BID DOCUMENT(TENDER FORM) FOR SUPPLY OF MEDICINE OXYGEN, NITROUS OXIDE AND CO2 TO DR. R.P.GOVT. MEDICAL COLLEGE, KANGRA AT TANDA

Sealed tender in two bids are invited from the manufacturer/authorized dealers having proven experience of at least five years in production and supply of medical oxygen, Nitrous Oxide and CO2 in totality from out station or in- house unit to a Govt. hospital / reputed private hospital having bed capacity of 500 beds or more/ any three hospital having bed strength of 300 beds or more, for supply of medical oxygen, Nitrous Oxide and CO2 to Dr. RPGMC & Hospital, Kangra at Tanda on FOR basis (Including transportation, loading/unloading etc.). The Tender form ( Bid document ) can be obtained from the office of the Rogi Kalyan Samiti (RKS) , Dr. RPGMC & Hospitals, Kangra at Tanda on any working day till 4.00 PM. as on 24.02.2018 on payment of Rs. 2500/- (Rs. Rupees two thousand five hundred only) (non- refundable). Tender form must be submitted along with the requisite earnest money and other requisite documents in the office of the RKS. Dr. RPGMC, Kangra at Tanda as on 26.02.2018 till 11.00 A.M. After which no tenders will be accepted. The tender will be opened on the same day at 3.30 PM in the presence of committee members and participants. The technically qualified bidder will be intimated for the opening of Financial Bid accordingly.

Signature and Stamp of Issuing Authority

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A.1. BIDDER’S ELIGIBILITY CRITERIA ( B.E.C.) Annexure-1):

A.1.1 The firm must comply with the statutory requirement, such as registration with the E.S.I.,E.P.F., P.A.N., TIN/ TAN P. Tax & Services Tax, GST, Factory Act License etc. along with proofs and copies of latest three months challans.

A.1.2. The firm must have five years proven experience in production and supply of medical oxygen, Nitrous Oxide, CO2 to a govt. hospital/reputed private hospital having bed strength of 500 beds or more/ any three hospital having bed strength of 300 beds or more, as per Annexure-v(1) in continuing supported by a certificate from the user hospital (s) Annexure-v. The firm should be sole supplier for supply of above said gases.

A.1.3. The firm must have sound financial stability with annual turnover of INR 100.00 lacs or more every years in preceding two financial years i.e. 2015-2016 & 2016-2017 and the sale solely from the medical oxygen should be Rs. 50.00 lacs or more every year during these two years and the firms net worth should be in positive as per Annexure-11 ( Copy of audited balance sheet and a certificate from the CA of turnover & ITRs must be enclosed in supported in thereof).

A.1.4. The Bidder should have the necessary valid licenses for running and production of Medical Oxygen, Nitrous Oxide and CO2 from the competent authorities for the last two years as under:-

i) License from the Director General of Explosives, GOI.

ii) License from the Drug Controller of India or the State of H.P.

iii) Factory License from the competent authority of GOI/ State

A.1.5. The firms should have the facility of laboratory equipped with the qualified & experience staff as per the requirement of Indian pharmacopeia (IP) for quality control measure and for ensuring the un/ interrupted production and supply of medical oxygen at their unit as per Annexure-VII.

A.1.6. The Bidder should have the valid license for cylinder Testing at least for the last three years to ensure safety of oxygen cylinder from the competent authority i.e. Director General of Chemicals and explosive .

A.1.7. The Bidder should have the backup plan to ensure the interrupted supply of medical oxygen within 12 hours in case of the main unit of the firm going out of order due to any reason

A.1.8. The Bidder should not have been blacklisted/any action taken by any Govt. , Semi – govt organizations or any other organization and the bidder should not have any litigation in any of the Labour Court (s) or by the CVC/CCI/CBI. An affidavit to that effect on Non – judicial stamp paper worth Rs. 10/- duly notarized should be enclosed with the Technical Bid as per Annexure-VI. Also to not that the contractor has not formed / on not a part of any cartel at any time of procuring any contract including the present tender.

A.1.9. The Bidder should enclosed the requisite earnest of Rs. 100000/- in the shape of Demand Draft of any schedule bank payable at Tanda .

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A.1.10. The Bidder should enclosed a latest solvency certificate from their Nationalized / scheduled bank to the effect that the firm is solvent for a sum of Rs. 2500000/-

A.1.11. The Bidder should enclosed a copy of proof/ brochure of its unit capable of producing the Medical oxygen of >99% purity as per Indian Pharmacopeia (IP) .

A.1.12 The Bidder should enclose its profile alongwith it a copy of registration / Incorporation of the firm.

A.1.13. The Bidder should enclose the necessary authorization letter in original for quoting and signing of the Tender on behalf of the firm on their letter head as per Annexure-IV.

A.1.14. The Bidder should invariable submit the original tender document purchased by the firm and duly signed and accepted with the Technical Bid.

A.1.15 Copy of VAT Challans / GST Challan for the last three months, returns for the years 2015-2017 should be enclosed with the bid.

A.1.16 The rates should be in limit of NPPA and other charges, if any, should be mentioned separately.

A.2. DETAIL OF BID DOCUMENT :

A.2.1 All the tender document should be properly numbered & indexed and should be accompanied with an Earnest money Deposit (EMD) of Rs. 100000( Rupees One lac) Only in the shape of Demand draft of any schedule bank drawn in favour of Member Secretary, Rogi Kalyan Samiti, ( RKS ) Dr. RPGMC, Kangra at Tanda and payable at Tanda.

A.2.2. The validity of the rates quoted in the tender shall not be less than three months from the date of opening of the tender / Bids ( Technical Bid ) and the rates quoted and approved shall remain valid during the course of contract .

B. INSTRUCTION TO BIDDER:

B.1. SUBMISSION OF BID:

B.1.1 The bid along with original tender form duly signed and stamped shall be submitted by the Bidder ,

B1.2. Bidder is advised to submit the bid strictly in accordance with the terms and conditions and specification contained in the BID Document and not to stipulate any deviation or condition. Chairman, E.C. R.K.S. Dr. RPGMC, Kangra at Tanda reserves the right to reject any BID containing deviation to the terms & conditions and requirement stipulated in the BID Document .

B.1.3. In the Financial Bid, the Bidder must quote the rates in figures as well as in words. If there is any discrepancy between the price quoted in figure and word whichever is the higher of the two shall be taken as the BID price .

B.1.4. BID shall be submitted in two part viz. Part -1 Technical bid and Part-II- Financial Bid .

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Part-1 and Part-II should be separately sealed and super scribed with words “Part-1- Technical Bid for supply of Medical Oxygen, Nitrous Oxide and CO2 to Dr. RPGMC, Kangra at Tanda and Part – II should be super scribed as Financial Bid

“Part –II – Financial Bid for supply of Medical Oxygen to Dr. RPGMC, Kangra at Tanda and both the part in duly sealed separately should be put in one another Bigger Envelope super scribed as “ Tender for supply of Medical oxygen, Nitrous Oxide and CO 2, Dr. RPGMC, Kangra at Tanda, due on 26.02.2018 at 3.30P.M.”

B.1.5 The BID must contain the name address and contract detail of business of the person or persons submitting the BID and must be signed and sealed by the Bidder with his signature on every page of the BID document in token of his acceptance of the terms & conditions of the tender.

B.1.6. Bid by a partnership firm must furnish names of all partners and be signed in the partnership name followed by signature and designations of authorized partner or other authorized representative. The copy of partnership deed should also be furnished.

B.1.7. The Bidder’s name stated in the Bid shall be exact legal name of the firms/ company / corporation etc. as registered or incorporated . All changes/ alterations / corrections in the Bid shall be signed with date in full by the person or persons signing the Bid. No erasing and overwriting is allowed.

B.2. TRANSFER OF TENDER DOCUMENT

B.2.1. Transfer of bid document purchased by the Bidder to another is not permissible. Similarly, transfer of bid submitted by one Bidder to another is also not permissible . No alteration in the essence of Bid once submitted shall be permissible . In case the Bidder transfer the bid or modifies / withdraws during period of validity his EMD shall be forfeited .

B.3. PROCEDURE FOR SUBMISSION OF BID:

B.3.1. Part -1 Technical Bid shall contain the following:-

A) Requisite Earnest Money Deposit ( EMD) as per advertisement;

b) Original Bid Document ( Tender – form ) duly signed and stamped on all pages by the authorized signatory of the thereby accepting all terms and conditions.

c) Bidders General Information along with the documentary proof.

d) Bidder’s eligibility criteria documents complete in all respect as per A.1. above i.e. (BEC) as per Annexure-1.

B.3.2. part-II- Financial Bid shall contain the price bid as per Annexure-III of the document .

B.4. EARNEST MONEY DEPOSIT ( EMD ):

B.4.1. Each Bid must accompany EMD in the form of Demand Draft amounting to Rs. 100000/- only of any scheduled/ nationalized bank drawn in favour of Member Secretary , Rogi Kalyan Samiti, ( RKS), Dr. RPGMC, Kangra at Tanda payable at Tanda. Technical bid submitted

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without EMD as mentioned above will not be considered for evaluation and shall be rejected summarily . The EMD of unsuccessful Biders shall be refunded only after the contract has been awarded to the successful Bidder. No interest shall be paid on the EMD.

B.4.2. The EMD of the successful Bidder will be adjusted against the performance security to be deposited by the Contractor.

B.5. VALIDITY OF BID:

B.5.1. BID submitted by the Bidder shall remain valid for acceptance for a period not less than three month from the date of opening of the Technical Bid. The Bidder shall not be entitled during the said period to revoke or cancel the Bid or to vary same or any term thereof without the consent in writing from the institute.

B.6. RIGHT OF THE INSTITUTE ACCEPT OR REJECT THE BIDS :

B.6.1. The institute reserves the right to accept or reject any or all the Bids received without assigning any reason whatsoever . The Bids in which any of the particulars and prescribed information is missing or is incomplete/ deficient in any respect and or the prescribed condition / documents are not fulfilled shall be considered non- responsive and are liable to the rejected or Bid not meeting the Bid evaluation criteria as stipulated in the Bid document shall be summarily rejected

B.6.2. The Institute reserves the right to cancel the whole tender process at any stage without assigning any reason whatsoever.

B.7. SELECTION CRITERIA :

B.7.1. A committee constituted by the competent authority shall examine the entire proposal submitted by the Bidder on the basic of :-

a) Profile of the Firm/ agency;

b) Past experience of the Business.

c) Financial strength of the firm/ agency

d) Fulfillment of mandatory provision as per relevant laws by the firm/ agency

e) Capability of the firm to execute contract.

f) Rates quoted by the firm for supply of the requisite grade medical oxygen, Nitrous Oxide and CO2.

Note photo copies of all relevant document have to be submitted along with the proposal failing which the same is liable to be rejected.

B.7.2. The Bidder whose technical bid is found in order as per a.1. bidder’s Eligibility Criteria (BEC) shall be declared qualified in the Technical evaluation .

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B.7.3. The Bidder who qualifies in the technical Evaluation stage shall only be called for opening of the financial Bids. RKS, Dr. RPGMC, Kangra at Tanda shall intimate the Bidders, the time, venue and date for opening of the Financial Bids in written/through telephone/ email/ communication or web notice.

B.7.3. The Bidders qualifies in the technical evaluation and offering the most competitive rates for supply of medical oxygen of the requisite grade shall be awarded the contract for a period of three year initially . it can be extended for the period mutually agreed.

B.7.4. In absence of completion of terms and conditions, the bid will be rejected straightway without assigning any reason and no claim will entertained.

B.8. SIGNING THE CONTRACT :

B.8.1. The successful Bidder shall be required to execute the contract agreement accepting terms and conditions stipulated herein on a Non – judicial stamp paper worth Rs. 100 only within 15 days from the issue of the Letter of acceptance of Bid. In the event of failure on the part of the successful Bidder to sign the contract within the period stipulated above, the EMD may be forfeited and the acceptance of the Bid may be considered as cancelled.

C TENTATIVE SCOPR OF WORK :

C.1. INTRODUCTION:

Dr. Rajendra Prasad Govt. Medical College & Hospital, Kangra at Tanda is the premier health institute of the state providing Tertiary health care to the people of the state.

C.2. DETAILS OF WORK TO BE CARRIED OUT BY THE CONTRACTOR :

C.2.1. The contractor shall be responsible for ensuring the un- interrupted supply of Medical Oxygen, Nitrous Oxide and CO2 to Dr. R.P. Govt. Medical College, Kangra at Tanda of purity level of >99% as per Indian Pharmacopeia ( IP ) during the course of the contract period.

C.3. SPECIAL CONDITIONS :

C.3.1. The purity level of Medical oxygen should be >99% as per Indian Pharmacopeia (IP) 1996.

C.3.2. The Capacity of the Unit should be enough to ensure the present as well as the future requirement i.e. 150-200 D. Type cylinders daily consumption of medical oxygen of this institution.

C.3.3. The contractor shall be solely responsible for all type of legal and statutory requirements of its unit and the institute will only be concerned with the availability of the required regular un- interrupted daily supply of the requisite grade medical oxygen to its hospitals.

D.1. TERMS AND CONDITIONS:

D.1.1. Canvassing in connection with the tender is prohibited and the tenders submitted by the Bidders who resort to canvassing are liable for rejection.

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D.1.2. The contractor shall be responsible for all his employees in observing security and safety regulations and instructions issue by the competent authorities.

D.1.3. The contractor shall employ only adult trained, efficient and responsible staff with good health and sound mind for relevant services, The workers should not be below 18 years and above 60 years of age. The contractor shall supply the list of workers employed by him to the Member Secy. RKS, Dr. RPGMC, Kangra at Tanda .

D.1.4. The Contractor should have in house quality control laboratory in the Unit with the requisite qualified staff as per Indian Pharmacopeia/ drug Controller,

D.1.5 The Contractor shall maintain the Minimum wages as applicable in the state of Himachal Pradesh from time to time.

D.1.6. The Contractor will abide by all the rules and regulations of the Labour Laws and rules framed there under and maintain all the register and display notices as requires under the above mentioned rules and regulations and the Chairman, E.C. RKS. Or his authorized representative shall be entitled to inspect all such records at any time.

D.1.7. The employees of this institute and their near relatives shall not be permitted to submit the tender. If such case is observed, the bid is liable for rejection.

D.1.8. The tender shall be dropped in the Tender Box kept at the Rogi Kalyan Samiti Office of Dr. RPGMC, Kangra at Tanda on or before the schedule date and time. Technical Bid shall be opened in presence of the authorized representative of the Bidders bearning authorization letter as per Annexure-IV . Technicaly qualified Bidders will be present during opening of the price Bids which will be intimated separately to such Technically Qualified Bidders.

D.1.9 The Bid documents submitted by the Bidder should be page numbered and complete in all respect.

D.1.10 Each page of the tender / Bid document should be signed and stamped by the Bidder as a token of acceptance of terms and conditions of the tender.

D.1.11. The contractor shall be responsible incase of complications in patients is solely due to impure supply of medical oxygen.

D1.12. The contractor shall have to ensure the back up supply of medical oxygen on the same rates as per daily requirement in less than 12 hours in case the unit is out of order for more than one day for which reserve is already provided.

D.1.13. The Contractor shall have to produce the convincing evidence for such back ups and uninterrupted supply to the hospital.

D.1.14 All duties , taxes if any should be shown separately .

D.1.15. Rates should be quotes per cylinder to be submitted in a separate envelop for the entire period of the contract as per Annexure-III.

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D.1.17. In case any of the information / document provided/ submitted by the bidder is found false, incorrect at any stage during the process of the tender, the tender of the firm be rejected straightway.

D.2. CONTRACT PERFORMANCE SECURITY :

D.2.1. The contractor shall furnish to the Member Secretary, RKS, Dr. RPGMC, Kangra at Tanda within 15 days from the date of notification of award performance security of Rs. 500000/- only in the shape of FDR duly pledged in the Name of Member Secretary RKS, Dr. RPGMC, Kangra at Tanda for the period of one year as contract performance security which will be released after three months of the satisfactory completion of the contract . The Institute shall be entitled to adjust any claim/ penalty/ due amount from the said security deposit during the contract period or on completion of contract period .

D.3. PENALITY :

D.3.1. In the event of the Contractors failure to execute the work entrusted to him under the contract agreement satisfactorily, the institute shall make alternative arrangement to do it and contract performance security shall be forfeited. The agency/firm will be blacklisted and will be debarred for three years for participating in any tender process of the institution.

D.3.2.. In the event of short/impure supply penalty @ double the amount of such short/impure supply on the approved rate shall be deducted from the monthly bill of the contractor.

D.4. ENHANCEMENT OF RATES:

D.4.1. Effect of enhancement of rates will be strictly as per the agreed terms and conditions of the contract agreement during the period of contract, if any.

D.5. TAXES, DUTIES & LEVIES:

D.5.1. All taxes, duties and levies etc. imposed by the Centre/State government and local bodies in connection with this contract in force at time of submission of bids shall be borne by the contractor and depositing of any such taxes and other levies with the government shall be the sole responsibility of the agency/firm concerned. Mandatory deduction such as Income tax, TDS, surcharge, service tax etc. will be deducted from the bill of the contractor as per govt. instructions.

D.6. PERIOD OF CONTRACT

D.6.1. The period of contract will be for three year initially.

D.6.2. The contract may be extended further on the mutual agreement on the same rates as well as terms and conditions of satisfactory performance of the contractor.

D.7. PAYMENT OF BILLS.D.7.1. The payment of bills of supply of medical oxygen for the month will be released by the RKS 10th day of the Following month provided the invoice / bill is accompanied by the proof of the following and subject to the availability of funds.

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i) Duly verified & page entered bill along with verified detail of daily medical oxygen supplied to the hospital.D.7.2 All payment will be subject to deduction of income tax at sources as per income tax Act/ rule & deductions of short / impure supply.

D.8 ACCIDENT OR INJURIES TO WORKMEN :

D.8.1. The Institute shall not be liable for any damage or compensation payable In respect of or in consequence of any accident or injury to any workman and other person in the employment of the contract . The contractor shall indemnify and keep indemnified the institute against all such damage and compensation whatsoever in respect or in relation thereto. Workman should be insured against personal accidents arising out of the course of their duties.

D.9. FORCE MAJEURE :

D.9.1. The contractor shall not be liable for loss or damage to the institute resulting from any delays or failure to meet deadline due to the acts of God, war declared or underclared, acts of public enemy , riots, civil commotion, invasion, insurrection, sabotage , acts of restraint of Government , federal , state or municipal action of regulations or any failure on the part of the institute or its representative to approved or comments on other causes, contingencies or circumstances not subjected to their control, whether or a similar or dissimilar nature which prevents the Bidder from completion of work. Any such cause or delays even through not existing on the date of the contract on or the date of start of reclaiming not existing on the date of the contract on or the date of reclaiming shall extend the time of completion automatically by length of delay occasioned thereby, including delay reasonable incidental to the resumption of normal reclamation work even though such case may occur after performace of firms obligation has been delayed for other causes.

D.9.2. If a Force Majeure situation arises, the Contractor shall promptly notify the institute in writing of such condition and the cause thereof . Unless otherwise directed by the institute in writing , the Contractor shall continue to perform its obligations under the contract as far prevented by the force majeure situation .

D.10. DISPUTE & JURISDICTION :

d.10.1. Except as otherwise provided elsewhere in the contract, if any dispute, difference , question or disagreement or matter, shall before and after completion or abandonment of work or extended period, hereafter arises between the parties , as to the meaning , operation or effect of the contract or out of relation to the contract or breach thereof, shall be subject to the sole jurisdiction of the Hon’ble High Court H.P. at shimla

D.11. GENERAL RULES :

D.11.1. Smoking and consumption of alcohol within the entire area of the institute is strictly prohibited. Violation of this rule shall be prosecuted as per Law in force in this regard.

D.12. SITE FALILIARISATION :

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d.12.1. Before quoting the Bidder in his own interest shall carry out site visit to know the site condition and full implication of the contract . This will also help him in proper assessment of the work. Failure to do so will not absolve the contractor of his responsibility to carry out the work as specified in the tender document. The cost visiting the site shall be borne by the Bidder himself and shall be at his own responsibility and risk.

Principal-cum-Chairman (E.C.),RKS, Dr. RPGMC,Kangra at Tanda.

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Annexure-1

( to be submitted with the Technical Bid)

BIDDER’S ELIGIBILITY CRETERIA ( B.E.C.) CHECK LISTS

Sr. No.

Description Yes/ No

Proof attached at page No.

1 The firm must comply with the statutory requirement, such as registration with the ESI, EPF,PAN, TIN/TAN P. Tax, GST & Services etc. in case applicable alongwith proofs and copies of latest three months challan.

2 The firm must have five years proven experience in production and supply of medical oxygen to a govt hospital/ reputed private hospital having bed strength of 500 beds or more/ any three hospital having bed strength of 300 beds or more as per Annexure-V

3 The firm must have sound financial stability with annual turnover of INR 100.00 lac or more every year in preceding two financial years i.e. 2015-16 & 2016-17 and the sale solely from the medical oxygen should be Rs. 50.00 lac or more every year during these two years and the firm’s net worth should be in positive as per Annexure-II (copy of audited balance sheet and a certificate from the CA on account of turnover & ITRs must be enclosed in support thereof.)

4 The bidder should have the necessary valid licenses for running and production of Medical Oxygen from the competent authorities as under:

i) Licence from the Director General of Explozives, GOI.

ii) Licence from the Drug Controller of Inda or the state of HP.

iii) Factory license from the competent authority of GOI/ state.

5 The firm should have the facility qualified and experienced staff as per the requirement of Indian Pharmacopiea (IP) for the production and quality control measures and also for ensuring the un-interrupted production and supply of medical oxygen at their unit as per Annexure VII in the unit

6 The bidder should have the valid license for cylinder testing at least of the last five years to ensure the safety of oxygen cylinders from the competent authority i.e. Director General of Chemicals and Explosives.

7 The bidder should have the back up plan to ensure the un-interrupted supply of medical oxygen within 12 hours in case failure of main unit due to any reasons.

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8 The bidder should have its own means of transportation for supply of medical oxygen, Nitrous Oxide & Co2 to enure the uninterrupted supply (copy of RC to be attached)

9 The bidder should not have been blacklisted by any Govt., Semi Govt. organization or any other organization and bidder should not have any litigation in any of the labour court(s) or by the CVC/CCI/CBI. An affidavit to that effect on non judicial stamp paper worth Rs, 10/- duly notarized should be enclosed with the technical bid as per Annexure-VI. Also to note that the contractor has not formed/ in not a part of any cartel ay any time for procuring any contract including the present tender.

10 The bidder should enclosed the requisite earnest monery of Rs. 1.00lac in the shape of demand draft of any scheduled bank payable at Tanda.

11 The bidder should enclose a latest Solvency Certificate from their Natioalize/scheduled bank to the effect that the firm is solvent for a sum of Rs. 25.00 lac.

12 The bidder should enclosed a copy of proof/broucher of its unit capable of producing the Medical Oxygen of greater than 99% purity as per Indian Pharmacopeia (IP).

13 The bidder should enclose its profile alongwith it a copy of Registration/incorporation of the firm.

14 The bidder should enclose the necessary authorization letter in original for quoting and signing of the tender on behalf of the firm on their letter head as per Annexure-IV

15 The bidder should invariably submit the original tender document purchased by the firm and duly signed and accepted with the technical bid.

16 Copy of VAT challan, GST return for the three months and return for the year 2016-17 should be enclosed with the bid.

Dated:_________________

Signature & seal of the bidder

Note: Enclosed copies of the relevant documents and use wherever required.

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Annexure-II

(To be submitted with the technical bid)

Proforma for showing annual turnover, sale of medical oxygen of the firm

Name of Bidder:_____________________________________________________

1. Annual Turn over & sale of Medical Oxygen, Nitrous Oxide and CO2

Year Total turnover (figure in lac) Sale from Medical Oxygen, Nitrous Oxide and CO2 (figure in lacs)

Remarks, if any

2015-162016-17

2. Financial Net worth of the firm

Sr,. No. Dexccritpion 2015-16 2016-171 Assets2 Current Assets3 Liabilities4 Current Liabilities5 Profit before tax6 Profit after tax7 Net worth

Signature & stamp of charted accountant

Signature and stamp of authorized person

Note: The above information is to be supported by the copies of balance sheets and income tax return.

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Annexure-III

(To be submitted with the technical bid)

Financial bid for supply of Medical Oxygen to Dr. RPGMC, Kangra at Tanda

Sr. No. Description Unit Rate Rs. Remarks1 Medical Oxygen Gas

i) D typeii) B Typeiii) A type

EachEacheach

2 Nitrous Oxide Gas each3 CO2 Gas4 Testing charges

i) D typeii) B typeiii) A type

5 Loading , Unloading & other charges

Per cylinder

6 Freight charges Each tripNote: The L-1 will be considered on the basis of total cost i.e. loading/unloading and transportation charges.

Signature______________________

Name and Designation_________________

Signature of authorized person

(May use their letter head)

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Annexure-IV

(To be submitted with the technical bid)

PROFORMA FOR LETTER OF AUTHORITY FOR SIGNING SUBMITTING AND ATTENDING THE OPENING OF TECHNICAL/FINANCIAL BIDS AND OTHER COMMUNICATIONS/ CORRESPONDENCE RELATING TO BID FOR SUPPLY OF MEDICAL OXYGEN TO DR. RPGMC, KANGRA AT TANDA.

NO.:________________________ Dated_______________

To

The Medical Superintendent,

Dr. RPGMC,

Kangra at Tanda.

Dear sir,

I/we_________________________________ hereby authorize the following representative(s) to sign,submit and attend technical/financial bid opening and for other correspondence and communication relating to the above bidding process.

1. Name & Designation____________________________________________

Signature__________________________________________________

2. Name & Designation ______________________________________________

Signature _______________________________________________________

Yours sincerely,

Note: This letter of authority should be on the letter head of the bidder and should be signed by a competent authority of the firm/company.

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Annexure-V

(To be obtained on the Official letter head of the institution/hospital & to be submitted with the technical bid)

CERTIFICATE

It is certified that M/S ____________________________________________ has been supplying

medical oxygen to (____Name of Hospital___________ since ___________________ till date)

and the quality of the medical oxygen being supplied by the firm during the period mentioned

herein above is up to mark and satisfactory and no case of complication due to administering

medical oxygen in any patient has reported.

Further, it is certified that the bed strength of our hospital is __________________ bed

since_________________

Place:

Dated:

Signature and stamp of the competent authority of

the hospital with date

Contact No.___________________

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Annexure-VI

(To be submitted with the technical bid)

List of customer hospitals for the last five years for medical oxygen

Sr. No.

Name of Hospital Bed Capacity 2015-16 Supply in Rs.

2016-17 Supply in Rs.

Signature & stamp of the authorized person

Note: Information is to be supported by the necessary certificate from the customer

gospital/hospitals as per Annexure-V

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Annexure- VII

Detail of staff employed in the unit/firm

Sr. No. Name Designation Qualification Experience

1

2

3

4

5

6

7

8

9

10

11

12

Signature and stamp of authorized person

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Annexure-VIII

(To submitted with the technical bid)

Affidavit regarding non blacklisting by any Govt. Deptt./Semi Govt/Undertaking

I, ____________________________________ S/o ___________________________ age __

Resident of Village_________________________ PO_____________________

Tehsil__________________ Distt ________________________ State____________________

doe hereby solemnly affirm and declare in oath as under:

1. That I am Proprietor ______________________________ of M/S

______________________ _____ situate at Address of the

firm___________________________________________________________________

2. That our firm/company has not been debarred or blacklisted by any Govt./Semi Govt.

department/concerned authority etc. for participation in any tender process.

3. That our firm/company has not been penalized by the CVC/CCI/CBI for participation in

any tender process.

4. That we have not formed / is not a part of any cartel at any time for procuring any

contract including the present tender.

5. That all information provided in the bids are true and correct. In case any

information/document found to be false at any stage our bid is liable to be rejected

straightway.

6. That rates quoted in the financial bid are genuine and most competitive and are not more

than prevailing market rates.

Deponent

Verification:

I the above name deponent do hereby verify that the contents of my above affidavit are tru to the

best of my knowledge and noting has been concealed therein and verified at _______________

on ___________________

Deponent

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Annexure-IX

(To be submitted with the technical bid)

Particular of Transportation

Sr. No.

Vehicle No Registration No. Insurance No. Particular of Driver alongwith the copy of driving license

Signature & stamp of the authorized person

Note: Information is to be supported by the necessary certificate.

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