Form 3: Manufacturers'/Producers’ Authorization Form

Date: 04-08-2022

To:
Special Secretary
U P Secretariat Lucknow,
Secretariat Administration
Department Uttar Pradesh.

Dear Sir,

Subject: Selection of System Integrator for Supply, Installation and Implementation of CCTV Based
Surveillance System for UP Secretariat Buildings (except Lok Bhawan).
OEM Authorization LetterforBid Number: GEM/2022/B/2340203

We, (name and address of the manufacturer) who are established and reputed manufacturers of having
factories at (addresses of manufacturing locations) do hereby authorize M/s Ishan Infotech Limited
having registered office at 315-316, Shivam Complex, Dr. Yagnik Road, Opp. Jagnath Temple, Rajkot –
360001 – Gujarat (India) to bid, negotiate and conclude the contract with you against the above
mentioned tender for the above equipment manufactured buys.

Yours faithfully,
For and on behalf of,
M/s. Dolphin Poly Plast Pvt. Ltd.

Signature Name – Shailesh Limbasiya

Designation – Director
Address – Plot No.-G/1/C, Near Almighty Gate, Kalawad Road, Metoda GIDC, Rajkot - 360021
Date – 04-08-2022

Note: This letter of authority should be on the letterhead of the manufacturer and should be signed by a
person competent and having the power of attorney to bind the manufacturer. The Bidder in its Bid
should include it. The Bidder should complete the below given table with details of all OEMs as proposed
for this assignment.

Item Name of OEM and brand / Make Model

HDPE PLB Duct Pipe Dolphin Poly Plast Pvt. Ltd. 40/33 duct
Dolphin brand