REQUEST FOR PROPOSAL (RFP) ENGAGEMENT OF PRACTICING COMPANY SECRETARIES AS CONSULTANT IN THE BANK ON RETAINERSHIP BASIS.

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1 REQUEST FOR PROPOSAL (RFP) ENGAGEMENT OF PRACTICING COMPANY SECRETARIES AS CONSULTANT IN THE BANK ON RETAINERSHIP BASIS. RFP REFERENCE NO. CC/S&B/PSS/2015/01 DATED: 30/10/2015 STATE BANK OF INDIA, SHARES AND BONDS DEPTT., CORPORATE CENTRE, 14 TH FLOOR, STATE BANK BHAVAN, MADAM CAMA ROAD, MUMBAI

2 Table of contents Clause Topic Page No. 1 General Background 5 2 Purpose of RFP 5 3 RFP Terminology 6 4 Invitation 6 5 The Proposal 7 6 Scope of work 7 7 Preparation and Bid Submission 7 8 Evaluation Weightage 10 9 Technical Evaluation of Bids Commercial Evaluation of Bids Overall Evaluation Final Engagement/ General Conditions 11 2

3 RFP Issuance Date 30/10/2015 Pre-bid meetings for clarifications / discussions 05/11/2015 Last date for requesting any clarification 07/11/2015 Last Date and Time for Receipt of Bids at the Bank 16/11/2015 Time: 2 P.M Date and Time of opening of Technical Bids 16/11/2015 Time: 3 P.M Presentation on experience, proposed approach, work plan and methodology, if required. 18/11/2015 Date and time of opening of Price Bids 18/11/2015 Time: 5 P.M Contact Person & address for communication Ms. Prathishya, Mr.Manoj Joshi State Bank of India, Shares & Bonds Department, Corporate Centre, 14 th Floor, State Bank Bhavan, Madame Cama Road, Mumbai gm.snb@sbi.co.in Ph : /40848 Fax : Bid Document Availability 3

4 Disclaimer The information contained in this Request for Proposal (RFP) document and any subsequent amendment/modification/clarification to the same are provided on the terms and conditions set out in this RFP and such other terms and conditions subject to which such information is provided. This RFP is not an agreement and is neither an offer nor invitation by the Bank to the prospective Applicants or any other person. The purpose of this RFP is to provide interested parties with information that may be useful to them in the formulation of their Application pursuant to this RFP. The bidder should therefore, conduct its own investigations and analysis, check the accuracy, adequacy, correctness, reliability and completeness of the details/ information contained in this RFP and obtain independent advice from appropriate sources if required by them. The information given is not an exhaustive account of statutory requirements and should not be regarded as a complete or authoritative statement of law. The Bank accepts no responsibility for the accuracy or otherwise for any interpretation or opinion on law expressed herein. The Bank & its employees make no representation or warranty and shall have no liability to any person, including any Applicant or Bidder/(s),under any law, statute, rules or regulations or tort, principles of restitution or unjust enrichment or otherwise for any loss, damages, cost or expense which may arise from or be incurred or suffered on account of anything contained in this RFP or otherwise, including the accuracy, adequacy, correctness, completeness or reliability of the RFP and any assessment, assumption, statement or information contained therein or deemed to form part of this RFP or arising in any way with pre-qualification of Applicants for participation in the Bidding Process. The Bank also accepts no liability of any nature whether resulting from negligence or otherwise howsoever caused arising from reliance of any Applicant upon the statements contained in this RFP. The Applicant shall bear all its costs associated with or relating to the preparation and submission of its bid documents including but not limited to preparation, copying, postage, delivery fees, expenses associated with any demonstrations or presentations which may be required by the Bank or any other costs incurred in connection with or relating to its Application. All such costs and expenses will remain with the Applicant and the Bank shall not be liable in any manner, whatsoever, for the same or for any other costs or other expenses incurred by an Applicant in preparation or submission of the Application, regardless of the conduct or outcome of the Bidding Process. 4

5 1. General Background: The State Bank of India (herein after called as SBI ) a body corporate constituted under the State Bank of India Act, 1955 represents a sterling legacy of over 200 years. It is the oldest commercial Bank in the Indian subcontinent, strengthening the nation s trillion-dollar economy and serving the aspirations of its vast population. The Bank is India s largest bank, with a network of over branches and five associate Banks having over 5000 branches spread across India. Bank also has presence in 32 countries across the globe The Bank also has one of the largest networks of ATMs spread across geographical locations, it also provides services to its customers through alternate channels such as Internet Banking, Debit Cards, Mobile Banking etc. The Government of India is holding % of the paid up equity capital of the Bank and the remaining % is held by public. The functions of the Bank is governed by the provisions of the State Bank of India Act, 1955, the State Bank of India General Regulations, 1955 and such other applicable legal provisions such as section 51 of the Banking Regulations Act, 1949, etc. The Bank is also a listed entity, listed with various stock exchanges and governed by the applicable provisions in the listing agreement, SEBI Regulation etc. Shares and Bonds department of the Bank deals with the compliance of equity and debt Listing Agreement, conducts the Annual General Meeting, Capital Raising Activities, finds solution for the Grievances of Shares and Bond holders and such other activity related to Shares and Bonds of the Bank. 2. Purpose of the RFP SBI operates under strict regulatory environment. The prime Regulator of the Bank is Reserve Bank of India. Securities issued by the Bank are listed on Stock Exchanges, hence required to comply with the applicable provisions of the Listing Agreement as amended from time to time., SBI is also subject to observance of various Regulations/Guidelines & instructions issued by Securities and Exchange Board of India (SEBI), from time to time. The Bank is also committed to the best practices in the area of Corporate Governance, in letter and in spirit. Therefore, not merely to establish, but also be perceived to establish the best Corporate Governance practices in the Bank, both in letter and spirit, it has been decided to engage the services of an established and reputed firm/entity of Company 5

6 Secretaries a consultant, on retainer-ship basis, to advise the Bank on compliance of various Legal/Regulatory matters and to achieve best Corporate Governance practices. 3. RFP Terminology Definitions Throughout this RFP, unless inconsistent with the subject matter or context: 3.1 Applicant or Bidder An eligible entity/firm of Practicing Company Secretaries submitting a Proposal/Bid in response to this RFP 3.2 Consultant Selected Bidder under this RFP. 3.3 Bank/ SBI - Reference to the the Bank, Bank, SBI shall be determined in context and may mean without limitation State Bank of India 3.4 Proposal/ Bid the response received in the prescribed format from a bidder in accordance with the RFP 3.5 RFP the request for Proposal (this document) in its entirety, inclusive of any addenda/modification/ clarification/amendment that may be issued by the Bank. 3.6 Consultancy Service Consultancy Service means all services, scope of work and deliverables to be provided by a selected Bidder as described in the RFP and include services ancillary to the services and other service obligation of the Consultant covered under the RFP. 3.7 Contract means the Contract in the format approved by the Bank to be signed between the Bank & the consultant, and all the attached documents and the Appendices, consequent to the completion of the proceedings as per the RFP. 3.8 Day means calendar day. 3.9 Parties Party or Parties means the SBI or Bidder / Consultant or both as the case may be Personnel means professionals and support staff of the Consultant assigned to perform the Services or any part thereof Proposal means the Technical Proposal and the Financial Proposal/ bid Assignment / job means the work to be performed by the Consultant pursuant to the Contract. 4. Invitation: The bidders desirous of providing consultancy service to the Bank are invited to submit their technical and commercial bids in response to this RFP. The criteria and the process of the evaluation of the responses to this RFP and subsequent selection of 6

7 the successful bidder will be as mentioned in the RFP. Bidders have to adhere to the Bank s requirements outlined in this RFP. The information provided by the bidders in response to this RFP document will become the property of SBI and will not be returned. SBI reserves the right to amend, rescind or reissue this RFP and all amendments will be advised to the bidders and such amendments will be binding on them. i. This RFP will be limited to the bidders who have the necessary experience, capability and expertise. ii. This RFP is not an offer by the State Bank of India, but an invitation to receive responses from the Bidders. No contractual obligation whatsoever shall arise from the RFP process unless and until a formal contract is signed and executed by duly authorised official (s) of State Bank of India with the Consultant. 5. The Proposal The Bank invites bids from established and reputed firms/llps/companies of Practising Company Secretaries, fulfilling the eligibility criteria mentioned in Annexure-I. 6. Scope of work The broad scope of work is as mentioned in Annexure-II. 7. Preparation and Submission of Bids 7.1 The bids prepared by the bidder and all correspondence and documents relating to bids exchanged by the bidder and the Bank must be written in English. 7.2 The Bidders must provide individual and factual replies to specific questions asked in the RFP. Documents submitted should be complete in all respects as detailed in this RFP. 7.3 Technical bid The Technical bid should be submitted as per Annexure -IV of the RFP (super scribed as Technical Bid - Eligibility Details ) containing complete technical Bid details. The technical bid should be a complete document and placed in a sealed envelope superscribed as TECHNICAL BID. The bidder should provide brief description of the bidder entity and in the case of a firm, of each partner/individual. Details of experience of assignments which are similar to the proposed assignment / job as per the terms of reference should also be provided. Information should be provided only for those Assignment/jobs for which the 7

8 Bidder was legally contracted as a Firm/entity. Jobs completed by individual Professional staff working privately or through other consulting firms cannot be claimed as the experience of the Bidder, or that of the Bidder s associates, but can be claimed by the Professional staff themselves in their CVs. Bidders should be prepared to substantiate the claimed experience along with the proposal and must submit letter of award / copy of contract for all the assignments mentioned in the RFP. Data on Team Composition and Task assignments along with Curriculum Vitae (CV) of the proposed staff should be attached. Comments and suggestions on the RFP including workable suggestions that could improve the quality/ effectiveness of the assignment/job may be made before the submission of the bids i.e. on the date of the pre-bid meeting. SBI reserves the right to accept / reject the suggestions made by the Bidders. 7.4 Financial Bid Bidder should submit financial bid as per Annexure VI of the bid document. Financial bid should be a complete document and placed in a separate sealed envelope super-scribed as FINANCIAL BID The financial proposal shall not include any conditions attached to it and any such condition attached to the financial proposal shall be liable for rejection. Payment will be made after deducting Tax Deductible at Source as per applicable Tax Laws. Please note no additional expenses what so ever would be paid for hiring of personnel / specialized person, if any, required. 7.5 Bid Prices The prices should be specified only in Financial Bid and must not be specified at any other place in the bid document. The quotes prices and taxes & statutory levies should be specified separately. The total price quoted must be inclusive of Professional Fees, other expenses, applicable taxes, duties, levies, charges etc. but excluding Service Tax and Travelling Expenses. Travelling expenses may be paid by the Bank only in case personal meeting is requested by the Bank with the officials of the firm/ entity at the Bank s premises or any other place as may be convenient to the officials of the Bank with the production of valid voucher/receipt/ticket etc. 7.6 Revealing of Prices The rates and/ or prices in any form or for any reasons should not be disclosed in the technical or other parts of the bid except in the financial bid, failure to do so shall make the bid liable to be rejected. Before opening of financial bid, if price revision is envisaged by the Bank, revised financial bid may be required to be submitted in a separate sealed envelope. 8

9 7.7 Pre-Bid Meeting SBI may, but not obliged to, at its sole discretion, organize a pre-bid meeting, to resolve any queries, bidder may have. Any further information (if required) will be provided to all bidders by SBI as corrigendum. Any clarification on queries raised by any bidder will be communicated to all bidders. The tentative date, time and location of the pre-bid meeting, if any, is as stated in this RFP Bid Integrity Willful misrepresentation of any fact within the Bid will lead to the cancellation of the contract without prejudice to other actions that Bank may take. All the submission, including any accompanying documents, will become property of SBI. The bidders shall be deemed to license, and grant all rights to SBI, to reproduce the whole or any portion of their consultancy services for the purpose of evaluation, to disclose the contents of submission to other bidders and to disclose and/ or use the contents of submission as the basis for RFP process Format and Signing of Bid (a) The bidder should prepare submission as per minimum eligibility criteria, Technical Bid, Financial Bid and other requested information. (b) Bid should be submitted as per the format stipulated in the Annexures (III, IV &VI) to this RFP along with such other documents mentioned elsewhere in the RFP. (c) All pages of the Bid document should be serially numbered and shall be signed by the authorized person(s) only. The person(s) signing the bid shall sign all pages of the bid and rubber stamp should be affixed on each page. The bidder should submit a copy of power of attorney or any other authorization document as applicable, showing that the signatory has been duly authorized to sign the bid document. (d) Any interlineations, erasures or overwriting shall be valid only if the person(s) signing the bid counter sign(s)/authenticates them. (f) Bid except the financial bid, should be typed and submitted on A4 size paper, spirally bound securely and in serial order. Bidders responding to this RFP shall submit covering letter included with the bid and compliance certification statement required for submission of a proposal. (g) Financial bid should be submitted strictly as per the prescribed format in a separate sealed envelope along with the Technical Bid documents Last date, address & time of receipt of bids The bid should be submitted on or before Date: 16/11/2015 Time: 2 P.M at following The General Manager (shares & bonds). (Attention: D.K.Kaul) Shares & Bonds Department, 9

10 State Bank of India, Corporate Centre, 14 th Floor, State Bank Bhavan, Madame Cama Road, Mumbai Ph: , 848 Fax: In the event of the target date for the receipt of bids being declared as holiday for the Bank, the bids will be received till the target time on the next working day. The Bank may at its discretion extend the bid submission date. The modified target date & time will be notified on the web site of the Bank Bid Currency Prices shall be expressed in Indian National Rupees (INR) only Late Submission of bids Any bid received by the Bank after target date and time prescribed at Bid details may be rejected and /or returned unopened to the bidder at his own risk and responsibility Modification and Withdrawal of Bids No bid may be withdrawn/ modified in the interval between the deadline for submission of bids and the expiration of period of bid validity. 8. Evaluation Weightage The technical bids will be allotted weightage of 70% while financial bids will be allotted weightage of 30%. 9. Technical Evaluation of Bids 9.1 Only those Bidders and Bids, found to be eligible as per the criteria mentioned in Annexure I, would be taken up by the Bank for further detailed evaluation. Those Bids which do not qualify the terms during preliminary examination will not be taken up for further evaluation. 9.2 The Bank may invite, if required so, all Bidders, whose bids qualify in the preliminary evaluation, to make a presentation to a committee of the Bank on the approach and methodology, procedure of advisory services, time frame for deliveries, and strengths of the bidders in discharging their obligations. The technical capability of the bidders shall clearly reflect during the presentation. Bids of those bidders who 10

11 fail to attend this meeting and make the presentation will be rejected. No travelling or any other expenditure shall be paid, in any case, by the Bank to the Bidders for such presentation. 9.3 During evaluation of the Bids, the Bank, at its discretion, may ask the Bidder for clarification of its Bid. The request for clarification and the response thereof may be sought in writing also. However, no change in the prices or substance of the Bid shall be allowed or permitted Technical bids will be evaluated based on the submitted bid as well as presentation to the Bank Criteria for Technical Evolution is listed in Annexure V. 10. Commercial Evaluation of Bids The bidder who has quoted the lowest will be given 100% of marks in financial evaluation and the other bids will be given percentage of marks that are inversely proportional to their prices. For example, If bidder A quotes Rs.50 which is the lowest price quoted, gets 100% of marks in financial evaluation; Bidder B quotes Rs.125, bidder B will get percentage which is inversely proportional to the lowest price bidder, i.e. Bidder B gets (50/125)*100=40% in financial evaluation. 11. Overall Evaluation The overall score will be calculated as weighted score of technical and financial i.e. 70% of technical score + 30% of financial score. For example, if technical score is 80 and financial score is 60, the total score would be 70% (80) + 30% (60) = 56+18=74. The Bidder who scores a minimum of 70 in technical bid will only be considered for opening the Commercial Bid. However, if one or two bidder(s) score more than 70 marks in technical bid, the top three will be considered for opening the same. The proposal obtaining the highest total combined score in evaluation of quality and cost will be ranked as L-1 followed by proposal securing lesser marks as L-2, L-3 etc. 12. Final Engagement /General Conditions The proposal securing highest combined marks and ranked L-1 shall be recommended for engagement of services. 11

12 After identification of L-1 Bidder, Bank will follow the internal procedure for necessary approvals and thereafter proceed with notification of award to L-1. However, the Bank may or may not engage the services a consultant even after finalization of bidding process. The engagement of the consultant shall be for 3 years from the date of engagement. However, the Bank reserves the right of terminating the services of the consultant, after the expiry of 1 year or earlier, if their services are found unsatisfactory or not up to the expectations of the Bank. In case of termination of the engagement, no amount/charges shall be paid, in any case, for the residual period, or any other compensation, whatever nature. Bank reserves the right to accept any Bid and to reject any or all Bids in part or in full, and to cancel the Bidding process and reject all Bids at any time prior to finalization of engagement, without thereby incurring any liability to the affected or Bidder or Bidders or any obligation to inform the affected Bidder or Bidders of the grounds for the Bank s action. Any effort by a Bidder to influence the Bank in its decisions on Bid evaluation, Bid comparison or engagement may result in the rejection of the Bidder s Bid. Confidentiality: Except with the prior written consent of the Bank, the Consultant so engaged and the personnel/employees of the consultant shall not at any time communicate to any person or entity any information acquired in the course of the services, nor shall the Consultant and its personnel make public the recommendations formulated in the course of, or as a result of, the Services. The consultant should also sign (1) The Service Agreement on the terms and conditions, as mentioned in the RFP. (2) The Agreement for Confidentiality and Non-dealing in SBI Securities as required under the code of conduct for prohibition of insider trading in the securities of state bank of India. 12

13 Annexure-I Eligibility Criteria The consultant is required to meet the following eligibility criteria: The firm/entity should be:- 1. A reputed & professionally managed consulting firm / entity of practising Company Secretaries setup on or before 1 st January Have minimum three qualified Company Secretaries practicing for not less than five years having good command over Indian Securities Laws and at least one of them should be a law graduate with minimum of 5 years experience. At least one Company Secretary of the firm/entity should have experience of more than 10 years as a Practising Company Secretary. 3. Have or have served at least one Commercial Bank or at least two listed entities as their client. 4. Have never been blacklisted/ barred/ disqualified by any regulator/ statutory/governing body. 5. Have all certificates of practice in force. 6. Not have been blacklisted by the Bank or any other listed entity in the past for any reason. 13

14 Annexure-II Broad Scope of work 1. Advising the Bank on : Matters related to shares & Bonds issued by the Bank. Issues related to the best practices of Corporate Governance. SEBI Rules, Regulations, and Guidelines related to securities market. 2. Advise the Bank on the extent of applicability and interpretation of various provisions of the Securities Laws including Listing Regulations without violating any of the provision of the SBI Act and Regulations. 3. Assisting the Bank in compliance with the provision of Listing Regulations and circulars/instructions issued by SEBI in the matter. 4. Advising and assisting the Bank in devising a suitable compliance calendar and continuous updation thereof. Also providing compliance alerts to the Bank on an ongoing basis. 5. Advising and assisting the Bank as and when there is any change/amendment in Securities market Laws, Rules, Regulations & Guidelines. 6. To keep the Bank updated on various circulars & instructions issued by SEBI with specific actions to be taken by the Bank to comply with the provisions mentioned in those circulars & instructions. 7. To act as an advisor in case of further issue of securities to ensure compliance with SEBI/Stock Exchanges requirements. Prepare/verify checklist for the same. 8. To vet and advise on various notices, disclosures documents, resolutions & applications required to be issued/submitted/executed in compliance with the Regulatory requirements. 9. To advise on the contents and disclosure requirements under Corporate Governance section of the Annual Report. 10. Assist and advise the Bank in framing suitable policies & Code of Conduct as may be required under SEBI Regulations. 14

15 11. Advising the Bank on the best practices on General Meeting and Annual General Meeting. 12. Assist & advise the Bank activities related to election of directors by shareholders. 13. Any other matter as may be required to be referred under Capital Market Regulations/Guidelines and/or Corporate Governance. 14. Assisting the Bank during the transition period for adoption new Regulation/Guidelines issued by any Regulatory Authority. 15. Any other matter incidental or ancillary to the above mentioned items. *********** 15

16 Annexure-III Note:-Technical bid should be submitted in sealed cover super scribing- RFP for Engagement of practicing company Secretary as consultant- Technical Bid BID FORM (Technical) (To be included in Technical Bid Envelope) The General Manager Shares & Bonds, State Bank of India Corporate Centre, State Bank Bhavan, Madam Cama Road, Mumbai Date: Sir, Request for Proposal for engagement of practicing Company Secretaries as Consultant in the Bank Having examined the RFP Document, we, the undersigned, offer our Consultancy Services in conformity with the requirements mentioned in said RFP documents. We undertake, if our bid is accepted, to carry out the work as per the scope of work, deliverables and in accordance with the time frames specified in the RFP document as well as on the payment terms mentioned in the commercial bid. We confirm that the information submitted by us in our Bids is true and correct. We agree to abide by the terms and conditions including confidentiality obligation mentioned in the RFP document. We enclose a duly signed copy of RFP document having read, understood and accepted the terms and conditions therein. We declare that we have not made any alterations/changes whatsoever in the RFP document which is provided by the Bank and we are fully aware that in the event of any change, the RFP document maintained at the Bank will be treated as authentic and binding and the Bid submitted by us will be liable to be rejected by the Bank in the event of any alteration made in the RFP document. We understand that you are not bound to accept the lowest, or any other Bid/Proposal, you may receive. The undersigned is duly authorised to sign and submit the bid response to the Bank. Dated this day of 2015 (Signature) (in the capacity of) Duly authorized to sign Proposal for and on behalf of 16

17 Annexure-IV Technical Details: - Name of the firm/entity Registration number PAN/TAN number Address and contact numbers with IDs Names of the proprietor and associate members with membership number. (Please furnish a brief resume clearly stating the educational qualification & professional experience on separate sheets) Number of qualified CS, CA, Law Graduates in the firm along with the years of service they are having Number of trainees/articles in the firm and the years of service they are having Copy (ies) of Certificate of Practice/ whether in force or date of expiry if applicable Yes/No Name(s) of the clients who were Commercial Bank or listed entities Details of penalty/restriction imposed by SEBI or any other regulator against the proprietor or its associates, if any. 17

18 Details of penalty / restriction imposed by the ICSI/ICAI/Bar Council of India against the proprietor or associates, if any. Details of experience gained by a member of the firm/entity, as whole time employment in a Listed entity, if any ( Name of Company & No. of years) Professional experience (number of years since the firm/entity is in existence) A brief of the area of practice & experience. Brief write-up on the vision or the methodology/procedure for rendering the service and your strength for discharging the obligations as per the RFP. I/we declare that the information provided hereinabove is true to the best of my/our knowledge. No fact has been misinterpreted or concealed. My/our certificate(s) of practice, issued by the Institute of Company Secretaries of India (ISCI)/ The Institute of Company Secretaries of India/ the Bar Council of India is/are valid and is/are in force. I, the undersigned, am the proprietor / duly authorised of the firm/ entity to furnish the details mentioned hereinabove. I understand that:- i. the Bank reserve the right to not to engage the services of my/our firm/entity even after my/our firm is selected as L-1. ii. the Bank reserve the right to engage one or more firms/entities for the proposed task. iii. the Bank reserve the right to cancel the RFP or terminate the engagement, any time, at its sole discretion, without quoting the reason thereof. For.. (Name(s) of the signatory (ies)) Seal of the firm Place: Date: Please also provide the individual bio data of each member/partner 18

19 Annexure-V Technical Evaluation criteria Sl.No. Indicative Criteria 1. Experience & Capabilities 2. Approach, Methodology & Work Plan 3. Quality of Understanding of the Scope. 4. Full time Manpower proposed to be assigned-name/experience/cv 5. Time Span committed to execute a particular assignment. 6. Number of trainees/articles in the firm and the years of service they are having 7. Number of clients who are commercial banks/listed entities 8. Number of Clients who are member of NIFTY-50 or BSE-100 index. 9. Number of Scheduled commercial Banks as Clients 19

20 Annexure-VI Note:- To be submitted in a separate scaled cover Super scribing RFP for engagement of Practicing Company Secretaries as Consultant- Commercial bid. The General Manager, Shares & Bonds Dept. State Bank of India, 14 th Floor, Corporate Centre, Madame Cama Road, Mumbai. Dear Sir, Request for Proposal (RFP): Engagement of Consultant Commercial Bid With reference to your RFP number CC/S&B/PSS/2015/01 dated 30/10/2015, we submit herewith commercial bid for the assignment proposed by the Bank to work as Consultant. Year of engagement Particular Amount (Rs.) Amount in words First year Total fees Second year Total fees Third year Total fees Total fee for all three years I/we understand, agree, and confirm that:- i. The quotes mentioned above are all inclusive expenses. ii. The Bank will deduct the TDS, wherever applicable. iii. The Bank will reimburse the service tax, if any applicable Date: Signature Place: Name(s) of authorised signatory (ies) Name of entity 20

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