1. Table & Office stationery such as pens, files, photocopier paper, Punching Machines, Staplers etc.

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1 Divisional Office: 1, West Patel Nagar circuit house road Jodhpur (Raj.) Tel , Empanelment of Supplier/Printer/Manufacturers Applications are invited from reputed/manufacturers/printers/venders/service providers for empanelment(for 3 financial year) for following items: S.No. CATEGORY 1. Table & Office stationery such as pens, files, photocopier paper, Punching Machines, Staplers etc. 2. Computer continuous stationery Plain & Pre Printed 3. (i) Computer consumables. (ii) Repair of Printer head, Drums etc., Refilling of Toner Cartridges, Printer Ribbons etc. 4. Offset/ Screen printers for printings of forms/ledgers, visiting cards etc. 5. Manufacturer/Supplier of Cloth/Kraft Envelops,Dockets,Envelops 6. Supply/ Maintenance/ Servicing of telecommunication equipments such as Fax, EPABX systems, etc. 7 Tour Operator for hiring taxi & ticket booking for LTC/Tour purposes. 8 Courier Service all over India. 9 Transport services for transporting goods local/outstations. 10 Supply / Maintenance/Servicing of Safety & Fire Fighting Equipment, Fire Alarms systems. 11 Supply / Maintenance/Servicing of Water Coolers, Refrigerators. 12 Supply / Maintenance/Servicing of Note Counting & Fake detector machine. 1

2 13 Supply / Maintenance/Servicing of Purifiers & R.O. Systems for domestic & commercial. 14 Supply of Desert Coolers. 15. Repairing & Supply of Wooden/Steel/Molded furniture & Fixture manufacturer/supplier. 16 Hiring of Photo Copier 17 Binder 18 Canteen Services 19 Catering Services 20 Advertise agency for newspaper 1. The eligibility conditions and applications form can be downloaded from Our website or the same can be obtained from the office of Manager (OS) LIC of India Divisional Office, Jeevan Prakash,1 West Patel Nagar Circuit house road, Jodhpur. Pin Application for empanelment duly completed should be submitted at the same address in a closed envelop super scribed as Application for empanelment of suppliers/venders/category Sr.No. along with non-refundable application fee of Rs. 100/- in the form of demand draft in favour of Life Insurance Corporation of India payable at Jodhpur. for submitting of application forms duly completed Last date is 24th January, P.M.. 2. The firms/suppliers who are on our panel are required to apply for fresh empanelment if interested. 3. Firms/suppliers who have been black listed / removed earlier, should not apply. If applied, their applications will not be considered. 4. Mere submission of Application for empanelment does not confer the 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 for which Life Insurance Corporation of India shall neither be liable nor obligatory to inform the applicant the grounds of any such action. 5. If you have any query related to empanelment process, you may contact at following Telephone no , and Sr. Divisional Manager 2

3 Divisional Office: 1, West Patel Nagar circuit house road Jodhpur (Raj.) Tel , Condition for Empanelment of Suppliers/Printers 1. The applicant firm /supplier should be in profession for at least three years.(copy of proof must be enclosed ). 2. The firm /supplier should be on the approved panel of at least three reputed firms. If on quality issue firm which has been panelized by our or any office of LIC application may not be considered. 3. The firm/supplier should have registration with state and local authorities for undertaking the profession (Copies of proof to be enclosed.). 4. The firm/supplier must have a valid GST number.without GST no. no application will be entertained. 5. Separate application is required for each category. 6. The firm/supplier should keep sufficient stock in hand so as to comply with the urgent needs without delay. 7. Incomplete application will be rejected without assigning any reason thereto. 8. Minimum annual turnover should be Rs.2 Lacs. 9. The Printers/Suppliers who have been blacklisted/removed earlier, should not apply. If applied, their applications will not be considered. 10. Please not that all particulars required as per the application form shall be filled in completely in all aspects strictly as per the format. 11. The eligible Suppliers/Printers who will be selected for empanelment after scrutiny of Application forms,shall be informed through letter. Please note that no enquires or correspondence regarding the selection for empanelment shall be entertained. 12. Earnest Money Deposit equivalent to 1% of the total tender value will be deposited on the time of tender. The amount of EMD will be refunded without interest after final supply of tender. If tender value is more than Rs.10 lac then 10% of tender value will be deposited as Security Deposit which will be refunded without interest after final supply of tender as per corporation satisfaction. EMD/Security Deposit will be forfeited in case of any damage supply or not as per our specifications. 13. Penalty will be charged from bill amount for delay supply as per tender conditions. 14. Quality is an important aspect. Firms/Suppliers who are seriously believe in delivering of quality goods/services should only apply. If any duration it is found that quality is poor than corporation reserve the right to blacklist or removed the firm from our panel, which result as such that the said firm could not serve any office of the corporation. 15. Affix your Firm/Company seal and authorized signature on every page. 16. Panel is for three F.Y , & , Competent authority may extend this period for one more F.Y. I agree with term & condition. Seal and sign of Firm 3

4 Divisional Office: 1, West Patel Nagar circuit house road Jodhpur (Raj.) Tel , APPLICATION FORM FOR EMPANELMENT OF FIRM S.NO.OF CATEGORY NAME OF CATEGORY (Separate application is to be filled up for each category) APPLICATION FOR FIRM/SUPPLIER/SERVICE PROVIDER PART 1: GENERAL INFORMATION S.NO. INFORMATION SOUGHT INFORMATION PROVIDED 1 Name of the Firm (In Block Letters) 2 Date of Establishment/Incorporation 3 Correspondence address and Telephone No. & 4 Address of Head Office (if Separate) and Telephone No. & 5 Status Proprietary/Partnership limited company/public Limited Company 6 Names of the Partners/Directors 7 Name of Chief Executive with his 4

5 present addresses and Telephone Nos. & 8 Name,Mobile no. & id of Representative (s) with Designation who would be calling on us and attending to our jobs 9 Name of bankers with addresses & Telephone Nos. 10 GSTIN NO. (Copy to be enclosed) 11 Is the firm is registered under the factories Act? If so, state (a) License No. (b) Date of renewal of License (copy of license to be enclosed) (c) Pan No. (Copy to be enclosed) (d) ESIS No. if any (e) EPF registration No. if any 12 Whether holding certificate under shops & establishment act, duly renewed copy should be enclosed. 13 State 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 Turnover for last three years FY FY FY Registered with MSME/NSIC Are you agreeable to make deliveries to Corporation s office at Jodhpur and other Offices outside Jodhpur when so directed? 5

6 17 Are you agreeable to abide strictly by the Terms and Conditions of the Tenders and Contracts 18 If your firm is empanelled with any of office of LIC of India or any other PSU (Central) Please give name and address. 19 Name, Addresses and Telephone Nos. of some of your most valued Clients ( Separate list may be attached) 20 Whether Black Listed / Removed by any Govt.Dept./ Public Sector company/ any office of LIC 21 Are you in panel of parent Division of LIC (Division that is comes in your registered office / factory area), if YES please mention the name of Division and from which year you are in panel 22 Approximate value of your output per year. 23 Mention any other specialties 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. Dated at this day of 2018 Signature with seal Name Designation 6

7 Divisional office: 1-West Pate lnagar, Circuit House Road, Jodhpur (Raj.) os.jodhpur@licindia.com, Tel , DECLARATION I/WE request Life Insurance Corporation of India, Divisional Office-Jodhpur to Consider inclusion of my/our name in the list of their empanelment of approved firms/suppliers,etc. We agree to give full satisfaction to the Corporation in the event of their doing so. 1. I/We have read the instructions and conditions and I/We have understand that any false information is revealed at a later date,any contract made in between ourselves and the corporation, on the basis of the information given by me/us can be treated as invalid at the sole discretion of the corporation and I/We will be solely responsible for the consequences. 2. I/We agree that the decision of the corporation in the selection of Suppliers/Printers will be final and binding on me/us. 3. All the information furnished by me here under is correct to the best of my/our knowledge and belief. 4. I/We agree that I/We have no objections if inspection of my/ our premises/ workshop,shop, etc is done by the official of the corporation. 5. I/We hereby declare that our firm is not blacklisted by L.I.C. of India/P.S.U./Government / Semi Government Organization and any other department of Government of India. Note : The Corporation reserves the right to cancel the name of the supplier/firm from its approved list at the absolute discretion without assigning any reason. Dated at this day of Signature with Seal Name Designation 7