Nepal Telecom

Nepal Doorsanchar Company Limited

Section V: Sample Form

Sample Form No. – 11

Application for the Purchase of Tender Document

To: Nepal Telecom

Nepal Doorsanchar Company Limited,
Material Management Department,
Central Office, Doorsanchar Bhawan,
Bhadrakali Plaza, Kathmandu, Nepal.

Subject: Purchase of Tender Document

We, ------------------------------------------- (Specify name of the Bidder, having office at ------- (Specify Address)
have gone through the Bidder’s Eligibility and Goods/ Equipments Field Proven-ness criteria (Clause No.
16 of Section III) for Tender Invitation No. NDCL/08/071-72 for Supply and Delivery of SIM Cards for
GSM Prepaid and Postpaid Services published in daily newspaper “Gorkhapatra” and in your website
(http:/eproc.ntc.net.np) and willing to participate in said Tender Invitation.

Therefore, we are hereby submitting non-refundable fee of NRs. ... (Nepalese Rupees: … only) or US$
… (US Dollars: … Only) or Euro … (Euro: … only) and hereby authorize -------------------------------(Specify
Name and Address of Bidder/Agent) to collect the Tender Document on behalf of our company.

Please find below the details of our authorized contact person and kindly request you to make all the
correspondences related to Tender No. NDCL/08/071-72 before the opening of Bids.

Details of the Contact Person for the Correspondences:

Name:
Designation:
Company Name:
Tel:
Fax:
E-mail:

____________________________
[Signature for and on behalf of Bidder]
[Name] ----------------------
[Designation] ------------------
Date :

Seal of the Company

Signature of Document Collector:

Tender No. NDCL/08/071-72 for Supply and Delivery of SIM Cards for GSM Prepaid and Postpaid Services 72