Life Insurance Corporation of India. Jorhat Divisional Office. Rajabari, Jorhat

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Lfe Insurne Corporton of In. Jorht Dvsonl Offe. Rjr, Jorht-785014 Annexure-1 Tehnl B TO BE SUBMIITTED IN ENVELOPE-I Referene No (Note: The referene numer to e flle up y the tenerers for the prtulr Premses offere n shll e quote n pre B lso for esy n orret entfton. Sr Detl Remrks 1 1 Nme of the Lessor 2 Aress of the Lessor e Phone No. Fx No. E - Ml ID Permnent Aount Numer (PAN) 3 Nme of the ontt person uly uthorze. Phone No. 4 Consttuton of venor/ frm (Propretry/ Prtnershp/ Prvte/ Pvt.Lt./ Pul Lt/ PSU et) PAN numers of the Dretors/ Prtners/ Frms. 2 Detls of the property : 1 Nme of the Owner 2 Aress : 3 Phone No. 4 Nme of the ulng 5 Detls of enumrnes, f ny? 6 Loton n ress of the property 7 Usge of the property ( s pprove y the Competent Authorty). 8 Resentl Commerl Resentl um Commerl Shoppng entre 1

9 Whether the proposl for Offe premses n mult - store ulng. Numer of floor n the ulng. At whh floor, the offe premses re offere. 10 CTS No 11 Survey No 12 Wr NO 13 Whether the plot s free hol or lese hol? If lese hol, plese menton the etls of Nme of the Ttle Holer/ Lessor Tenure of the ln Resul lese pero v Annul lese rents n mount. Whether the property s mortgge? If yes menton the etls. Nme of the Orgnzton where the property s mortgge. Aress of the Orgnzton wth phone no. Amount of lon vle. v Tenure of mortgge v Resul mortgge pero v EMI p. 14 Chrter / Type of lolty e Resentl Commerl Commerl um Resentl Inustrl Slum 15 Are of the plot 16 Sze of the plot Frontge n meters Depth n meters 17 Sheule of the plot.e. ounres of the plot on 2

North Est South West 18 Whether the lolty s free from Spel hzrs lke fre / floo et. 19 Whether the lolty hs proteton from verse nfluene suh s Enrohment. Inustrl nusne, smoke, nose et. 20 Plese enlose opy of Property Cr or Ptt et. 21 Plese lso nte stne from the nerest v v Rlwy (lol) stton Bus Stn Bnk ( Nerest) Arport Hosptl/ Shools/ Colleges/ Unverstes. 22 Yer of onstruton. Enlose tteste opy of NOC or Oupny ertfte ssue y the Munpl Authorty or ny other Government Boes. 23 Inse of ol onstrutons, NOC from the Soety my e enlose Menton yer of ompleton ( s gven n Completon Oupny Certfte ssue y the Authorty). Inte n whose nme the onveyne ee s exeute. 24 Dte on whh Offe premses n e hne over to LIC fter fnlzton of the el. 25 Bult up re of the premses eng offere now for offe usges on lese ss. Plese enlose opes of pprove plns. 26 Wht s the rpet re (for onserton purpose). 3 Speftons 1 Type of ulng (Resentl/Sem ommerl)? 2 Type of struture (RCC / Steel frme/ lo erng). 3 Type of wll (Brk/ Cement lok). Menton thkness of externl wll n nternl prtton wll. 4 Detls of Floorng (M.M.Tles/ Cerm/ Vtrfe/ Mrle) or ny other. 5 Detls of Door frmes (Sl woo/ Tek Woo/ Hr woo/ Alumnum) or ny other. 3

6 Detls of Door shutters (Flush oor/ Tek woo/ Alumnum / PVC) or ny other. 7 Detls of Wnow frmes (Sl woo/tek Woo/ Hr woo/ Alumnum) or ny other. 8 Detls of wnow shutters (Tek woo / Alumnum / steel) or ny other wth seurty grlls or wthout seurty grlls. 9 No of tolets n eh floor. Detls of Floors n Do n Tolets. 4 Whether Struturl stlty ertfte enlose ( Certfte shll e from Lense Struturl Engneer of Munpl Corporton) 5 Serve 1 If Lft flty s vlle, plese gve etls of Numer of lfts, pty, mke n the yer of nstllton. 2 Plese nte soure of wter supply. 3 Is ore well prove? If so wht s the yel n epth of ore well. 4 Cpty of the over he tnk feeng to the offe premses uner onserton for lesng. 5 Plese gve etls of sewerge system n for storm wter sposl. 6 Plese nte whether the ulng s prone to floong. 6 Eletrty 1 Wht s the onnete lo to the ulng n KW / KVA? Type of eletr onneton. Commerl / Resentl. 2 Plese nte the type of wrng use, Alumnum or opper? 3 Whether ELCB s prove Yes / No 7 Common serves 1 Cr prkng Reserve..nos. Open..nos. 2 Two wheeler prkng Reserve..nos. Open..nos. 3 Power / Eletrty supply vlle. Yes / No 4 24 Hrs. wter / Overhe tnks vlle. Yes / No 5 Genertor for emergeny. If yes menton, pty of the Genertor. Yes / No 6 Ant lghtenng eve rrngement. Yes / No 7 Seurty rrngements, plese gve etls. 8 Other Informton 1 Whether ny rey ult flts / Offe premses hve een onstrute n sol y the uler to ny government n sem government nsttutons/fnnl nsttutons? If so 4

plese gve nme n resses of suh lents. 9 Detls of Pln / Blue Prnts / Sntone Pln 1 Whether the pln of the property s sntone y the Competent Authorty. 2 If sntone, plese enlose opy of pprove Floor Pln/s, Setons, Elevtons n Ste Pln of the ulng. 3 Nme/s n Aress Phone No. of the Arhtet / Engneer. 4 Provson for proper rrngement of fre sfety. 10 1 Are the sfety mesures tken? 2 If yes, gve etls of rrngement. 3 Is No Ojeton ertfte otne / Seure from fre ontrol uthortes. 4 If yes, proue opes of proof / ertftes. 11 Lst of Enlosures; 1.Munpl/ lol oy pprove rwng of the ulng. 2.Struturl stlty ertfte of the ulng from lense struturl engneer. 3. Commerl usge ertfte of the ulng. 4. Ltest ln revenue reept. Sgnture of venor wth sel n te. Dte: Ple:.. 5