A CO: INFORMATION TECHNOLOGY DEPARTMENT,

INDIAN BANK, CORPORATE OFFICE,

254-260, AVVAI SHANMUGAM SALAI
CHENNAI – 600014

Proforma of Certificate for issue by the Branch/Circle Office/Head Office after

successful installation of LTE Module in the Cisco 4221 Router

Date:

Sub: Installation of LTE module in the Cisco 4221 router at Branch/Office

Ref: Bid Document No. CO/ITD/PG/622/R1/2017-18 dated 08.08.2017

1. This is to certify that the LTE module/s detailed below has/have been received in good
condition in accordance with the purchase order. The same has been installed in the
router and commissioned.

(a) Order No. CO/ITD/PG/PO/1216/PO1/20 17-18 dated: 29.11.18

(b) Description/S.No of the New LTE Modules Installed

____________________________________________________

(C) Old Module Serial Number___________________

(d) Quantity ____________________________________________

(e) Date of delivery___________________

(f)Date of installation / commissioning ____________________

2. LTE Module has been installed to our entire satisfaction.

3. The supplier has fulfilled its obligations as per order.

or

The supplier has failed to fulfil its obligations with regard to the following:

(a)

(b)

Signature _______________________

Name ______________________

Designation with stamp __________________

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