From: Chartered Accountants Ref. Date: To, The General Manager (Internal Audit) Bank Of Baroda Central Internal Audit Division Head Office 10 th Floor, Suraj Plaza-1 Sayajigunj Baroda-390 005. Dear Sir, Re: Application for empanelment for Concurrent Audit-----2015-16 We are submitting the application for empanelment of our firm for Concurrent Audit in your Bank for following Centres( Please mention the name of state in bracket) 1. 2. 3. We enclose herewith our firm s profile for your perusal. Thanking you, Yours faithfully, For Chartered Accountants Proprietor / Partner Encl: as above Page 1 of 6
NOTE: 1) No columns of application are to be kept blank. 2) Incomplete applications and / or applications not in format may be rejected without any further reference. 3) Since large number of applications is received for limited number of vacancies, no communication will be sent by the Bank and no correspondence will be entertained in respect of firms, which are not being selected. 4) No Annexure/Extra papers to be enclosed without being called for except copy of grade suggested by RBI for Statutory Audit be enclosed. 5) The existing Concurrent Auditors which are completing -03- Financial Years as on 31.03.2015 with BOB need not apply as the firms will be under cooling period for minimum -02- years. 6) The firms which will not be completing -02- years of cooling period as of 31.03.2015 need not apply. 7) Other existing Concurrent Auditors also need not submit their application form to Central Internal Audit Division. They should send Soft Copy only to the concerned ZIAD. 8) Submit the application through e. mail on ciad.bcc@bankofbaroda.com in WORD FORMAT (No scanned Copies) followed by Hard Copy on address mentioned at forwarding copy. 9) Grade suggested by RBI for Statutory Branch Audit as available on website www.mefcai.org is compulsory for appointment of Concurrent Auditors. 10) Proprietorship Firms and Individual CA are not considered for appointment at Metro and Urban Centres. 11) Those who have already submitted application form in format other than the following format are required to submit the same again in this prescribed format. PROFILE OF THE FIRM FOR EMPANELMENT FOR CONCURRENT AUDIT BASIC DATA: Sr. Particulars Details 1. the CA Firm 2. Centres applied Distance of the centre (KM.) from the HO/Branch of the firm to be mentioned in bracket if it is outside the city/local place. 3. Constitution 4. Address of Head Office 1) 2) 3) 5. Addresses of Branch Offices 6. Landline No/s (with STD Code) / Fax No/s Page 2 of 6
7. E-mail Address 8. Date of Establishment 9. Registration of Firm with ICAI 10. Unique Code for Bank Audit 11. Grade suggested by RBI for Statutory Branch Audit as available on website www.mefcai.org 12. Nature of training attended by the partners/ staff in connection with Concurrent audit during last -02- years. 13. Name & Mobile of FCA partner of the CA Firm for contact 14. Peer Review if done mention year (YYYY) and name of institution/s 15. Whether any disciplinary action by ICAI instituted/pending against any member of the firm (if yes give details) 16. Whether any assignment given by Bank of Baroda in past was refused/ discontinued/terminated 17. Manpower (Nos) A) Qualified Professionals: (i) Partners (ii) Others B) Articles: C) Details of Other Audit Staff(including of Ex Bank Officers/Executives) 18. Out of above staff available for Concurrent Audit 19. of Audit Staff having CISA/DISA qualification with names.(including propriter/partner) 19. Particulars of Partners/Proprietor/Individual Sr. Name Qualification ICAI Membership Date of Certificate of practice Whether DISA / CISA Whether FCA or ACA Mobile Page 3 of 6
20. Details of Associate Firms, if any, of the Applicant Firm: Name Associate Firm of Partners Address Landline (with STD Code) Mobile EXPERIENCE: 21. Experience of Concurrent Audit of Public Sector Bank including Bank of Baroda (In applicant firm s name): 22. Details of Current Assignment of Concurrent Audits of Public Sector Bank on hand (including Bank of Baroda): 23. Details of Current Assignment of Concurrent Audits of Public Sector Bank on hand in the name of associate concerns(including Bank of Baroda): 24. Experience of Concurrent Audit of Specialized Functions in Public Sector Bank i.e. IS Audit (In applicant firm s name): 25. Experience of Statutory Audit of Public Sector Banks (In applicant firm s name): Page 4 of 6
ADDITIONAL INFORMATION: 26. If Firm or partners are having any Credit Facilities / stood as a guarantor with Bank of Baroda, please furnish necessary details indicating nature of the dealings and the name of the Bank s branch where the account/s is/are maintained: the partner Bank s Branch Nature of Credit Facilities / guarantee 14 Digit A/c. 27. Whether the Firm or any partner has ever been debarred by ICAI/RBI, if yes, details: Sr. the partner Brief reasons for debarment 28. Whether any partner is relative of existing staff member of Bank of Baroda: Staff & Designation Branch Relation 29. Whether any employee of firm is retired Public Sector Bank Employee : Employee Bank Last Designation of Years of Service Date of VRS / Superannuation Branches served during last -05- Years* * The employee cannot be deputed for Concurrent Audit of or Bank Branches where he has served (if he was a employee of our Bank). 30. Whether any partner is retired officer of Public Sector Bank: Partner Bank Departments worked of Years of Service Date of VRS / Superannuation Page 5 of 6
31. If any of your client is having credit facilities with our Bank, please furnish name of the branches: 33. Please furnish the name of borrowers of our Branches, where your firm is a statutory Auditor/Internal Auditor. 33. Certificate/s a) I / We hereby confirm that the Firm / any partner is neither Statutory Auditor nor associate concern (as defined by RBI) of Statutory Auditors of Branches of Bank of Baroda and we are not disqualified under any of grounds given in Sec. 226 of the Companies Act, 1956. b) I / we hereby declare that neither I nor any of our partners/members of my/their families (family will include besides spouse, only children, parents, brothers, sisters or any of them who are wholly or mainly dependent on the Chartered Accountants) or the firm/company in which I am/they are partners/directors have been declared as willful defaulter by any bank / financial institution. c) I / We hereby confirm that I / We am / are not disqualified / ineligible for appointment at Concurrent Auditor of any Branch / Office of Bank under Sections 139 to 146 of the Companies Act 2013. d) I / We confirm that the information furnished here are true to the best of my knowledge. SIGNATURE DATE: P.S. submit the application through e-mail on ciad.bcc@bankofbaroda.com in word format followed by hard copy on address mentioned on forwarding copy (letter). Page 6 of 6