site 41
Schedule 2. Technical Schedule 42

Request for Proposal Volume II 3


Draft Concession Agreement for Design, Build, Finance, Own and Operate Super Specialty Hospital in Kanpur

CONCESSION AGREEMENT
This AGREEMENT is entered into on this the [ ] day of [ ] (Month), 2009 at Kanpur

BETWEEN

1. Kanpur Development Authority established under the Uttar Pradesh Urban Planning
and Development Act 1973, having its registered office at Moti Jheel, Kanpur, Uttar
Pradesh (hereinafter referred to as Concessioning Authority which expression shall
unless repugnant to the subject or the context include its successors) of One Part;

AND

2. ______________, a company incorporated under the Companies Act, 1956, and having
its registered office at _________________________ (hereinafter referred to as the
Concessionaire which expression shall unless repugnant to the subject or the context
include its successors) of the Other Part.

WHEREAS:

A. The Government of Uttar Pradesh has established Kanpur Development Authority under
the Uttar Pradesh Urban Planning and Development Act 1973 (hereinafter called the
Act), for the development and planning of Kanpur.

B. In order to develop the tertiary healthcare infrastructure in Kanpur, KDA intends to setup a
500 Bed Super-Specialty Hospital and related facilities and has earmarked 15 acres of
land for the same.

C. Concessioning Authority through Awas Bandhu,UP had invited proposals for the selection
of a Concessionaire through the competitive route on the basis of Design, Build, Finance
Owb and Operate the Project, from bidders, including the Consortium comprising of
_____________ as the Lead Member/Company by issuing the Request for Qualification
(RFQ cum RFP) document dated 22nd January 2009 containing inter-alia the minimum
qualification for a bidder and the technical and commercial parameters of the Project and
the terms and conditions for the implementation of the Project.

D. On evaluation of the submitted proposals, Awas Bandhu, UP accepted the proposal of the
Consortium/Company and issued Letter of Intent (LOI) dated __________ to the
Consortium/Company specifying interalia the obligation of the Parties to create a Special
Purpose Vehicle for implementing the Project [ Applicable in case of Consortium]

Pursuant to the issuance of LOI vide letter no. ___________ dated ________, the
Consortium have incorporated and constituted ______________ as the Special Purpose
Vehicle created for the sole purpose of implementation the Project which is
Concessionaire.
E. The Concessionaire is desirous of developing the Project, in accordance with all approved
plans and has the necessary capability for completion of the project and has offered his

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services and has made payment of 1% of the project cost and taxes as applicable to M/s
Darashaw & Company Pvt. Ltd.

NOW THEREFORE IN CONSIDERATION OF THE FOREGOING AND THE RESPECTIVE COVENANTS


AND AGREEMENTS SET FORTH IN THIS CONCESSION AGREEMENT, THE SUFFICIENCY AND
ADEQUACY OF WHICH IS HEREBY ACKNOWLEDGED, AND INTENDING TO BE LEGALLY BOUND
THE CONCESSIONING AUTHORITY AND THE CONCESSIONAIRE (HEREINAFTER REFERRED TO
AS PARTIES AND INDIVIDUALLY AS PARTY) HEREBY AGREE AND THIS AGREEMENT
WITNESSTH AS FOLLOWS:

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Article 1. Definitions and Interpretation


1.1. Definitions
The words and expressions defined in this Agreement shall, unless repugnant to the
context or meaning thereof, have the meaning ascribed thereto herein, and the words
and expressions defined in the Schedules and used therein shall have the meaning
ascribed thereto in the Schedules;

Accounting Year means the financial year commencing from the first day of April of
any calendar year and ending on the thirty-first day of March of the next calendar year;
Affected Party shall have the meaning set forth in Clause 12.1;
Agreement or Concession Agreement means this Agreement, the Schedules
hereto and any amendments thereto made in accordance with the provisions contained
in this Agreement;
Agreement Date means the date of execution of this Agreement;
Applicable Laws means all laws, brought into force and effect by GOI or the State
Government including rules, regulations and notifications made there under, and
judgments, decrees, injunctions, writs and orders of any court of record, applicable to this
Agreement and the exercise, performance and discharge of the respective rights and
obligations of the Parties hereunder, as may be in force and effect during the subsistence
of this Agreement;
Applicable Permits means all clearances, licenses, permits, authorisations, no
objection certificates, consents, approvals and exemptions required to be obtained or
maintained by the Concessionaire under Applicable Laws during the subsistence of this
Agreement;
Approvals means all approvals, permissions, authorisations, consents and
notifications from any Governmental Authority, regulatory or departmental authority
including, but not limited to the approvals of the Kanpur Development Authority,
Secretariat for Industrial Assistance, Reserve Bank of India and any other regulatory
authority, as may be applicable.
Arbitration Act means the Arbitration and Conciliation Act, 1996 and shall include
modifications to or any re-enactment thereof, as in force from time to time;
Bank Guarantee means an irrevocable and unconditional bank guarantee payable on
demand issued by a bank in favour of Concessioning Authority and furnished by the
Concessionaire to Concessioning Authority for guaranteeing the due performance of the
obligations of the Concessionaire under this Agreement. Here Bank means any Indian
Nationalized Bank or any Indian Scheduled Commercial Bank whose net worth is not
less than Rs.3000 million as on 31st March 2008.
Bid means the documents in their entirety comprised in the bid submitted by the
Concessionaire in response to the RFQ/RFP in accordance with the provisions thereof;

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Business Day means a day on which banks are generally open for business in the city
of Kanpur in India;
Change in Ownership means a transfer of the direct and/or indirect legal or beneficial
ownership of any shares, or securities convertible into shares, that causes the change in
management structure of the bidder company according to the opinion of the
Concessioning Authority;
Conditions Precedent shall have the meaning set forth in Clause 4.1;
Construction Period means maximum period of 24 months from the Effective Date,
after which commercial operations must start;
Consortium means the group of entities that have jointly submitted the proposal for
the Project.
Consortium Member means each entity in the Consortium shall be referred to as a
Consortium Member.
Damages shall have the meaning set forth in Sub-clause (t) of Clause 1.2;
Developmental and Operations Standard(s) means the minimum parameters and
standards to be achieved by the Concessionaire in the construction, development and
operations of the Project in accordance with internationally sound engineering practices,
National Building Code and Applicable Law and / or as determined by the relevant
Governmental Authority;
Dispute shall have the meaning set forth in Clause 15.1.1;
Dispute Resolution Procedure means the procedure for resolution of Disputes set
forth in Article 15;
Effective Date means the date on which all the conditions Precedent are satisfied or
waived as per Article 4 in writing by both the Parties.
Financial Commitment means the legally binding undertaking of the Concessionaire
to mobilize the financial requirements of the project, for ensuring the completion of the
project;
Financial Year shall mean the year commencing from the 1st April of any calendar
year and ending on 31st March of the next calendar year.
Force Majeure or Force Majeure Event shall have the meaning set forth in as per
Clause 12;
GOI means the Government of India;
Good Industry Practice means the practices, methods, techniques, designs,
standards, skills, diligence, efficiency, reliability and prudence which are generally and
reasonably expected from a reasonably skilled and experienced operator engaged in the
same type of undertaking as envisaged under this Agreement and which would be
expected to result in the performance of its obligations by the Concessionaire in
accordance with this Agreement, Applicable Laws and Applicable Permits in reliable,
safe, economical and efficient manner;
Government Instrumentality means any department, division or sub-division of the
Government of India or the State Government and includes any commission, board,
authority, agency or municipal and other local authority or statutory body including

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Panchayat under the control of the Government of India or the State Government, as the
case may be, and having jurisdiction over all or any part of Kanpur or the performance of
all or any of the services or obligations of the Concessionaire under or pursuant to this
Agreement;
Indemnified Party means the Party entitled to the benefit of an indemnity pursuant to
Article 14;
Indemnifying Party means the Party obligated to indemnify the other Party pursuant
to Article 14;
Lenders shall mean the banks, financial institutions, international credit agencies that
extend or agree to extend a credit facility to the Concessionaire in relation to the Project;
Parties means the parties to this Agreement collectively and Party shall mean any
of the parties to this Agreement individually;
Performance Security shall have the meaning set forth in Clause 9.1;
Project shall mean Design, Build, Finance, Operate and Transfer of 500 Bed Super
Specialty Hospital with at least four specialties from the selected specialties like Trauma
centre, Plastic surgery unit, Burn Unit, Neurology, Ophthalmology in the hospital as
mentioned in Annexure B of this document, round the clock emergency unit along with
15 acres Site earmarked for the purpose in accordance with the provisions of this
Agreement at the end of the concession period;(more specifically as mentioned in
Article 2 of this agreement).

Project Completion Date shall mean the date on which the Concessioning Authority
has issued the Project Completion Certificate after completion of the Project and shall
have the meaning set forth in Clause 11.2;
Project Completion Certificate shall mean the Project Completion Certificate issued
by the Concessioning Authority certifying completion of Project by the Concessionaire;
Rs. or Rupees refers to the lawful currency of the Republic of India;
Revenue of the Hospital shall mean registration fees, hospital bed revenue, diagnostics
laboratory tests, consultation charges, operation charges and lease rental from the commercial
facilities like bank, restaurant etc. of that Financial Year. Revenue of the Hospital shall not
include revenue from pharmacy, service apartments, training institutes and consumables cost
directly reimbursed by the patients.

Security Interest means any existing or future mortgage, charge (whether fixed or
floating), pledge, lien, hypothecation, assignment, security interest or other
encumbrances of any kind securing or conferring any priority of payment in respect of
any obligation of any Person and includes without limitation any right granted by a
transaction which, in legal terms, is not the granting of security but which has an
economic or financial effect similar to the granting of security in each case under any
Applicable Law.
Site means the Project site measuring 15 acres as given in Schedule 1 of this
Agreement given on lease for a total lease period of 90 years. The lease is renewed

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every 30 years till the end of the total lease period of 90 years. The Project shall mean
the same as defined in this Agreement.
Standards of Reasonable and Prudent Concessionaire means the standards,
practices, methods and procedures expected from a person seeking in good faith to
perform its contractual obligations and in so doing and in the general conduct of its
undertaking exercising that degree of skill, diligence, prudence and foresight which would
reasonably and ordinarily be expected from a skilled and experienced Person engaged in
the same type of undertaking under the same or similar circumstances and conditions
including the conditions as contemplated by the Basic Documents.
Taxation or Tax means all forms of taxation whether direct or indirect and whether
levied by reference to income, profits, gains, net wealth, asset values, turnover, added
value or other reference and statutory, governmental, state, provincial, local
governmental or municipal impositions, duties, contributions, rates and levies (including
without limitation social security contributions and any other payroll taxes), whenever and
wherever imposed (whether imposed by way of withholding or deduction for or on
account of tax or otherwise) and in respect of any person and all penalties, charges,
costs and interest relating to it;
Third Party Agreements means all Agreements entered into between the
Concessionaire and third Persons, including, but not limited to other Agreements with
Concessionaire and vendors of any goods or services to the Concessionaire.
Termination means the expiry of the Concession period or termination of this
Agreement;
Termination Notice means the communication issued in accordance with this
Agreement by one Party to the other Party terminating this Agreement;

1.2. Interpretation

1.2.1. In this Agreement, unless the context otherwise requires,


(a) references to any legislation or any provision thereof shall include amendment or re-
enactment or consolidation of such legislation or any provision thereof so far as such
amendment or re-enactment or consolidation applies or is capable of applying to any
transaction entered into hereunder;
(b) references to laws of India or Indian law or regulation having the force of law shall
include the laws, acts, ordinances, rules, regulations, bye laws or notifications which
have the force of law in the territory of India and as from time to time may be
amended, modified, supplemented, extended or re-enacted;
(c) references to a person and words denoting a natural person shall be construed as a
reference to any individual, firm, company, corporation, society, trust, government,
state or agency of a state or any association or partnership (whether or not having
separate legal personality) of two or more of the above and shall include successors
and assigns subject to the provisions of this Agreement;
(d) the table of contents, headings or sub-headings in this Agreement are for
convenience of reference only and shall not be used in, and shall not affect, the
construction or interpretation of this Agreement;

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(e) the words include and including are to be construed without limitation and shall be
deemed to be followed by without limitation or but not limited to whether or not they
are followed by such phrases;
(f) references to construction include, unless the context otherwise requires,
investigation, design, developing, engineering, procurement, delivery, transportation,
installation, processing, fabrication, testing, commissioning and other activities that
are to be completed on or before Project Completion Date as per the scope of work
as defined under Article 2, and construct shall be construed accordingly;
(g) any reference to any period of time shall mean a reference to that according to Indian
Standard Time;
(h) any reference to day shall mean a reference to a calendar day;
(i) any reference to month shall mean a reference to a calendar month as per the
Gregorian calendar;
(j) references to any date, period or Milestone shall mean and include such date, period
or Milestone as may be extended pursuant to this Agreement;
(k) any reference to any period commencing from a specified day or date and till or
until a specified day or date shall include both such days or dates; provided that if
the last day of any period computed under this Agreement is not a business day, then
the period shall run until the end of the next business day;
(l) the words importing singular shall include plural and vice versa;
(m) references to any gender shall include the other and the neutral gender;
(n) lakh or lac means a hundred thousand (100,000) and crore means ten million
(10,000,000);
(o) references to the winding-up, merger, amalgamation, takeover,
dissolution, insolvency, or reorganization of a company or corporation shall be
construed so as to include any equivalent or analogous proceedings under the law of
the jurisdiction in which such company or corporation is incorporated or any
jurisdiction in which such company or corporation carries on business including the
seeking of liquidation, winding-up, reorganization, dissolution, arrangement,
protection, change in management or relief of debtors;
(p) any reference, at any time, to any Agreement, deed, instrument, license or document
of any description shall be construed as reference to that Agreement, deed,
instrument, license or other document as amended, varied, supplemented, modified
or suspended at the time of such reference; provided that this Sub-clause shall not
operate so as to increase liabilities or obligations of the Concessioning Authority
hereunder or pursuant hereto in any manner whatsoever;
(q) any Agreement, consent, approval, authorization, notice, communication, information
or report required under or pursuant to this Agreement from or by any Party shall be
valid and effective only if it is in writing under the hand of a duly authorized
representative of such Party, as the case may be, in this behalf and not otherwise;
(r) the Schedules and Recitals to this Agreement form an integral part of this Agreement
and will be in full force and effect as though they were expressly set out in the body of
this Agreement;

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(s) references to Recitals, Articles, Clauses, Sub-clauses or Schedules in this Agreement


shall, except where the context otherwise requires, mean references to Recitals,
Articles, Clauses, Sub-clauses and Schedules of or to this Agreement, and references
to a Paragraph shall, subject to any contrary indication, be construed as a reference
to a Paragraph of this Agreement or of the Schedule in which such reference
appears; and
(t) the damages payable by either Party to the other of them, as set forth in this
Agreement, whether on per diem basis or otherwise, are mutually agreed genuine
pre-estimated loss and damage likely to be suffered and incurred by the Party
entitled to receive the same and are not by way of penalty (the Damages).
(u) any reference to Build shall mean Construct and vice-versa unless the context
otherwise requires
(v) any reference to Operate/Operations shall mean Operate and Transfer/ Operations &
Maintenance unless the context otherwise requires

1.2.2. Unless expressly provided otherwise in this Agreement, any documentation required to be
provided or furnished by the Concessionaire to the Concessioning Authority and/or the agency or
person appointed by the Concessioning Authority shall be provided free of cost and in two copies,
and if the Concessioning Authority and/or the person appointed by the Concessioning Authority is
required to return any such documentation with their comments and/or approval, they shall be
entitled to retain one copy thereof.

1.2.3. the rule of construction, if any, that a contract should be interpreted against the parties responsible
for the drafting and preparation thereof, shall not apply.

1.2.4. any word or expression used in this Agreement shall, unless otherwise defined or construed in this
Agreement, bear its ordinary English meaning.

1.3. Measurements and Arithmetic Conventions


All measurements and calculations shall be in the metric system and calculations done to
2 (two) decimal places, with the third digit of 5 (five) or above being rounded up and
below 5 (five) being rounded down.

1.4. Priority of Agreements and Errors/Discrepancies

1.4.1. This Agreement, and all other Agreements and documents forming part of this Agreement are to
be taken as mutually explanatory and, unless otherwise expressly provided elsewhere in this
Agreement, the priority of this Agreement and other documents and agreements forming part
hereof shall, in the event of any conflict between them, be in the following order:
(a) this Agreement;
(b) RFP Document
(c) all other agreements and documents forming part hereof;

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i.e. the agreement at (a) above shall prevail over the agreements and documents at
(b) and (c) above and (b) shall prevail over all documents in (c) above.

1.4.2. In case of ambiguities or discrepancies within this Agreement, the following shall apply:
(a) between two or more Clauses of this Agreement, the provisions of a specific
Clause relevant to the issue under consideration shall prevail over those in
other Clauses;
(b) between the Clauses of this agreement and the Schedules, the Clauses shall
prevail and between Schedules and Annexes, the Schedules shall prevail;
(c) between the written description on the Drawings and the Specifications and
Standards, the latter shall prevail;
(d) between the dimension scaled from the Drawing and its specific written
dimension, the latter shall prevail; and
(e) between any value written in numerals and that in words, the latter shall prevail.

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Article 2. Scope of the Project


2.1. Scope of the Project
The Concessionaire shall Design, Build, Finance, Own and Operate a Super Specialty Hospital on the 15
acre plot earmarked for the purpose over the concession period of 90 years, after which the facility will be
transferred to the Concessioning Authority. The site shall be given on lease for the concession period of 90
years and the lease is renewable twice during the concession period at every 30 years. The maximum
allowable FAR is 2.5 as per the prevailing Development Control Regulations of KDA .The successful bidder
shall construct following facilities and get all the approvals for commercial operations within 36 months from
the effective date.

A. Minimum Development Obligations (Essential Facilities):

To build and operate 500-bedded Super-specialty hospital as per the International standards / Indian Public
Health Standard (IPHS). However, the Concessionaire is allowed to construct 250 bed capacity within 36
months from the Effective Date and remaining 250 bed capacity in next two years.
Atleast four specialties from the following disciplines shall be developed in the Hospital.

Departments / Specialties
Trauma Care
Cardio Thoracic care unit (ICCU- Intensive Cardiac Care Unit)
Intervention specialty and Cerebral Intervention
Kidney Transplant (Hemodialysis)
Neurology unit
Obs & Gynecology
Pediatric unit (with NICU Neonetal Intensive Care unit)
Dental unit for surgery
Ophthalmology and ENT
Cancer unit

The hospital shall also have a round the clock emergency unit.
All the facilities are to be developed as per the minimum quality standards set out for the purpose in the
Technical Schedule appended as Schedule B with this document.
While undertaking development of the Project, the Successful Bidder shall adhere to latest amended
National Building Code of India, other relevant IS Codes and practices, Development Control Rules, FAR
Limits, statutory requirements, guidelines and approvals of the Health Department of the Government of
Uttar Pradesh, laws of land, the principles of good industry practices and any other norms as applicable from
time to time. The developer shall also take into account the guidelines issued by the State Health
Department and obtain the necessary approvals.
The Concessionaire shall be responsible for all the clearances as may be required for the development and
operations of the project. The project shall be ready for operation after taking all the clearance(s) within 36
months from the effective date.

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For the purpose of providing subsidized health services to poor, the Concessionaire shall provide 1% of the
revenues of the hospital every year to the Uttar Pradesh Government Health Department. Revenue of the
Hospital shall mean registration fees, hospital bed revenue, diagnostics laboratory tests, consultation
charges, operation charges and lease rental from the commercial facilities like bank, restaurant etc.
Revenue of the Hospital shall not include revenue from pharmacy, service apartments, training institutes and
consumables cost directly reimbursed by the patients.

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Article 3. Consideration of the Contract


3.1. The Consideration

3.1.1. Subject to and in accordance with the provisions of this Agreement, the Applicable Laws, rules and
regulations and the Applicable Permits, the Concessionaire shall pay to the Concessioning Authority:

_____% of the Hospital Revenue every year from the 11th year of the signing of the Concession Agreement
for the Concession period of 90 years.

The Concessionaire shall also pay to the Concessioning Authority an annual lease rental equivalent to 2% of
the land cost (considered as present circle rate) per acre of land on the 15 acre land earmarked for Super
Specialty Hospital for the entire concession period of 90 years. The lease period is renewed every thirty years
during the concession period.

3.1.2. Subject to and in accordance with the provisions of this Agreement, the Consideration hereby given by
Concessionaire, the Concessionaire shall be entitled to Construct and operate the Project on the land area
given on Concession period of 90 year, subject to :
(a) performing and fulfilling all of the Concessionaires obligations under and in accordance with this
Agreement; and
(b) bear and pay all costs, expenses and charges in connection with or incidental to the performance of the
obligations of the Concessionaire under this Agreement; and
(c) At the end of the concession period, the entire construction made by the Concessionaire till that date on
the Project site as part of the scope of work shall get transferred without any consideration to the
Concessioning Authority.

3.1.3. In consideration of the mutual covenants and other good and valuable consideration expressed herein, the
Concessionaire hereby accepts the Consideration to be given and agrees to construct and operate the
Project on land given for 90 year Concession period as per the scope of work given in Article 2 and minimum
specifications mentioned in the technical schedules and to perform/discharge all of its obligations in
accordance with the provisions hereof.

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Article 4. Conditions Precedent to the Agreement


4.1. Conditions Precedent

4.1.1. The respective rights and obligations of the Parties under this Agreement shall be subject to the satisfaction
in full of the conditions precedent specified in this Clause 4.1 (the Conditions Precedent).

4.1.2. The Concessionaire may, upon providing the Performance Security to the Concessioning Authority in
accordance with Article 9, by notice require the Concessioning Authority to satisfy the Conditions Precedent
set forth in this Clause 4.1.2 within a period of 30 (thirty) days of the notice, and the obligations of the
Concessioning Authority hereunder shall be deemed to have been performed when the Concessioning
Authority shall have procured for the Concessionaire the peaceful possession of the Site as demarcated
under Schedule 1;

4.1.3. Concessionaire shall satisfy the Conditions Precedent at any time within 30 (thirty) days from the date the
Concessioning Authority has given the Letter of Intent for the appointment of the Concessionaire and all the
Conditions Precedent shall be deemed to have been fulfilled when the Concessionaire shall have
(a) provided Performance Security to the Concessioning Authority; and
(b) Delivered to the Concessioning Authority a legal opinion from the legal counsel of the
Concessionaire with respect to the authority of the Concessionaire to enter into this
Agreement and the enforceability of the provisions thereof
(c) The members of the Consortium must form a Special Purpose Vehicle (SPV) and submit an
MoU for the purpose of Special Purpose Vehicle.

4.2. Compliance Certificate


Upon compliance with the Conditions Precedent, each Party shall forthwith issue a Compliance
Certificate pursuant to which the obligations of the Parties under this Agreement shall commence.

4.3. Non-Fulfillment of the Conditions Precedent

4.3.1. In the event of failure by any Party to procure compliance with any of the Conditions Precedent as per the
provisions of this Article 4 and the other Party have not waived any of the conditions (partially or absolutely),
the Agreement shall cease to have any effect as of that date.

4.3.2. In the event of the Agreement not coming into effect on account of the Concessionaire not fulfilling the
Conditions Precedent then the Concessionaire shall forfeit the Earnest Money Deposit and the Performance
Security.

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4.3.3. In the event of the Agreement not coming into effect on account of the Concessioning Authority not fulfilling
any of the Conditions Precedent then the Earnest Money Deposit and the Performance Security shall be
returned to the Concessionaire.

4.3.4. Notwithstanding anything contained in this clause, the Parties may mutually decide to extend the time period
for the fulfillment of the Conditions Precedent.

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Article 5. Obligations of the Concessionaire

5.1. Obligations of the Concessionaire

5.1.1. Subject to and on the terms and conditions of this Agreement, the Concessionaire shall at its cost and
expense procure finance for and undertake the Project scope of work as mentioned in Article 2 and observe,
fulfill, comply with and perform all its obligations set out in this Agreement or arising hereunder.

5.1.2. The Concessionaire shall comply with all Applicable Laws in the performance of its obligations under this
Agreement.

5.1.3. Without prejudice to Clauses 5.1.1 and 5.1.2 above, the Concessionaire shall discharge its obligations as per
the National Building Code, Development Control Rules, the principles of good industry practice and as a
reasonable and prudent person, statutory requirements, laws of the land and any other norms, which are
applicable from time to time.

5.1.4. The Concessionaire shall get prior approval of the Concessioning Authority in case of there is any change in
the facilities defined under the Project during the Concession Period.

5.1.5. Without prejudice to Clauses 5.1.1 and 5.1.2 above the Concessionaire shall, at its own cost and expense
observe, undertake, comply with and perform, in addition to and not in derogation of, its obligations
elsewhere set out in this Agreement, the following:
(a) make, or cause to be made, necessary applications to the relevant Governmental Agencies
with such particulars and details, as may be required for obtaining all Applicable Permits
and obtain such Applicable Permits in conformity with the Applicable Laws;
(b) procure, as required, the appropriate proprietary rights, licences, agreements and
permissions for materials, methods, processes and systems used or incorporated into
development and operations of the Project;
(c) not to damage any other infrastructure or any other utility developed by the Concessioning
Authority or any other utilities developed and maintained by any other authority or person
and in case of any such damage to undertake the repair and also to pay for any losses that
is incurred by the Concessioning Authority or any authority or any other person, as the case
may be.
(d) ensure and procure that the Concessionaire shall comply with all Applicable Permits and
Applicable Laws in the performance by them of any of the Concessionaires obligations
under this Agreement;
(e) not to do or omit to do any act, deed or thing which may in any manner be violative of any of
the provisions of this Agreement;
(f) not to create any third party rights, except for the purpose of borrowing from banks, on the
land given on Concession for 90 years. But also to ensure that Government of
UP/Concessioning Authority are not adversely affected in any way;

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(g) shall make payment towards the Concessioning Authority as per provisions of this
Agreement;
(h) Procure at its own costs, expenses and risk all services necessary for the construction and
operations of the Project including without limitation electricity, water, materials and labour;
(i) shall ensure reservation in matters of employment as per applicable Government of UP
policies
(j) shall complete construction of the Project and get necessary approvals for commercial
operations within a period of 36 months from the Effective Date; and
(k) transfer the Project site on the date of termination of Concession to the Concessioning
Authority.

5.2. Obligations relating to Other Agreements

5.2.1. It is expressly agreed that the Concessionaire shall, at all times, be responsible and liable for all its
obligations under this Agreement notwithstanding anything contained in any other agreement, and no default
under any agreement shall excuse the Concessionaire from its obligations or liability hereunder.

5.2.2. The Concessionaire may undertake development of Project by itself or through one or more
contractors possessing requisite technical, financial and managerial expertise/capability; but in
either case, the Concessionaire shall remain solely responsible to meet the scope of work as
mentioned under Article 2.1.

5.3. Obligations relating to Change in Ownership

The Concessionaire shall not undertake or permit any Change in Ownership, except with the prior written
approval of the Concessioning Authority as per the provisions of this Article 5.3.

5.3.1. No change in Consortium Members shall be allowed till the completion of the project or a minimum of 3 years
(whichever is later). However, the Lead Consortium Member shall not be allowed to be changed over the
entire Concession Period and shall continue to hold 51% stake in the Consortium till the start of Commercial
Operations. The Lead Consortium Member shall be allowed to dilute the stake after the commercial
operations date with the approval of the Concessioning Authority such that the stake of the Lead Consortium
Member in the consortium shall not fall below 26% at any time till the end of Concession Period.

5.3.2. Each Consortium Member shall invest minimum 11% stake in SPV. None of the Consortium Member
shall be allowed to dilute its stake till the completion of the Project or a minimum of 3 years from the
date of signing of the Concession Agreement (whichever is later).

5.3.3. Lead Consortium Member shall invest minimum 51% stake in the SPV. Lead Consortium Member
shall not be allowed to dilute its stake to a level below 51% till the start of commercial operations.
The Lead Consortium Member shall be allowed to dilute the stake after the commercial operations
date with the approval of the Concessioning Authority such that the stake of the Lead Consortium
Member in the consortium shall not fall below 26% at any time till the end of Concession Period.
This holds for the single entity bidder also and hence no bidder who has 100% equity in the Project

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can dilute it to a level below 51% till the start of commercial operations. Remaining stake can be
diluted as per the provisions of Clause 5.3.3.

5.4. Novation
The Concessionaire may be allowed to novate the agreement after completion of three consecutive years of
commercial operations. The Concessionaire shall submit the details of the proposed novatee along with its
other qualifications (financial and technical capabilities) to the Concessioning Authority for its due approval.
Such novation shall be subject to execution of proper documents by the proposed novatee. Concessioning
Authority shall reserve the right to reject any novation at any time.

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Article 6. Obligations of the Concessioning Authority


6.1. Obligations of the Concessioning Authority

6.1.1. The Concessioning Authority shall, at its own cost and expense, undertake, comply with and perform all its
obligations set out in this Agreement or arising hereunder.

6.1.2. The Concessioning Authority agrees to provide support to the Concessionaire and undertakes to observe,
comply with and perform, subject to and in accordance with the provisions of this Agreement and the
Applicable Laws, the following:
(a) upon written request from the Concessionaire, and subject to the Concessionaire complying
with Applicable Laws, provide all reasonable support and assistance to the Concessionaire
in procuring Applicable Permits required from any Government Instrumentality for
implementation and operation of the Project;
(b) upon written request from the Concessionaire, assist the Concessionaire in obtaining
access to all necessary infrastructure facilities and utilities, including water at rates and on
terms no less favourable to the Concessionaire than those generally available to
commercial customers receiving substantially equivalent services;
(c) extend the assistance of its good offices on a reasonable effort basis to assist the
Concessionaire in the provision of electricity;
(d) procure that no barriers are erected or placed on the Project site or the way towards the
Project site by the Concessioning Authority, by any Government Instrumentality or persons
claiming through or under it, except for reasons of Emergency or national security, law;
(e) assist the Concessionaire in procuring Police assistance for regulation of movement of any
person on the Project site, removal of trespassers and for security of the material, labour
and machinery;
(f) not to do or omit to do any act, deed or thing which may in any manner be violative of any of
the provisions of this Agreement; and
(g) support, cooperate with and facilitate the Concessionaire in the implementation of the
Project.

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Article 7. Representations and Warranties


7.1. Representations and Warranties of the Concessionaire
The Concessionaire represents and warrants to the Concessioning Authority that:
(a) it is duly organized and validly existing under the laws of India, and has full power and
authority to execute and perform its obligations under this Agreement and to carry out the
transactions contemplated hereby;
(b) it has taken all necessary corporate and other actions under Applicable Laws to authorize
the execution and delivery of this Agreement and to validly exercise its rights and perform
its obligations under this Agreement;
(c) it has the financial standing and capacity to undertake the Project in accordance with the
terms of this Agreement;
(d) this Agreement constitutes its legal, valid and binding obligation, enforceable against it in
accordance with the terms hereof, and its obligations under this Agreement will be legally
valid, binding and enforceable obligations against it in accordance with the terms hereof;
(e) it is subject to the laws of India, and hereby expressly and irrevocably waives any immunity
in any jurisdiction in respect of this Agreement or matters arising there under including any
obligation, liability or responsibility hereunder;
(f) the information furnished in the Bid and as updated on or before the date of this Agreement
is true and accurate in all respects as on the date of this Agreement;
(g) the execution, delivery and performance of this Agreement will not conflict with, result in the
breach of, constitute a default under, or accelerate performance required by any of the
terms of its Memorandum and Articles of Association or any Applicable Laws or any
covenant, contract, agreement, arrangement, understanding, decree or order to which it is a
party or by which it or any of its properties or assets is bound or affected;
(h) there are no actions, suits, proceedings, or investigations pending or, to its knowledge,
threatened against it at law or in equity before any court or before any other judicial, quasi-
judicial or other authority, the outcome of which may result in the breach of this Agreement
or which individually or in the aggregate may result in any material impairment of its ability
to perform any of its obligations under this Agreement;
(i) it has no knowledge of any violation or default with respect to any order, writ, injunction or
decree of any court or any legally binding order of any Government Instrumentality which
may result in any material adverse effect on its ability to perform its obligations under this
Agreement and no fact or circumstance exists which may give rise to such proceedings that
would adversely affect the performance of its obligations under this Agreement;
(j) it has complied with Applicable Laws in all material respects and has not been subject to
any fines, penalties, injunctive relief or any other civil or criminal liabilities which in the
aggregate have or may have a material adverse effect on its ability to perform its obligations
under this Agreement;
(k) the existing Lead Consortium Members hold not less than 51% (fifty one percent) of its
issued and paid up Equity and together with the existing consortium member hold not less
than 100% as on the date of this Agreement and the respective holding of each Consortium
Member conforms to the representation made by the Consortium and accepted by the

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Concessioning Authority as part of the Bid and that no member of the Consortium shall hold
less than 11% (eleven per cent) of such as per the provisions of Article 5.3;
(l) no order has been made and no resolution has been passed for the winding up of the
Concessionaire or for a provisional liquidator to be appointed in respect of the
Concessionaire and no petition has been presented and no meeting has been convened for
the purpose of winding up the Concessionaire. No receiver has been appointed in respect of
the Concessionaire or all or any of its assets. The Concessionaire is not insolvent or unable
to pay its debts as they fall due.
(m) no representation or warranty by it contained herein or in any other document furnished by it
to the Concessioning Authority or to any Government Instrumentality in relation to
Applicable Permits contains or will contain any untrue statement of material fact or omits or
will omit to state a material fact necessary to make such representation or warranty not
misleading; and
(n) no sums, in cash or kind, have been paid or will be paid, by it or on its behalf, to any person
by way of fees, commission or otherwise for securing the grant of land or entering into this
Agreement or for influencing or attempting to influence any officer or employee of the
Concessioning Authority in connection therewith.
(o) It shall not novate the Concession Agreement and any rights and obligation arising
therefrom to any party without any written approval from the Concessioning Authority

7.2. Representations and Warranties of the Concessioning Authority


The Concessioning Authority represents and warrants to the Concessionaire that:
(a) it has full power and authority to execute, deliver and perform its obligations under this
Agreement and to carry out the transactions contemplated herein and that it has taken all
actions necessary to execute this Agreement, exercise its rights and perform its obligations,
under this Agreement;
(b) it has taken all necessary action under the Applicable Laws to authorise the execution,
delivery and performance of this Agreement;
(c) it has the financial standing and capacity to perform its obligations under the Agreement;
(d) this Agreement constitutes a legal, valid and binding obligation enforceable against it in
accordance with the terms hereof;
(e) there are no actions, suits or proceedings pending or, to its knowledge, threatened against it
at law or in equity before any court or before any other judicial, quasi-judicial or other
authority, the outcome of which may result in the default or breach of this Agreement or
which individually or in the aggregate may result in any material impairment of its ability to
perform its obligations under this Agreement;
(f) it has no knowledge of any violation or default with respect to any order, writ, injunction or
any decree of any court or any legally binding order of any Government Instrumentality
which may result in any material adverse effect on the Concessionaires ability to perform its
obligations under this Agreement;
(g) it has complied with Applicable Laws in all material respects;
(h) it has not entered into any other Agreement, contract, transaction, arrangement or
understanding in relation to the same Project or part of the Project with any third party, or
the sale, Concession assignment, or other disposition in whole or in part in respect of the
said land other than the disclosed in this Agreement;

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(i) all information provided by it in the Tender Notice and invitation to bid in connection with the
Project is, to the best of its knowledge and belief, true and accurate in all material respects;
(j) it has good and valid right for construction of the Project, and has power and authority to
give land on 90 years Concession to the Concessionaire; and
(k) upon the Concessionaire completing the Project as per this Agreement, and performing the
covenants herein, it shall not at any time during the 90 years Concession, interfere with
peaceful enjoyment of the land by the Concessionaire, except in accordance with the
provisions of this Agreement.

7.3. Disclosure
In the event that any occurrence or circumstance comes to the attention of either Party that renders
any of its aforesaid representations or warranties untrue or incorrect, such Party shall immediately
notify the other Party of the same. Such notification shall not have the effect of remedying any
breach of the representation or warranty that has been found to be untrue or incorrect nor shall it
adversely affect or waive any obligation of either Party under this Agreement.

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Article 8. Disclaimer
8.1. Disclaimer

8.1.1. The Concessionaire acknowledges that prior to the execution of this Agreement, the Concessionaire has,
after a complete and careful examination, made an independent evaluation of the Tender Notice, Scope of
the services to be provided, Project site, Specifications and Standards set for providing quality of services,
local conditions, possible demand and all information provided by the Concessioning Authority, and has
determined to its satisfaction the accuracy or otherwise thereof and the nature and extent of difficulties, risks
and hazards as are likely to arise or may be faced by it in the course of performance of its obligations
hereunder. Save as provided in Clause 7.2, the Concessioning Authority makes no representation
whatsoever, express, implicit or otherwise, regarding the accuracy and/or completeness of the information
provided by it and the Concessionaire confirms that it shall have no claim whatsoever against the
Concessioning Authority in this regard.

8.1.2. The Concessionaire acknowledges and hereby accepts the risk of inadequacy, mistake or error in or relating
to any of the matters set forth in Clause 8.1.1 above and hereby acknowledges and agrees that the
Concessioning Authority shall not be liable for the same in any manner whatsoever to the Concessionaire or
any person claiming through or under this Agreement.

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Article 9. Performance Security


9.1. Performance Security
The Concessionaire has submitted to the Concessioning Authority Performance Guarantee of
Rs.12, 00, 00,000 (Rupees Twelve Crores Only) in the form of a Bank Guarantee in favor of Kanpur
Development Authority, payable at Kanpur; the details of which are given below:
The Performance Security shall be valid for a period of twelve months and shall be renewed every
year, at least 30 days prior to the last date. All charges, fees, costs and expenses related to the
Bank Guarantee shall be borne and paid by the Concessionaire. 25% of the Performance Security
in the form of bank guarantee shall be released to the Concessionaire on the issuance of
Construction Completion Certificate by the Concessioning Authority. The next 25% of the
Performance Security in the form of bank guarantee shall be released to the Concessionaire on the
start of Commercial Operation. The Concessionaire undertakes and warrants to Concessioning
Authority that the balance 50% of bank guarantee furnished as above shall be irrevocable and shall
continue to be effective and enforceable six months beyond the period of six months from the date
of the expiry of the Concession Period.

9.2. Appropriation of Performance Security


Upon occurrence of a Concessionaire Default, the Concessioning Authority shall, without prejudice
to its other rights and remedies hereunder or in law, be entitled to invoke and appropriate the
relevant amounts from the Performance Security as Damages for such Concessionaire Default.
Upon such invocation and appropriation from the Performance Security, the Concessionaire shall,
within 15 (fifteen) days thereof, replenish, in case of partial appropriation, the Performance Security
to its original level, and in case of appropriation of the entire Performance Security provide a fresh
Performance Security, as the case may be, and the Concessionaire shall, within the time so
granted, replenish or furnish fresh Performance Security as aforesaid failing which the
Concessioning Authority shall be entitled to terminate this Agreement in accordance with Article 13.

9.3. Release of Performance Security

25% of the Performance Security in the form of bank guarantee shall be released to the
Concessionaire on the issuance of Construction Completion Certificate by the Concessioning
Authority. The next 25% of the Performance Security in the form of bank guarantee shall be
released to the Concessionaire on the start of Commercial Operation. The balance 50% of the
Performance Security in the form of bank guarantee shall remain in force and effect beyond the
period of six months from the date of the expiry of the Concession Period. It shall be duly
discharged and released to the Concessionaire beyond the period of six months from the date of
expiry of the Concession Period and transfer of the Project along with the land to KDA.
The performance security in the form of bank guarantee shall be renewed every year till the end of
the Concession Period and transfer of the Project along with the land to KDA. If the Agreement is
terminated due to any event other than a Concessionaire Event of Default, the Performance
Security shall, subject to the Concessioning Authoritys right to receive or recover amounts, if any,
due from the Concessionaire under this Agreement, be duly discharged and released to the
Concessionaire.

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Article 10. Access on Project Site


10.1. Project Site
The Project site shall comprise of the land as described in Schedule- 1 and which shall be given on
Concession by the Concessioning Authority to the Concessionaire for 90 years.

10.1.1. The Concessioning Authority on providing the performance security and signing this Agreement, shall
within 15 days, give on Concession to the Concessionaire, the Project site for 90 years for the Scope of the
Project as mentioned in Article 2.

10.1.2. It is being expressly agreed and understood that the Concessioning Authority shall have no liability
whatsoever in respect of survey and investigations carried out or work undertaken by the Concessionaire
pursuant hereto in the event of Termination or otherwise.

10.1.3. It is expressly agreed that the rights granted hereunder shall terminate automatically and forthwith, without
the need for any action to be taken by the Concessioning Authority to terminate the rights, upon the
Termination of this Agreement for any reason whatsoever.

10.1.4. It is expressly agreed that mining rights do not form part of the rights granted to the Concessionaire under
this Agreement and the Concessionaire hereby acknowledges that it shall not have any mining rights or
any interest in the underlying minerals on or under the area where cable have been laid. For the avoidance
of doubt, mining rights mean the right to mine any and all minerals or interest therein.

10.2. Others

10.2.1. Access to the Concessioning Authority and any person appointed as the Engineers / consultants appointed
by Concessioning Authority

The right of way granted for construction on the Project site shall always be subject to the right of access of
the person appointed by the Concessioning Authority for inspection, viewing and exercise of their rights
and performance of their obligations under this Agreement.

10.2.2. Special/temporary right of way


The Concessionaire shall bear all costs and charges for any special or temporary right of way
required by it in connection with access to the Project Site. The Concessionaire shall obtain at its
cost such facilities on or outside the Site as may be required by it for the purposes of the
Construction and the performance of its obligations under this Agreement.

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Article 11. Construction on the Project Site


11.1. Obligations prior to the commencement of any work
Prior to commencement of any work, the Concessionaire shall:
(a) submit to the Concessioning Authority time schedule for completion;
(b) appoint its representative duly authorised to deal with the Concessioning Authority in
respect of all matters under or arising out of or relating to this Agreement;
(c) Undertake, do and perform all such acts, deeds and things as may be necessary or required
before commencement of any work under and in accordance with this Agreement, the
Applicable Laws and Applicable Permits; and
(d) Procure all such approvals/consents/permits as necessary as per applicable laws

11.2. Project Start and Completion date

11.2.1. On or after the Effective Date, the Concessionaire shall undertake construction of Project. The 36th month
from the Effective Date shall be the Scheduled Completion Date for completion of the Project and the
Concessionaire agrees and undertakes that atleast 250 beds of the Hospital shall be completed on or
before the Scheduled Completion Date. The remaining 250 beds shall be completed within 2 years from
the Scheduled Completion Date.

11.2.2. In the event that Project is not completed by the Scheduled Completion Date, unless the delay is on
account of reasons solely attributable to the Concessioning Authority or due to Force Majeure, the
Concessioning Authority shall encash 10% of the Performance Security amount per month, for a maximum
period of six months after which Concessioning Authority shall be entitled to terminate this Agreement. .
The Performance Security shall be replenished by the Concessionaire as soon the Performance Security is
encashed by the Concessioning Authority.

11.3. Completion Certificate


The Concessionaire after completion of the Project shall inform in writing to the Concessioning
Authority that it has completed the construction as per Project scope. The Concessioning Authority
shall issue the Completion Certificate, after which the Concessionaire can start the commercial
operations.

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Article 12. Force Majeure


12.1. Force Majeure
As used in this Agreement, the expression Force Majeure or Force Majeure Event shall mean
occurrence in India of any or all of events, as defined in Clause 12.2, if it affects the performance by
the Party claiming the benefit of Force Majeure (the Affected Party) of its obligations under this
Agreement and which act or event (i) is beyond the reasonable control of the Affected Party, and (ii)
the Affected Party could not have prevented or overcome by exercise of due diligence and following
Good Industry Practice, and (iii) has Material Adverse Effect on the Affected Party.

12.2. Force Majeure Events


A Force Majeure Event shall mean one or more of the following acts or events:
(a) act of God, plague, lightning, earthquake, landslide, cyclone, flood, volcanic eruption,
radioactive contamination;
(b) an act of war (whether declared or undeclared), invasion, armed conflict or act of foreign
enemy)
(c) any failure of another service provider to the extent caused by any of the Force Majeure
Event mentioned above affecting the performance of the Agreement;
(d) any event or circumstances of a nature analogous to any of the foregoing;

12.3. Duty to Report Force Majeure Event


Upon occurrence of a Force Majeure Event, the Affected Party shall by notice report such
occurrence to the other Party forthwith. Any notice pursuant hereto shall include full particulars of:
(a) the nature and extent of each Force Majeure Event with evidence in support thereof;
(b) the estimated duration and the effect or probable effect which such Force Majeure Event is
having or will have on the Affected Partys performance of its obligations under this
Agreement;
(c) the measures which the Affected Party is taking or proposes to take for alleviating the
impact of such Force Majeure Event; and
(d) any other information relevant to the Affected Partys claim.
The Affected Party shall not be entitled to any relief under the Agreement for or in respect of a
Force Majeure Event unless it shall have notified the other Party of the occurrence of the Force
Majeure Event as soon as reasonably practicable, and in any event not later than 24 (twenty four)
hours after the Affected Party knew, or ought reasonably to have known, of its occurrence, and
shall have given particulars of the probable material effect that the Force Majeure Event is likely to
have on the performance of its obligations under this Agreement.

12.4. Effect of Force Majeure Event


Upon the occurrence of any Force Majeure Event the period set forth for the Project Completion
Date shall be extended by a period equal in length to the duration of the Force Majeure Event.

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12.5. Allocation of Costs Arising out of Force Majeure


Upon occurrence of any Force Majeure Event, the Parties shall bear their respective costs and no
Party shall be required to pay to the other Party any costs thereof. Neither Party shall be liable in
any manner whatsoever to the other Party in respect of any loss, damage, cost, expense, claims,
demands and proceedings relating to or arising out of occurrence or existence of any Force
Majeure Event or exercise of any right pursuant hereto.

12.6. Dispute Resolution


In the event that the Parties are unable to agree in good faith about the occurrence or existence of
a Force Majeure Event, such Dispute shall be finally settled in accordance with the Dispute
Resolution Procedure as mentioned in Article 15; provided that the burden of proof as to the
occurrence or existence of such Force Majeure Event shall be upon the Party claiming relief and/or
excuse on account of such Force Majeure Event.

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Article 13. Termination


13.1. Termination for Concessionaire Default
Save as otherwise provided in this Agreement, in the event that any of the defaults specified below
shall have occurred, and the Concessionaire fails to cure the default within the Cure Period set
forth below, or where no Cure Period is specified, then within a Cure Period of 15 (fifteen) days, the
Concessionaire shall be deemed to be in default of this Agreement (a Concessionaire Default),
unless the default has occurred solely as a result of any breach of this Agreement by the
Concessioning Authority or due to Force Majeure event. The defaults referred to herein shall
include:
(a) the Performance Security has been partially or fully invoked and appropriated by the
Concessioning Authority as per the Concession Agreement and the Concessionaire fails to
replenish or provide fresh Performance Security within a Cure Period of 15 (fifteen) days;
(b) the Concessionaire does not make payment to the Concessioning Authority and remains in
default for a period of more than 15 days from the due date of payment;
(c) the Concessionaire does not complete the Project as per the date mentioned in the
Agreement and continues to be in default for 180 (One Hundred and Eighty) days;
(d) the Concessionaire does not construct and operate any of the items mentioned in the scope
of work;
(e) the Concessionaire abandons or manifests intention to abandon the Project without prior
written consent of the Concessioning Authority;
(f) the Concessionaire has failed to make any payment towards damages to any user or any
utility within the period specified in this Agreement;
(g) the Concessionaire repudiates this Agreement or otherwise takes any action or evidences
or conveys an intention not to be bound by the Agreement;
(h) Change in management control of the Concessionaire Company which according to the
Concessioning Authority may have material adverse effect towards the completion of the
Project.
(i) the Concessionaire is adjudged bankrupt or insolvent, or if a trustee or receiver is appointed
for the Concessionaire or for the whole or material part of its assets at any time before the
Scheduled Project Completion Date;
(j) the Concessionaire has been, or is in the process of being liquidated, dissolved, wound-up,
amalgamated or reconstituted in a manner that would cause, in the reasonable opinion of
the Concessioning Authority, a Material Adverse Effect;
(k) a resolution for winding up of the Concessionaire is passed, or any petition for winding up of
the Concessionaire is admitted by a court of competent jurisdiction and a provisional
liquidator or receiver is appointed and such order has not been set aside within 90 (ninety)
days of the date thereof or the Concessionaire is ordered to be wound up by Court;
(l) the Concessionaire has failed to fulfill any obligation, for which failure Termination has been
specified in this Agreement; or
(m) the Concessionaire commits a material default in complying with any other provision of this
Agreement.

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(n) The Concessionaire novates and /or assigns the agreement to any third party without any
prior approval from the Concessioning Authority

13.2. Procedure to issue Termination Notice


Without prejudice to any other rights or remedies which the Concessioning Authority may have
under this Agreement, upon occurrence of a Concessionaire Default, the Concessioning Authority
shall be entitled to terminate this Agreement by issuing a Termination Notice to the Concessionaire;
provided that before issuing the Termination Notice, the Concessioning Authority shall by a notice
inform the Concessionaire of its intention to issue such Termination Notice and grant 15 (fifteen)
days to the Concessionaire to make a representation, and may after the expiry of such 15 (fifteen)
days, whether or not it is in receipt of such representation, issue the Termination Notice.

13.3. Effect of Termination


Upon Termination as per article 13.1, the Concessionaire hereby acknowledges that no
Termination Payment shall be due or payable by the Concessioning Authority. Concessionaire
acknowledges that within 10 days of termination, the Concessionaire vacates the Project site.
Concessionaire acknowledges that once the agreement is terminated the land allocated shall be
returned back to the Concessioning Authority. In such case, the lease deed will stand cancelled
ipso facto and land is returned back to the Concessioning Authority automatically. The entire
construction made by the Concessionaire till that date on the Project site as part of the scope of
work shall get transferred without any consideration to the Concessioning Authority. Concessioning
Authority at its own discretion may repay the consideration already paid by the Concessionaire after
adjusting for any direct or indirect losses that Concessioning Authority might have incurred due to
delay in completion of the Project. No liability with respect to the land or assets shall devolve on
Concessioning Authority.

13.4. Other Rights and Obligations of the Concessioning Authority


Upon Termination for any reason whatsoever, the Concessioning Authority shall:
(a) be deemed to have taken possession and control of the Project site and any construction
made on such site till the date of termination;
(b) take possession and control of all materials, stores, implements and construction on or
about the Project;
(c) be entitled to restrain the Concessionaire and any person claiming through or under the
Concessionaire from entering upon the Project Site or any part of the Project; and
(d) Invoke the Performance Security as part Damages.
In case termination is done by the Concessioning Authority not because of the default of the
Concessionaire, then in such condition the Concessioning Authority will pay for all the financial loses
incurred by the Concessionaire and the quantum of the financial losses will be decided by the
Arbitrator as per Clause 15.3.

13.5. The Concessioning Authority shall have at all times right to reject any third party which has been
proposed in relation to the novation of this agreement

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Article 14. Liability and Indemnity

14.1. General indemnity

The Concessionaire will indemnify, defend, save and hold harmless the Concessioning Authority
and its officers, employees, agents and consultants against any and all suits, proceedings, actions,
demands and third party claims for any loss, damage, cost and expense of whatever kind and
nature arising out of any breach by the Concessionaire of any of its obligations under this
Agreement or any related Agreement, except to the extent that any such suits, proceedings,
actions, demands and claims have arisen due to any negligent act or omission, or breach of this
Agreement on the part of the Concessioning Authority indemnified persons.

14.2. Liability of Concessioning Authority

The Concessioning Authority will indemnify, defend, save and hold harmless the Concessionaire
against any and all suits, proceedings, actions, demands and third party claims for any loss,
damage, cost and expense of whatever kind and nature arising out of

(a) defect in title and/or the rights of the Concessioning Authority in the land given on
Concession to the Concessionaire
(b) breach by the Concessioning Authority of any of its obligations under this Agreement or any
related Agreement, which materially and adversely affect the performance by the
Concessionaire of its obligations under this Agreement, save and except that where any
such claim, suit, proceeding, action, and/or demand has arisen due to a negligent act or
omission, or breach of any of its obligations under any provision of this Agreement or any
related Agreement and/or breach of its statutory duty on the part of the Concessionaire, its
subsidiaries, affiliates, contractors, employees or agents and the same shall be the liability
of the Concessionaire.

14.3. Indemnity by the Concessionaire

Without limiting the generality of Clause 14.1, the Concessionaire shall fully indemnify, hold
harmless and defend the Concessioning Authority from and against any and all loss and/or
damages arising out of or with respect to:

(a) failure of the Concessionaire to comply with Applicable Laws and Applicable Permits;
(b) payment of taxes required to be made by the Concessionaire in respect of the income or
other taxes of the Concessionaires contractors, suppliers and representatives; or
(c) non-payment of amounts due as a result of materials or services furnished to the
Concessionaire or any of its contractors which are payable by the Concessionaire or any of
its contractors.
(d) Breach by the Concessionaire of any of the obligations under this Agreement.

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14.4. No consequential claims

Notwithstanding anything to the contrary contained in this Article 14, the indemnities herein provided
shall not include any claim or recovery in respect of any cost, expense, loss or damage of an
indirect, incidental or consequential nature, including loss of profit, except as expressly provided in
this Agreement.

14.5. Survival on Termination

The provisions of this Article 14 shall survive Termination.

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Article 15. Dispute Resolution


15.1. Dispute resolution

15.1.1. Any dispute, difference or controversy of whatever nature howsoever arising under or out of or in relation to
this Agreement (including its interpretation) between the Parties, and so notified in writing by either Party to
the other Party (the Dispute) shall, in the first instance, be attempted to be resolved amicably in
accordance with the conciliation procedure set forth in Clause 15.2.

15.1.2. The Parties agree to use their best efforts for resolving all Disputes arising under or in respect of this
Agreement promptly, equitably and in good faith, and further agree to provide each other with reasonable
access during normal business hours to all non-privileged records, information and data pertaining to any
Dispute.

15.2. Conciliation
In the event of any Dispute between the Parties, either Party may call upon the Vice Chairman of
the Concessioning Authority to mediate and assist the Parties in arriving at an amicable settlement
thereof. Failing mediation by the Vice Chairman of the Concessioning Authority within 7 (seven)
days from the date of reference to discuss and attempt to amicably resolve the Dispute , either
Party may require such Dispute to be referred to the Principle Secretary, Housing for amicable
settlement. If the Dispute is not resolved as evidenced by the signing of written terms of settlement
within 30 (thirty) days of the notice in writing referred to in Clause 15.1.1 or such longer period as
may be mutually agreed by the Parties, either Party may refer the Dispute to arbitration in
accordance with the provisions of Clause 15.3.

15.3. Arbitration

15.3.1. Any Dispute which is not resolved amicably by conciliation, as provided in Clause 15.2, shall be decided by
reference to Arbitral Tribunal appointed in accordance with Clause 15.3.2. Arbitration shall be held in
accordance with the provisions of Arbitration and Conciliation Act, 1996 .The venue of arbitration shall be
Kanpur, and the language of arbitration proceedings shall be English.

15.3.2. The Arbitral Tribunal shall consist of three arbitrators. Each Party shall appoint one arbitrator, and the third
arbitrator shall be appointed by the two arbitrators so appointed, and in the event of disagreement between
the two arbitrators, the appointment shall be made in accordance with the Arbitration and Conciliation Act,
1996.

15.3.3. The arbitrators shall make a reasoned award (the Award). Any Award made in any arbitration held
pursuant to this Article 15 shall be final and binding on the Parties as from the date it is made, and the
Concessionaire and the Concessioning Authority agree and undertake to carry out such Award without
delay.

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Draft Concession Agreement for Design, Build, Finance, Operation and Transfer Super Specialty Hospital in Kanpur

15.3.4. The Concessionaire and the Concessioning Authority agree that an Award may be enforced against the
Concessionaire and/or the Concessioning Authority, as the case may be, and their respective assets
wherever situated.

15.3.5. This Agreement and the rights and obligations of the Parties shall remain in full force and effect, pending
the Award in any arbitration proceedings hereunder.

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Draft Concession Agreement for Design, Build, Finance, Operation and Transfer Super Specialty Hospital in Kanpur

Article 16. Miscellaneous


16.1. Governing Law and Jurisdiction
This Agreement shall be construed and interpreted in accordance with and governed by the laws of
India, and the courts at Kanpur shall have jurisdiction over matters arising out of or relating to this
Agreement.

16.2. Waiver of Immunity


Each Party unconditionally and irrevocably:
(a) agrees that the execution, delivery and performance by it of this Agreement constitute
commercial acts done and performed for commercial purpose;
(b) agrees that, should any proceedings be brought against it or its assets, property or
revenues in any jurisdiction in relation to this Agreement or any transaction contemplated by
this Agreement, no immunity from such proceedings shall be claimed by or on behalf of the
Party with respect to its assets;
(c) waives any right of immunity which it or its assets, property or revenues now has, may
acquire in the future or which may be attributed to it in any jurisdiction; and

16.3. Delayed Payments


The Parties hereto agree that payments due from one Party to the other Party under the provisions
of this Agreement shall be made within the period set forth therein, and if no such period is
specified, within 15 (fifteen) days of receiving a demand along with the necessary particulars. In the
event of delay beyond such period, the defaulting Party shall pay penalty for the period of delay
calculated at a rate equal to 12% per annum, and recovery thereof shall be without prejudice to the
rights of the Parties under this Agreement including Termination thereof.

16.4. Waiver

16.4.1. Waiver, including partial or conditional waiver, by either Party of any default by the other Party in the
observance and performance of any provision of or obligations under this Agreement:-
(a) shall not operate or be construed as a waiver of any other or subsequent default hereof or
of other provisions or obligations under this Agreement;
(b) shall not be effective unless it is in writing and executed by a duly authorised representative
of the Party; and
(c) shall not affect the validity or enforceability of this Agreement in any manner.

16.4.2. Neither the failure by either Party to insist on any occasion upon the performance of the terms,
conditions and provisions of this Agreement or any obligation thereunder nor time or other indulgence
granted by a Party to the other Party shall be treated or deemed as waiver of such breach or acceptance of
any variation or the relinquishment of any such right hereunder.

16.5. Liability for Inspection of Documents


Except to the extent expressly provided in this Agreement:
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Draft Concession Agreement for Design, Build, Finance, Operation and Transfer Super Specialty Hospital in Kanpur

(a) no review, comment or inspection by the Concessioning Authority of any document submitted by the
Concessionaire nor any observation or inspection of any document or operations conducted at the
Project Site hereunder shall relieve or absolve the Concessionaire from its obligations, duties and
liabilities under this Agreement, the Applicable Laws and Applicable Permits; and
(b) the Concessioning Authority shall not be liable to the Concessionaire by reason of any review,
comment, approval, observation or inspection referred to in Sub clause (a) above.

16.6. Exclusion of Implied Warranties etc.


This Agreement expressly excludes any warranty, condition or other undertaking implied at law or
by custom or otherwise arising out of any other Agreement between the Parties or any
representation by either Party not contained in a binding legal Agreement executed by both Parties.

16.7. Survival

16.7.1. Termination shall:


(a) not relieve the Concessionaire or the Concessioning Authority, as the case may be, of any
obligations hereunder which expressly or by implication survive Termination hereof; and
(b) except as otherwise provided in any provision of this Agreement expressly limiting the liability of
either Party, not relieve either Party of any obligations or liabilities for loss or damage to the other
Party arising out of or caused by acts or omissions of such Party prior to the effectiveness of such
Termination or arising out of such Termination.

16.7.2. All obligations surviving Termination shall only survive for a period of 5 (five) years following the date
of such Termination.

16.8. Entire Agreement


This Agreement and the Schedules together constitute a complete and exclusive statement of the
terms of the Agreement between the Parties on the subject hereof, and no amendment or
modification hereto shall be valid and effective unless such modification or amendment is agreed to
in writing by the Parties and duly executed by persons especially empowered in this behalf by the
respective Parties. All prior written or oral understandings, offers or other communications of every
kind pertaining to this Agreement are abrogated and withdrawn.

16.9. Severability
If for any reason whatever, any provision of this Agreement is or becomes invalid, illegal or
unenforceable or is declared by any court of competent jurisdiction or any other instrumentality to
be invalid, illegal or unenforceable, the validity, legality or enforceability of the remaining provisions
shall not be affected in any manner, and the Parties will negotiate in good faith with a view to
agreeing to one or more provisions which may be substituted for such invalid, unenforceable or
illegal provisions, as nearly as is practicable to such invalid, illegal or unenforceable provision.
Failure to agree upon any such provisions shall not be subject to the Dispute Resolution Procedure
set forth under this Agreement or otherwise.

16.10. No partnership
This Agreement shall not be interpreted or construed to create an association, joint venture or
partnership between the Parties, or to impose any partnership obligation or liability upon either

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Draft Concession Agreement for Design, Build, Finance, Operation and Transfer Super Specialty Hospital in Kanpur

Party, and neither Party shall have any right, power or authority to enter into any Agreement or
undertaking for, or act on behalf of, or to act as or be an agent or representative of, or to otherwise
bind, the other Party.

16.11. Third Parties


This Agreement is intended solely for the benefit of the Parties, and nothing in this Agreement shall
be construed to create any duty to, standard of care with reference to, or any liability to, any person
not a Party to this Agreement, unless expressly provided in this Agreement.

16.12. Successors and Assigns


This Agreement shall be binding upon, and inure to the benefit of the Parties and their lawful
successors, as per the provisions of this Agreement.

16.13. Notices
Unless otherwise stated, all notices, approvals, instructions and other communications for the
purposes of this Agreement shall be given in writing and may be given by facsimile, by personal
delivery or by sending the same by prepaid registered mail addressed to the Party concerned at its
address stated in the title of this Agreement or the fax numbers set out below and/or any other
address subsequently notified to the other Parties for the purposes of this clause 16.14 and shall
be deemed to be effective (in the case of registered mail) 10 calendar days after posting, (in the
case of facsimile) two Business Days after receipt of a transmission report confirming dispatch or
(in the case of personal delivery) at the time of delivery.

If to Concessioning Authority:

Address : Kanpur Development authority


Moti Jheel,Kanpur
Uttar Pradesh
Tel: No. 0091-522-2302578
Fax No. 0091-522-2398386

Attention : Vice Chairman

If to the Concessionaire:

Address :
Telephone :
Fax :
Attention :

16.14. Language
All notices required to be given by one Party to the other Party and all other
communications, Documentation and proceedings which are in any way relevant to this
Agreement shall be in writing and in English or Hindi language.

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Draft Concession Agreement for Design, Build, Finance, Operation and Transfer Super Specialty Hospital in Kanpur

16.15. Counterparts
This Agreement may be executed in two counterparts, each of which, when executed and
delivered, shall constitute an original of this Agreement.

16.16. Validity
This Agreement shall be valid for the entire concession period

IN WITNESS WHEREOF THE PARTIES HAVE EXECUTED AND DELIVERED


THIS AGREEMENT AS OF THE DAY, MONTH AND YEAR FIRST ABOVE
WRITTEN.
SIGNED, SEALED AND SIGNED, SEALED AND
DELIVERED DELIVERED
For and on behalf of For and on behalf of
Concessioning Authority (Kanpur Development CONCESSIONAIRE by:
Authority) by:

(Signature) (Signature)
(Name) (Name)
(Designation) (Designation)

In the presence of:


1.

2.

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Draft Concession Agreement for Design, Build, Finance, Operation and Transfer Super Specialty Hospital in Kanpur

Schedule 1. Project Site

Request for Proposal Volume II


Page 41
Schedule 2. Technical Schedule
The proposed Super specialty hospital at Kanpur shall have 500 beds. Atleast four specialties from the following
disciplines shall be developed in the Hospital.
Sr. No. Departments / Specialties
1 Trauma Care
2 Cardio Thoracic care unit (ICCU- Intensive Cardiac Care Unit)
3 Intervention specialty and Cerebral Intervention
4 Kidney Transplant (Hemodialysis)
5 Neurology unit
6 Obs & Gynecology
7 Pediatric unit (with NICU Neonetal Intensive Care unit)
8 Dental unit for surgery
9 Ophthalmology and ENT
10 Cancer unit

The Concessionaire may also develop additional specialties other than those mentioned above. The hospital
shall also have a round the clock emergency unit.

A. Planning

The Concessionaire shall plan the facilities, manpower and the service as per the Indian Public Health Standard
(IPHS).
 The hospital shall be developed with 500 bed capacity within 36 months from the Effective Date.
However, the Concessionaire is allowed to construct 250 bed capacity within 36 months from the
Effective Date and remaining 250 bed capacity within 60 months from the Effective Date.
 The hospital shall be planned in accordance with the Development Control Regulations applicable to the
region and norms if any prescribed by the Medical Council of India, Ministry of Health and Family
Welfare and the State Health Department.
 The developer shall obtain necessary clearances and approval for the plans from the relevant authority
as per the requirements.
 Service Apartments can be provided within the hospital complex to cater to the needs of the patients
and their relatives.
 Institute offering Laboratory Technician courses, Nursing courses can also be developed within the
hospital complex.
 Restaurants, ATMs, Pharmacy for the convenience of the patients can be provided within the hospital
complex.
 Research Institutes can also be setup in the hospital complex.
 Helipad for picking up patients may be provided.

B. Designing

 Modular design to enable addition of new departments, least disturbance to existing facilities, quality,
and added benefits of economy of scale shall be preferred.
 Architectural design norms as per NBC (National Building Code 2005)
 Structural Design norms as per NBC and BIS (Bureau of Indian Standards)
 Services design norms as per CPEEHO (Central Public Health and Environmental Engineering
Organisation), NBC and BIS

42
In case of contradiction between the IPHS norms and the Design Norms specified above, the former shall prevail.

C. Construction

The construction shall be strictly as per the design norms specified above.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Disclaimer:
Neither Awas Bandhu, UP nor their employees or consultants make any
representation or warranty as to the accuracy, reliability or completeness of
the information in this Pre Feasibility report . Awas Bandhu, UP nor their
employees or consultants take any responsibility for any kind of investment
done on the basis of this report. This report is only for reference of the
bidders.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Table of Content

1 Background ........................................................................................... 4
1.1 Kanpur City Profile 4

2 Benchmarking Study ........................................................................ 7


2.1 Indian Healthcare Scenario 7
2.2 Key Healthcare Statistics 9
2.3 Demand Drivers for Healthcare 10
2.4 Benchmarking of Hospitals 18
2.5 Key Observations 33

3 Healthcare Scenario in Uttar Pradesh................................... 38


3.1 Healthcare Facilities in Kanpur 45
3.2 Partial List of Hospitals 45
3.3 Partial List of Diagnostic Clinics 47

4 Project costing and Phasing....................................................... 49


4.1 Site Details 49
4.2 Departments proposed in the Hospital 50
4.3 Hospital Configuration 50
4.4 Area Statement 51
4.5 Capital Expenditure 52
4.6 Project Costing and Phasing 54
4.7 Project Funding 54

5 Feasibility Study ............................................................................... 55


5.1 Revenue Assumptions 55
5.2 Operating Expenses 58
5.3 Summary of Operating Expenses 61
5.4 Debt and Interest Repayment 62
5.5 Financial Viability 62
5.6 Projected Profit and Loss Statement 62
5.7 Projected Balance Sheet Error! Bookmark not defined.
5.8 Projected Cash Flow Statement Error! Bookmark not defined.

6 Conclusion............................................................................................ 65

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Abbreviations
FSI Floor Space Index
GoUP Government of Uttar Pradesh
IURP Integrated Urban Rejuvenation Plan
JCAHO Joint Commission on the Accreditation of Healthcare Organisation
JCI Joint Commission International
KDA Kanpur Development Authority
WHO World Health Organisation

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

1 Background

1.1 Kanpur City Profile

Kanpur is the
biggest city of the
State of Uttar
Pradesh, sprawling
over an area of 260
sq km. It is also the
main centre of
commercial and
industrial activities
in state. It is known for its cotton and woolen textile and leather industries.
Apart from leather and textile industry, the fertilizer, chemicals, two wheelers,
soaps, Pan Masala, hosiery and engineering industries are also operating
prominently in the city. Kanpur is situated on bank of holy river Ganga and is
about 126 meters above the sea level.

1.1.1 Demographic and Social Profile


According to Census 2001, Kanpur has a population of 25.51 lakhs. It is
administratively divided into 6 zones and 110 wards with an average ward
population range of 19000 to 26000. The average annual growth of population
is 3.5 percent during 1991-2001. The average population density in Kanpur is
97.56 persons per hectare. The density in core area is six times higher than
the outer area. As per the simple graph method, proposed population is 48
lakhs in 2031 which means that another Kanpur will be added in next 25
years.

1.1.2 Economy

Kanpur has traditionally been an industrial city and on economic center. At one
point in time it was the second most industrialized city in India being second

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

only to Calcutta. Due to large number of cotton textile units and a vibrant
trade center for cotton it was also called he Manchester of India.

Kanpur has several locational advantages i.e. location at a vantage point on


two national highways i.e. NH2 and NH25; raw material availability for many
industries viz. leather, food processing, plastics etc., proximity to large
markets, availability of skilled manpower due to various institutes located
within and existing traditional industrial base attracting skilled workers to the
city.

During the British times, it was mainly the industries related to tanneries,
cotton and woolen clothes production, sugar mills, flour mills, refineries which
were established in Kanpur. Kanpur during that time was of strategic
importance for movement of troops from one region of the country to another.
This lead to development of a large cantonment base at Kanpur and
contributed to development of leather industry in the form of various saddle
units catering to the requirement of British troupes.

After independence, Kanpur continued to be an important city and large public


sector companies such as British India Corporation, National Textile
Corporation, ordnance factories, etc were set up here. Private sector also set
up large units such as many factories of JK Industries group, Lohia machines,
Duncans, etc.

As far as economy is concerned, most of the yesterdays industries are sick.


Mostly small and medium sector industries are flourishing. Tanneries appear to
be thriving. There are not much of new age industries such as I.I.T. Kanpur is
growing as a trade and commerce centre. Kanpur has an image of dying city.
Power shortage and electricity cut for 10-12 hours per day on average being
observed. There is no air connectivity between major stations. All this create
hindrance in the economic growth of the city. For the economic growth of the
city, the infrastructure and means of communication needs to be improved so
that trading activities can be boost. The need is also felt to facilitate marketing
linkages for small scale industries.

At present, Kanpur has mostly industries relating to leather shoe making and
cotton textiles. Other factories include manufacture silk, woolen and jute
textiles, food products, fire-bricks, fertilizers, railway wagons, textile
machinery, television sets, metal ware, leather goods, soap, tents, durries,
fountain pens, hosiery, cutlery, television picture tubes, etc. In Kanpur (MC),
the banking services were availed by only 61 percent of the households
(Census 2001). About 8 percent of the households did not possess basic assets
such as vehicles (bicycles, scooter, moped, car, jeep, etc.), televisions and
radios.
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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Following are some of the key drivers of Kanpur city economy:


 Defense Establishments like OEF, SAF and Ordinance Factory etc.
 Tanneries, which have swelled from 170 nos in 1995 to 300 in 2006
 Coaching industry for I.I.T, JEE, IAS/IPS etc.
 Trading Activities

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

2 Benchmarking Study
2.1 Indian Healthcare Scenario

The global healthcare market has been one of the fastest growing markets in
the world over the last decade. Underlying this growth is a combination of
factors such as a) enhanced living standards, b) increase in aging population,
c) growing healthcare awareness and d) market-oriented industrial reforms in
many countries.

The healthcare industry is the world's largest industry with global revenues of
an estimated $2.8 trillion, or close to 9 per cent of global domestic product
(GDP). U.S. health care expenditures are $1.68 trillion in 2003. (Source : CII-
McKinsey Report).

The size of Indian healthcare industry is about US$ 20 billion (close to Rs


100,000 crore, or about 5% of GDP) and India could emerge as a major player
owing to its high population (1.05 bn- 2001census survey), which is the
second largest in the world.

India's healthcare sector has been growing rapidly and estimated to be worth
US$ 40 billion by 2012, according to Pricewaterhouse Coopers in its report,
'Healthcare in India: Emerging market report 2007'. Revenues from the
healthcare sector account for 5.2 per cent of the GDP, making it the third
largest growth segment in India.

The sector's growth will be driven by the country's growing middle class, which
can afford quality healthcare. Over 150 million Indians have annual incomes of
more than US$ 1,000, and many who work in the business services sector
earn as much as US$ 20,000 a year. Today at least 50 million Indians can
afford to buy Western medicines-a market only 20 per cent smaller than that
of the UK.
The growing purchasing power of Indian patients is revealed in the increased
business of air ambulance services. Around 365 airliftings worth several
millions of rupees happen in Delhi in a year on average.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

If the economy continues to grow faster than the economies of the developed
world, and the literacy rate keeps rising, much of western and southern India
will be middle class by 2020.

To meet this demand, the country needs US$ 50 billion annually for the next
20 years, says a CII study. India needs to add 2 million beds to the existing
1.1 million by 2027, and requires immediate investments of US$ 82 billion.

Funds in the sector have been largely private. In fact, it is believed that the
private sector provides 60 per cent of all outpatient care in India and as much
as 40 per cent of all in-patient care. It is estimated that nearly 70 per cent of
all hospitals and 40 per cent of hospital beds in the country are in the private
sector, says PWC.

In India, 5% of the national annual expenditure is on healthcare. Indias


expenditure on health is relatively high when compared to other South Asian
countries
a) Pakistan 3.2%
b) Sri Lanka 3.7%
c) Bangladesh 3.1%
(Source : UNDP 2005)

Of this, 81% of the outpatient care and 56% of inpatient care is being
provided by the private sector in the country while employers account for 9 %
and insurance cover, 5 per cent of the total healthcare expenses.

As per the study of CII and McKinsey the sector is growing at 13%, consumers
are likely to increase total healthcare spending from Rs 86,000 crore (2001) to
more than Rs 200,000 crore (2012)

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

2.2 Key Healthcare Statistics

India has 503,900 Doctors, 737,000 Nurses, 162 Medical Colleges, 143
Pharmacy Colleges and 350,000 Chemists. There are 43,322 hospitals and
dispensaries accounting for 870,161 hospital beds in India. There is an
extensive three-tiered government healthcare infrastructure comprising
23,000 Primary Health Centers and 137,000 sub-centers serving, the semi-
urban and rural areas and more than 3000 Community Health Centers.(Source :
NHP- 2002)

2.2.1 Quality
On the quality front the Indian Healthcare
Sector, lags behind. For instance, India has
1.5 beds per 1,000 people while China,
Brazil and Thailand have an average of 4.3
beds. The density of doctors is also low.
There are only 43 doctors for a population of
10,000.This is a result of the poor
performance of the health system in terms
of coverage, purchasing and delivery. The
country is below international standards on
basic healthcare infrastructure and facilities.
One of the main reasons underlying the poor state of healthcare facilities in
India happens to be the very low levels of public expenditure in health sector,
which happens to be among the lowest in the world. The healthcare spending
Per Capita is low in India as compared to other countries, which is as low as
$71.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

2.3 Demand Drivers for Healthcare


2.3.1 Change in Demographics
The most important structural change affecting the Indian healthcare sector is
the changing demographic and socio-economic profile. As India has been
demographically late expanding, the proportion of the country's population in
the 15-54 and the 54 years and above age groups is increasing. The average
age of the Indian population for many years has been less than that of the
general population. However, successes at improving the health status of
Indian people have resulted in a rapid life span increase, with a corresponding
increase in our elder population. Those numbers are expected to increase
greatly in the coming years. Unfortunately, the prevalence of chronic disease
among Indian elders also continues to increase, contributing to a frail,
medically complicated elder population with increasing long-term care needs.
Projections of current levels of functional impairment and current population
growth rates into the next decade suggest a 51 per cent increase in the
number of elders with functional impairment by 2010. The increase in the
proportion of the working age group (15-54) is being accompanied by an
unprecedented rise in per capita income, which is ushering in lifestyle and
consumption patterns markedly different from that observed, five years ago.
And with lifestyle patterns changing, the countrys disease profile has been
changing too.

2.3.2 Change in Disease Profiles


 61% spend out patient care
 39% spend- in patient care
 57%- outpatients-spend on acute infections
 85%- inpatients- spend on cardio, cancer, accidents, acute infections
and maternity
 Substantial share of spending for inpatient care comes from urban and
rich Indians
 Inpatient care to grow to 47% of total spends
 Increase in inpatient spends on lifestyle diseases (cancer and
cardiovascular diseases)

With the rise in lifestyle diseases such as cancer and cardiovascular, the
spending pattern will change dramatically by 2012 with inpatient spending
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Pre Feasibility Report- Super Specialty Hospital, Kanpur

accounting for 47% of the private health care spending, up from the 39% at
present. The outpatient spending which accounts for 61% of the private
spending at present will decrease in terms of share but increase in absolute
terms to Rs 74,000 crores.

2.3.3 Emergence of Corporate Hospitals


The emergence of corporate hospitals on a large scale is another important
development. Corporate entry into healthcare is important for the bed-supply
deficit to be bridged, as well as for the professionalisation of hospital
management. Of late modern management systems have penetrated most
healthcare institutions However, most hospitals organize their resources and
manpower within structures that have evolved rather than been designed.

Healthcare establishments such as hospitals, nursing homes, diagnostic


centres and clinical research organisations have been experiencing an
unprecedented growth during the last five years in India.

The growth of healthcare establishments in India is actually propelled by a


spurt in the income levels of the people and the consequent tendency to spend
more on health. This is indeed a positive indicator of a growing economy.
Prominent examples are Wockhardt Medical Centre and Apollo Clinics.

2.3.4 Increasing use of Information Technology and Entry


of International Players
Healthcare is racing towards high-tech, automated technologies and health
agencies wanting to distinguish themselves from the pack will have to opt for
leading -edge technologies.

This means healthcare delivery through application of telecommunications


technology or rather tele-medicine. This will transfer electronically, medical
data, including high resolution images, sounds, live video and patient records
from one location to another through telephone lines, ISDN, modem, Internet,
satellites, video-conferencing, etc.

Prominent examples are Wipro-GE Medical Systems is India s largest medical


systems sales and service provider. Drager Medical AG, a joint venture

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

between Dragerwerk AG and Siemens AG has entered India. Proton Health


Care has also entered the market realizing the growth potential for digital
health monitoring devices. Philips has emerged as the number 2 player in the
medical equipment market.

2.3.5 Health Maintenance Clinics


Few Indian corporates are in the process of establishing a new operational
system of linking the primary care with secondary and tertiary care, all under
one management. Besides, the healthcare providers plan to concentrate on
setting up small clinics known as Health Maintenance Clinics that provide
simple treatments and laboratory facilities in major catchments areas. The
idea of connecting these clinics to the same organizations larger diagnostic
centers and hospitals makes sense if further medical intervention in the form
of testing or hospitalizations are available or needed by the patient. Prominent
example are Kovai Medical Centre at Ramnagar and Perundarai.

2.3.6 Accreditation
A disturbing trend in this sector is the lack of standards of these
establishments in terms of their operations and services. There are a few
hospitals, diagnostic centres and CROs maintaining high standards but a large
majority of them are operating without any norms and good practices. Most of
the state governments have also been lax in framing rules to control the
activities of healthcare establishments. Hence, there has been no check in the
growth of these establishments and their standards in most parts of the
country.

The plan by the Central government to establish a National Commission for


Excellence in Healthcare, in this context, is certainly a welcome move. The
body, proposed by the National Commission for Macroeconomics and Health, is
expected to lay standards for the entire healthcare sector.

NCMH has also mooted establishment of a National Commission for


Accreditation for all healthcare institutions on the basis of standards prescribed
by NCEH. Standards followed by most of the nursing homes and diagnostic
centres in the country are pathetic and they are getting away with it. The need
for enforcing stringent standards in healthcare institutions is extremely

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

important especially when India is being looked at as a major source of clinical


research services to the global pharmaceutical industry.

A dozen or more CROs are doing extremely well with orders from US and
European companies. Many more are expected to set shops soon. An
accreditation system for CROs, as proposed by NCMH, could check the entry of
ill equipped ones into this sector. The good clinical practices as per the
amended Schedule Y of the Drugs and Cosmetics Act could also help to
upgrade the clinical practices in the country. Syngene International, Lotus
Labs, Rallis India Ltd are the leading players in this industry.)

In recognition of the quality of healthcare delivery services in India, a number


of Indian hospitals have received accreditation from international agencies
worldwide.
Five hospitals in India -- Indraprastha Apollo Hospital (New Delhi),
Apollo Hospital (Chennai), Apollo Hospital (Hyderabad), Wockhardt
Hospital (Mumbai) and Shroff Eye Hospital (Mumbai) -- have been
accredited to the leading healthcare accreditation agency in the United
States, Joint Commission International (JCI).
NHS of the UK has indicated that India is a favoured destination for
surgeries.
The British Standards Institute has now accredited the Delhi-based
Escorts Hospital.
India's independent credit rating agency CRISIL has assigned a grade 'A'
rating to super specialty hospitals like Escorts and multi specialty
hospitals like Apollo.
Wockhardt Hospital has an exclusive association with Harvard Medical
International, the global arm of Harvard Medical School, the world's
leading medical institution.
Max Healthcare, in collaboration with Singapore General Hospital, is into
clinical practice, research and training.

2.3.7 Medical Equipment Financing


In India, both Banks and Non-Banking Financial Companies ( NBFCs) finance
Medical Equipment.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Bank of Baroda, ICICI and the State Bank of India (S.B.I) are among the
Banks that have a Medical Equipment Financing Division. L & T Finance Ltd,
also has a Medical Equipment Finance arm. Loans are offered for purchase of
new equipments as well as takeover or existing loans. The features include
a) Competitive Interest Rates
b) Flexible Repayment Structure.

2.3.8 Infrastructure
The current situation in the healthcare sector in India reflects poor
performance of the sector in terms of coverage, purchasing and delivery in
comparison to other developing countries such as Brazil.

For example, India has only 1.5 beds per 1000 people in comparison to the
average of 4.3 beds per 1000 in Brazil. In order to meet the growing demand
of healthcare in the country, huge investments worth Rs 1,00,000 crore to Rs
1,40,000 crore need to be made in infrastructure for providing cost effective
facilities in the next 10 years.
a) United States, the corresponding figure is 6 beds per 1000 people
b) Australia 3.7 beds
c) U.K. 3.7 beds
( Source WHO Report 01)

The bulk of the investments made will need to come from the private sector
for India to increase the distribution of medical facilities amongst its
population.

2.3.9 Insurance Coverage


The proportion of Health Care Financing in India is very low. Upto 83% of
Indias health-care spending is done by the Private Sector. Only 17% of
spending is done by the Public Sector. ( Source: CII-Mskinsey Report 03)
This has been recognized by the National Health Policy and corrective steps
have being initiated.

India with a population of 1.05 billion experiences a vast inequity that exists in
the healthcare industry with Insurance Penetration at 3% in 2003 and 1% in
2001. Compared to Healthcare Insurance Penetration in United States. 85%
(Source : K.P.M.G. Report 03 )
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Pre Feasibility Report- Super Specialty Hospital, Kanpur

In India, presently the health insurance exists in the form of Mediclaim policy
offered to the individual or to any group, association or corporate bodies.
Penetration of Mediclaim is currently carried out by state-owned insurance
companies, covering only about 2.5 million people i.e., less than even 0.50 per
cent of the countrys population. (Source : I.R.D.A.)

Geographic spread in terms of healthcare facilities and financing awareness is


limited. Selection Criteria by suppliers often restricts the poor (and more likely
to be ill ) from affordable pre-payment schemes.

Social insurance schemes available in India, such as the Employee State


insurance Scheme (ESIS) and Central Government Health Scheme (CGHS)
have restricted coverage to a very small segment of the population, around 3
per cent which shows there is a vast scope for the insurance coverage to be
increased to provide better healthcare facilities. Voluntary health insurance
market is estimated at Rs 4 billion currently and growing fast.

2.3.10 Investments
The opportunities presented by the healthcare sector have made it a major
draw for potential investors. The healthcare sector attracted US$ 379 million in
2006 - 6.3 per cent of the total private equity (PE) investment of US$ 5.93
billion. The PE deals that the sector attracted in 2006 were as large as inputs
into the automotive sector.
Medical care services provider Apollo Hospitals group will invest about
US$ 235.69 million in the next 18 months to set up 15 hospitals in tier-
II and tier-III cities in India.
The Indian government plans to invest US$ 177.22 million across the
golden quadrilateral (GQ) project, to develop nearly 140 trauma care
centres on the 6,500 km long north-south and east-west corridors.
Competitor Fortis Healthcare Ltd will add 28 hospitals to its 12-hospital
chain by 2012.
George Soros's fund Quantum and BlueRidge bought 10 per cent in
Fortis Healthcare.
Manipal Health Systems raised over US$ 20 million equity from IDFC
Private Equity Fund.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Bangalore-based HealthCare Global Enterprises raised over US$ 10


million in equity from IDFC.
Metropolis Health Services, a diagnostic chain, raised over US$ 8 million
in equity from ICICI Venture.
Investment firms Apax Partners, IFC and Trinity Capital have invested
over US$ 200 million in hospital firms.

2.3.11 Private healthcare


With private healthcare driving a large chunk of healthcare in India, the stage
is set for private healthcare players to take wing.
Global Hospitals in Hyderabad, which had a modest beginning as a 150-
bed facility dedicated to multi-organ transplantation in Hyderabad, is set
to invest close to US$ 178 million in a couple of years to set up hospitals
in other metropolitan cities.
Mumbai-based healthcare firm Wockhardt Hospitals is planning to set up
14 super-speciality hospitals across the country over the next two years,
which could entail an investment of up to US$ 152 million.
Apollo Hospitals, Asia's largest healthcare group, is planning to expand
its operations by setting up 50 hospitals across the country, including
many in tier-II cities. It will invest US$ 5-9 million in each of the
facilities.

2.3.12 Medical Tourism


The attraction of high quality healthcare facilities at competitive costs has been
instrumental in a large number of foreign arrivals to access healthcare services
in India. Going by the current pace with which this segment has been growing,
the CII-McKinsey study estimates that revenues from this segment could touch
US$ 2.2 billion by 2012 (from the current figure of US$ 333 million).
Indian hospitals are fast becoming the first choice for an increasing number of
foreign tourists. Over 150000 medical tourists travelled to India in 2002 alone,
bringing in earnings of US$ 300 million. India's growing reputation as a major
medical tourism destination is attracting more and more visitors from Gulf
countries with many travel agents now offering packages combining treatment
with a vacation.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Cost of Key HealthCare Procedures

Currency: USD US Thailand India India healthcare cost-%


of US

Cardiac surgery 50,000 14,250 4,000 12.5

Bone marrow 62,500 62,500 30,000 13.33


transplant

Liver transplant 500,000 75,000 45,000 11.11

Orthopaedic 16,000 6,900 4,500 3.56


surgery

Source: IBEF Research

However, the Indian healthcare story is not about cost advantage only. It has
a high success rate and a growing credibility.
Indian specialists have performed over 500,000 major surgeries and
over a million other surgical procedures including cardio-thoracic,
neurological and cancer surgeries, with success rates at par with
international standards.
The success rate of cardiac bypass in India is 98.7 per cent against 97.5
per cent in the U.S.
India's success in 110 bone marrow transplants is 80 per cent.
The success rate in 6,000 renal transplants is 95 per cent.

The Government has also been proactive in encouraging prospects in this


sector with a number of initiatives:
A new category of visa "Medical Visa" ('M'-Visa) has been introduced
which can be given for a specific purpose to foreign tourists coming into
India.
Guidelines have been formulated by Department of AYUSH prescribing
minimum requirements for Ayurveda and Panchkarma Centres.

Consequently, easy access to visa facilities coupled with the best emerging
medical infrastructure in large and tertiary towns will lead to an increase in
foreign exchange earning through medical tourism. Annual earnings from
medical tourism is estimated to rise from the current US$ 815.32 million to
US$ 1.87 billion by 2012.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

2.4 Benchmarking of Hospitals

Darashaw has collected information by way of secondary research details of


facilities provided by hospitals across India, their financials, education
initiatives of these hospitals, tariffs for their various services etc. The hospitals
covered as part of the secondary research are:
 Kovai Medical Centre and Hospital
 Indraprastha Apollo Hospitals
 Malar Hospitals Ltd.
 K. G. Hospital
 Malabar Institute of Medical Sciences Ltd.
 Wockhardt Hospitals
 Breach Candy Hospital Trust
 Madras Institute of Orthopaedics and Traumatology (MIOT) Hospitals
 Apollo Gleneagles
 Escorts Hospital and Research Centre Ltd.
 Lakeshore Hospital and Research Centre
 Other Hospitals

Comparison of the financials, facilities provided, pricing of services of these


hospitals will help in arriving at
 Pricing of different services
 Revenue projections
 Cost of different components of the hospital project
 Departments

The findings from the Benchmarking studies can be compared with the primary
research data. This will help in developing pricing strategy for the various
services of the proposed hospital.

2.4.1 Kovai Medical Centre and Hospital

 Located at Coimbatore, TamilNadu


 Established in 1986

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

 350 bed Multi-disciplinary Super Specialty Hospital


 Equipped with most modern equipments like CT Scanner, Angiography
equipment with DSA, Operating Microscope, Mammography, C-arm,
Color Doppler etc.
 11 Operation Theatres
 Nearly 500 Outpatients & Inpatients are treated everyday
 25 major and minor surgeries are performed everyday
 Super-speciality procedures like Coronary Bypass surgeries, Coronary
Angioplasty, Stent Implantation, Laparoscopic & Vascular Surgeries, Hip
& Knee replacements, Kidney transplants, complex Neuro surgeries are
regularly done.
 Hospital has two satellite medical centers at Ramnagar,Coimbatore and
Perundurai.
 Hospital is recognised to carry out Renal transplants, Corneal
transplants and Heart transplants by TamilNadu Government. Cadaver
transplant programmes are also done regularly
 Hospital is recognised by National Board of Examinations for training
DNB candidates in General surgery, Orthopaedic surgery, Cardiothoracic
surgery, Cardiology, Anesthesiology, and Obstetrics & Gynaecology.
 Hospital is recognised by the Royal College of Surgeons, Edinburgh to
train AFRCS candidates.
 Market price for land and building estimated to be Rs. 350 Cr. as of 31st
March 2006. (Source: Hindu Business Line)

Departments
Medical Surgical Other
Internal Medicine General Surgery Anaesthesiology
Cardiology Cardio-Thoracic Surgery Radiology & Imaging
Sciences
Dermatology Dentistry Laboratory Sciences
Endocrinology ENT Physical Medicine &
Rehabilitation
 Physiotherapy
 Occupational Therapy
 Artificial Limb Center
Gastro Enterology Neuro Surgery
Haematology & Haemato Obstetrics &

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Medical Surgical Other


Oncology Gynaecology
Nephrology Ophthalmology
Neurology Orthopaedics
Paediatrics Paediatrics Surgery
Psychological Medicine & Plastic Surgery
De-Addiction
Pulmonology Urology
Rheumatology Vascular Surgery
Master Health Check Up
Diabetology

Financials
Sr. No. Particulars 2005 2004 2003 2002

1 Sales (Net of Consulting Doctor Fee) Rs. 40.55 35.08 30.92 29.12
Cr.
2 Consulting Doctor Fee Rs. Cr. 5.86 4.3 3.5 2.8

3 PBDIT Rs. Cr. 6.06 6.3 5.78 6.26

4 PAT Rs. Cr. 1.16 1.14 0.48 1.54

5 Gross Fixed Assets Rs. Cr. 51.7 49 46 40.3

6 Medical Equipments Rs. Cr. 27.4 26.2 24.6 21.6

7 Medical Equipments to GFA 0.53 0.53 0.53 0.54

8 Sales to Gross Fixed Assets 0.78 0.72 0.67 0.72

9 PBDIT to Sales (%) 15% 18% 18.7% 21.5%

10 Debt Equity ratio 1.2 1.14 1.14 0.88

Tariffs for Health Check-up Programs


S.No. Name of The Check Up Cost
1 Executive master health check up plus for men Rs.4,500/-
2 Executive master health check plus up for women Rs.4,500/-
3 Executive master health check up Rs.3,500/-
4 Master health check up Rs.2,500/-
5 Senior citizen's master health check up Rs.3,000/-
6 Master health check up for children Rs.750/-
7 Pre marriage check up for men Rs.1,500/-

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

S.No. Name of The Check Up Cost


8 Pre marriage check up for women Rs.1,500/-
9 Comprehensive heart check up Rs.1,750/-
10 Comprehensive diabetic check up Rs.1,750/-
11 Cancer screening for men Rs.1,500/-
12 Cancer screening for women Rs.3,000/-
13 Master health check up for alcohol abusers Rs.2,250/-
14 Sexual dysfunction check up (Males) Rs.1,250/-
15 Health check up for Haj Pilgrimage / Foreign travels Rs.2,000/-
16 Routine health check up Rs.1,000/-
17 Pre employment check up Rs.1,000/-

Education Initiatives
 B.Sc (Nursing) Programme at KMCH College of Nursing Started in
1993
 B.P.T programme at KMCH College of Physiotherapy Started in 1994
 B.O.T course at KMCH College of Occupational Therapy Started in
1995.
 B.Pharmacy degree course at KMCH College of Pharmacy Started in
1995
 M.Sc (Nursing) started at KMCH College of Nursing in the year 1998 in
four specialities viz.,
a. Medical - Surgical Nursing
b. Child Health Nursing
c. Maternity Nursing
d. Community Health Nursing
 M.P.T started at KMCH College of Physiotherapy in the year 1999 in
three specialities viz.,
a. Advanced PT in Orthopaedics
b. Advanced PT in Neurology
c. Advanced PT in Cardio - respiratory diseases
 Diploma Courses
a. PGDMLT (Medical Lab Technician) 2 year course
b. DMIT (Medical Imaging Technology) - 2 years
 Certificate Courses
a. Cath Lab Technician

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

b. Dialysis Lab Technician

2.4.2 Indraprastha Apollo Hospitals


 Located in New Delhi
 Established in 1996
 Total beds 695 including 138 ICU beds with provision for expansion to
1000 beds in future.
 No. of patients treated annually about 2,00,000
 Land Area is 12 acres and Built-up area is about 6,75,000 Sq. Ft
 Has 14 Operation Theatres
 Has Joint Commission International USA Accreditation - Gold Standard
Certification
 9,500 International Patients mainly from USA, Australia, Malaysia,
Yemen, Brunei and Tanzania
 181 Consulting Doctors Fee ranging from Rs. 350 500; average Rs.
400; This explains the reason for consulting fee contributing to about
25% of the hospitals total income.
 Over 40 Departments

Tariff for Health Checkup Programs


Price for
Name of the Health Price for Local International
Sr. No. Checkup patients Patients
1 Apollo Health Cheq Rs. 2,250/- $65
2 Apollo Executive Cheq Rs. 2,750/- $80
3 Apollo Heart Cheq Rs. 3,500/- $100
4 Apollo Whole Body Cheq Rs. 5,250/- $150
5 Apollo Well Women Cheq Rs. 1,350/- $35
6 Apollo Breast Cheq Rs. 1,000/- $30
7 Apollo Child Cheq Rs. 950/- $25
8 Apollo Diabetic Cheq Rs. 2000/- NA
9 Apollo Cancer Cheq Rs. 2000/- NA
10 Apollo Master Cheq Rs. 2250/- NA
Financials

Sr. No. Particulars 2005 2004

1 Sales (Excluding Consulting Doctor Fee) Rs. Cr. 146.5 136.2

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Sr. No. Particulars 2005 2004

2 Consulting Doctor Fee Rs. Cr. 47.6 44.4


3 PBDIT Rs. Cr. 38.2 39.3
4 PAT Rs. Cr. 16.34 15.5
5 Gross Fixed Assets Rs. Cr. 234.55 227.12

6 Medical Equipments Rs. Cr. 111.45 108.75

7 Medical Equipments to Gross Fixed Assets 0.47 0.48

8 Sales to Gross Fixed Assets 0.62 0.6


9 PBDIT to Sales 26.1% 28.9%

10 Debt Equity ratio 0.21 0.15

Education Initiatives
Fellowship in Emergency Medicine
Nursing - Offer 3 year diploma course in gen. Nursing & midwifery
(recognized by Indian nursing council & Delhi nursing council)
with an annual intake of 50 students.
2.4.3 Malar Hospitals Ltd.
 Located in Chennai
 Total No. of Beds - 250
 Leading centre for Cardiac Care, Renal Transplants, Neurosurgery,
Oto-laryngocoloy, Limb Reconstruction Surgery and Maxillo Facial
Orthodontology.
 The Department of Orthopaedic Surgery of Malar Hospitals is a reputed
centre for trauma care in India.
 Attracts International Patients from Bangladesh, Mauritius and Middle
East
Financials
Sr. No. Particulars 2005 2004

1 Sales Rs. Cr. 15.86 16.19

2 Consulting doctor Fee Rs. Cr. 2.31 2.32

3 PBDIT Rs. Cr. 3.65 2.93

4 PAT Rs. Cr. -0.58 -0.67

5 Gross Fixed Assets Rs. Cr. 34.97 37.81

6 Medical Equipments Rs. Cr. 14.14 17.09

7 Medical Equipments to GFA 0.4 0.45

8 Sales to GFA 0.45 0.43

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Sr. No. Particulars 2005 2004

9 PBDIT to Sales 23% 18.1%

10 Debt Equity ratio 1.67 1.67

2.4.4 K.G. Hospital


 Located at Coimbatore, TamilNadu
 Founded in 1974
 No. of beds : 300 bed Multi-specialty Hospital
 Employs over 250 doctors, 800 nurses, and 200 Para-medical staff
including consultants.
 Hospital has 2 intensive care units, 2 coronary care units and 1 post
operative intensive care unit
 Run by K. Govindswamy Medical Trust
 KG Hospital has been active in Medical Tourism. It offers Pick-up
services, translator, accommodation for international patients
 The centers of excellence of K.G. Hospital include KG Brain and Spine
Center, KG Heart Center, Joint and Replacement Center, Kidney Center,
KG Eye Hospital, KG Advanced Laprascopy Center
 Education Initiatives
o Diploma in General Nursing and Midwifery
o B.Sc. Nursing
o Post Basic B.Sc. Nursing
o M.Sc. Nursing
o BPT and MPT
o Certificate in MLT and Diploma in MLT
o Total no. of students in various programmes - about 1000

2.4.5 Malabar Institute of Medical Sciences Ltd.


 Location: Calicut, Kerala
 No. of beds: 300 bed Multi-specialty hospital
 Department: Has over 40 disciplines
 Has over 1200 employees including 100 full time doctors
 12 Operation Theatres
 Financials (2004)
o Sales Rs. 27.63 Cr.
o PBDIT- Rs. 4.86 Cr.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

o PBDIT to sales 17.6%


o PAT Rs. 0.88 Cr.
o Gross Fixed Assets Rs. 63.38 Cr.
o Sales to Gross Fixed Assets 0.44
o Debt Equity Ratio 0.26
 Education Initiatives
Sr. No. Name of the course Duration No. of
seats
1 DNB - General Medicine 3 Years 2
2 DNB - General Surgery 3 Years 1
3 DNB - ENT 3 Years 1
4 DNB - Anaesthesia 3 Years 2
5 DNB - Paediatrics 3 Years 1
6 DNB - Family Medicine 3 Years 2
7 Post Doctoral Certificate course in Cardiac
Anaesthesiology (PDCC) 2 years 2
8 Certificate Course in Critical Care Medicine
(Recognized by Critical Care Education
Foundation) 1 years 4
9 Critical Care Nursing 1 year 20
10 Diploma in Cardiac OT Nursing 1 year 2
11 Diploma in Cardiac Surgical ICU Nursing 2 years 2
12 Diploma in Cardiac Rehabilitation Technology
(CRT) 1 year 2
13 Post Graduate Diploma Course in Cardio 2 Years 4
Vascular Technology(PGDCVT)
14 DMLT - Diploma in Medical Laboratory
Technology 2 years 10
15 Diploma Course in Anesthesia Technology 2 years 8
16 Diploma Course in C.S.S.D (Sterilization
Technology) 2 years 10
17 Diploma Course in Medical Records
Management 1.5 year 4
18 Diploma Course in Dialysis Technology (DDT) 2 years 2
19 Diploma in Endoscopy Technology 2 years 2
20 Diploma in Cardiac Operation theatre
technology (COTT) 2 years 2
21 Diploma in Podiatry Technology 2 years 2

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Sr. No. Name of the course Duration No. of


seats
22 Nursing Assistants Course 2 years 40
23 Physician Assistant Course 3+1 years 1
24 BSc. Nursing 4 years 50
25 GNM - General Nursing & Midwifery 3 years 20

 Some of the Corporate Clients with whom MIMS has tie-ups are -
Airport Authority of India, Association of Senior Citizens, BSNL, Canara
Bank, E-Serve International, HPCL, HUDCO, IOC, Malayala Manorama,
Punjab National Bank, Taj Hotels, TATA Motors, Mathrubhumi, UTI, AMP
Sanmar, ICICI Prudential Life Insurance, HDFC Standard Life Insurance,
Metlife India, ING Vysya, Vijaya Bank, Indian Airlines, Air India, Jet
Airways etc.
 It also has tie-ups with following Third Party Administrators - Family
Health Plan Medi Assist, Medicare TPA Pvt Ltd., Paramount, TTK
Healthcare Pvt Ltd., Universal Medi-aid Services Ltd.

2.4.6 Wockhardt Hospitals


 No. of Hospitals : 5; Location: Mumbai, Bangalore, Kolkatta, Hyderabad,
Nagpur
 No. of beds: 420
 Wockhardt, Mumbai First Super specialty hospital to achieve JCI
accreditation
 Special division to look after international patients
 Wockhardt Heart Hospital, Brain and Spine Hospital, Eye Hospital, Bone
and Joint Hospital, Minimal Access Surgery Hospital, Hospital and Kidney
Institute, Kolkatta
 Financials (2004):
o Sales Rs. 76. 87 Cr.
o PBDIT- Rs. 11.84 Cr.
o PBDIT to sales 15.4%
o PAT Rs. (8.65) Cr. due to depreciation of Rs. 8.22 Cr. and
interest charge Rs. 8.36 Cr.
o Gross Fixed Assets 125.73 Rs. Cr.
o Sales to Gross Fixed Assets 0.61

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

o Debt Equity Ratio Negative networth and debt Rs. 124.21 Cr.
Charges for various procedures
Sr. Wockhardt
Procedure / Treatment USA UK
No. Hospitals, India
1 Total Knee Replacement $6,000 $32,000 $11,700
2 Birmingham Hip Resurfacing $7,000 Not Available $19,000
Coronary Artery by-pass
3 $7,600 $35,000 $16,000
surgery
$ 4,500- $ 2,700-
4 Liposuction / Tummy Tuck $1,200-2,000
10,000 8,500
5 Face lift $1,800-3,200 $9,000 $10,200
Obesity Surgery (Gastric
6 $9,000 $35,000 $20,100
Bypass)

2.4.7 Breach Candy Hospital Trust


 Location: Mumbai
 No. of beds : 173
 Over 17 departments and 8 operation theatres
 Financials (2004)

o Sales Rs. 61.62 Cr.


o PBDIT- Rs. 22.33 Cr.
o PBDIT to sales 36.2%
o PAT Rs. 17.34 Cr.
o Gross Fixed Assets Rs. 16.98 Cr.
o Sales to Gross Fixed Assets 3.63
o Their investments in Mutual Funds and other investments to the
tune of Rs. 46.49 Cr.
o Debt Equity Ratio Negligible debt.

2.4.8 Madras Institute of Orthopaedics and Traumatology


(MIOT) Hospitals
 Located in Chennai
 No. of beds is 250
 The hospital is spread over a land area of 22 acres
 No. of departments: 32
 Financials (2004):
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Pre Feasibility Report- Super Specialty Hospital, Kanpur

o Sales Rs. 31.3 Cr.


o PBDIT- Rs. 8.94 Cr.
o PBDIT to sales 28.6 %
o PAT Rs. 1.56 Cr.
o Gross Fixed Assets Rs. 46.96 Cr.
o Sales to Gross Fixed Assets 0.67
o Debt Equity Ratio 0.31
 Medical Tourism Initiative - In 2004-05, 26,000 from abroad to MIOT for
treatment, of them 1300 being foreigners. Ordinarily foreigners account
for 5-7 per cent of the total patients at MIOT.
 Expansion Plans - MIOTs expansion plans include Rs. 28 Cr. on
extending Medicare facilities including an additional 85 beds
 2004-05 revenues is Rs. 37 crore, a growth of Rs 6 crore and generated
a profit of around Rs. 7 Cr. (before tax). The number of patients visiting
India is expected to increase by 15 per cent annually in the future.

2.4.9 Apollo Gleneagles


 Location: Kolkatta
 No. of beds: 325
 Land area: 9 acres
 Setup with an investment of Rs. 2.1 billion
 Departments: Cardiology & Cardiothoracic Surgery, Neurology and
Neurosurgery, Gastroenterology, Nephrology, Orthopaedics,
Dermatology, Emergency
 JV between Apollo and Parkway Group, Singapore.
 72-bed Intensive Care Unit, 7 Super-specialty Operation Theatres, 1
Emergency Operation Theatre, 2 Digital Cath Labs, 12-bed Dialysis Unit
 Serves as a healthcare hub for East and North East India, Bangladesh,
Myanmar, Nepal and Bhutan.
 Well-equipped 'Renal Transplant Unit'. First in Eastern India to introduce
the concept of 'Full Time Consultants'.
 Financials (2003):
o Sales Rs. 12.07 Cr.
o PBDIT- Rs. -(0.66)Cr.
o PBDIT to sales NA
o PAT Rs. (2.15) Cr.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

o Gross Fixed Assets Rs. 166.3 Cr. Capital work in progress


very high
o Sales to Gross Fixed Assets 0.073
o Debt Equity Ratio 4

2.4.10 Escorts Hospital and Research Centre Ltd.


 Location: Haryana
 No. of beds: 250
 No. of patients treated per year : More than 1,00,000
 Departments 22
 Financials (2003)
o Sales Rs. 18.94 Cr.
o PBDIT- Rs. 2.1 Cr.
o PBDIT to sales 11.1%
o Loss Rs.1.46 Cr.
o Gross Fixed Assets Rs. 68.14 Cr.
o Sales to Gross Fixed Assets 0.28
o Debt Equity Ratio 0.3

2.4.11 Lake shore Hospital and Research Centre


 Located at Kochi, Kerala
 Established in 2002 First Phase with 350 beds at a cost of Rs. 50 Cr.
(Source: Project Monitor Online Edition dated 1st June 2002); Became
Operational from January 2003.
 Has 31 departments; Eight clinics Liver, Pancreas, Proctology, IBD,
Epilepsy, Spine, Asthma, Rheumatoid Arthritis
 40 Beds in Critical Care Unit
 Health Check-up Programs
Sr. No. Program Fee Rs.
Comprehensive Executive
1 3900
Health Checkup
Special Executive Health
2 7500
Checkup
3 Diabetes Basic Checkup 2900
Diabetes Comprehensive
4 6900
Checkup

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

5 Healthy Women Checkup 2000


 Patients from USA, Australia, Britain, Canada, Sweden, Italy, France,
Finland, Malaysia, Mauritius, Netherlands, UAE, Oman, Bahrain, Saudi
Arabia, Qatar, Kuwait, Chile, Tanzania, Tunisia, Libya, Kenya,
Bangladesh, Maldives, Japan.
 Financials
Sr. No. Particulars 2004 2003
1 Sales Rs. Cr. 20.42 2.68
2 PBDIT Rs. Cr. 3.07 -0.83
3 PAT Rs. Cr. -4.08 -4.26
4 Gross Fixed Assets Rs. Cr. 55.05 51.97
5 Land and Building Rs. Cr. 20.2 18.8
6 Plant and Machinery Rs. Cr. 20.81 19.22
7 Others Rs. Cr. 14 14
8 Share Capital Rs. Cr. 23.65 20.27
9 Debt Rs. Cr. 31.02 29.29
10 Sales to Gross Fixed Assets 0.37 0.05
11 Plant and Machinery to 0.38 0.37
Gross Fixed Assets
12 PBDIT to Sales (%) 15.03% -(30.97)%
13 Debt Equity Ratio 1.31 1.45

2.4.12 Apollo Hospitals, Chennai


 No. of beds: 1000
 Major Departments: Cardiology & Cardiothoracic Surgery, Cancer care,
Cosmetic Surgery, Neuro Science, Nephrology & Urology, Orthopaedics,
Critical Care Medicine, Obstetrics and Gynaecology and IVF, Radiology &
Imaging Sciences
 Established 1983.
 Departments
 Comprehensive wellness centre - Ayurveda, Aromatherapy, Pranic
Healing, Yoga, Meditation and Music Therapy.
 27,000 heart surgeries - success rate of 99.6%. in Bone Marrow
Transplant - success rate of 70%.
 Specialised Clinics - BreatheEazy - the Asthma Clinic, Andropause, Pain
Clinic, Migraine, Epilepsy, Stroke, Adolescent Clinic.

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Pre Feasibility Report- Super Specialty Hospital, Kanpur

Sr. No. Particulars 2005 2004

1 Sales Rs. Cr. 595.6 499.8

2 PBDIT Rs. Cr. 121.6 104.1

3 PAT Rs. Cr. 49.2 37.1

4 Gross Fixed Assets Rs. Cr. 430.4 394.6

5 Medical Equipments Rs. Cr. 218.7 199.8

6 Medical Equipments to Gross Fixed 50.81% 50.63%


Assets

7 Sales to GFA 1.38 1.27

8 PBDIT to Sales 20.42% 20.83%

9 Debt Equity ratio 0.42 0.63

2.4.13 Apollo Hospitals, Hyderabad

 No. of beds: 550; patients treated annually: 1,00,000


 Land area: 35 acres; Built-up area: 1,90,000 Sq.ft.
 50 Medical and Surgical disciplines.
 Average staff to patient ratio 3:1 with a 1:1 ratio in priority areas like
the ICU and Cardiac Care Unit.
 International patients from Tanzania, the USA, the UAE, Kenya, Oman
and neighbouring Asian countries.
 Has treated over 3 million patients so far. Over 1,00,000 Preventive
Health Checks done.
 Performed over 80,000 major and 1,20,000 minor surgeries. Over
10,000 cardiac surgeries with a success rate of 98.8 %. Over 12,000
interventional cardiac procedures with a success rate of 98.9 %. Over
600 renal transplants with a success rate of 95 %. Pioneers in balloon
and LASER angioplasty techniques. Pioneers in Keyhole spinal surgery.

2.4.14 Apollo, Colombo


 No. of beds 254; Built-up area: 3,00,000 Sq.ft.
 Established June 2002.
 Equipped for over 500 beds. Over 1200 Cardiac Surgeries performed
with a 98.5% success rate.
 Treated over half a million patients since its inception.

31
Pre Feasibility Report- Super Specialty Hospital, Kanpur

2.4.15 Apollo, Bilaspur, Chattisgarh


 No. of beds: 275; Land area: 17 acres
 Established October 2001.
 Has treated more than 100,000 patients so far.
 Over 500 Cardiothoracic surgeries and 2200 Cardiac interventional
procedures with a success rate of 98.5%. Over 5500 major and 2000
minor surgeries that include: Neuro and Spinal surgeries, 1250
Orthopaedic surgeries including 95 Knee, Hip & Elbow joint
replacements, Over 400 Paediatric and Laparoscopic surgeries, Over
2500 eye surgeries, Uro-surgeries, Over 250 Oncology surgeries, 255
Plastic surgeries, Over 25 Facio- Maxillary surgeries.

2.4.16 Noida Medicare Centre Ltd.


 Located in Noida, Uttar Pradesh
 Established in 1990
 120 bed hospital
 There are 14 medical departments; 15 surgical departments; 5
departments in the diagnostics services and 4 departments in the
clinical services
 Medical Tourism initiatives Regional Office at Dhaka, Bangladesh.
Services like pick-up facilities, Travel and Tourism assistance, Visa and
Foreign Exchange assistance etc.
 One of the first hospitals in India having tie-up arrangement with major
Insurance Companies for Mediclaim registered under IRDA
 Health Check-up rates
o Preliminary/Pre-employment Health Check Rs. 500/-
o General Health Check Rs. 900/-
o Well Women Check Rs. 1500/-
o Executive Health Check Rs. 3000/-

 Financials (2003)
o Sales Rs. 10.25 Cr.
o PBDIT- Rs. 1.04 Cr.
o PBDIT to sales 10.15%
o PAT Rs.(- 0.69) Cr. (Loss)
o Gross Fixed Assets Rs. 47.58Cr.

32
Pre Feasibility Report- Super Specialty Hospital, Kanpur

o Medical Equipment Rs. 15.81 Cr.


o Medical Equipment to Gross Fixed Assets 0.33
o Sales to Gross Fixed Assets 0.22
o Debt Equity Ratio 1.08

2.4.17 Ruby Hospital, Kolkatta


 Founded in 1995
 Medical Tourism being thrust area
 Special rates
 Empanelled with BUPA, International UK
 Empanelled with Vanbreda International Belgium

2.5 Key Observations

Darashaw carried out secondary research on different hospitals in the country.


The research findings can be brought under the following heads
 Financials
 Medical Tourism Initiatives
 Facilities and tariffs for services

2.5.1 Financials

 Apart from the 10 hospitals mentioned in this report, the financials of


smaller hospitals like Seahorse Hospitals Ltd., Devaki Hospital Ltd.,
Dhanvantri Jeevan Rekha Ltd., Dolphin Medical Services Ltd., Lakeshore
Hospital and Research Centre Ltd., CDR Healthcare Ltd., Secunderabad
Healthcare Ltd., Dolphin Medical Services Ltd. Peerless Hospitex Hospital
and Research Center Ltd. were studied.
 Many of these hospitals were making losses. One main reason is the
need for continuous investment in medical equipments. Medical
equipment constitute about 40-50% of Gross Fixed Assets.
 An ICU set-up, costs around Rs. 40-50 lakh per bed. (Source: Express
Healthcare Management Online issue dated 1st to 15th May 2005)
 Sales to Gross Fixed Assets on an average should be about 0.6 to
achieve a good operating profit margin of more than 15%. Super

33
Pre Feasibility Report- Super Specialty Hospital, Kanpur

Specialty Hospitals achieve this profit margin even with sales to gross
fixed assets of about 0.45.
 Lakeshore Hospital and Research Centre, Kochi, Kerala is a 350 bed
hospital constructed at a cost of Rs. 50 Cr. in 2002. It started
functioning from January 2003. The debt equity ratio was about 1.4. For
the year 2004, it achieved a profit margin of 15%.
 Consulting fee to doctors expenditure in most hospitals is about 10-15%
of the total income. However hospitals like Indraprastha Apollo which
has large number of consulting doctors (about 180) the consulting fee to
doctors account for 25% of the hospitals total income. At Indraprastha
Apollo the Consulting fees charged by doctors is about Rs. 500/-.
 Depreciation on medical equipment has been increased from 25% to
40% as per the IT Act.
 Medical Equipment Financing Banks like ICICI Bank, SBI, Union Bank
of India, Bank of Baroda offer Medical Equipment Loans. ICICI offers
medical equipment loan to the tune of 85% of the invoice amount. L&T
Finance Ltd. offers medical equipment lease financing to select
hospitals. They have tie-ups with medical equipment manufacturers.

 Average Revenue per Hospital bed


Malabar
Kovai
Apollo Malar Institute of
Medical Wockhardt
Particulars Indraprasth Hospitals Medical
Center and Hospitals
a Hospital Ltd. Sciences
Hospital
Ltd.

No. of Beds 350 695 250 300 420

Sales Rs. Cr. 40.55 146.5 15.86 27.63 76.87


Gross Fixed
Assets Rs. 51.7 234.55 34.97 63.38 125.73
Cr.
Revenue per
bed in Rs. 11.59 21.08 6.34 9.21 18.3
lakhs
Gross Fixed
Assets per
14.77 33.75 14 21.13 29.94
bed Rs.
lakhs

34
Pre Feasibility Report- Super Specialty Hospital, Kanpur

Lakeshore Escorts
Breach Noida
Hospital Hospital
Candy Medicare
Particulars MIOT and and
Hospital Centre
Research Research
Trust Ltd.
Centre Centre
No. of Beds 173 250 350 120 250
Sales Rs.
61.62 31.3 20 10.25 18.94
Cr.
Gross Fixed
Assets Rs. 16.98 46.96 55.05 47.58 68.14
Cr.
Revenue
per bed in 35.62 12.52 5.71 8.54 7.58
Rs. lakhs
Gross Fixed
Assets per
9.82 18.78 15.73 39.65 27.26
bed Rs.
lakhs

 Financials of other hospitals


Peerless
Seahorse Devaki Pulikkal
Jaipur Hospitex
Particulars Hospitals Hospital Medical
Hospital Hospital
(Rs. In cr) Ltd. Ltd. Foundatio
(2005) Ltd.
(2005) (2005) n (2004)
(2003)
Sales
Excluding
3.36 5.92 2.6 *26.32 *28.53
Consulting
Fees
Consultatio
n fee to 0.34 0.28 0.7 NA NA
doctors
PBDIT -0.2 0.22 0.37 2.76 6.28
PAT -1.3 -1 0.06 -0.92 4.28
Gross Fixed
24.4 15.1 7.7 70.26 45.5
Assets
Medical 9.7 6.2 4 *38.38 *15.18

35
Pre Feasibility Report- Super Specialty Hospital, Kanpur

Peerless
Seahorse Devaki Pulikkal
Jaipur Hospitex
Particulars Hospitals Hospital Medical
Hospital Hospital
(Rs. In cr) Ltd. Ltd. Foundatio
(2005) Ltd.
(2005) (2005) n (2004)
(2003)
Equipments
Medical
Equipments
to Gross 39.75% 41.06% 51.95% 54.63% 33.36%
Fixed
Assets
PBDIT to
-5.95% 3.72% 14.23% 10.49% 22.01%
Sales
Sales to
Gross Fixed 0.14 0.39 0.34 0.37 0.63
Assets

Note:
 Sales figures of Peerless and Pulikkal include consulting fees to doctors.
 Medical Equipment figures given for Pulikkal and Peerless is that of Plant
and Machinery. Figures of Medical Equipment separately not available.

Im p a c t o f A d d itio n a l B e d s
250
225
200
175
150

125
100
75
50
25
0
0 100 200 300 400 500 600 700 800
No. of Beds

S a le s R s . C r . PB D IT R s . C r . G r o s s F ix e d A s s e ts R s . C r .

36
Pre Feasibility Report- Super Specialty Hospital, Kanpur

2.5.2 Medical Tourism Initiatives

 Hospitals both in cities and towns are taking initiative to attract


international patients. Common services offered include pick-up from
airport, accommodation facilities, assistance in visa, foreign exchange,
insurance transfer, sight-seeing trips etc.
 Big hospitals like Apollo, Wockhardt attract international patients from
US, UK etc. Indraprastha Apollo has Joint Commission International
Accreditation, USA.
 Many of the hospitals receive patients from the neighbouring countries
like Sri Lanka, Bangladesh, Mauritius, Nepal and also from Middle East
Countries.
 Noida Medicare Center Ltd. has a Regional Office at Dhaka to attract
patients from Bangladesh.
 Ruby Hospital, Kolkatta as part of its Medical Tourism initiative has a
tie-up with BUPA International, world's largest provider of international
expatriate health insurance for attracting international patients.

2.5.3 Facilities and tariffs for services

 Room charges and charges for medical services vary across hospitals.
Many hospitals have tie-ups with corporates for offering their services.
 Malabar Institute of Medical Sciences has tie-ups with Third Party
Administrators like Family Health Plan Medi Assist, Medicare TPA Pvt. Ltd
Paramount, TTK Healthcare Pvt. Ltd., Universal Medi-aid Services Ltd.
Hospitals offer preventive health check-ups like Executive health check,
Senior citizen's master health check up, routine health checkup, pre-
employment health checkup, well women checkup etc.
 The tariffs for these services in some of the hospitals have been
included in the report. Executive Health Checkup offered in most
hospitals is priced at about Rs.3000/-.

37
3 Healthcare Scenario in Uttar
Pradesh

Uttar Pradesh, with a population of around 166 million (Census 2001), is the
most populous State of the Indian Union and accounts for approximately 16.17
percent of the country's population. Out of the total population of the State,
more than 79 percent (13.15 crores) live in the rural areas, while the

Healthcare Facilities in Lucknow


remaining 21 percent (3.45 crores) live in the urban areas. The population
density of the State is 689 persons per sq. km, as against the national average
of 324 persons per sq. km. The demographic indicators are summarized in the
table ahead.
Demographic Profile of Uttar Pradesh
Description Value
Population ( Census 2001)
Male 8.75 Crores
Female 7.85 Crores
Total 16.60 Crores
Population Density (Per Square Kilometre) 689
Annual Exponential Growth Rate (1991-2001) 2.30
Sex Ratio per Thousand Male (In 2001) 898
Female Literacy (2001) Percent 42.98

Out of the total population, 52.7 percent (8.75 crores) are males and 47.3
percent are females (7.85 crores). The sex ratio of the population is 898
females per 1000 males for the State, compared to 933 for all India (Census
2001). The population density is very high in the Eastern and Western regions
and very low in Bundelkhand region. The literacy rate among those aged seven
years and above is 70.23 percent among males and 42.98 percent among
females. The life expectancy in the State is 65.48 years for males and 67.10
years for females, as compared to the national average of 65.63 years for
males and 66.38 years for females.

For planning and development purposes, the State is divided into four distinct
regions on the basis of homogeneity, contiguity and economic criteria. These
38
regions are Western, Central, Eastern and Bundelkhand. For administrative
purposes, these regions are further divided into 17 divisions and 70 districts.
These districts are further divided into tehsils (303) and developmental blocks
(813). Each block consists of a number of villages (97,134), which is the
smallest unit in the rural areas. There are approximately 700 urban local
bodies, 8135 Nayay Panchayats, 52028 Gram Sabhas. There are around 631
cities and urban agglomerations in the State.

Health Status
The mortality indicators of the State depict an alarming situation. As per SRS

Healthcare Facilities in Lucknow


2004, the infant mortality in the State stood at 72 deaths per 1,000 births as
compared to the all India average of 58. Past trends have demonstrated that
while both the neo-natal & post-neonatal components of infant mortality have
declined, the decline in neo-natal mortality has not kept pace with the decline
in post neonatal mortality. Deaths during the neo-natal period (within 28 days
of life) contribute to almost 64% of the infant mortality in the State. As per
NFHS-II, U.P. had the highest Under 5 Mortality Rate in the country (122.5
deaths per 1000 live births as compared to the all India average of 94.9).

The latest survey of NFHS-III (2005-06) shows that only 23 percent of children
(12-23 months) were found to be fully immunized against the six vaccine
preventable diseases. Findings of NFHS-III reveal that although the State's
total fertility rate is high (3.8), there is a dismally low prevalence of ante-natal
care and birth related counseling being provided to pregnant women in the
State. As per the survey, only 26 percent of the pregnant women in the State
received 3 or more ANCs. The share of institutional deliveries in the State
stands at only 22 percent. The nutritional status of women is also poor. Almost
50 percent of women in the State suffer from some form of anaemia. In 1997,
there were an estimated 707 maternal deaths per 100,000 live births (SRS
1997), almost 70 percent higher than the national average of 437, as per the
recent SRS (2001-03), the maternal mortality stands at 517 per 100,000 live
births.

Nutritional indicators of the State are also one of the poorest in the country
with large interregional imbalances. High levels of malnutrition particularly
among women and children have been directly and indirectly influencing

39
mortality rates in infants, children and women. Although the incidence of florid
nutritional deficiencies like pellagra, beriberi etc has significantly gone down,
undernutrition among children and micronutrient deficiencies across all
sections of the population continues to be widespread in the State. NFHS-III
data indicates that out of 10 children under 3 years, almost 5 are underweight
and 4 are stunted. High incidence of general undernutrition and micronutrient
deficiency is reflected in the high childhood mortality and infant mortality.

Awareness of AIDS and HIV among women is quite low. As per NFHS-III, only
40 percent of ever married women (15-49 years) reported having heard of

Healthcare Facilities in Lucknow


AIDS and only 27 percent of women reported to know that consistent condom
use can reduce the chances of getting HIV/AIDS.

The draft Uttar Pradesh Human Development Report mentions that combined
losses due to premature death and disability from non-fatal illnesses
(measured as Disability Adjusted Life Years DALYs) are very high in Uttar
Pradesh. A World Bank Study of the year 2000 showed that the estimates of
DALYs lost in six States in India suggest that Uttar Pradesh at 273.2 DALYs,
has the highest loss rate among all the Indian States. A further analysis of
ailments by cause shows that the overwhelming cause of premature death and
disability can be attributed to Group 1 diseases, namely communicable
diseases, malnutrition and peri-natal conditions, a disease pattern common
among poor populations.

Distribution of Reported Ailments across Disease categories in U.P.


%age of cases to Total No. of Cases Reported
Ailments requiring
Disease Categories Short Ailments
Hospitalization
Rural Urban Total Rural Urban Total
Infectious & parasitic
56.21 54.86 55.98 92.07 20.19 91.00
diseases

Neoplasm 0.33 0.60 0.37 0.17 6.29 0.26

Endocrine, nutritional &


0.73 1.02 0.78 0.07 1.04 0.09
metabolic disorders
Diseases of blood &
0.21 0.28 0.22 0.06 0.91 0.07
blood forming organs

40
%age of cases to Total No. of Cases Reported
Ailments requiring
Disease Categories Short Ailments
Hospitalization
Rural Urban Total Rural Urban Total
Mental, psycho-neurotic
0.67 0.26 0.60 0.07 0.79 0.08
& personality disorders
Diseases of nervous
2.89 3.31 2.96 0.34 6.06 0.43
system & sense organs
Diseases of circulatory
1.35 6.19 2.16 0.16 9.25 0.30
system

Healthcare Facilities in Lucknow


Diseases of respiratory
10.58 8.97 10.31 0.11 2.97 0.15
system
Diseases of digestive
2.45 2.21 2.41 0.14 2.52 0.17
system
Diseases of genito-
0.90 1.65 1.02 0.22 6.11 0.31
urinary system
Diseases of pregnancy &
0.57 0.92 0.63 0.31 7.54 0.42
child birth
Diseases of skin &
0.91 1.03 0.93 0.01 0.34 0.02
musculoskeletal system

Accidents & injuries 1.63 2.22 1.73 0.32 11.12 0.48

Other Diseases 20.60 16.48 19.91 5.94 24.86 6.22

100.0
Total 100.00 100.00 100.00 100.00 100.00
0
Source: NSS 52nd Round

It is evident from the above Table that about 56% of short duration ailments
reported belonged to the category of infectious and parasitic diseases, more so
in rural than in urban areas. Short duration fevers constituted 38.6% of all
ailments reported followed by diarrhoea and gastroenteritis (7.88%). 92
percent of hospitalization cases in rural areas in Uttar Pradesh fell in the
infectious and parasitic diseases category, more specifically within diarrhoea
and gastroenteritis. This indicates the widespread problem of poor water
quality and lack of basic sanitation and hygiene.

41
Health Infrastructure
The present public health infrastructure in the State, both in the urban and
rural areas, is shown below :

No. of
Urban Areas No. of Facilities Rural Areas
Facilities
Super Specialty Institute 5* CHCs 315
7 - Govt.
2 Central
Medical Colleges BPHCs 823
Govt.

Healthcare Facilities in Lucknow


3 Private
District Male/Female
53 Additional PHCs 3640
Hospitals

Combined Hospitals 13 Rural PPCs 147

Urban FW Bureau 5 Sub Centres 20521


Urban FW Centres 61
Health Posts 136

District Level PPCs 63

* 1 super specialty institute, SGPGI, is functional at Lucknow, 3 institutes at


Lucknow and 1 at Saifai, Etawah are in the process of development

Although Uttar Pradesh has a fairly large public sector health infrastructure
comprising one Super Specialty Institution (SGPGI) - 4 more in the process of
establishment, 7 government medical colleges & hospitals, 53 District
Hospitals, 13 Combined Hospitals, 388 Community Health Centres, 823 block
PHCs, 2817 Additional PHCs apart from 20521 Sub Centres, yet only 9 percent
of the States population actually make use of this facility for treatment of
ordinary ailments and people mostly have to depend on private healthcare. In
the private sector, there are 3 medical colleges & hospitals and 4913
Male/Female hospitals/nursing homes at District level in the State. However,
there are a large number of registered and non-registered medical
practitioners in the State and they play an important role in providing medical
service to the rural population.

However, the physical health infrastructure in the State is still much below the
country average. For instance, the population covered by a Sub-centre in the
42
State is 7080 and the average distance is 3.4 km. while the country average is
5109 and 1.3 km. It is estimated that 11% of people in Uttar Pradesh are not
able to access medical care due to locational reasons. Further, even when
accessed, there is no guarantee of sustained care. Several other deterrents
such as bad roads, the unreliability of finding the health provider, costs for
transport and wages foregone, etc. make it cheaper for a villager to get some
treatment from the local quack.

Besides the inadequate number of facilities, there is a severe shortage of


manpower at all levels in the public health delivery system. Every health

Healthcare Facilities in Lucknow


functionary is under a lot of pressure on account of the large numbers that
s/he is expected to serve. This has a direct bearing on the quality of services
rendered and uptake of services.

Human Resources
The ratio of doctors per thousand population for U.P. is much below the
national figure of 1 and although the ratio of beds is almost the same as the all
India figure of 0.7, their geographical distribution is highly skewed in favour of
the urban areas, depriving the rural masses.

The current position of doctors and paramedical staff in the State is as under:
Human Resource Sanctioned* Filled*
Medical Officers
Male (General) 6468 4940
Male (Specialist) 4128 3694
Female (General + Specialist) 1740 1319
Paramedical Staff
Pharmacist 5078 4695
Staff Nurse 4528 3678
ANM 23656 21944
Optometrist 923 833
Lab. Technician 1915 1442
X-Ray Technician 514 452
Dark Room Assistant 163 102
Physiotherapist 19 16

43
It is evident that the situation is grave in terms of requirement of medical
personnel, specially doctors and specialists. Although the State also has a
large presence of private health providers, it is mostly concentrated in the
urban areas and is largely focusing on curative aspects, rather than maternal &
child health services.

A survey of hospitals in the private sector, commissioned by the Government


of UP, revealed that there are 2,592 private hospitals with total bed capacity of
47,269. There are 2,321 general hospitals that account for 92.4 percent of
beds in the private sector, 201 nursing homes with 2,506 beds that offer

Healthcare Facilities in Lucknow


maternal and child health services exclusively, and 70 hospitals with 1,010
beds that offer specialty services1.

Total number of doctors and hospital beds, both public and private sector
combined, are estimated as under
Ratio
Government Private
Description Total (Per 1000
Sector Sector
Popn)
Allopathic
9950 29000 38950 0.2
Doctors
54193
Total Beds (Urban-31646, 46269 100462 0.6
Rural-22547)

The magnitude of various private health providers in the State (2001-02) is as


under:
Nurses,
Physicians Diag.
Physio-
Hospitals & Ayurveda Unani Homeo. /Patho.
therapists &
Specialists Labs.
Paramedical

4424 214,127 53,280 27,042 5192 19,861 5,957

Source: National Commission on Macroeconomics and Health

1
UPHSDP Project Implementation Plan, Vol. 1, 2000
44
3.1 Healthcare Facilities in Kanpur

There is a lack of world class hospital facility in the region. KDA intends to
develop a 500 Bed Super Specialty Hospital at this site with latest technology
and facilities so that it is one of its kinds in the region and has earmarked 10
acres for the same. Other developments which would be in close vicinity of the
proposed super specialty hospital would be Eldeco County and Green City by
KDA. The proposed development would not only provide medical facilities to
the people of Kanpur but also to the people from other adjoining towns like
Allahabad, Kannauj, Jhansi, Kalpi, Etah, etc.

Healthcare Facilities in Lucknow


3.2 Partial List of Hospitals

The city has a number of hospitals and diagnostic clinics but lacks world class
tertiary hospitals. Presented below is a list of some of the hospitals and
diagnostic clinics in Kanpur.

Sr. No. Partial List of Hospitals Discipline

Kanpur Medical Center Pvt.Ltd., General/Specialized treatment &


1 120/500, (24), Lajpat Nagar, diagnostic
Kanpur. procedures.
Regency Hospital Ltd., General/Specialized treatment &
2 A-2, Sarvodaya Nagar, diagnostic
Kanpur. procedures.
Kanpur Urology Center,
(B.R.Stone Clinic),
3 Specialized treatment in Urology.
111/456 Harsh Nagar,
Kanpur.
Madhulok Hospital,
General purpose treatment including
4 628, K-Block, Kidwai Nagar,
Primary Dental care.
Kanpur.

Dr.Devender Eye Center,


5 Specialised treatment in Phako Surgery
Geeta Nagar,Kanpur.

Brij Medical Center Pvt. Ltd.,


6 General purpose treatment.
94-E, Panki, Kanpur.
Saral Nursing Home, General purpose treatment & diagnostic
7 Lal Bangla (Opp. Thana Chakeri) procedures of E.C.G., X-Ray &
Kanpur. Ultrasound.
Jolly Nursing Home & Research
General purpose treatment & diagnostic
8 Center, 119/22, Naseemabad,
procedures.
Kanpur.

45
Sr. No. Partial List of Hospitals Discipline

Chandani Hospital,
General purpose treatment & Specialized
9 9/60, Arya Nagar,
treatment in Dialysis & ICU.
Kanpur.
R.K.Devi Memorial Hospital,
General purpose treatment in
10 113/157, Swaroop Nagar,
Ophthalmology
Kanpur.
Shree Ram Nursing Home Pvt.Ltd.,
General purpose treatment & diagnostic
11 128/817-A, K-Block,
procedures.
Kidwai Nagar, Kanpur.
Kulwanti Hospital & Research

Healthcare Facilities in Lucknow


12 Center, 117/N/8, Saket Puri, General and specialized treatment
Kakadeo, Kanpur.
Lala Amba Prasad Samarak
Chikitsalya, General purpose treatment in Pediatrics
13
15/201, Civil Lines, & Obst. & Gynae.
Kanpur.
Jain Dental Clinic,
14 124, O-Block, Kidwai Nagar, General dental treatment
Kanpur.
Shakun Dental Care & X-Ray,
229, Chandel Market,
15 General dental treatment
Harjinder Nagar, Lal Bangla,
Kanpur.
Laxmi Devi Kishan Chand
Memorial Hospital Pvt. Ltd. General purpose treatment & diagnostic
16
150, Ratan Lal Nagar, procedures.
Kanpur.
Bhargava Hospital,
General purpose treatment & diagnostic
17 15/263, Civil Lines,
procedures.
Kanpur.
Dr. Jawahar Lal Rohatgi Smarak
Netra Chikitsalya, General/Specialized treatment in
18
Sarvodaya Nagar, Ophthalmology.
Kanpur.
Madhuraj Nursing Home Pvt. Ltd., General purpose treatment & diagnostic
19 113/121, Swaroop Nagar, procedures in X-Ray, Ultrasound &
Kanpur. Color Doppler.
Dental Maxillo Facial Center,
20 118/534, Kaushal Puri, Specialized Dental Treatment
Kanpur.
Suraj Hospital, General-purpose treatment & Specialized
(Suraj Medical & Diagnostic treatment in Lithotripsy and diagnostic
21 (P) Ltd.), procedures in CT Scan, MRI, Color
117/N/65, Kakadeo, Doppler,
Kanpur. X-Ray and Ultrasound.
Prashant Nursing Home (P) Ltd.,
22 88/593, Prem Nagar, General-purpose treatment.
Kanpur.

46
Sr. No. Partial List of Hospitals Discipline

Priya Hospital,
23 D/25, HIG, World Bank Colony, General-purpose treatment.
Barra, Kanpur.
Gopinath Hospital Pvt. Ltd.,
24 Unit-1, Sector-8, Chetak Marg, General-purpose treatment.
Pratap Nagar, Jaipur.
Mohammadia Hospital,
25 Nala Road, Railway Crossing, General-purpose treatment.
Becon Ganj, Kanpur.
Raja Ram Hospital,

Healthcare Facilities in Lucknow


26, A&B, Block-E, Panki, General-purpose treatment & diagnostic
26
(Kalpi Road) procedures
Kanpur.
Khairabad Eye Hospital,
27 112/202, Swaroop Nagar, Specialised treatment in Ophthalmology.
Kanpur.

3.3 Partial List of Diagnostic Clinics

Partial List of Diagnostic


Sr. No. Discipline
Centres
Bharat X-Ray, Pathology &
Ultrasound,
1 Pathological Investigations & Ultrasound.
26/86, Karachi Khana,
Kanpur.

Brij X-Ray & Pathology Center,


2 General diagnostic procedures.
94-E, Panki, Kanpur.

General diagnostic procedures in


Med Beam Scan Pvt. Ltd.,
Radiology,
117/31, 22, Sarvodaya Nagar,
3 & Specialized procedures in CT Scan,
Near Baba Bhool Nath Ashram,
Color
Kanpur.
Doppler 2D Echo.
Singh X-Ray & Pathology,
7/201, Swaroop Nagar,
4 X-Ray only.
Opp.L.L.R.Hospital,
Kanpur.
Standard Ultrasound Center,
(Standard X-Ray, Ultrasound
5 X-Ray & Ultrasound.
Center), 40-41, O-Block,
Kidwai Nagar, Kanpur.
Adarsh Diagnostic Center,
General diagnostic procedures of X-Ray,
6 33-V, Govind Nagar,
Ultrasound, Hematology & Biochemistry.
Kanpur.

47
Partial List of Diagnostic
Sr. No. Discipline
Centres
Universal Pathology Lab &
Blood Bank. Blood Bank & Pathological
7
Opp. L.L.R.Hospital, Investigations.
Kanpur.
Dr.Thawanis Chest Clinic &
Diagnostic Center, Pulmonary Function Test, ECG &
8
MIG 2, Barra 6, Ultrasound
Kanpur.
X-Ray, Ultrasound & General
Usha Pathology, X-Ray &
Pathological
Ultrasound Center,
9 Investigations & Specialized Diagnostic
Opp. L.L.R.Hospital,
procedures in Cytopathology &

Healthcare Facilities in Lucknow


Kanpur.
Histopathology.
Sita Pathology,
2N, Jai Ram Market,
10 Pathological investigations
Juhi Gaushala,
Kidwai Nagar, Kanpur.
Dr.B.L.Rohatgi Memorial
X-Ray, Ultrasound and General
Diagnostic Center,
11 Pathological
15/268, Civil Lines,
Investigations & Color Doppler.
Kanpur.
Sneh Pathology X-Ray, Blood General diagnostic procedures in
Bank & Ultrasound, Pathology &
12
133/10, O-Block, Blood Bank & Specialized diagnostic
Kidwai Nagar, Kanpur. procedures in Pathology.
Gumti Pathology, X-Ray &
ELISA Center, X-Ray & General Pathological
13
118/13, Kaushalpuri, Investigations
Gumti No.5, Kanpur.
Ratan MRI & Spiral CT Center,
14 7/141-A, Swaroop Nagar, MRI, CT Scan, X-Ray & UltrasoundQ
Kanpur.
Perfect Scan, X-Ray, Ultrasound & General
15 117/N/59, Kakadeo, Pathological
Kanpur. Investigations.
Sanjeevani - The Clinical Lab. &
General/Specialized Pathological
16 Blood Bank,
Investigations and Blood Bank.
Kanpur.
Prakash Liver & Gastroenterology
17 Clinic, Specialized Endoscopic procedures.
Kanpur.
Madhulok Diagnostic Center,
18 628-K, Kidwai Nagar, X-Ray & Ultrasound.
Kanpur.
Kanpur Scans Pvt. Ltd.,
19 113/58-A, Swaroop Nagar, CT Scan & Color Doppler only.
Kanpur.

48
4 Project costing and Phasing

The proposed 500 bed multi-specialty hospital will be spread across 15


acres of land. The details of project cost and its phasing is presented in
this chapter.

4.1 Site Details

Developments near Super Specialty Hospital

Location of Super Specialty Hospital

The Site is strategically located just opposite to IIT Kanpur. The site is by the
proposed Mandhana-Bhounti Bye Pass so as to allow access to people coming
not only from within the city of Kanpur but also from other adjoining cities.

49
4.2 Departments proposed in the Hospital
The following are the departments that can be established in the proposed
500 bed hospital:
Sr.
No. Departments / Specialities
1 Trauma Care
a. Ortho unit
b. Maxillofacial surgery unit
c. Cosmetic surgery (plastic surgery)
d. Blood Bank
e. Burn Care Unit
f. Physiotherapy
g. MRI, CT scan
Cardio Thoracic care unit (ICCU- Intensive Cardiac
2
Care Unit)
3 Intervention specialty and Cerebral Intervention
4 Nephro unit
5 Neurology unit
Obs & Gynecology (IVF center may be kept as
6
optional)
Pediatric unit (with NICU Neonetal Intensive Care
7
unit)
8 Dental unit for surgery etc
9 Ophthalmology and ENT
10 Cancer unit (for Lucknow only)
Fitness center (that can include diet counseling etc.
11
for additional source of revenue)
12 OPD
General Surgery - will include laproscopy, hernia,
13 biopsy, cyst excison, thyroidrectomy, haemorrhoids
etc.

4.3 Hospital Configuration


The proposed 500 bed shall have the following configuration. The configuration
presented below is based on the standard practices adopted in major private
hospitals in the country.

Hospital Configuration Nos. Unit


Total in-patient beds 500
Intensive care unit 100 beds
Emergency wards 25 beds

Single bed suites (with two rooms) 25 beds

Delux room 25 beds


Single room 100 beds
Inpatient double bed rooms 125 beds

50
Hospital Configuration Nos. Unit
4 bedded wards 100 beds

Other facilities
OPD (Consulting rooms) 15 Rooms
Emergency rooms 3 Rooms
Surgical suite (OT) 15 OTs
Cardiac catheterisation labs 1 labs
Labour room 4 Rooms
Imaging rooms 5
Pathology department 5 Labs

4.4 Area Statement


For the above configuration of the hospital, approximately 5,00,000 Sq.Ft. of
built-up space need to be constructed. The area statement is presented below:
Norm
Area (sq (sq.m./u
Area occupied by hospital mt) No. of bed nit)
Total inpatient services 15250
Intensive care unit 4000 100 40
Emergency wards 1000 25 40
In-patient single rooms
Single bed suites (with two rooms) 1000 25 40
Delux room 875 25 35
Single room 2500 100 25
Inpatient double bed rooms 4375 125 35
4 bedded wards 1500 100 15
Other facilities 6689
OPD (Consulting rooms) 750 15 50
Emergency rooms 174 3 58
Surgical suite (OT) 3000 15 200
Cardiac catheterisation labs 100 1 100
Labour room 620 4 155
Imaging rooms 550 5 110
Pathology department 700 5 140
Blood Bank 155 1 155
Mortuary 165 1 165
Dialysis Suite 175 1 175
Physiotherapy Section 300 1 300
Administration for 500 beds 5720 500 11.44
Engineering Services @10% carpet area
10% 2765.9
Subtotal 30424.9
Wall Area @ 8% 2433.992
Core Area (Lift, shaft, fire stair, Main stair
well) @ 8% 2433.992
51
Corridor / Circulation Area @ 20% 6084.98
Toilets (Wet area) @ 10% 3042.49
Total 44420.35

The FSI applicable is 1.5. Hence in 15 acres of land, the following are the
facilities constructed:

Facilities Sq. Mt
Hospital Facilities 44420
Staff Quarters 19500
Guest House and Training Institute
25000
for Diploma Courses
Other Commercial 6000
The commercial includes the following:
 Banks and ATM
 Pharmacy
 Restaurant and Service Apartment

4.5 Capital Expenditure


4.5.1 Land Development Cost
The cost of land development is taken as Rs. 25 lakhs per acre. The total
land development cost will be Rs. 375 lakhs.

Land Development Value Units


Land area 15 acres
Land development cost per Rs.
25
acre Lakhs
Rs.
Land development cost 375
Lakhs

4.5.2 Cost of Civil works


Cost of finishes have been taken separately. The capital cost of civil works
is as follows:
Civil
Cost per Construction
Facilities Sq. Mt
Sq.Mt Cost (Rs.
Lakhs)
Hospital Facilities 44420.354 10760 4779.63
Staff Quarters 19500 8608 1678.56
Guest House and Institutes 25000 8608 2152.00
Other Commercial 6000 8608 516.48
Subtotal 9126.67

52
4.5.3 Cost of Medical Equipment
Medical equipment accounts for 35%-40% of a hospital project cost. The
details of cost of medical equipment is presented below:
Medical Equipment Rs. Lakhs

Cardiac, Cardiothoracic and Vascular 910


Oncology 1050
Radiology & imaging 1197
Nucleur medicine 337
Gastro 95
Gynecology & Obstetrics 24
Nephrology 19
Neurlogy 1027
Opthalmology 121
Orthpaedics 200
Pediatrics 46
Physiotherapy 20
Bed related equipment 654
Urology 450
Blood bank 57
OT 384
Laboratory 30
Anesthesia 2
Total 6625

4.5.4 Other Capital Costs


Plant and Machinery
Plant and Equipment Rs. Lakhs
Lifts / Elevators 144
Plumbing / Sanitation / Boiler/
Firefighting (High side) 0
Medical gases 175
Kitchen Equipment & fridges 80
IT and Telecommunication 180
Laundry Equipment 70
Incinerator 25
Mortuary 5
Vehicles 45
Total 724

53
Atleast 3 ambulances are envisaged for the 500 bed hospital.
Services
Services Rs. Lakhs
HVAC 635
Electrical 1073
Plumbing / Sanitation /
399
Boiler/ Firefighting

Wood work and Furnishing


Wood work and furnishing including office furniture costs Rs. 325 lakhs and
civil finishing cost is Rs.673 lakhs.

4.6 Project Costing and Phasing


Initially, 250 beds will be constructed in a period of three years.
Remaining 250 beds will be added such that within the next two years.
Cost escalation factors have been suitably assumed and included in the
project cost. The project cost is as follows:

Capital Expenditure Rs. Lakhs


Land development Cost 375
Civil works and finishing 9799
Wood work and furnishing 325
Services - HVAC, Electrical,
1730
Plumbing, Boiler, Fire fighting
Plant and Machinery 724
Medical Equipment 6625
Sub total 19578
Design and Architect's fee
294
(1.5%)
Project Management Consultant
294
fee (1.5%)
Contingency (5%) 779
Cost Escalation (5%) 2334.38
Interest during Construction 727
Total Project Cost 24005

The cost of the 500 bed hospital is Rs. 240.05 Crores.

4.7 Project Funding


The project will be funded by a mix of debt and Equity. The debt equity
ratio assumed is 1.5 and the interest rate of debt is assumed as 13%
which is inline with the prevailing interest rate scenario.

54
5 Feasibility Study

5.1 Revenue Assumptions


5.1.1 In patient Revenue Assumptions
Inpatient Revenue Inpatient Volume
Assumptions Spread

Dental Unit 3%
Cardiac,Thoracic & Vascular 30%
E.N.T 4%
G.I Surgery 2%
Gastroenterology 3%
General Surgery 5%
Medicine 3%
Nephrology 5%
Neuro Surgery 3%
Neurology 5%
Obst & Gynaecology 4%
Oncology 5%
Opthalmology 6%
Orthopaedics 6%
Paediatric Surgery 3%
Paediatrics 3%
Plastic Surgery 5%
Urology 5%
Total 100%

5.1.2 Out patient Revenue Assumptions

OPD Revenue Assumptions


% of New Patients 35%
Average Consultation charges Rs. 400
% of Repeat patients 65%
Consultation charges - Repeat Patients Rs. 300
% of patients undergoing lab tests 50%
Average lab test revenue per patient Rs. 300
% of patients undergoing imaging 15%
Average imaging revenue per patient Rs. 1500
% of people buying medicines from hospital
75%
pharmacy

55
OPD Revenue Assumptions

Average pharmacy revenue per patient Rs. 200

5.1.3 Revenue for the first four years of operation

Year 1

Year 2

56
Year 3

Year 4

Other revenues include revenue from parking, patient registration and


ambulance charges.

5.1.4 Revenue from Lease Rentals


The commercial space can be constructed in phases over a four year period as
the occupancy levels improve in the hospital. The lease rental is taken as Rs.
10 per Sq. Ft initially with an escalation of 4% y-o-y.

57
5.2 Operating Expenses
5.2.1 Employee Costs
Employee cost is one of the major operatign expense in a hospital. Planning
and efficient utilisation of manpower is key to successful operation of a
hospital. For a 500 bed hospital the total no. of doctors is estimated to be 110-
125. The total no. of patients after commissioning of 500 beds is expected to
be about 475 per day. For the 500 bed hospital the doctor patient ratio will be
about 1:4. The nurse to bed ratio is 1:5 and for ICU and Emergency Unit it is
1:1. Further provision needs to be provided for nurses working in shifts.
Accordingly the Nurses required for 500 bed hospital is 248.

The employee costs for the first 4 years have been taken at 40%, 60%, 80%
and 100% of the total employee costs for a 500 bed hospital.

Presented below is the manpower and salary levels of staff for a 500 bed
hospital.

TOTAL STAFFING PATTERN

Department Nos. Salary (Rs. lacs)


Doctors 122 1873
Nurses 248 386
Specialty related other
staff 92 81
Diagnostics 50 114
Other medical deptts. 33 133
Medical support facilities 69 79
Non-medical staff 75 167
Corporate 42 127
Finance & Commercial 26 94
Directors' office 3 40

Doctors
HOD Level-1 Level-2 Level-3 Residents
Salary Levels (Rs. Lacs) 75 24 20 15 6
Cardiac 1 2 2 3 3
E.N.T 1 1 3
G.I Surgery 2 2 3

58
Gastroenterology 2 2 3
General Surgery 1 1 2 3
Medicine 1 1 3
Nephrology 1 1 1 2 3
Neuro Surgery 1 1 2 3
Neurology 1 1 2 3
Obst & Gynae. 1 1 3 3
Oncology 1 2 1 2 3
Opthalmology 1 1 3
Orthopaedics 1 1 3
Paediatric Surgery 1 1 3
Paediatrics 1 2 3
Cosmetic surgery 1 2 2 2
Plastic Surgery 1 1 1 1 3
Urology 1 1 3
Medical Suprintendent 1
Sub Total 5 15 17 32 53

NURSES
Norms for nurses Nurses Beds
Surgical Wards 1 3
Other Wards 1 3
ICU 1 1
CCU 1 1
OT 1 1
ICU 100 100
Other 133 133
OTs 15 15
Total number of Nurses
required 248

DIAGNOSTICS STAFFING
Imaging
Salary/ Salary
Type of staff Number person (pm)
Head - Radiology 1 100000 100000
Senior resident 1 50000 50000
Supervisors 1 12500 12500
Technicians 1 20833 20833
Radiographer 5 10000 50000
Steno 2 6000 12000
Dark room asst. 2 6000 12000
Assistant 2 6000 12000
Attendant 1 4500 4500
273833

Radiotherapy

59
DIAGNOSTICS STAFFING

Salary/ Salary
Type of staff No. person (pm)
Senior Resident 1 50000 50000
Technicians 3 20833 62500
Receptionist 1 10000 10000
Asst. Technician 2 8000 16000
138500

Nuclear medicine

Salary/ Salary
Type of staff No. person (pm)
Senior Resident 1 50000 50000
Technicians 2 20833 41667
Receptionist 1 10000 10000
Asst. Technician 1 8000 8000
109667
Laboratory
Salary/ Salary
No. person (pm)
Chief - Microbiology 1 100000 100000
Resident Biochemist 1 50000 50000
Resident Pathologist 1 50000 50000
Senior res 2 50000 100000
Suprintendent 1 12500 12500
Sr. Lab tech 1 20833 20833
Lab. Technician 5 8000 40000
Asst. 3 6000 18000
Attendant 2 4500 9000
Lab trainees 5 5000 25000
50 425333
Total salary for diagnostics 114

OTHER MEDICAL/ PARAMEDICAL DEPARTMENTS STAFFING

Salary/ Salary
Deptt. Type of staff Number person (Rs.)

Head - Other
medical deptts 0 100000 0

Anaesthesiology
Consultant 2 125000 250000
Residents 6 50000 300000
Technician 4 20833 83333
Attemdent 2 4500 9000
Steno 1 6000 6000
648333
Physiotherapy
Attendant 1 4500 4500
60
Physiotherapists 5 7500 37500
Tech. Physio. 1 7500 7500
49500
Internal Medicine
Consultant 1 125000 125000
Chief Resident 0 50000 0
Residents 5 50000 250000
Clinical Offr 1 10000 10000
Compounder 1 6500 6500
Steno 1 6000 6000
Attendant 2 4500 9000
33 406500

Total salary for other medical deptts.


(Rs. Lakhs) 133

5.3 Summary of Operating Expenses

The Summary of Operating Expenses for the first 4 years have been
estimated. The staff will be 40% of the total in the first year, 60% in 2nd, 80%
in the 3rd and 100% in the fourth year when the hospital has 500 beds.

30% Revenue sharing with doctors have been considered in the revenue
stream itself and net revenues have been considered in the revenues.

Operating Expenses Yr-1 Yr-2 Yr-3 Yr-4

Surgical, Pharmacy & bloodbank consumables (


834 2105 3680 6512
drugs and disposables)
Lab & Imaging consumables 187 294 368 488
Uniforms 12 18 24 30
Linen cost 45 45 45 52
Laundry 35 35 35 40
Kitchen (F&B) / Pantry 75 75 75 86
Electricity & fuel charges 370 555 740 925
Water charges 5 5 5 6
Personnel costs 1238 1856 2475 3094
Advertising and Publicity 300 300 300 250
Books and periodicals 100 100 100 100
Training 200 220 242 266
Internal audit fees (icldg. OPEs for auditor) 10 10 10 10
Legal fees 17 29 39 54
Printing and stationery 29 49 64 91
Communication expenses 27 27 27 27
Referral costs 58 98 128 182
Bad Debts 29 49 64 91
Miscellaneous 174 294 385 545
Total Operating costs 3745 6164 8807 12849

61
5.4 Debt and Interest Repayment
The interest rate assumed for long term debt is 12%. The debt is assumed to
be repaid in 8 years period.

5.5 Financial Viability

Though the operating margins of hospitals vary widely between 10% and 25%
depending on the specialty services offered, due to the high capital cost and
periodic capital investment in medical equipments reduces the viability of a
hospital.

For the 90 year concession period the project yields and Internal Rate of
Return of 20% and the Cash Equity IRR is 24%.

5.5.1 Debt Service Coverage Ratio (DSCR)


The average Debt Service Coverage Ratio for the seven year repayment period
is 1.76 and the minimum DSCR is 1.34

5.6 Projected Profit and Loss Statement

The construction period is 2 years and the operations of the hospital will
commence from the third year. The Projected P&L statement for 10 year
period is presented below:

Projected P&L Statement (Rs. Lakhs)

62
5.7 Projected Balance Sheet
Projected Balance Sheet (Rs. Lakhs)

63
5.8 Projected Cash Flow Statement
Projected Cash Flow Statement (Rs. Lakhs)

64
6 Conclusion
Hospital projects have a long gestation period owing to the huge initial capital
expenditure and recurring capital expenditure on medical equipments. Hence
to make the project viable commercial exploitation within the hospital complex
area shall be allowed. However, the commercial activity shall be related to
Hospital services catering to the needs of the patients. The Project IRR for 90
year concession period is 20% and the Cash Equity IRR is 24%.

Conclusion

65