INDIAN OIL CORPORATION LIMITED

(REFINERIES DIVISION)
Panipat Refinery

Exhibit Formats – PART-1

NOTE

1. Bidders are advised not to make any changes/ noting /comments in this section.

2. Any comment made in this section will not be taken into consideration while evaluation.
All comments/noting/deviations/exceptions if any may be recorded in exception and deviation
3.
format (Annexure-L) of Exhibit Formats – PART-2 of tender document.

Doc No. PRCC_04_TEN_06_18

Rev_03 Date 29.03.2022
 INDEX

No. of
SN Description
Pages
1. PERFORMANCE REPORT OF CONTRACTOR (Annexure-A1) 2
INSTRUCTIONS TO CONTRACTOR FOR COMPLIANCE OF
2. (Annexure-B1) 1
SAFETY BRIEFING
3. Issue of gate pass (Annexure-C1) 1
4. DECLARATION / UNDERTAKING (Annexure-D1) 1
5. Medical Examination Form for Contract Workers (Annexure-E1) 1
UNDERTAKING BY A CONTRACTOR FOR COMPLIANCE OF ALL
6. (Annexure-F) 1
LAWS, AS APPLICABLE.
7. Requisition for generation of Receipt (Annexure-G1) 1
8. FORM OF CONTRACT (Annexure-H) 3
9. No Claim Declaration (Annexure-I) 1

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 Annexure – A
PERFORMANCE REPORT OF CONTRACTOR
A) Name of Contractor :

B) LOA No. :

C) Date of Starting work :

D) Date of completion :
(Scheduled/Actual)
E) Name of work (in short) :

Sr. No Activity Action Marks Give marks as

Applicable
1 Initial Mobilization
i) For works costing upto 15 lacs a) within 7 days of LOI 8
b) within 8 to 14 days of LOI 4
c) After 14 days of LOI (-) 4
ii) “Between 15 to 50 lacs a) within 14 days of LOI 8
b) within 15 to 21 days of LOI 4
c) After 21 days of LOI (-) 4
iii) “above 50 lacs a) within 20 days of LOI 8
b) within 21 to 30 days of LOI 4
c) After 30 days of LOI (-) 4
2 Performance of work
i) Submission of progress- a) within 7 days of LOI 4
schedule identifying 5 b) within 10 days of LOI 2
important milestones. c) within 15 days of LOI 1
d) After 15 days of LOI (-) 2
ii) Milestones achieved as per a) As per schedule(Ro) 10
original progress schedule (Ro) a-1) Delayed on A/c of dept 10
b) “Within acceptable limits (as per 8
subsequent acceptable prog. Schedule)
Revision 1
b-1) “ As per Revision 2 6
c) Just satisfactory 0
iii) Man-power deployment
1) Skilled a) Adequate as per R0 8
b) Adequate as per R1 6
c) Adequate as per R2 3
d) Just adequate 0
2) Unskilled a) Adequate as per R0 8
b) Adequate as per R1 6
c) Adequate as per R2 3
d) Just adequate 0
iv) Material availability a) Adequate as per R0 10
b) Adequate as per R1 8
c) Adequate as per R2 5
d) Just adequate 0
v) Healthiness of M/Cs & a) Sound health 5
Tools & Tackles b) Satisfactorily maintained 2
c) Poorly maintained 0

3 Labour wage payments and

Adherence to labour laws
i) Payment of wages a) Full payments in time 8
b) Late payments 3
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 ii) Adherence to labour laws a) Full compliance 6
b) partly compliance 2
4 Quality of work & material
i) Materials under a) Excellent 5
contractor’s scope b) Good 3
ii) Workmanship a) Maintaining very good line & level 5
b) “ “ just enough line & level 2
5 Site clearance after a) Within 7 days 5
completion of work b) within 15 days 3
c) After 15 days (-) 5
6 Sub-letting of work a) With deptt. approval 0
b) Without deptt. approval if noticed (-) 15
7 Depositing ISD and Signing of a) Within 10 days of information as per 5
Agreement LOI
(to be filled up by Contract cell) b) After 10 days of LOI 0
8 Co-operation a) Full Co-operation with deptt. 5
b) Partial co-operation 2
9 Safety & Environment Norms a) Adherence to safety norms 5
b) Per violation of safety norm (-) 2
10 Statutory Requirement a)Adherence as per schedule 3
b) Not as per schedule 0
Total 100

CONTRACTOR PERFORMANCE:

A) UNSATISFACTORY < 45 B) SATISFACTORY => 45 BUT < 60

C) GOOD => 60 BUT < 75 D) EXCELLENT > 75

SITE ENGINEER ENGINEER IN CHARGE HOD

TO : HOD (CONTRACT – CELL)

Digital Signature of the Tenderer

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Rev_03 Date 29.03.2022
 Annexure – B

INSTRUCTIONS TO CONTRACTOR FOR COMPLIANCE OF SAFETY BRIEFING

There will be compulsory safety briefing to contractor employees, before their entry inside Refinery. The
training will be imparted by Fire & safety Officer and a safety briefing card shall be issued to each participant
with validity of one year.

1. The list of contractor’s employees will be submitted by the contractor to CISF and CISF will allow entry of
those contractor employees from gate No.1 of Refinery to safety training hall. The contractor/ Contractor
supervisor will identify their employee at gate No.1 of employees in presence of CISF during entry.

2. The contractor employees will sign/ put thumb impression, as the case may be on attendance registered
in Safety training hall, before the training.

3. After the training, the Safety briefing card will be issued to the contractor supervisor for their employees,
which will be valid for 1 year from the date of training.

4. The contractor supervisor will produce the safety briefing cards to CISF for processing the permanent
gate passes/ renewal of old gate pass, as the case may be.

5. On expiry of safety card validity, contractor employees has to again take the safety training and get it
renewed, without which gate pass will not be issued.

6. In case of loss of safety briefing card, Safety card can be re-issued if the contractor employees can inform
about the date of training, otherwise new card will be issued only after training.

7. Contractor workers have to always carry the safety briefing card along with the gate pass during the
working period while working in Refinery area.

8. Any IOCL employee can demand to the contractor/contractor employee to show their safety briefing
card, failing which the concerned contractor employees may not be allowed to work.

9. Safety violation will be endorsed on safety cards. 1st violation will lead to warning, on 2nd violation entry
will be banned for a week and on 3rd violation gate pass will be withdrawn. No gate pass will be issued to
such contractor employee for a period of atleast three weeks.

10. From 25.12.2012, issue of permanent gate pass to contractor employees by security will be done on
availability of safety briefing card only.

We agree to comply the above, before entry of our workmen/ employees inside Battery Area. IOCL will have the
right to refuse entry of our workmen/employees in case of Non-compliance of any of the above said clause.
IOCL reserves the right to modify/alter any of the above mentioned clauses.

Digital Signature of the Tenderer

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 Annexure – C

(To be typed on Contractors’ Letter Head)

Indian Oil Corporation Limited

Panipat Refinery

Dear Sir,

REF : Contract No. ________________________ Dated ___________.

Issue of Gate Passes

We have been awarded the above contract on ______________________

____________________________________for the performance of which we would require to enter into the
premises of Corporation at PNC Panipat Refinery. For the performance of the said employees whose names
and designations are given in the annexed statement declaration to enter into the said Refinery for the period
of maximum 6 (Six) months commencing from _______. Also, enclosed are two passport size photographs of
each of our employees for whom the Gate Pass is sought. (One photograph to be appended on the Gate Pass
and the other to be kept for record).

The annexed statement contains a declaration by each of our employees by whom a Gate Pass is requested
disclaiming any right to make any claim on employment or otherwise against he Corporation.

It is understood that Gate Pass will be counter-signed by us as the employee the person to whom the Gate Pass
is issued and by our employee to whom the Gate Pass is issued. We undertake to present our authorized
representative and the employee(s) with proper identification at the time of issue of the Gate Passes physical
verification and counter-signature.

It is understood that the issue of Gate Passes shall not impose any liability on Indian Oil Corporation Limited and
that we as employers of persons for whom Gate Passes are sought assume full responsibility for all acts and
omission for persons to whom the Gate Passes are issued.

Yours faithfully,

Signature of Contractor :

Place :

Date :

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 Annexure – D

DECLARATION / UNDERTAKING

Contract No. ________________________at _______________________

Name of Employer : M/s. _______________________________________

(M/s. of Indian Oil Corporation Ltd. )

We, the undersigned employee (s) of the above named employer and his establishment do hereby undertake
that if the Gate Pass (es) applied for in the accompanying application of the above named employer is / are
issued to me / us. I/We shall:

i) Duly and faithfully observe all safety ad other regulations applicable to the Refinery to which the
gate Pass (es) relate (s).
ii) Not anywise do any act or omission that can cause any fire or other hazard or loss or damage to any
property or harm or injury to any person within the said premises.
iii) Not indulge in any act or activity except such activities as necessary and in the ordinary course of
my duties assigned to me/ us by my / our employer above-named.
iv) Not make any claim against Indian Oil Corporation Ltd. for any loss damage or injury to me / us
while in the premises
v) Not make any claim against Indian Oil Corporation Ltd. employment, compensation, absorption or
otherwise.
vi) I shall not claim any right for issuance of Gate Pass if it is found during the course of antecedent
verification that there is adverse remarks against by the District / Police authorities and / or any
criminal case is pending against me or I have been convicted for any criminal offence by any or of
law either before taking up employment or after getting employment with the present employer.
vii) Not use the Gate Pass for any purpose other than for entry into designated premises for the bona
fide performance of such duties as be assigned to me / us by our aforesaid employer.

Name ________________Designation ____________ Signature ______________

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 Annexure- E
INDIAN OIL CORPORATION LIMITED
PANIPAT REFINERY (PR / PNC)
OCCUPATIONAL HEALTH SERVICES
MEDICAL EXAMINATION REPORT
CONTRACT WORKER
Date of Examination:
Name of the Contract Worker:
Name of the Contractor :
Date of Birth :
Gate Pass No:
Department:
HISTORY:

Phobia for Confined Space Y/N, Phobia for Height: Y/N

Giddiness: Y/N Vertigo: Y/N
Diabetes: Y/N Hypertension : Y/N
Psychiatric Illness :
Any other illness:
PHYSICAL EXAMINATION:
Height : Weight : Pallor:
Pulse : BP: Appendages:
CVS:
Respiratory:
Abdomen:
CNS: Ataxia: Vertigo:
Motor Reflexes: Sensory:
INVESTIGATIONS:
Haemoglobin:
Blood Sugar:
ECG:
Vision Test:
ENT: Audiometry:
PFT:
Remarks: Fit / Unfit for the job.
Signature of employee Occupational Health Physician

Name :

Registration No. :

Digital Signature of the Tenderer

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 Annexure – G

To

Finance Department
Works Section
Panipat Refinery & Petrochemical Complex.

Sub: Requisition for generation of Receipt

Particulars To be filled by vendor

Tender No.
WO NO. & Date / FOA NO. & Date
Vendor Code
Vendors Name
Nature of the Deposit- ISD / SD / Others specify
Amount Deposited
Date of Deposit
Deposited with SBI / HDFC Bank - IFSC code
UTR NO./Transaction Reference No.

We, M/S …………….………………….Vendor code …………….……hereby declares that a sum of

Rs…………………has been deposited in IOCL Bank Account , you are requested to issue a receipt for the

same for our record.

Encl: Proof for remittance of funds to IOCL A/c.

(Vendor)

For Finance:

Accounting document No……………………generated for raising receipt voucher.

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 Annexure-H
FORM OF CONTRACT

THIS CONTRACT made at …………… this …….. Day of ………, ……………; BETWEEN INDIAN OIL CORPORATION LTD, a
Government of Indian Undertaking registered in India under the Indian Companies Act 1956, having its
registered office at G-9, Ali Yavar Jung Marg, Bandra (East), Bombay-400 051 and the Headquarters of its
Refineries Division of Indian Oil Corporation Ltd. (Refineries Division), Scope Complex, Core -2, 4th Floor, 7
Institutional Area, Lodhi Road, New Delhi-110 003 (hereinafter referred to as the "OWNER" which expression
shall include its successors and assigns) of the One Part; AND …………………., ………….. carrying out business in
Company/ Proprietorship /Partnership under the name and style of ………………… …………… having its office at
…………….. ……………. ………….. ………….. ……………….. (hereinafter referred to/as collectively referred to as the
"Contractor'' which expression shall include his/their/its executors, administrators, representatives and
permitted assigns/successors and permitted assign) of the other part:

WHEREAS
The OWNER desires to have executed the work of “……….. ……………. ……………. …………… ……………” (Tender
No : ……………..) more specifically mentioned and described in the contract documents (hereinafter called the
''work'' which expression shall include all amendments therein and/or modifications thereof) and has accepted
the tender of the CONTRACTOR for the said work.

NOW, THEREFORE. THIS CONTRACT WITNESSETH as follows:

ARTICLE – 1

CONTRACT DOCUMENTS

1.1 The following documents shall constitute the ‘Contract documents’, namely:

(a) This contract;

(b) Tender Documents as defined in the General Instructions to Tenderers;
(c) Letter of Acceptance of Tender (Letter of Acceptance No. ………… dtd. ……..)

1.2 A list of the Tender Documents is annexed hereto as Annexure 'A' while a copy of the Letter of
Acceptance of Tender along with annexure thereto dtd. ……… …… are annexed hereto and said copies have been
collectively marked as Annexure -'B'.

1.3 The Tender Documents mentioned in Annexure ‘A’ are available in electronic form at the OWNER’S e-
tender portal [https://iocletenders.nic.in] under the subject ‘Tender Number ’. These Tender Documents are
an integral and valid part of the present Contract.

ARTICLE -2

WORK TO BE PERFORMED

2.1 The CONTRACTOR shall perform the said work upon the terms and conditions and within the time specified
in the Contract Documents.

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 ARTICLE -3
COMPENSATION

3.1 Subject to and upon the terms and conditions contained in the Contract documents, the OWNER shall pay
CONTRACTOR compensation as specified in the Contract documents upon the satisfactory completion of the
work and/or otherwise as may be specified in the Contract documents.

ARTICLE -4
JURISDICTION

4.1 Notwithstanding any other court or courts having jurisdiction to decide the question(s) forming the subject
matter of the reference if the same had been the subject matter of a suit, any and all actions and proceedings
arising out of or relative to the contract (including any arbitration in terms thereof) shall lie only in the court of
competent civil jurisdiction in this behalf at New Delhi (where this Contract has been signed on behalf of the
OWNER) and only the said Court(s) shall have jurisdiction to entertain and try any such action(s) and/or
proceeding(s) to the exclusion of all other Courts.

ARTICLE -5
ENTIRE CONTRACT

5.1 The Contract documents mentioned in Article – I hereof, irrespective of whether they are available or
executed electronically or physically, embody the entire Contract between the parties hereto, and the parties
declare that in entering into this Contract they do not rely upon any previous representation, whether express
or implied and whether written or oral, or any inducement, understanding or agreements of any kind not
included within the Contract documents and all prior negotiations, representations, contracts and/or
agreements and understandings relative to the work are hereby cancelled.

ARTICLE -6
NOTICES

6.1 Subject to any provisions in the Contract documents to the contrary, any notice, order or
communication sought to be served by the CONTRACTOR on the OWNER with reference to the Contract shall be
deemed to have been sufficiently served upon the OWNER (notwithstanding any enabling provisions under any
law to the contrary) only if delivered by hand or by Registered Acknowledgment Due Post to the Engineer-in-
Charge as defined in the General Conditions of Contract.

6.2 Without prejudice to any other mode of service provided for in the Contract Documents or otherwise
available to the OWNER, any notice, order or other communication sought to be served by the OWNER on the
CONTRACTOR with reference to the Contract, shall be deemed to have been sufficiently served if delivered by
hand or through Registered Post Acknowledgement Due to the principal office of the CONTRACTOR ………..
………… ………….. ……………… or to the CONTRACTOR's representatives as referred to in the General Conditions of
Contract forming part of the Contract Documents.

ARTICLE-7
WAIVER

7.1 No failure or delay by the OWNER in enforcing any right or remedy of the OWNER in terms of the Contract
or any obligation or liability of the CONTRACTOR in terms thereof shall be deemed to be a waiver of such right,
remedy, obligation or liability, as the case may be, by the OWNER and notwithstanding such failure or delay, the
OWNER shall be entitled at any time to enforce such right, remedy, obligation or liability, as the case may be.

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 ARTICLE-8

NON-ASSIGNABILITY

The Contract and benefits and obligations thereof shall be strictly personal to the CONTRACTOR and shall not
on any account be assignable or transferable by the CONTRACTOR.

IN WITNESS WHEREOF the parties hereto have executed this Contract in duplicate the place, day and year first
above written

SIGNED AND DELIVERED SIGNED AND DELIVERED

for and on behalf of for and on behalf of
M/s. ………………….. INDIAN OIL CORPORATION LTD.
(CONTRACTOR)

in the presence of : in the presence of :

1. 1.

2. 2.

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 Annexure-I

Declaration to be obtained from the Contractor at the time of settlement of final bill

(To be executed on stamp paper of Rs.50/-)

No Claim Declaration

Details of the Contract/work order

Name of the Contract/work:

Name of the Contractor:

LOA/FOA No. :__________Dated:_______

Work Order No:_________Dated:_______

Date of Commencement:

Date of Completion:

I/We _________ hereby declare that, I/We have received the sum of Rs.
_____________(Rupees_________________________________________________
______only) as full and final settlement of all the payments due and payable to us
for the above mentioned work of ______________________________ at (Location
of the work), executed by us from (Date of Commencement) to (Date of
Completion), under the contract between ___________ and Indian Oil Corporation
Limited.

We hereby unconditionally and without any reservation certify that, with this
payment, we shall have no claim of any description, on any account whatsoever
from Indian Oil Corporation Limited, against aforesaid job/work executed by us.

We further declare unequivocally that with this payment we have received all the
amounts due and payable to us from Indian Oil Corporation Limited and we have no
dispute or claim of any description whatsoever regarding the amounts worked out as
payable to us and received by us.

We hereby declare that we shall not raise any notice, claim or dispute in any legal
forum or otherwise with respect to the above said contract and the payment
made/received thereof.

(Authorised Signatory)

Date:

Place:

Doc No. PRCC_04_TEN_06_18

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