5. Cost of Tender Form Rs. 250/- ( in cash ) for each Tender Form

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1 EMPLOYEES STATE INSURANCE CORPORATION SUB-REGIONAL OFFICE PANCHDEEP BHAVAN, S.NO. 689/690. BIBWEWADI PUNE (ISO-9001:2008 Certified) Phone: ,139, Fax: , dir-pune@esic.nic.in TENDER NOTICE The Director Employees' State Insurance Corporation, Sub Regional Office,Bibvewadi,Pune , invites sealed offers for the supply of Printed forms and Registers for a period of One year ( ) from reputed suppliers/printers. Tender No. Name of Work Approx. Estimated Cost ( In Rs.) Earnest Money (In Rs.) 05 / Supply of Printed Forms & Registers. 3,43,180/- 6864/- Sr.No. SCHEDULE 1. Period for availability of Tender Forms 2. Address for availability of Tender Forms 3. Last Date of Submission of Tender Forms. 18/05/2015 to 02/06/2015 (During Office hours on all working days) Sub Regional Office,ESI.Corporation,Panchdeep Bhavan,S.No. 689/690,Bibvewadi Pune /06/2015 ( Up to 3.00 P.M.) 4. Date of Opening of Tenders 12/06/2015 ( At A.M) 5. Cost of Tender Form Rs. 250/- ( in cash ) for each Tender Form Bidders downloading the Tender Forms from our website : or shall have to submit Demond Draft towards cost of the Tender Rs.250/- for each Tender Form in favour of ESIC A/C NO.I,not drawn later than 02/06/2015. Place:-Pune Date:-. ASSTT. DIRECTOR

2 2- Cost of Tender Form: Rs.250/ EMPLOYEES STATE INSURANCE CORPORATION SUB-REGIONAL OFFICE PANCHDEEP BHAVAN, S.NO. 689/690. BIBWEWADI PUNE (ISO-9001:2008 Certified) Phone: ,139, Fax: , dir-pune@esic.nic.in TENDER FOR SUPPLY OF PRINTED FORMS AND REGISTERS PREAMBLE:- ESI.Corporation is a Social Security Organization, Statutory Body set-up under the ESI Act,1948 functioning under the control of Ministry of Labour & Employment, Govt. of India. This Tender document is for supply of Printed Forms and Registers at ESIC,SRO.Pune for the period of one year from the date of award of the workorder. Sealed tenders are invited from the eligible suppliers by the Director, ESI Corporation, Pune, for the supply of PRINTED FORMS AND REGISTERS as per specifications and quantities detailed in the Annexure -IV ( Price bid). The conditions of contract which will govern any contract made are given hereunder and in General conditions of Tender (Annexure-I). If you are in a position to quote for supply in accordance with the requirements in the attached schedule, please submit your tender to this office. Preparation of Tender:- a) The Annexure-IV should be returned intact though you are quoting for any item or not. If any item in the Annexure-IV is not being tendered for, the corresponding space against the item should be indicated as not quoting. b) In the event of the space in the Annexure-IV being insufficient for the required purpose additional page may be added. Each such additional page must be numbered consecutively, bear the tender number and be fully signed by tenderer. In such cases, reference of the additional pages must be made in the tender form. Signing of Tender:- a) The tender is liable to be ignored if complete information is not given therein or if the particulars & date (if any), asked for in the Annexure-II,III & IV of the Tender Forms are not fully filled in. Annuxure -I (Technical Bid) should also be submitted duly signed on each page. Particular attention may be paid to the particulars referred to in the conditions of contract as the supplier has to comply with them. b) Individual signing the tender or other documents connected with the Tender must specify:- 1) Whether signing as a Sole Proprietor. 2) Whether signing as Registered active Partner'. 3) In the case of companies and firms registered under the Company Act & Indian Partnership Act, The capacity in which signing e.g. Secretary, Manager, Partner etc. or their attorney and produce copy of document empowering him to do so, NOTE:-IN THE CASE OF UNREGISTERED FIRMS ALL THE MEMBERS OR ALL ATTORNEY DULY AUTHORISED BY ALL OF THEM OR THE MANAGER OF THE FIRM SHOULD SIGN THE TENDER AND OTHER DOCUMENTS.

3 ELIGIBILITY CRITERIA : 3 1. The bidder should have minimum three year experience in the work of similar nature as on 31/03/ The Bidder should have successfully undertaken / completed either following work in the last 7 (seven) years; I) One similar work of value not less than Rupees 2,74,544/-. (Equal to 80% of the value of work to be executed) OR II) Two similar work of value not less than Rupees 1,71,590/-. (Equal to 50% of the value of work to be executed) OR III) Three similar work of value not less than Rupees 1,37,272/-. (Equal to 40% of the value of work to be executed) 3. The Tenderer must have following licenses/registration(s) & copies of the same may be attached with the proforma Annexure-II (Technical bid). I. Registration under Mumbai Shop & EstablishmentAct. II. Registration under LBT Act. III. Registration under Vat Act. IV. Registration under Service Tax Act. V. Pan Card. 4. Tenderer must submit copies of Orders executed in support of Point No. 2 ( I to III ) above as the case may be. EARNEST MONEY DEPOSIT:- The amount of EMD shall be Rs.6864/- must be deposited alongwith thetender Form through Demand Draft drawn in favour of 'ESIC A/c.No.I payable at Pune. Tenders without Earnest Money Deposit will not be entertained. I). No interest shall be payable by the ESI Corporation on this amount. II). successful bidder's EMD will be returned as promptly as possible. III). The successful bidder's EMD will be refunded after furnishing the performance guarantee by him. IV). The EMD shall be forfeited:- If the bidder withdraws his bid after closure time of submission of tender. OR In case of a successful bidder, if the bidder fails to sign the contract and or to furnish performance security. Submission of Tender:- The tender documents duly completed should be submitted in two separate parts. The first part should be sealed in a separate envelope and super scribed as Tender for Supply of Printed Forms and Registers Technical Bid. This should contain all the information with documentary evidence as per Technical Bid at Annexure-I & II and the second part will consist of 'Financial Bid'(Annexure-III &IV) and should be sealed in second envelope and super scribed as Tender for Supply of Printed Forms and Registers Financial Bid. Both the envelopes should again be sealed in the Third Envelope which shall contain the Earnest Money Deposit and duly super scribed as Tender for Supply of Printed Forms and Registers. Last date for Submission of tender:- Your tender must be dropped in the tender box kept in this office not later than P.M. On 11/06/2015. In the event of the said date of the opening of the tender be or being declared a closed holiday for Government Offices, the date of opening of the tenders will be the next working day.

4 4. The Period for which the Offer will remain open. I). All tenders should remain valid for acceptance for a period of Sixty (60) days from the date of opening of tenders. ii). Tenders submitted in vague and indefinite expressions such as Subject to immediate acceptance. Subject to prior sale etc. will not be considered. Duly filled documents should be dropped in tender box kept at reception area Regional office ESI Corporation, Pune at the following address. of Sub EMPLOYEES STATE INSURANCE CORPORATION SUB-REGIONAL OFFICE, S.NO. 689/690.PANCHDEEP BHAVAN, BIBWEWADI, PUNE All tenderers or their representatives if they so desire may remain present at the time of opening of the tender at A.M on 12/06/2015 at the above address. Price bids in respect of the bidders who do not qualify in technical bid would not be opened. Submission / Opening of Tender:- Prices:- i) The prices quoted must be in Rupees, net per unit, shown in the Annexure-IV (Price Bid) inclusive of all packing and delivery charges. ii) Tenderers should clearly quote the prices inclusive of sales tax Vat,L.B.T.,Service Tax & other levies Insurance etc. Where no specific mention is made of sales tax or other duties, prices will be deemed to be inclusive of sales tax and other duties. Iii). While quoting the rates it may be noted that even if the taxes work out in fraction (Paise), the final quoted amount should be in full Rupee. Delivery Terms:- a) The stores is required to be delivered as specified in the Annexure-IV at the above address free of cost during the period mentioned in the supply orders issued from time to time. b) The tenderers shall deliver the Printed Forms, Registers in good order of which the Director, Employees State Insurance Corporation, SRO, Pune shall be sole judge within the limits of time as the Director, Employees State Insurance Corporation, SRO, Pune may deem reasonable and specify, and in such quantity or quantities as may from time to time be ordered by him.

5 -5- Inspection of Stores:- Supplies will be accepted subject to inspection by Director, Employees State Insurance Corporation, SRO, Pune or his Agent. Any defect found in the material will render the supplies open to rejection and decision of the Director, Employees State Insurance Corporation, SRO, Pune in the matter shall be final and legally binding on the supplier. The rejected stores will be returned to the suppliers at their risk and cost. System of Payment:_ Payment for the stores or for each delivery will be made to the tenderer on the submission of bills in accordance with the procedure laid down. The Director, Employees State Insurance Corporation, SRO, Pune does not pledge himself to accept lowest or any tender and reserve to himself the right of accepting the whole or any part of the tender or portion of the quantity offered and you shall supply the same at the rate quoted. You are at liberty to tender for the whole or any portion or to state in the tender that the rate quoted shall apply only if the entire quantity is duly taken from you. ( ) Assistant Director ESIC,SRO,PUNE

6 6 EMPLOYEES STATE INSURANCE CORPORATION SUB-REGIONAL OFFICE PANCHDEEP BHAVAN, S.NO. 689/690. BIBWEWADI PUNE (ISO-9001:2008 Certified) Phone: ,139, Fax: , dir-pune@esic.nic.in Technical Bid ANNEXURE-I GENRAL CONDITIONS OF TENDER 1) The tender should be accompanied by an Earnest Money Deposit of Rs.6864/- i.e.2% of the estimated value of forms and Registers, in the form of Demand Draft/Pay Order drawn in favour of ESIC. A/c. No.I payable at State Bank of India, Pune. The tender shall be complete in all respects. Incomplete tenders without Earnest Money Deposit shall be treated as invalid. This deposit will be refunded without interest after completion/acceptance of Tender. 2) As soon as Letter of Intimation is issued to the successful supplier, the Supplier will submit a Performance 5% of the contract amount within 10 days which will be valid upto 60 days after a period of one year from the date of award of workorder. 3) If the required security is not received by the due date, the Corporation reserves the right to cancel the order. The Security Deposit will be refunded only after satisfactory completion of the order. If the order is not executed within the prescribed time limit in accordance with specifications, the order will be cancelled and the Earned Money Deposit/Security Deposit will be forfeited. 4) The rates should be valid for 1 year from the date of issue of work order and should be inclusive of all taxes. The delivery of the articles should be free of cost at various places which will be communicated to you at the time of placing of the order. 5) All entries in the Tender form should be legible and filled in clearly. Any overwriting or cutting which is unavoidable shall be signed by the authorized signatory. 6) Tender incomplete in any form will be rejected outright. Conditional Tenders will be rejected outright. 7) The quantity indicated above is approximate and is subject to variation.

7 :7 : 8) The Corporation reserves the right not to accept the lowest tender or to accept any tender or to divide the whole or a part of the tender among a number of tenderers without assigning any reasons thereof & no correspondence will be entertained in this regard. 9). The tender should be addressed to the Director, ESI Corporation, Sub Regional Office, Pune and submitted in double covers, on the inner cover of which the following words should be written in bold letters. Tenders for supply of PRINTED FORMS AND REGISTERS. 10) Tenders will be available at above address from 18/05/2015 to 02/06/2015 at the cost of Rs.250/- between am to 5.00 p.m. on working days at the above address.. Saturday/Sunday & closed Holiday are not working days for this office. Last date of submission of tender is 11/06/2015 upto 3.00 PM. 11) Tenders will be opened on 12/06/2015 at A.M. at Sub Regional Office, Pune. 12) The delivery of ordered items should be in time as specified in an order. If the stock supplied is found to be old/defective, the same should be replaced immediately as per requirements of this office, failing which EMD/SD will be forfeited and the tenderer will be black listed. 13). The supply should be made as & when intimated by this Office & quantity should be supplied as stated in Purchase Order only. 14). The bidder to whom the work is awarded will execute the work himself. He will not be allowed to sub-let the work to any other agency. 15). SAMPLES IN RESPECT OF FORMS AND REGISTERS FOR INFORMATION WILL BE AVAILABLE from 18/05/2015 to 02/06/2015 between am to 5.00 pm on all working days at the above address.. Saturday/Sunday & closed Holiday are not working days for this office. 16). Arbitratiion- In case of any dispute or differences arising out of the tender conditions the same shall be referred to Sole Arbitrator. He shall be Director, ESI.Corporation, S.R.O.Pune & his decision shall be binding on both the parties. Encl:- Annexure-II.

8 :08: Annexure II TECHNICAL BID. TENDER APPLICATION FORM FOR SUPPLY OF PRINTED FORMS AND REGISTERS 1 Name of the firm 2 a Full Postal Address with the name of the owner/occupier/partner/director b c d e Cell Phone No. Telephone no. Fax No. ID, if any 3 Registration No. under 1) Mumbai Shop & Estt.Act. 2) Registration under LBT. Act. 3) Registration under Vat Act. 4) Registration under Service Tax Act. 5) Pan Card. (Copies of above may be attached.) 4 Name and Address of your Bankers stating the name in which the Account stands and Account No.MICR No./IFSC Code No./RTGS/NEFT No. 5 Are you in the list of approved contractors of any other organizations/ institutions, including ESIC, if any give details (Attach extra page if necessary) 6 Give details of any Government or any other contracts executed during the last 3 years as on 31/03/2014 (Attach Work Order) 7 Any other information which you consider necessary to furnish. Name, Signature Seal of the Tenderer

9 : 9 : SUB-REGIONAL OFFICE EMPLOYEES STATE INSURANCE CORPORATION PANCHDEEP BHAVAN, S.NO. 689/690. BIBWEWADI PUNE (ISO-9001:2008 Certified) Phone: ,139, Fax: , dir-pune@esic.nic.in To be submitted with PRICE BID ANNEXURE-III DECLARATION I, (First Name ) (Middle Name) (Surname) Owner of M/S. all Hereby declare that, I have gone through the instructions mentioned in the tender document/form carefully. The terms, conditions & instructions mentioned in the said documents are binding on me in respects & I also agree with the same. Signature:- Name of the Owner:- Name of the Firm: Date:- Place:- Name, Signature and Seal of the Company/Firm/Shop

10 PRICE BID Annexure-IV Sr. No. Name of item Description Net Requirement Rate per Unit Total cost including tax applicable. 1 BI 2 70 gsm. Double fold, As per sample, 2 BI 1(a) 70 gsm. A pad of 100 sheets. 3 B I 7 70 gsm. A pad of 100 sheets nos. 15 pads 10 pads 4 TR-58 (A) As per Sample 30 pads. 5 BRO -50-A A pad of 100 sheets. 10 pads 6 Service Book As per Sample 50 Books 7 ESIC nos. 8 ESIC MED-5 (Appendix- 1) 100 Books. 9 TR pads. 10 ESIC 9 70 gsm. A pad of 50 sheets, as per sample 40 pads 11 ESIC 19 (Shedule Sheet) 70 gsm. A pad of 100 sheets, as per sample 30 pads 12 ESIC 25-A 70 gsm. A pad of 100 sheets, as per sample 10 pads 13 ESIC 26 (PDB REG.) 70 gsm. A Register of 200 ledger sheets cloth binding. 10 books 14 ESIC gsm as per sample 30,000 nos. 15 ESIC gsm as per sample 20 pads 16 Ledger Sheet-I 130 gsm nos. 17 ESIC 47 (Reg.) 18 Regd. A.D. Books (Journal) 70 gsm. A Register of 100 sheets 70 gsm. A Register of 200 sheets 120 books

11 19 ESIC 59 (RM 1 Reg.) 20 ESIC 60 (Form 28 Reg.) 21 ESIC 61 (Ref.to Med. Board Reg.) 22 ESIC 62 (A.E. Reg.) 70 gsm. A Register of 100 sheets 70 gsm. A Register of 100 sheets 70 gsm. A Register of 100 sheets 70 gsm. A Register of 100 sheets 23 ESIC gsm as per sample 10 pads 24 Acknowledg ement (R.R. Cell) 25 Ledger Sheet-2 40 pads nos. 26 ESIC gsm A pad of 100 sheets as per sample 20 pads 27 ESIC gsm as per sample 10 pads 28 ESIC gsm as per sample 15 pads 29 Form gsm A pad of 100 sheets as per sample 30 E.R. 70 gsm A pad of 100 sheets as per sample 31 RM 1/6 60 gsm. A pad of 100 sheets 32 RM 3 60 gsm. A pad of 100 sheets 33 RM 4 60 gsm. A pad of 100 sheets 10 pads. 100 pads 100 pads 100 pads 100 pads 34 Review Sheets 70 gsm a pad of 100 sheets, as per sample 150 pads 35 Regd.AD Cards 160 gsm,s nos 36 C-10 (B) I.R. 70 gsm double fold, as per sample nos 37 C-18/C-19 Register 38 I.R.Scrutiny Register 70 gsm. A Register of 200 ledger sheets full cloth binding- 70 gsm A ledger paper 200 sheets as per sample 10 Books 15 nos

12 39 Form gsm A pad of 100 sheets as per sample 10 pads. 40 Daily/month ly summary 70 gsm A pad of 100 sheet 20 pads 41 D.A.Diary 70 gsm A Register, as per sample 42 Despatch 70 gsm A Registerof 200 Register sheets as per sample 25 nos 25 nos. 43 Form 8 (Old form 11) 44 Form 10 (old 28) 45 Form 17 (old 19 20) 46 Form 18 (old 21, 23) 47 Feed back forms 48 Cash Book Account No Cont.bill Register(Ac cts.br.) 60 gsm. A pad of 25 sheets 60 gsm. A pad of 100 sheets 60 gsm. A pad of 25 sheets with Sr.No. 60 gsm. A pad of 25 sheets with Sr.No. 70 gsm. A pad of 100 sheets 70 gsm A ledger paper book of 200 sheets full Ledger binding 70 gsm- A Reg.of 200 sheets 100 books 100 books 100 books 120 books 30 pads 10 nos. 50 ESIC gsm as per sample 10 pads 51 ESIC gsm as per sample 10 pads 52 ESIC gsm as per sample 10 pads 53 ESIC gsm as per sample 1000 nos. 54 Legal Adj.letters 70 gsm. A pad of 100 sheets 20 pads 55 Med 103 A 70 gsm. a pad of 100 sheets 20 pads 56 I.I.Observati on sheet 60 gsm. double fold paper 4000 nos. 57 TR gsm. a pad of 100 sheets 10 pads. 58 TR 22 (outer) 70 gsm double fold, as per sample 3000 sheets 59 ESIC Med nos

13 60 TR 25 (conveyanc e)(outer) 61 TR 27A (Med Bill) 62 TR-29 Register of Cont.Charg es 63 Cont.Audit Reg.of Br.office. (Iyer) 70 gsm double fold, as per sample 70 gsm a pad of 100 sheets as per sample 70 gsm 200 sheets as per sample 70 gsm- Ledger paper, cloth Binding, 200 sheets 1000 nos, 15pads 10 pads 64 Bill Register 200 sheets 10 nos. 65 Visitors Register 66 Receipt & Exp.Daily position Reg. (Babar) 67 Pension Audit Reg. (Mrs.Phatak ) 68 Branch Diary 70 gsm A Register of 200 pages, as per sample. 70 gsm A Register of 200 pages, cloth binding. 70 gsm A Register of 200 pages, cloth binding. 10 nos. 5 nos. 5 nos. 10 nos. 69 B.R.O. 167 pad of 100 sheets 20 pads 70 Central Diary 30 nos. 71 B-I gsm. Double fold, As per sample, 72 Incashment Leave Form 35 pads 10 pads 73 Visitor s Pass (Gate Pass) 74 Watch Over Register 75 A.T.M. 7 Register 76 ESIC MED ESIC MED gsm. 100 pages, As per sample. 200 pads 100 books 100 books

14 78 RM 5 60 gsm. A pad of 100 sheets nos. 79 Medical Board Case forwarding letter 80 ESIC MED 1 (MRE) 160 gsm Brown envelopas per sample 10 pads nos. 81 ESIC MED gsm - as per sample nos. Name: Signature: Seal of the tenderer :

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