NTPC LIMITED

(A Government of India enterprises)

RAJIV GANDHI COMBINED CYCLE POWER PROJECT

POST: CHOOLATHERUVU, DIST: ALAPPUZHA, KERALA PIN 690506

APPLICATION FOR ENLISTMENT OF CONTRACTORS

1 GENERAL

1.1Name of the Organization

1.2Registered Office

1.3Regional Office

1.4Full Address for Correspondence

1.5a) E mail id

b)Telephone Numbers

c)Fax Numbers

1.6Organizational set up of the company with details

1.6(a) If company provide the following details

i)Date of registration

ii)Place of registration

III) Public Ltd/ Private Ltd

iv)Memorandum of Association / Article of

Association

v)Name of directors

1.6(b) If partnership provide the following details Date of partnership deed

 

Name and address of the partner

i

ii

iii

 

1.6 ( c)

In case of individuals/ proprietorship provide

 

the following details

 

Date of ownership

 

Nature of business

Page 1 of 4

Professional tax Reg. no

Municipal/ Local body registration

1.6(d) Others specify below

1.7Whether registered with any other NTPC

Stations; If yes gives details

2 TECHNICAL

2.1Type of work for which enlistment is sought

(Refer Annexure I)

2.2List of 3 major similar works executed in last six years

2.2a Name of the work

Client for the work

Awarded value

Period of execution

Final executed value

2.2b Name of the work

Client for the work

Awarded value

Period of execution

Final executed value

2.2c Name of the work Client for the work

Awarded value

Period of execution

Final executed value

3 FINANCIAL

3.1Annual Turn Over of last 3 Financial Years

FINANCIAL YEAR

A T O(`)

PROFIT/LOSS(`)

2012-13

2011-12

2010-11

4

OTHER INFORMATION (if applicable)

4.1PAN no

4.2Employees Provident Fund Registration no.

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4.3Employees State Insurance Corporation no

4.4Service Tax Registration no

4.5VAT/ Sales Tax Registration no

4.6NSIDC/ SSIDC registration no(if applicable)

I have read & understand the terms and conditions prescribed by NTPC Kayamkulam for enlistment of vendors / Contractors .I/We certify that all the information and data furnished by me in this application form are true and complete to the best of my knowledge

Signature of the Applicant

Name:

Designation

Page 3 of 4

 

DOCUMENTS TO BE SUBMITTED FOR ENLISTMENT

 

 

 

Sl.No.

Documents

Enclosed / Not enclosed

 

 

 

 

1

Application form (duly filled & signed)

 

 

 

 

2

Copy of Memorandum of Association or Article of

 

 

Association/Partnership deed/ Ownership of

 

 

company

 

3

Copies of work orders along with completion certificates as per

 

 

QR

 

4

Copy of PAN no ( if applicable)

 

 

 

 

5

Copy of Employees Provident Fund Registration no.( if applicable)

 

 

 

 

6

Copy of Employees State Insurance Corporation Registration no(

 

 

if applicable)

 

7

Copy of Service Tax Registration no ( if applicable)

 

 

 

 

8

Copy of VAT/ Sales Tax Registration no ( if applicable)

 

 

 

 

9

Copy of NSIDC/ SSIDC registration certificate(if applicable)

 

 

 

 

10

Enlistment fee in the form of DD

 

 

 

 

11

Power of Attorney of the authorized Signatory

 

 

 

 

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