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NBCC (INDIA) LIMITED

(A Govt. of India Enterprise)


Central Procurement Group (CPG) Division
NBCC Bhawan, 2nd Floor, Lodhi Road, New Delhi-110003.
Email ID : cpg.ho@nbccindia.com

Date:- 06.10.2018
NOTICE INVITING e-APPLICATION (NIA)

1.0 NBCC (INDIA) LTD. invites online applications on All India basis for 3rdPhase NIA for
Pre-Qualification of Contractors from reputed experienced and eligible contractors for
Civil works, as per monetary Groups prescribed below :-

Notice Inviting e- Application No. NBCC/CPG/PQ/Contractors/3rd Ph/ 2018/167


Name of the Work Application for pre-qualification of Contractors
shall be done in the following groups with
monetary limits as under:

Group-I: Up to Rs.5 Crs.


Group-II: Above Rs. 5 Cr to Rs.10 Crs.
Group-III: Above Rs.10 Cr toRs.25 Crs.

Tentative Schedule for Pre-Qualification will be as under:

S No. Period for Receipt of Period for Scrutiny of Validity of Pre-


Applications Pre- Qualification Qualification
3rd Phase 06.10.2018 to 31.12.2018 01.01.2019 to 31.03.2019 01.04.2019 to 31.03.2020

4th Phase 01.01.2019 to 29.03.2019 01.04.2019 to 30.06.2019 01.07.2019 to 30.06.2020

NOTE :- The above Schedule is tentative and may be changed by NBCC, if required.

Non-refundable cost of Rs. 25000.00+GST@18%.=Rs 29,500.00 (Rupees Twenty Nine


Application processing fee Thousands Five Hundred only) through DD/ Pay Order only (in favour
for each Group payable to of NBCC (INDIA) LTD. payable at New Delhi).
NBCC(INDIA) Ltd.
Beneficiary Name- NBCC (INDIA) LTD.
Account Number-91443050000021
Bank Name- SYNDICATE BANK, LODHI ROAD, NBCC BRANCH,
NEW DELHI-110003
IFS Code- SYNB0009144

Note: The bidder qualified in higher group is also eligible for lower
monetary Group.

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Non-refundable e- (i) Up to Rs.5 Crs - Rs.2500.00 +GST@18% = Rs.2950.00
processing fee for ITI
LTD. (ii) Above Rs.5 Crs to Rs.10 Crs - Rs. 2500+GST@18%=Rs2950.00

(iii) Above Rs10 Crs to Rs. 25Crs.- Rs. 2500+GST@18%=Rs2950.00

Through e-payment gateway to ITI Ltd.

Last date & time of Before and upto 11:00 AM on 31.12.2018


submission of Online
Application

Period during which hard Before and up to 11:00 AM on 31.12.2018 in the Central
copy of documents as Procurement Group (CPG Division), 2nd Floor, NBCC Ltd., NBCC
mentioned in NIA shall be Bhawan, Lodhi Road, New Delhi-110003
submitted.

Date & Time of Opening of 11:30 AM on 31.12.2018


NIA (3rdPhase)

Validity of offer 90 days from the date of opening of Online Application.

The Notice Inviting Application can be downloaded from website


www.tenderwizard.com/NBCC and www.eprocure.gov.in. “Corrigendum, if any, would
appear only on the web site and not to be published in any News Paper”.

2.0 MINIMUM QUALIFICATION CRITERIA

The contractors should meet the following minimum qualifying criteria for getting pre-qualified
under different monetary groups:

For Contractors:

(A) Technical parameters.


(Figures are in Rs-Cr.)

(i) Work Experience

Group Monetary Past experience in completed similar works during last 7 years
Limits ending on 31st March of last FY (To fulfil either of three options)
Single project value Two projects each at Three projects each at
least least
80% of the mean 60% of the mean 40% of the mean value
value of lower and value of lower and of lower and upper limit
upper limit upper limit
Group-I Up to Rs. 5 2.00 1.50 1.00
Crs.
Group-II Above Rs. 5 6.00 4.50 3.00
Crs. up to Rs.
10 Crs.
Group-III Above Rs. 10 14.00 10.50 7.00
Crs. up to Rs.
25 Crs.

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(ii) The past experience in similar nature of work should be supported by completion
certificate(s) issued by the client’s organisation. In case the work experience is of
Private sector, the completion certificate shall be supported with copies of Letter of
Award and copies of Corresponding TDS Certificates. Value of work will be
considered equivalent to the amount of TDS Certificates.

(iii) No Joint venture or Consortium of firms shall be allowed and the contractors should
meet the eligibility criteria by themselves.

(iv) The value of executed works shall be brought to the current level by enhancing the
actual value of work done at a simple rate of 7% per annum, calculated from the date
of completion to previous day of last date of submission of application.

(v) SIMILAR WORKS DEFINITION:

For Civil Works:

The applicant should have executed “Residential / Non-Residential building(s) of any no. of
storeys”
or

One or more Civil Work(s) having items which are included in CPWD Schedule of Rates/
Compound Wall/ External Development work/ Road work/ Sewerage work/ Drainage work/
Water Supply work/ Plumbing work/ electrical work/ repair/renovation/restoration work etc.
However, such work should also include Reinforced Cement Concrete and Masonry work.

Note: - Works done purely on labour rate basis will not be considered.

(B) Financial parameters.

(Figures are in Rs-Cr.)

(i) Financial Strength

Group Monetary Average annual turnover during last 3 financial


Limits years
50% of the mean value of lower and upper limit

Group-I Up to 5 Cr 1.25

Group-II Above Rs. 5 Cr to 10 Cr 3.75

Group-III Above Rs. 10 Cr to 25 Cr 8.75

ii) Average annual turnover of audited balance sheet during last 3 financial years ending
31.03.2018 duly certified by Chartered Accountant in original with his seal/signature
and registration no.

iii) The gross annual turnover, balance sheet and profit & loss account of last 03 years or
for the period or as specified in the PQ document should be certified by Chartered
Accountant. There is no need to upload entire voluminous balance sheet. In case, no
turnover is shown in any particular year, the average turnover would be worked out
considering nil turn over in that particular year.
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iv) Net worth of the company / firm as on 31st March of the immediate preceding FY to the
one in which application is submitted, should be positive.

v) The contractor should at least have earned profit in minimum one year during the last
three years ending 31st March of the immediate preceding FY to the one in which
application is submitted.

3.0 The application documents should be signed and stamped on each page of the
application. Additional sheets, if any, added by the contractor, should also be page
numbered and submitted as a package with signed letter of transmittal. Pages of the
prequalification documents submitted without writing page numbers will not be
considered.

4.0 For the purpose of pre-qualification, parameters like minimum work experience,
financial strength, registration with Authorities of GST/ Income Tax, EPF, PAN etc. are
to be stipulated in the pre- qualification documents.

5.0 List of Documents to be signed and stamped, scanned, uploaded and also submitted in
hard copy within the period of application submission:

i. Letter of Transmittal (Form-1)

ii. Executive Summary Sheet. (Form-2/Form-3/Form-4) as per group in which


applicant wish to pre-qualify)

iii. General Information (Form-5)

iv. Financial Details (Form-6)

v. Details of work experience certificate (Form-7)

vi. Completion Certificates from Clients/Owners (Form-8)

vii. TDS Details For Private Sector Projects ( Form-9 )

viii. Affidavit of the person authorized for signing/submitting the application for
correctness of Documents /Information notarised on non-judicial paper of
Rs.100.00 - Original (Form-10)

ix. GST Registration certificate & GST registration details (Form-11)

x. Summarized page of balance sheet and profit & loss account for the last Three
years.

xi. Valid GST Registration no / EPF registration/ PAN No.

xii. All pages of the entire Corrigendum (if any) duly signed by the authorized person.

xiii. Power of Attorney of the person authorized for signing/submitting the application
on non-judicial stamp paper of value Rs. 100/- (Rupees Hundred only) duly
Notarized by notary..

xiv. Registration with NBCC/ other government organisation like CPWD etc, if any.

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6.0 All the online applications received, shall be evaluated on the basis of information and
documents submitted by the applicant. In case the applicant is not found suitable for
the applied Group, his application may be considered for the pre-qualification in lower
monetary group.

7.0 The processing fee is required to be submitted through DD/PO, as mentioned in Notice
for Pre-qualification. Under no circumstances the processing fees can be adjusted
against the pending dues of Contractors working with NBCC.

8.0 All information called for in the enclosed forms should be furnished against the relevant
columns. If for any reason, information is furnished on a separate sheet, this fact
should be mentioned against the relevant column. Even if no information is to be
provided in a column, a ‘NIL’ or ‘NO SUCH CASE’ entry should be made in that
column. If any particulars / query are not applicable in case of an applicant, it should be
stated as “not applicable”. The applicants are cautioned that not giving complete
information called for in the application forms or not giving it in clear terms or making
any change in the prescribed forms or deliberately suppressing/ furnishing false
information may result in the applicant being rejected.

9.0 Overwriting should be avoided. Correction, if any, should be made by neatly crossing
out, initialling, dating and rewriting.

10.0 Any information furnished by the applicant found to be incorrect either immediately or
at a later date would render him liable to be debarred from pre-qualification / tendering /
taking up works in NBCC.

11.0 Pre-qualification letters will be sent to the successful applicants and validity of the
same will be from 01.04.2019 to 31.03.2020.

12.0 Validity of already pre-qualified contractors whose validity was up to 31.03.2019,


30.06.2019 and 30.09.2019 shall remain the same.

13.0 In case of assistance/problem/enquiry in uploading documents, Helpdesk-Tel. nos. of


M/s ITI Ltd are 011-49424365 /8799753411/ 9811926979/

14.0 In case of any query, please contact Shri A.K. Thakur, DGM (Engg.) Ph. No. 011-
24367314 extn.1407 during office hours.

General Manager (Engg.)


Central Procurement Group

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INDEX-
SECTION – 1

Requisite data in following forms is to be filled in signed & stamped and uploaded /
submitted with e-PQ documents.

Form Brief description of contents of paragraph PAGE


No Nos.

01 Letter Of Transmittal (Form-1)

02 Executive Summary Sheet for Group-I (Form-2)

03 Executive Summary Sheet for Group-II (Form-3)

04 Executive Summary Sheet for Group-III (Form-4)

05 General Information (Form-5)

06 Financial Details (Form-6)& Last 03 Year Balance sheet and Profit and
Loss sheet at year ending 31 March

07 Details of Works Completed Certificate (Form-7)

08 Completion Certificate from Clients/ Owners (Form-8)

09 TDS Details for Private sector Projects ( From -9 )

10 Affidavit (Form-10)

11 GST Registration Details (Form-11) & certificate

12 EPF registration

13 Copy of PAN card

14 Power of attorney in the name of signatory onnon-judicial stamp paper of Rs


100/- duly Notarized by notary.

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Form-1

LETTER OF TRANSMITTAL

[ON THE LETTER HEAD OF APPLICANT]

To,

The Chief General Manager (Engg.).

NBCC(INDIA) Limited,

Central Procurement Group,

NBCC Bhawan, Lodhi Road,

NEW DELHI – 110 003

SUB: APPLICATION FOR 3rdPHASE OF PRE-QUALIFICATION OF CONTRACTORS (FY


2018-19)

Sir,

Having examined the details given in Notice for Pre-qualification, we hereby submit relevant
documents. We certify that all the statements made and information supplied in the enclosed
forms and accompanying statements are true and correct. We have furnished all information
and details necessary for pre-qualification and authorize NBCC (INDIA) Limited or their
representatives to approach individuals, employers, firms and corporations to verify our
submittals, competency and general reputation. We hereby confirm that we have read and
understood all the stipulations given in this prequalification document and the decision of
NBCC (INDIA) Ltd with regard to our pre-qualification shall be final and binding on us. We
have submitted the certificates in support of our meeting the minimum eligibility criteria of
completed work(s) specified Form-7 for having successfully completed the works.

The requisite processing fees of Rs. 29,500/- (Rupees Twenty Nine Thousand Five Hundred
only) is herewith deposited through Demand draft/ Pay Order payable at New
Delhi_______________ on dated __________

Thanking You,
Yours faithfully

(Signature with Seal of firm/ Applicant/firm)

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Form-2 (Executive Summary Sheet for Group-I)

e-Pre-qualification of contractors for 3rd Phase FY 2018-19


Monetary Group - Up to Rs 5Cr.
Name,Address,e-mail, Telephone No. of applicant/firm:-
S.No Details in brief Min. As per As per supporting Page no of
qualifying Form-6 document document.
criteria (Rs-Cr) From To
(Rs-Cr)
1 Turnover of Fy 2015-16 C.A. Fig. as in audited balance Page nos
as per Audited balance Certified Fig. sheet to put here
sheet to put here
2 Turnover of Fy 2016-17 do Do do
as per Audited balance
sheet
3 Turnover of Fy 2017-18 do Do do
as per Audited balance
sheet
4 Average T.O. of latest 1.25 To put here To put here Avg.
three financial years Avg. of 3 of 3 above
(Rs. in Cr.) above
5 Letter of Transmittal (Form-1) Write here the value Page no
of project/s within range of
mentioned it
Rs 2 Cr and Rs 1Cr should be
same as
uploaded on
web site
6 General Information (Form-5) Page no mentioned here should be same
as uploaded on web site
7 Financial information Net worth Positive Member Page no
(Form-6) as on -ship No. mentioned it
31.03.2018 CA should be
(should be same as
+ve) uploaded on
web site
8 Work completed during Min. Completed Add 7% per Updated Page no. to
last 7 years to previous eligibility value of annum value of mention
day of last date of project project below in
submission of following
application (As per rows
Form-7)
8(a) Similar single work 2.00 Write page
completed during last 7 no.
years ending on date of
previous day of last
date of submission of
application (Form-7)
8(b) Similar two works 1.50 Write page
completed during last 7 no.
years ending on date of
previous day of last
date of submission of
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application (Form-7)
8(c) Similar three works 1.00 Write page
completed during last 7 no.
years ending on date of
previous day of last
date of submission of
application(Form-7)
9 Completion Certificate from Page no
Clients/Owners mentioned it
(Form-8) should be
same as
uploaded on
web site
10 TDS Details for Private sector Page no
Projects (Form-9) mentioned it
should be
same as
uploaded on
web site
11 Details of Processing fee of Rs. DD/PO No. Date of Name of Page no
29,500/- paid in favour of NBCC Pay-ment Bank / mentioned it
(INDIA) LTD in any kind of DD/Pay Branch should be
order
same as
uploaded on
web site
12 Affidavit concerning authenticity of documents Page no mentioned it should be same as
(Form-10) uploaded on web site
13 GST registration certificate Date of issue GSTN Designation Write page
to write here Registration of officer nos.
No to write issuing
here registration
14 Details of EPF registration certificate Date of EPF Designation Write page
issue to write Registration of officer nos.
here number to issuing EPF
write here registration
15 Copy of PAN card PAN CARD Number Write page
nos.
16 Power of attorney in the name of Date of POA Name, Designation to Write page
signatory onnon-judicial stamp to write here whom POA issued nos.
paper of Rs 100/- duly Notarized by
notary.
17 Registration with NBCC/other Write page
government Organization like CPWD nos
etc, if any

Signature of authorized person with seal of agency/firm

Page 9 of 20
Form-3 (Executive Summary Sheet for Group-II)

e-Pre-qualification of contractors for 3rd Phase FY 2018-19


Monetary Group – Rs 5Cr to Rs 10 Cr
Name,Address,e-mail, Telephone No. of applicant/firm:-
S.No Details in brief Min. As per As per supporting Page no of
qualifying Form-6 document document.
criteria (Rs-Cr) From To
(Rs-Cr)
1 Turnover of Fy 2015-16 C.A. Fig. as in audited balance Page nos
as per Audited balance Certified Fig. sheet to put here
sheet to put here
2 Turnover of Fy 2016-17 do Do do
as per Audited balance
sheet
3 Turnover of Fy 2017-18 do Do do
as per Audited balance
sheet
4 Average T.O. of latest 3.75 To put here To put here Avg.
three financial years Avg. of 3 of 3 above
(Rs. in Cr.) above
5 Letter of Transmittal (Form-1) Write here the value Page no
of project/s within range ofmentioned it
Rs 2 Cr and Rs 1Cr should be
same as
uploaded on
web site
6 General Information (Form-5) Page no mentioned here should be same
as uploaded on web site
7 Financial information Net worth Positive Member Page no
(Form-6) as on -ship No. mentioned it
31.03.2018 CA should be
(should be same as
+ve) uploaded on
web site
8 Work completed during Min. Completed Add 7% per Updated Page no. to
last 7 years to previous eligibility value of annum value of mention
day of last date of project project below in
submission of following
application (As per rows
Form-7)
8(a) Similar single work 6.00 Write page
completed during last 7 no.
years ending on date of
previous day of last
date of submission of
application (Form-7)
8(b) Similar two works 4.50 Write page
completed during last 7 no.
years ending on date of
previous day of last
date of submission of
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application (Form-7)
8(c) Similar three works 3.00 Write page
completed during last 7 no.
years ending on date of
previous day of last
date of submission of
application(Form-7)
9 Completion Certificate from Page no
Clients/Owners mentioned it
(Form-8) should be
same as
uploaded on
web site
10 TDS Details for Private sector Page no
Projects (Form-9) mentioned it
should be
same as
uploaded on
web site
11 Details of Processing fee of Rs. DD/PO No. Date of Name of Page no
29,500/- paid in favour of NBCC Pay-ment Bank / mentioned it
(INDIA) LTD in any kind of DD/Pay Branch should be
order
same as
uploaded on
web site
12 Affidavit concerning authenticity of documents Page no mentioned it should be same as
(Form-10) uploaded on web site
13 GST registration certificate Date of issue GSTN Designation Write page
to write here Registration of officer nos.
No to write issuing
here registration
14 Details of EPF registration certificate Date of EPF Designation Write page
issue to write Registration of officer nos.
here number to issuing EPF
write here registration
15 Copy of PAN card PAN CARD Number Write page
nos.
16 Power of attorney in the name of Date of POA Name, Designation to Write page
signatory onnon-judicial stamp to write here whom POA issued nos.
paper of Rs 100/- duly Notarized by
notary.
17 Registration with NBCC/other Write page
government Organization like CPWD nos
etc, if any

Signature of authorized person with seal of agency/firm

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Form-4 (Executive Summary Sheet for Group-III)

e-Pre-qualification of contractors for 3rd Phase FY 2018-19


Monetary Group - Rs 10Cr to Rs 25 Cr.
Name,Address,e-mail, Telephone No. of applicant/firm:-
S.No Details in brief Min. As per As per supporting Page no of
qualifying Form-6 document document.
criteria (Rs-Cr) From To
(Rs-Cr)
1 Turnover of Fy 2015-16 C.A. Fig. as in audited balance Page nos
as per Audited balance Certified Fig. sheet to put here
sheet to put here
2 Turnover of Fy 2016-17 do Do do
as per Audited balance
sheet
3 Turnover of Fy 2017-18 do Do do
as per Audited balance
sheet
4 Average T.O. of latest 8.75 To put here To put here Avg.
three financial years Avg. of 3 of 3 above
(Rs. in Cr.) above
5 Letter of Transmittal (Form-1) Write here the value Page no
of project/s within range ofmentioned it
Rs 2 Cr and Rs 1Cr should be
same as
uploaded on
web site
6 General Information (Form-5) Page no mentioned here should be same
as uploaded on web site
7 Financial information Net worth Positive Member Page no
(Form-6) as on -ship No. mentioned it
31.03.2018 CA should be
(should be same as
+ve) uploaded on
web site
8 Work completed during Min. Completed Add 7% per Updated Page no. to
last 7 years to previous eligibility value of annum value of mention
day of last date of project project below in
submission of following
application (As per rows
Form-7)
8(a) Similar single work 14.00 Write page
completed during last 7 no.
years ending on date of
previous day of last
date of submission of
application (Form-7)
8(b) Similar two works 10.50 Write page
completed during last 7 no.
years ending on date of
previous day of last
date of submission of
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application (Form-7)
8(c) Similar three works 7.00 Write page
completed during last 7 no.
years ending on date of
previous day of last
date of submission of
application(Form-7)
9 Completion Certificate from Page no
Clients/Owners mentioned it
(Form-8) should be
same as
uploaded on
web site
10 TDS Details for Private sector Page no
Projects (Form-9) mentioned it
should be
same as
uploaded on
web site
11 Details of Processing fee of Rs. DD/PO No. Date of Name of Page no
29,500/- paid in favour of NBCC Pay-ment Bank / mentioned it
(INDIA) LTD in any kind of DD/Pay Branch should be
order
same as
uploaded on
web site
12 Affidavit concerning authenticity of documents Page no mentioned it should be same as
(Form-10) uploaded on web site
13 GST registration certificate Date of issue GSTN Designation Write page
to write here Registration of officer nos.
No to write issuing
here registration
14 Details of EPF registration certificate Date of EPF Designation Write page
issue to write Registration of officer nos.
here number to issuing EPF
write here registration
15 Copy of PAN card PAN CARD Number Write page
nos.
16 Power of attorney in the name of Date of POA Name, Designation to Write page
signatory onnon-judicial stamp to write here whom POA issued nos.
paper of Rs 100/- duly Notarized by
notary.
17 Registration with NBCC/other Write page
government Organization like CPWD nos
etc, if any

Signature of authorized person with seal of agency/firm

Page 13 of 20
FORM -5

GENERA INFORMATION

1. Name of Applicant/Company

2. Address for correspondence

3. Official e-mail for communication

4. Contact Person:

Telephone Nos.

Fax Nos.

Mobile

5. Type of Organization:

a) An individual

b) A proprietary firm

c) A firm in partnership
(Attach copy of Partnership)

d) A Limited Company
(Attach copy of Article of Association)

e) Any other (mention the type)

6. Place and Year of Incorporation

7. Name of Directors/Partners in the


organization

8. Name(s) and Designation of the persons,


who is authorized to deal with NBCC

(Attach copy of power of Attorney)

9. Bank Details : Name of Bank, Address of


Bank Branch, Account No., RTGS, IFS Code

Seal &Signature of Contractor

Page 14 of 20
FORM-6

FINANCIAL DETAILS

Application for .......................................................................

MANDATORY INFORMATION DOCUMENTS:

(The certificate is to be submitted in original )

S. 1st FY 2nd FY 3rdFY


N. 2015-16 2016-17 2017-18
Rs. (In Lakhs) Rs. (In Lakhs) Rs. (In Lakhs)

a b c

i) Profit/Loss

ii) Annual Turnover of Previous 3


financial years ending as on 31st
March of last FY

Gross Annual Turnover of Previous 3


financial years ending as on 31st
March of last FY
=(a+b+c)=

iii) Average Annual Turnover for previous


3 financial years (Rs In Lakhs) =
(a+b+c)/3 =

iv) Net Worth (paid up Capital + Reserves) as on 31st March of last FY

1. Summarised Page of Audited Profit& Loss Account of previous Three Financial Years duly
certified by a Chartered Accountant, is to be submitted

2. Summarised Page of Audited Balance Sheet of last financial year (ending 31st March of
preceding F.Y) duly certified by Chartered Accountant is to be submitted.

Signature of Chartered Seal and Signature


Accountant with Seal and of Contractor
Membership No.

Page 15 of 20
FORM-7

DETAILS OF WORK EXPERIENCE CERTIFICATES

Sl. Name Name Project Date Date No. and Cost Reference & Page
No. of Of Cost Of Of Date of of the No. of
Work In Start Completion Completion work on Documentary
Client Certificate completion in Proof of the Detail
Crores Crores Missing
In completion
certificate
1

Note :

1. Certified that the Completion Certificate of above works are enclosed with application
documents.

2. Details mentioned in the above Form are as per Completion Certificates and have not
been presumed.

3. If any details is not mentioned in the Work Completion Certificate, Documentary proof of
details like LOA, BOQ, completion certificate/occupation certificate, copy of final bill, etc is to
be submitted and uploaded on e- Tender Website along with the Completion Certificate.

Signature of Contractor with seal

Page 16 of 20
FORM- 8

Name of Client with Address, email & phone no.

Dispatch No……………. Date : ……………

WORK EXPERIENCE CERTIFICATE

Name of Contractor: -------------------------------------------------------------

1 Name of work / project & Location

2 Name and Address of the Clients

3 Agreement Amount

4 Cost of work on completion

5 Date of start

6 Stipulated date of completion.

7 Actual date of completion

8 Amount of compensation levied


for delayed completion, if any

9 Type of Work :

10 Performance report Outstanding Very Good Good Poor

(a) Quality of work.

(b) Resourcefulness

(c) Financial soundness

(d) Technical proficiency

(e) General behaviour

Date: Name & Designation

Signature with seal of issuing Authority.

Page 17 of 20
FORM- 9

TDS DETAILS FOR PRIVATE SECTOR PROJECTS

Sl. Name Name Project Date Date No. and Cost Payment TDS Year
No. of Of Cost Of Of Date of of the s Correspo Wise
Work Clients In Start Comple Completio work on received -nding TDS
Crores tion n comple as per as per
Certificate -tion TDS in to the Form
in Crores payment -26AS
Crores relating
to the
work
1

Note : Value of Work done will be considered commensurate with value of TDS
Certificates.

In case of multiple contracts undertaken from a Client, reconciliation for the TDS pertaining to
the work mentioned above need to be segregated and reconciled with Form-26AS.

This form need to be supported with Form-26AS taken in HTML format .

Signature of Chartered Accountant Signature of Contractor with seal with


Stamp and Membership Number

Page 18 of 20
FORM-10

AFFIDAVIT
(To be submitted by bidder on non-judicial stamp paper of value Rs. 100/- (Rupees
Hundred only) duly attested by Notary Public)

Affidavit of Mr. ...............................................S/o ............................................. R/o


.............................................
I, the deponent above named do hereby solemnly affirm and declare as under:

1. That I am the Proprietor/Authorized signatory of M/s ……………………………………….


Having its Head Office/Regd. Office at ……………………………………………………

2. That the information/documents/Experience certificates submitted by


M/s…………………………. along with the NIA for Prequalification of Contractors - 3rd
Phase FY 2018-19 To NBCC Ltd. are genuine and true and nothing has been concealed.

3. I shall have no objection in case NBCC verifies them from issuing authority. I shall also
have no objection in providing the original copy of the document(s), in case NBCC
demands so for verification.

4. I hereby confirm that in case, any document, information & / or certificate submitted by
me found to be incorrect / false / fabricated, NBCC (INDIA) LTD. at its discretion may
disqualify / reject/terminate the bid/contract.

5. I hereby confirm that our firm /company is not blacklisted/ barred /banned from tendering
by NBCC. If this information is found incorrect, NBCC at its discretion may disqualify /
reject / terminate the bid/contract.

6. The person who has signed the application documents is our authorised representative.
The company is responsible for all his acts and omissions in the application.

7. The work experience certificates submitted by me are not for the works executed purely
on labour rate basis.

I, ....................................., the Proprietor / Authorised signatory of


M/s....................................... do hereby confirm that the contents of the above Affidavit are
true to my knowledge and nothing has been concealed there from and that no part of it is
false.

DEPONENT

Verified at ................this.................day of .....................

DEPONENT

ATTESTED BY (NOTARY PUBLIC)

Page 19 of 20
FORM-11

GST REGISTRATION DETAILS

Sr.
Particulars Details
No.

1 Entity Name

2 Address (As per registration with GST)

3 City

4 Postal Code

5 Region/ State (Complete state Name)

6 Permanent Account Number

7 GSTN/ ARN/ UID/ Provisional ID no.

8 Type of Business (As per registration with GST)

9 Contact Person

10 Phone no./ Mobile no.

11 E-mail Id

12 Service Accounting Code/ HSN Code

13 If GST Number is not applicable, reason thereof

14 Compliance Rating (If updated by GSTN)

Signature of Applicant with seal

Page 20 of 20