A. Applications are invited from reputed Firms/Suppliers/Printers/Vendors for Empanelment for following items:

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1 LIFE INSURANCE CORPORATION OF INDIA, BARDHAMAN DIVISIONAL OFFICE, GHORDOUR CHATI,NEAR BAIKUNTHAPUR G.P.- 2, P.O.-SREEPALLY,DIST.- BURDWAN,PIN , os.bardhaman@licindia.com, Telephone No.: Tel / / / , Notice for Empanelment of Firms/Suppliers/Printers/Vendors/Service Providers (From date of approval of empanelment till ) A. Applications are invited from reputed Firms/Suppliers/Printers/Vendors for Empanelment for following items: Sl.No. CATEGORY Minimum Turnover Required ( in last three years) 1 Table & Office stationery such as pens, files, photocopier paper, 10 Lacs Punching Machines, Staplers etc. 2 Computer continuous stationery (Policy Bond, Premium 20 Lacs Receipts,Payment vouchers,leaflets, Forms with LIC logo etc. 3 I.T. consumables such as Ink cartridge, Ribbon,Printer head, 10 Lacs Toner, Pen Drive etc 4 Offset/ Screen printers for printing of forms/ledgers, visiting cards/publicity brochures/booklets 5 Manufacturer/Supplier of Cloth/Kraft Envelopes/ordinary 10 Lacs envelopes/policy dockets etc 6 Supply of telecommunication equipments such as Fax, EPABX 2 Lacs systems,telephone Instruments etc. 7 Supply of Safety Equipments & Fire Extinguishers 10 Lacs 8 Supply of Water Coolers, Note Counting Machine, Safe, Cash 20 Lacs Box,Policy racks, Office Table,Chairs,Refrigerators,LCDs, Photo Copy machine,cc TV. Camera, LCDs etc. 9 Supply of water Purifiers & R.O. Systems for domestic & commercial use. 10 Supplier of Desert Coolers/ Air Coolers / fake note detector machine, Air-condition machines etc. 11 Supplier/Manufacturer of Linen items such as towels, bed sheets, 2 Lacs upholstery for residences and guest houses and Cloth for uniform. 12 Manufacturer/Supplier of furniture & Fixture 2 Lacs

2 B. Applications are invited from reputed SERVICE PROVIDERS for empanelment for following items: Sl. No. CATEGORY Minimum Turnover required (in last three years) 13 Courier Service all over India 4 Lacs 14 Supply of Gift Items/Trophies/ All kind of Sales promotional Items Canopy/Standee 15 House keeping and security Services 60 lacs 16 Catering Services 10 lacs 17 Advertising & Publicity work 5 lacs 18 Supply of office upkeep material such as Branded phenyl, soap, broom, duster etc 2 lacs C. Applications are invited from reputed SERVICE PROVIDERS for empanelment for following items ( for which No Minimum Turnover is required ) Sl.No. CATEGORY 19 Booking of Air & Railway Tickets 20 Refilling of Toner Cartridges, Printer Ribbons etc 21 Maintenance/ Servicing of telecommunication equipments such as Fax, EPABX systems,telephone Instruments etc./intercom 22 Maintenance/servicing of Desert Coolers/Air Conditioners/Water Coolers/ of Water Coolers, Note Counting Machine, Safe, Cash Box,Policy racks, Office Table,Chairs,Refrigerators,LCDs, Photo Copy machine,cc TV. Camera, LCDs etc. of water Purifiers & R.O. Systems for domestic & commercial use. of Desert Coolers/ Air Coolers / fake note detector machine/franking Machine etc 23 Repair/polishing and maintenance of Furniture and Fixtures 24 Dealers for scrap materials / waste paper 25 Gardening/ Landscaping/ Supply of Fresh Flowers 26 Photocopying/supply of rubber stamp etc 27 Car Rental/ Transportation services for supplying printed stationeries to offices under Bardhaman Divisional Office 28 Pest/Rat Control 29 Battery and UPS Maintenance 30 Refilling and Servicing of Fire extinguishers/servicing of fire alarm control system

3 1. The Separate forms (Annexure-A) are required to be filled up for each category which may be downloaded from our website Application for empanelment duly completed should be submitted to the MANAGER (OS), OFFICE SERVICE DEPARTMENT, LIC OF INDIA, BARDHAMAN DIVISIONAL OFFICE, GHORDOUR CHATI, SREEPALLY, BARDHAMAN , in a closed envelope super scribed as Application for empanelment of suppliers/vendors/category S.No.. (Name & Sl. No. of the Category) along with nonrefundable application fee of Rs. 200/- in the form of demand draft in favour of Life Insurance Corporation of India payable at BARDHAMAN or can be deposited at our cash counter in cash during cash working hours. The vendors/firms desirous to be empanelled with us for above said jobs (Category No.1 to 30) and fulfilling conditions as per Annexure A enclosed, may apply for empanelment for jobs undertaken at BardhamanDivisional Office. The applications in questionnaire form (Annexure A ) along with the enclosures i.e. necessary certificates in evidence of the facts, information, figures mentioned in the form is to be sent at the address mentioned above on or before upto 3.00 p.m. The Corporation bears no responsibility for applications received after due date and stipulated time and are liable to be rejected. 2. The firms/vendors/suppliers/printers/service providers who are on our panel as well as other offices of LIC of India are required to apply for fresh empanelment if interested. 3. Firms/vendors/suppliers/printers/service providers who have been black listed / removed earlier by any office of LIC of India, should not apply. If applied, their applications will not be considered. 4. Mere submission of Application for empanelment does not confer any right of empanelment. Life Insurance Corporation of India reserves its right to reject, accept any or all applications or cancel the process of empanelment without assigning any reason thereof. Life Insurance Corporation of India shall neither be held liable nor obligatory on its part to inform the applicant the grounds of any such action. 5. Applications incomplete in any respect will not be entertained and are liable to be rejected. Sr. Divisional Manager

4 LIFE INSURANCE CORPORATION OF INDIA, BARDHAMAN DIVISIONAL OFFICE, GHORDOUR CHATI,NEAR BAIKUNTHAPUR G.P.- 2, P.O.-SREEPALLY,DIST.- BURDWAN,PIN , os.bardhaman@licindia.com, Telephone No.: Tel / / / , APPLICATION FORM FOR EMPANELMENT OF FIRM-YEAR-2017 (Separate Application Is To Be Submitted For Each Category) CONDITIONS FOR EMPANELMENT -. 1) The Firm/supplier/service Providers Should Be In Profession For At Least 3 yrs. (Copy of Trade License Registration Certificate With Renewal of Principality/ Corporation /Statutory Authority Must Be Enclosed) 2) For Category (1 to 9, 23), the firm should be on the approved panel of at least one reputed firm which must be Govt./Quasi Govt. organization/ PSU. 3) The Firm/supplier should have registration with state & local authorities for undertaking the profession (Copies of proof to be enclosed) 4) The Firm/supplier should keep sufficient stock in hand so as to comply with the urgent need without delay. 5) Vendor should furnish the specific brand or make, in case of authorized dealer. (Copy of valid authorized dealership certificate must be enclosed) 6) Minimum annual turnover required for empanelment is indicated against its category. 7) The empanelment would be done only on the favorable recommendation of the duly constituted committee that would visit & inspect the premises, workshop etc of the applicants. 8) All applicants are required to affix the signature and seal of the Authorized official of the company on each page of Annexure A in acceptance of terms & conditions therein. 9) Balance sheet duly Audited is must (CA Certificate) IT returns. 10) Must present PAN No., VAT registration No. with VAT clearance certificate/ payment receipt, Bank Account No/GST Registration No 11) ESIC registration No. / EPF/ NSIC registration wherever applicable. 12) For Category 13 (Courier Service) the service provider should have necessary infrastructure to deliver consignments to all offices under the jurisdiction of Bardhaman Divisional Office (Bardhaman and Birbhum Districts.

5 Annexure-A Application Form For Firm/ Supplier/ Printer/Service Provider Part-I: General Information SL Information Sought No. 1 Name of the Firm(In Block Letter) Information Provided 2 Date of Establishment / Incorporation of the Firm. 3 Correspondence Address and Telephone No. 4 Address of Head Office (If Separate) and Telephone No, Address Factory Address. 5 Status: Proprietary/Partnership/Private Limited Company/Public Limited Company 6 Names of the Partners/ Directors/ Proprietor 7 Name of the Chief Executive with His Present Addresses, Telephone Nos., 8 Name of Representative(s) with Designation Who Would be Calling On Us and Attending to Our Jobs. Telephone No, Address of the said person. 9 Name of Bankers with Addresses & Telephone Nos. IFSC Code 10 Is the Firm is Registered Under the Factory Act? If So, State a) License No.:

6 b) Date of Last Renewal of License (Copy To Be Enclosed): c) PAN (Copy to be Enclosed) : d) ESIC No. if Any: e) EPF Registration No. if Any: f) GST Registration No (Copy of details to be enclosed) : 11 a) CST No. / VAT NO. / TAN No. b) Labour License No. & Validity Under Section of Labour Laws (Enclose Photo copy) c) Service Tax Registration No. (Enclose copy) d) EPF Registration No. (Enclose copy) e) ESI No. (Enclose copy) 12 Whether Holding Certificate under Shops & Establishment Act, Duly Renewed (Copy Should Be Enclosed) 13 Sate the Latest Income Tax Assessed year and the Amount of Tax Assessed (Copies of last 3 years, IT Returns, Balance Sheets & Revenue A/c to be Enclosed) 14 Turn Over for last Three Years (Audited Balance sheet/ CA Certificate to be Attached for Last 3 Years) F.Y F.Y F.Y Whether Black Listed by any Govt. Deptt. / Public Sector Company 16 Are You Agreeable to Make Deliveries to

7 Corporation s Office at Bardhaman & its Branches Under Jurisdiction 17 Are You Agreeable to Abide Strictly by the Terms & Conditions of the Tenders & Contracts. (Copies Annexed) 18 Is Your Firm is Empanelled with Any Office of LIC of India. Please give name, address & photo copy of certified documents of enlistment. 19 Is Your Firm is Empanelled with any Other PSU(Central) Please Give Name & address& photo copy of certified documents of enlistment. 20 Name, Address and Telephone Nos. of Some of Your Most Valued Clients (proof of documents along with copy of work order to be enclosed (Separate List may be Attached) 21 Mention any Other Speciality of Your Establishment Note : Please type this form or fill it legibly in ink. If space provided is insufficient, please type or write the replies on a separate sheet giving appropriate question number and attach it to the form. All the pages of application form and documents must be signed with seal. I/We request Life Insurance Corporation of India Bardhaman Divisional Office, Ghordour Chati, Sreepally, Bardhaman to consider inclusion of my/our name in the list of their approved firms/vendors/suppliers/printers/service providers. We agree to give full satisfaction to the Corporation in the event of their doing so. Dated at this. Day of.201. Signature with Seal Name: Designation: