NOTICE for EMPANELMENT

Transcription

1 KHARAGPUR DIVISIONAL OFFICE, E&OS Department, Malancha Road, P.O.-Nimpura, Kharagpur , Phone No-(03222) os.kharagpur@licindia.com NOTICE for EMPANELMENT Re: Empanelment of Manufacturers /Firms /Printers /Suppliers /Vendors /Dealers/Service Providers / Engineering Firms under different categories Applications are invited from the Manufacturers / Firms/Printers /Suppliers /Vendors/Dealers/Service Providers/ Engineering Firms having their establishment in East & / or in West Midnapore Districts or / and in Howrah District/ or in and around Kolkata for empanelment for the Supply, Printing, Maintenance and Service related and miscellaneous other jobs as mentioned below in all the Branch / Satellite & Divisional Office/s under the KHARAGPUR DIVISIONAL OFFICE of LIC of India for the period 2017 to Security, Office Upkeep and allied services & Office Upkeep 2. Supply of Acoustic DG set on hiring basis & Maintenance 3. Printing & Supply of printing items/magazine 4. Supply of continuous stationery items 5. Supply of table stationary items including Pen, Pencil, Plastic Folders, Writing Pads and other items used in office 6. Supply of Computer consumable items like, Printer ribbon, Printer heads, Ink, toner cartridge etc. 7. Supply of Fake Note Detecting Machine ( Note Authentication Machine ) & Note Counting Machine with maintenance 8. Supply of Fire Tender/Extinguisher, refilling, maintenance & training 9. Supply and Maintenance of Telephones with EPBX, knowledge of repairing at site 10. Supply of Steel Furniture : Almirah, Rack, Cabinet, Chair, Table etc 11. Supply of Plastic Furniture : Chair, Table and other items. 12. Supply of Modular Furniture : Almirah, Rack, Cabinet, Chair, Table etc. 13. Supply & Maintenance of Water Cooler/Purifiers 14. Supply & Maintenance of Refrigerators 15. Supply of Cloth/Curtains/Towel and other similar items 16. Supply of Crockery items 17. Supply of food items/catering 18. Supply of package Drinking water 19. Courier Services 20. Supply & Maintenance of UPS 21. Supply, Installation,Testing & Maintenance of UPS 22. Supply, Installation,Testing & Maintenance of UPS-Battery Banks ( SMF ), Battery for Inverters, DG Sets etc. 23. Supply & Maintenance of AC Machine 24. Supply & Maintenance of Voltage Stabilizers, Inverters etc. 25. Civil (Builders) Maintenance Works 26. Supply of various Electrical Equipments / Gadgets / Home & Office Appliances and Maintenance Works

2 27. Supply of Sanitary & Plumbing Items with water work & maintenance & training 28. Installation, Repair & Maintenance of Network Cabling 29. Supply of stamp/visiting cards/pads/ I Card/Lamination work 30. Preparation of Name Plate/Notice Board/Vinyl Board/Inventory numbering etc. 31. Firms dealing in Pesticides/rat killers 32. Supply & Watering of Khas- Khas Products 33. Maintenance of Xerox & Fax machines 34. Repair of Furniture and Fittings 35. Disposal of old / obsolete /Scrap /waste paper / un-serviceable items of furniture/ equipments / papers and other items. 36. Aquarium Maintenance 37. Maintenance of Garden & Indoor Plants 38. Supply of flowers on daily basis 39. Shifting of Office Furniture : Almirah, Cabinet. Racks etc. 40. Booking of Tickets for travel by Air, Rail and Bus. 41. Supply of Gift items / Mementos / Trophies / Conference & Competition Materials 42. Supply of Cloth Materials, Garments, Ready-made cloth-items 43. Transportation of Office Materials, Stationeries etc. 44. Car Hiring ( AC / Non AC for different models of car ) Interested Manufacturers / Firms/Printers /Suppliers /Vendors / Dealers/ Service Providers / Engineering Firms fulfilling the eligibility criterion and agreeable to the set Terms & Conditions are requested to apply within 30 th JANUARY, 2017 up to 3.00 PM. Application Forms have to be downloaded from our website The Enrolment form received without processing fees will be rejected. Please note that no consideration will be given for postal delays. Separate Application Forms are required for Security Services, DG Set suppliers and Printers and Engineering Firms. The envelope should be superscribed as Empanelment of Manufacturers / Firms/Printers /Suppliers /Vendors /Dealers/Service Providers / Engineering Firms (as applicable) along-with respective Serial No.. and to be submitted in the Drop Box at the E&OS Deptt. (1 st Floor), LIC of India, KHARAGPUR DIVISIONAL OFFICE, E&OS Department, Malancha Road, P.O.- Nimpura, Kharagpur , Phone No-(03222) Applications sent by Post or Courier Services should reach our Office on or before last date. Last date / time of submission of Application Forms is 30 th JANUARY, 2017 up to 3.00 PM. Note: 1. Existing Empanelled Firms should also apply for fresh empanelment. 2. Black listed firms/ and the firms removed earlier should not apply. ( if applies will not be considered ). Date: SR.DIVISIONAL MANAGER

3 ELIGIBILITY CRITERION [For all Category] 1. The Manufacturer / Firms/Printers /Suppliers /Vendors /Dealers/Service Providers should be in the continuous profession for at least last 3 years ( Self-attested copy of up-to-date Trade license /registration certificate with renewal of Municipality/Corporation/statutory authority etc. for 3 years must be enclosed) 2. Annual turnover should be up to a. Rs. 5 lakhs in each of the last 3 financial years for small jobs, b. Rs. 5 lakhs and above to Rs.25 lakhs in any 3 financial years for medium job c. More than Rs. 25 lakhs in any 3 financial years for big jobs (attach for last continuous 3 years IT returns). 3. Fully Audited PL A/C & Balance Sheet, along with IT Returns in case of medium and big firms/company/trader/suppliers is must). 4. The The Manufacturer / Firms/Printers /Suppliers /Vendors /Dealers/Service Providers / Engineering Firms must be in the approved panel of at least 3 reputed firms out of which at least one should be a Government/Public Sector or Govt. undertakings. (enclose letter of approval of the empanelment or any other supporting documents). 5. Must submit self-attested Copy of a) The PAN CARD issued by Income Tax Authority and Bank Account Pass Book / Bank. b) VAT registration No., with VAT clearance certificate/ payment receipt, wherever applicable. c) ESIC Registration No., EPF Registration No., Factory Registration No., NSIC Registration No., wherever applicable. 6. Medium and big firm/suppliers must possess Office, address and telephone No. SR. DIVISIONAL MANAGER

4 Terms & Conditions for Empanelment [For all Category] a. The applicant desirous to be empanelled should have their own establishment in East & or in West Midnapore Districts or / and Howrah District and / or in and around Kolkata. b. All requisite License and other relevant documents conforming Govt. Rules should be up to date c. Period of Empanelment will be for 3 Years i.e d. Application Fee: Rs.200/ for each Category (Non-refundable) : Application fee is payable only by a demand draft favouring LIC of India, drawn on any Nationalized / Scheduled Bank and payable at KHARAGPUR. Application submitted without the Demand Draft towards application fee will not be considered. e. The applicant must fulfill eligibility criterion already mentioned f. Security and allied services/ DG Set Suppliers/Printer should fulfill additional eligibility criterion mentioned in respective application Forms g. Existing empanelled vendors/service providers must also apply for empanelment. h. Application Form: Annexure-A:- For ( other than Security and allied services/ DG Set Suppliers/Printer / Engineering Firms) Annexure-B:-For Printers Annexure-C:-For DG Set Suppliers on hiring basis Annexure-D: For Security and allied services and Office upkeep ANNEXURE-E : For Engineering (Civil / Builder & Electrical) agencies / firms / contractors / Manufactures or authorized dealers of manufactures of UPS, Battery, Air- Conditioning machines, fire-alarm system. i. Application should be filled in properly and accompany all required documents j. Mere submission of application will not mean empanelment, The decision of the corporation is final Interested Manufacturers / Firms/Printers /Suppliers /Vendors / Dealers/ Service Providers / Engineering Firms fulfilling eligibility criterion and agreeable to the set Terms & Conditions are requested to apply as per respective prescribed Forms along with application fee for getting empanelled on the panel of LIC of India, KHARAGPUR DIVISION for 3 Years ( ). Note : 1. Firms/traders/suppliers who are already in our panel should also apply afresh for empanelment. 2. Firms/traders/suppliers who have been blacklisted / removed earlier from the panel, should not apply and their application will not be considered. SR.DIVISIONAL MANAGER

5 Annexure-A FORMS TO BE FILLED IN BY MANUFACTURERS/ FIRMS/SUPPLIERS /VENDORS//DEALERS/ SERVICE PROVIDERS Applied for Sl No. Name of the Particulars against the Serial No 1 Name of the FIRM (in Block letters) PROFILE OF VENDOR 2 Date of Establishment/Incorporation 3 Office address Ph- No 4 Factory Address (If any) 5 Status of the firm: (Whether Pvt. Ltd. Company / Pubic Ltd. Company/ Partnership Firm / Proprietorship Firm) 6 Name of the Proprietor/ Director/CEO (as the case may be): 7 Name, Address, Tel. No., , of the Chief executive 8 Whether registered with the Registrar of Companies/Registrar of Firms in India. If so, mention Number and date and enclose Registration Certificate copy. 9 (a)license No. (a)last renewed on documentary Proof (last 3 years, of Sl. No. ) (a) (b) 10 Name of the Banker with address Telephone No

6 A/C No. IFS Code No. 11. Whether an assessed of Income Tax. If so, mention Permanent Account Number ( PAN ): 12. Service Tax Registration No. 13. Trade License No. (Enclose copy of license duly attested) 14. VAT Registration No (Enclose copy of Certificate with clearance/payment receipt latest year) 15. NSIC Registration No. if any : (Enclose xerox copy) 16 ESIC Registration No. if any : (Enclose xerox copy of Certificate with copy of latest payment receipt ) 17. EPF Registration No if any : (Enclose xerox copy) 18. Registration No. under Shop & Establishment Act if any : (Enclose copy of Registration Certificate No. with date of renewal) 19. Whether registered for sales tax purposes. If so, mention number and date : (Furnish copies of up-to-date sales tax clearance certificate) 20. Turnover of the Company/Firm for the last 3 Years : : : (Please attach a copy of audited Balance Sheet and Profit & Loss Account) for the years mentioned above ) 21 Income Tax Return ( enclose copy of last 3 years) : : : 22 Name, address, Tel. No. of the firms with whom you are already empanelled : (enclose copy of approval letters) 1. 2.

7 Name of the Offices of LIC with whom you are already empanelled : (Enclose copy of approval letter/order copy/documents) Mention any other important information : Important : All the copies to be attached for item nos. 01 to 24 above, wherever applicable, must be self- attested by the person signing the application forms. I/We. request Life Insurance Corporation of India, KHARAGPUR DIVISIONAL OFFICE to consider inclusion of my/our/firm in the list of approved Manufacturers/Firms /Printers/Suppliers/ Vendors/Dealers/ Service Providers for the years 2017 to 2020 and agree to abide by all the Terms and Conditions in respect of any notice of Tender and also will abide by all Statutory Rules/Regulation/Act of both the State as well as the Central Government while carrying out job/work if any allotted to me/us. Further I/We undertake that I/we have no objection for inspection of our Office and verification of documents/certificates by the LIC Official/s. I/We also state that the information provided here-in-above are true to the best of my /our knowledge and belief. Date : Place : Note : Authorized Signatories (Name & Designation, seal of the firm) (1) Above form should be filled in legibly and duly signed and sealed (2) Incomplete forms and without required documents are liable to be rejected. (3) List of Panel will be displayed on the Notice Board of KHARAGPUR DIVISIONAL OFFICE ONLY. However, only the empanelled Manufacturers / Firms /Printers/ Suppliers/ Vendors/ Dealers/ Service Providers (as the case may be) will be informed by ( if communicated by him/them and available ) about their empanelment. (4) The Corporation reserves the right to cancel the name/s of the Manufacturers/Firms /Printers/Suppliers/ Vendors/Dealers/ Service Providers from its approved list at its absolute discretion without assigning any reason. SR.DIVISIONAL MANAGER

8 EMPANEMENT FOR PRINTERS Applications are invited for Empanelment of Printers for printing of various Forms, Policy Bond, Envelope, Policy Dockets, Magazines etc The categories are as follows: CATEGORY-A:Small Job:- Annual turnover up to Rs. 5 lakhs in any 3 financial years CATEGORY-B-Medium Job:- Annual turnover Rs. 5 lakhs and above to Rs. 25 lakhs in any 3 financial years CATEGORY-C:-Big Job:- Annual turnover more than Rs. 25 lakhs in any 3 financial years Interested Printers having work-experience in this field and fulfill all the requirements as per the criteria mentioned below may apply for empanelment of their Firm as per Annexure-B. a. The applicant desirous to be empanelled should have their own establishment in East &/or in West Midnapore Districts or / and in Howrah Districts and / or in and around Kolkata. b. All requisite License and other relevant documents conforming Govt. Rules should be up to date Period of Empanelment will be for 3 Years i.e SR.DIVISIONAL MANAGER

9 ANNEXURE-B Applied for Sl No. : APPLICATION FORM FOR PRINTERS Name of the Particulars against the Serial No. PROFILE OF VENDOR 1 Name of the FIRM (in Block letters) 2 Date of Establishment/Incorporation 3 Office address Ph- No 4 Factory Address (If any) 5 Status of the firm: (Whether Pvt. Ltd. Company / Pubic Ltd. Company/ Partnership Firm /Proprietorship Firm) 6 Name of the Proprietor/ Director/CEO (as the case may be): 7 Name, Address, Tel. No., , of the Chief Executive : 8 Whether Registered with the Registrar of Companies/Registrar of Firms in India. If so, mention Number and Date and enclose Registration Certificate copy. 9 (a)license No. (b)last renewed on ( Enclose documentary Proof ( for last 3 years ) for Sl. No. 9 (a) 9 (b) 10 Name of the Banker with address

10 Telephone No A/C No. IFS Code No. 11 i. Factory License No. ii. Date of Renewal of license (copy to be enclosed) 12 Whether assessed for Income /Tax by Income Tax Dept. : If so, mention Permanent Account Number ( PAN ) : 13 Service Tax Registration No. 14 Trade License No. (Enclose copy of the up-to-date renewed license duly attested) 15 VAT Registration No : (Enclose copy of Certificate with clearance/payment receipt latest year) 16 NSIC Registration No. if any : (Enclose self-attested xerox copy) 17 ESIC Registration No. if any : (Enclose self-attested xerox copy of the Certificate along with the copy of latest payment receipt ) 18 EPF Registration No if any : (Enclose self-attested xerox copy) 19 Registration No. under Shop & Establishment Act if any : (Enclose self-attested xerox copy of the Registration Certificate duly renewed up-to-date) 20 Whether registered for sales tax purposes : If so, mention number and date. ( Also furnish self-attested copies of sales tax clearance certificate ) 21 Turnover of the Company/Firm for the last 3 Years. (Please attach self-attested copy of audited Balance Sheet and Profit & Loss Account) : : : 22 Income Tax Return (enclose self-attested copy of last 3 years) : : : 23 Name, address, Tel. No. of the firms with whom you are approved suppliers (enclose copy of approval letters)

11 Name of the Offices of LIC with whom you are already empanelled : (Enclose self-attested copy of approval letter/order copy/documents) Approximate value of your output per year : 26 Are you agreeable to make deliveries to our offices when so directed : 27 Area occupied by the Press : 28 Total no. of workmen deployed on various categories in this year : 29 State the nature of printing jobs undertaken by you : 30 Do you carry stock of papers and any other material? If so what kind of stocks do you generally hold : 31 State the nature of printing jobs undertaken by you (full details ) : 32 Do you undertake manufacture of I. Envelopes : II. Policy dockets : III. Office file : IV. Stickers : V. Policy wallet : 33 Furnish type of printing machine used I. Make : II. Size : III. Speed : IV. color : 34 Are you Agreeable to abide strictly by the Terms and Conditions of the Tenders and Contracts :

12 35 Mention any other important information Important : All the copies to be attached for item nos. 01 to 35 above, wherever applicable, must be self- attested by the person signing the application forms. I/We. request Life Insurance Corporation of India, KHARAGPUR DIVISIONAL OFFICE to consider inclusion of my/our/firm in the list of approved Manufacturers/Firms /Printers/Suppliers/ Vendors/Dealers/ Service Providers for the years 2017 to 2020 and agree to abide by all the Terms and Conditions in respect of any notice of Tender and also will abide by all Statutory Rules/Regulation/Act of both the State as well as the Central Government while carrying out job/work if any allotted to me/us. Further I/We undertake that I/we have no objection for inspection of our Office and verification of documents/certificates by the LIC Official/s. I/We also state that the information provided here-in-above are true to the best of my /our knowledge and belief. Date : Place : Authorized Signatories (Name & Designation, seal of the firm) Note : (1) Above form should be filled in legibly and duly signed and sealed (2) Incomplete forms and without required documents are liable to be rejected. (3) List of Panel will be displayed on the Notice Board of KHARAGPUR DIVISIONAL OFFICE ONLY. However, only the empanelled Manufacturers / Firms /Printers/ Suppliers/ Vendors/ Dealers/ Service Providers (as the case may be) will be informed by ( if communicated by him/them and available ) about their empanelment. (4) The Corporation reserves the right to cancel the name/s of the Manufacturers/Firms /Printers/Suppliers/ Vendors/Dealers/ Service Providers from its approved list at its absolute discretion without assigning any reason. SR.DIVISIONAL MANAGER

13 EMPANEMENT FOR DG SET SUPPLY ON HIRING AND MAINTENANCE Applications are invited for Empanelment of Firm/Agency for supplying, installation, testing & commissioning of soundless DG set on hire basis as per the three categories as mentioned below at our Divisional Office and various Branch / Satellite Offices under KHARAGPUR DIVISION OF LIC OFINDIA. 1. Category 1 Hiring of DG set from 10 KVA to 40 KVA 2. Category 2 Hiring of DG set above 40 KVA to 100 KVA 3. Category 3 Hiring of DG set above 100 KVA Interested agencies having work-experience in this field and fulfilling all the requirements as per criteria mentioned below may apply for empanelment of their Firm/Agency. The details of requirements are as follows : 1) Trade License Certificate : 2) Professional License No. 3) Service Tax No. 4) Performance Certificate issued by the clients during the last 3 years. 5) Income Tax return for the last 3 years. 6) Average Annual turn over of the firm. 7) Sales Tax 8) VAT registration & clearance certificate. 9) Pan Card 10) List of DG sets installed during last 03 years in Govt Sector / Nationalized Banks/LIC of India 11) List of current contracts with capacity of DG set The interested Firms/ Agency fulfilling aforesaid criterion should submit Application as per Annexure -C along with the relevant documents for empanelment. SR.DIVISIONAL MANAGER

14 ANNEXURE-C FORMS FOR EMPANELMENT OF FIRMS FOR HIRING AND MAINTAINANCE OF DG-SET OF VARIOUS CAPACITIES FOR VARIOUS OFFICES UNDER KHARAGPUR DIVISIONAL OFFICE OF LIC OF INDIA. Applied for Sl. No : CATEGORY: SUPPLY OF DG SET ON HIRING-BASIS AND MAINTAINANCE 1 Name of the FIRM (in Block letters) PROFILE OF VENDOR 2 Date of Establishment/Incorporation 3 Office address Ph- No 5 Status of the firm: (Whether Pvt. Ltd. Company / Pubic Ltd. Company/ Partnership Firm /Proprietorship Firm) 6 Name of the Proprietor/ Director/CEO (as the case may be): 7 Name, Address, Tel. No., , of the Chief Executive : 8 Whether registered with the Registrar of Companies/Registrar of Firms in India: If so, mention Number and date and enclose Registration Certificate copy. 9 (a)license No. (a)last renewed on documentary Proof (last 3 years, of Sl. No. (a) (b) 10 Name of the Banker with address

15 Telephone No A/C No. IFS Code No. 11 Whether assessed for Income /Tax by Income Tax Dept. : If so, mention Permanent Account Number (PAN) : 12 Service Tax Registration No. 13 Trade License No. (Enclose copy license attested) 14 Professional License No. : (Enclose attested copy) 15 VAT Registration No : (Enclose copy of Certificate with clearance/payment receipt latest year) 16 NSIC Registration No. if any (Enclose xerox copy 17 ESIC Registration No. if any : (Enclose xerox copy of Certificate with copy of latest payment receipt ) 18 EPF Registration No if any : (Enclose xerox copy) 17 Registration No. under Shop & Establishment Act if any : (Enclose copy of Registration Certificate No. with date of renewal) 19 Whether registered for sales tax purposes : ( If so, mention number and date. Also furnish copies of sales tax clearance certificate.) 20 Turnover of the Company/Firm for the last 3 Years : (Please attach a copy of audited Balance Sheet and Profit & Loss Account) : : : 21 Income Tax Return (enclose copy of last 3 years): : : : 22 Name, address, Tel. No. of the firms with whom you are already empanelled as DG Set suppliers on hiring basis : (enclose copy of approval letters) 1.

16 Name of the Offices of LIC with whom you are already empanelled as DG Set suppliers on hiring basis : (Enclose copy of approval letter/order copy/documents) Please enclose self-attested Performance Certificate issued by the respective officer of the Department/Company for providing efficient service of similar nature ( along with the Name, Designation of the issuing authority and Place of work ) : 25 Mention any other important information Important : All the copies to be attached for item nos. 01 to 25 above, wherever applicable, must be self- attested by the person signing the application forms. I/We. request Life Insurance Corporation of India, KHARAGPUR DIVISION to consider inclusion of my/our/firm in the list of approved Firms / Printers/ Suppliers/ Vendors/Dealers/ Service Providers and agree to abide by all Terms and Conditions in respect of any notice of Tender and also will abide by all the Statutory Rules/Regulation/Act of both the State as well as the Central Government while carrying out job/work if any allotted to me/us. Further I/We undertake that I/we have no objection for inspection of our Office and verification of documents/certificates by LIC Official/s. I/We also state that the information provided herein-above are true to the best of my /our knowledge and belief. Date : Authorized Signatories (Name & Designation, seal of the firm) Note : (1) Above form should be filled in legibly and duly signed and sealed (2) Incomplete forms and without required documents are liable to be rejected. (3) List of Panel will be displayed on the Notice Board of KHARAGPUR DIVISIONAL OFFICE ONLY. However, only the empanelled Manufacturers / Firms /Printers/ Suppliers/ Vendors/ Dealers/ Service Providers (as the case may be) will be informed by ( if communicated by him/them and available ) about their empanelment. (4) The Corporation reserves the right to cancel the name/s of the Manufacturers/Firms /Printers/Suppliers/ Vendors/Dealers/ Service Providers from its approved list at its absolute discretion without assigning any reason. SR.DIVISIONAL MANAGER

17 EMPANEMENT FOR SECURITY SERVICES & HOUSE KEEPING Applications are invited for Empanelment of Firm/Agency/Service Provider for providing Security Service & House Keeping at the Divisional Office and various Branch and Satellite Offices under KHARAGPUR DIVISION OF LIC OFINDIA. CATEGORY-A:- Security Services CATEGORY-B- House Keeping CATEGORY-C:- Security Services & House Keeping Interested Firm/Service Provider/Agency having work-experience in this field and fulfilling all the eligibility conditions mentioned below may apply for empanelment of their Firm/Agency. The details of requirements are as follows : ELIGIBILITY CONDITIONS 1. The Service Provider should be in the profession for at least 3 years. 2. The Service Provider should be on the approved panel of at least 3 reputed firms out of which at least one should be a Public Sector or Government undertaking. 3. The Service Provider should be registered with the Labour Commission and having valid License (from the State & Central Labour Commission ) as per Contract Labour (Regulation & Abolition) Act, 1970 and should be registered with EPF Commission, ESIS Department. (Self-attested copies of up-to-date renewal to be enclosed) 4. The Service Provider should have PAN Card No. of Income Tax Department, Service Tax Registration No. (Self-attested copies of up-to-date renewal to be enclosed)) 5. The Service Provider should be complying with all the statutory requirements such as remittances to EPF, ESIS etc. 6. The Service Provider should be complying requirements specified in Bonus Act, Leave and other matters as per law / rules. 7. Average Minimum Turn Over for last 3 Financial Years should be Rs lakhs and at least one client of worth Rs lakhs and above should be served by the Firm/Service Provider/Agency for any one of the last 3 years (Name and addresses of such companies along with proof regarding average payment received should also be furnished under self-attestation.) 8. The Service Provider should be agreeable to make payment directly to the respective Bank Account of the deployed workmen BY NEFT as per Central Govt. Minimum Wage Act. The interested Firms/ Agency/Service Provider fulfilling aforesaid criterion should submit Application as per Annexure-D along with the relevant documents for empanelment. SR.DIVISIONAL MANAGER

18 Applied for Sl. No : Category: Name of Service applied for : 1 Name of the FIRM (in Block letters) ANNEXURE-D APPLICATION FORM FOR SECURITY & HOUSE KEEPING SERVICES 2 Date of Establishment/Incorporation 3 Office address PROFILE OF VENDOR Ph- No 4 Status of the firm: (Whether Pvt. Ltd. Company / Pubic Ltd. Company/ Partnership Firm /Proprietorship Firm) 5 Name of the Proprietor/ Director/CEO (as the case may be): 6 Name, Address, Tel. No., , of the Chief Executive : 7 Whether registered with the Registrar of Companies/Registrar of Firms in India : If so, mention Number and date and enclose Registration Certificate copy. 8 (a)license No. (a)last renewed on documentary Proof (last 3 years, of Sl.No. (a) (b) 9 i. Labour Commission License Number: ii. Date of last renewal of license (Copy of license to be enclosed)

19 iii. EPF Registration No. iv. ESIS Registration Code No. I. Ii. Iii. iv. 10 Name of the Banker with address Telephone No A/C No. IFS Code No. 11 Whether an assessed of Income Tax. If so, mention Permanent Account Number (PAN) : 12 Service Tax Registration No. 13 Trade License No. : (Enclose copy of license duly attested) 14 VAT Registration No : (Enclose copy of Certificate with clearance/payment receipt latest year) 15 NSIC Registration No. if any : (Enclose xerox copy) 16 ESIC Registration No. if any : (Enclose xerox copy of Certificate with copy of latest payment receipt ) 17 EPF Registration No if any : (Enclose xerox copy) 18 Registration No. under Shop & Establishment Act if any: (Enclose copy of Registration Certificate No. with date of renewal) 19 Whether registered for sales tax purposes : If so, mention number and date. Also furnish copies of sales tax clearance certificate 20 Turnover of the Company/Firm for the last 3 Years. (Please attach a copy of audited Balance Sheet and Profit & Loss Account) : : : 21 Income Tax Return (enclose copy of last 3 years) :

20 : : 22 Name, address, Tel. No. of the firms with whom you are already empanelled as suppliers : (enclose copy of approval letters) Name of the Offices of LIC with whom you are already empanelled as suppliers : (Enclose copy of approval letter/order copy/documents) Mention the number of workmen on Roll as on date : 25 Are you agreeable to abide strictly by the Terms and Conditions of the Tenders and Contracts : 26 Mention any other important information Important : All the copies to be attached for item nos. 01 to 26 above, wherever applicable, must be self- attested by the person signing the application forms. I/We. request Life Insurance Corporation of India, KHARAGPUR DIVISION to consider inclusion of my/our/firm in the list of approved Firms / Printers/ Suppliers/ Vendors/Dealers/ Service Providers and agree to abide by all Terms and Conditions in respect of any notice of Tender and also will abide by all the Statutory Rules/Regulation/Act of both the State as well as the Central Government while carrying out job/work if any allotted to me/us. Further I/We undertake that I/we have no objection for inspection of our Office and verification of documents/certificates by LIC Official/s. I/We also state that the information provided herein-above are true to the best of my /our knowledge and belief. Authorized Signatories (Name & Designation, seal of the firm) Date : Note : (1) Above form should be filled in legibly and duly signed and sealed (2) Incomplete forms and without required documents are liable to be rejected. (3) List of Panel will be displayed on the Notice Board of KHARAGPUR DIVISIONAL OFFICE ONLY. However, only the empanelled Manufacturers / Firms /Printers/ Suppliers/ Vendors/ Dealers/ Service Providers (as the case may be) will be informed by ( if communicated by him/them and available ) about their empanelment. (4) The Corporation reserves the right to cancel the name/s of the Manufacturers/Firms /Printers/Suppliers/ Vendors/Dealers/ Service Providers from its approved list at its absolute discretion without assigning any reason. SR.DIVISIONAL MANAGER

21 ELIGIBILITY CRITERION (ENGINEERING WORKS) Life Insurance Corporation of India, Khargapur Division intends to empanel the reputed Engineering (Civil / Builder & Electrical) agencies / firms / contractors / Manufactures or authorized dealers of manufactures of UPS, Battery, Air-Conditioning machines, fire-alarm system for various offices (Branch Offices / Satellite Offices) under Kharagpur Divisional Office located at Purba Midnapore and Pachim Midnapore Districts of West Bengal State for the period 2017 to Sr. No. Estimate cost of work / Nature of work The pre - qualification criteria for selection of agencies as under:- Minimum Solvency Average Annual turn-over during last 4 years Qualifying value of single work* completed during last 7 year 1 Repair & Maintenance, supply works for All Types incl. ARC/ AMC Works Rs. 1.0 Lakh Rs. 2.0 Lakhs Total Value of Repair & Maintenance Works Total Value of Repair & Maintenance Works Done in a Year- Rs. 2.0 Lakhs * Similar nature of work means Building work Office, Residential Buildings, Shopping Complex, Commercial Building but not Industrial Building like Ware house, factories, Plant. The Contractors having work experience in central Govt. Department/ State Govt. Department / Central Autonomous Body/ State Autonomous Body/ Central Public Sector Undertaking/ State Public Sector Undertaking/ City Development Authority/ Municipal Corporation of City formed under any Act by Central / State Government and Published in Central /State Gazette Organizations shall be preferred. The Enrolment form received without processing fees will be rejected. Please note that no consideration will be given for postal delays. LIC of India reserves the right to accept or reject any or all offers in full/ part without assigning any reason whatsoever. All the already enlisted contractors /firms/ agencies should also apply for empanelment. Sr. Divisional Manager

22 Annexure-E FORMS TO BE FILLED IN BY FOR ENGINEERING (CIVIL / BUILDER & ELECTRICAL) AGENCIES / FIRMS / VENDORS / CONTRACTORS / MANUFACTURES OR AUTHORIZED DEALERS OF MANUFACTURES OF UPS, BATTERY, AIR-CONDITIONING MACHINES, FIRE- ALARM SYSTEM (SUPPLY & MAINTENANCE) / MANUFACTURERS/ SERVICE PROVIDERS /VENDORS/ SUPPLIERS. Applied for Sl No. Name of the Particulars against the Serial No 1 Name of the FIRM (in Block letters) PROFILE OF VENDOR 2 Date of Establishment/Incorporation 3 Office address Ph- No 4 Factory Address (If any) 5 Status of the firm: (Whether Pvt. Ltd. Company / Pubic Ltd. Company/ Partnership Firm / Proprietorship Firm) 6 Name of the Proprietor/ Director/CEO (as the case may be): 7 Name, Address, Tel. No., , of the Chief executive 8 Whether registered with the Registrar of Companies/Registrar of Firms in India. If so, mention Number and date and enclose Registration Certificate copy. 9 (a)license No. (a)last renewed on documentary Proof (a) (b)

23 10 Name of the Banker with address Telephone No A/C No. IFS Code No. 11. Whether an assessed of Income Tax. If so, mention Permanent Account Number ( PAN ): 12. Service Tax Registration No. 13. Trade License No. (Enclose copy of license duly attested) 14. VAT Registration No (Enclose copy of Certificate with clearance/payment receipt latest year) 15. NSIC Registration No. if any : (Enclose xerox copy) 16 ESIC Registration No. if any : (Enclose xerox copy of Certificate with copy of latest payment receipt ) 17. EPF Registration No if any : (Enclose xerox copy) 18. Registration No. under Shop & Establishment Act if any : (Enclose copy of Registration Certificate No. with date of renewal) 19. Whether registered for sales tax purposes. If so, mention number and date : (Furnish copies of up-to-date sales tax clearance certificate) 20. Turnover of the Company/Firm for the last 4Years : : : : (Please attach a copy of audited Balance Sheet and Profit & Loss Account) for the years mentioned above ) 21 Income Tax Return ( enclose copy of last 4 years) : : : :

24 22 Name, address, Tel. No. of the firms with whom you are already empanelled : (enclose copy of approval letters) Name of the Offices of LIC with whom you are already empanelled : (Enclose copy of approval letter/order copy/documents) LIST OF MAJOR WORKS COMPLETED DURING LAST SEVEN YEARS : (Name of work done/ Name Authority & Address under whom work as carried out / Work done Value (Rupees) / Date of commencement / Scheduled dated of successful completion) (enclosed all supporting documents) 25. List of Work in Hand : (Name of work done/ Name Authority & Address under whom work as carried out / Work done Value (Rupees) / Date of commencement / Scheduled dated of successful completion) (enclosed all supporting documents) : 26. Name Technical Staff ( Name / Designation / Age/ Qualification/ Service with firm / Experience year to year): 27. Details of Machinery / Tool / Plants : 28. Enclose copy of Bank Solvency with all information Bank Details, with clearly mention the Solvency Value as mentioned in Eligibility Criteria : 29. Mention any other important information :

25 Important : All the copies to be attached for item nos. 01 to 29 above, wherever applicable, must be self- attested by the person signing the application forms. I/We. request Life Insurance Corporation of India, KHARAGPUR DIVISIONAL OFFICE to consider inclusion of my/our/firm in the list of approved Manufacturers/Firms /Suppliers/ Vendors/Dealers/ Service Providers for the years 2017 to 2020 and agree to abide by all the Terms and Conditions in respect of any notice of Tender and also will abide by all Statutory Rules/Regulation/Act of both the State as well as the Central Government while carrying out job/work if any allotted to me/us. Further I/We undertake that I/we have no objection for inspection of our Office and verification of documents/certificates by the LIC Official/s. I/We also state that the information provided here-in-above are true to the best of my /our knowledge and belief. Date : Place : Authorized Signatories (Name & Designation, seal of the firm) Note : (1) Above form should be filled in legibly and duly signed and sealed (2) Incomplete forms and without required documents are liable to be rejected. (3) List of Panel will be displayed on the Notice Board of KHARAGPUR DIVISIONAL OFFICE ONLY. However, only the empanelled Manufacturers / Firms /Printers/ Suppliers/ Vendors/ Dealers/ Service Providers (as the case may be) will be informed by ( if communicated by him/them and available ) about their empanelment.] (4) The Corporation reserves the right to cancel the name/s of the Manufacturers/Firms /Printers/Suppliers/ Vendors/Dealers/ Service Providers from its approved list at its absolute discretion without assigning any reason. SR.DIVISIONAL MANAGER